Hip Arthritis.
The most common reason for hip replacement.
Hip arthritis is the degradation of the cartilage lining of the ball-and-socket joint. Most cases are osteoarthritis (wear-and-tear), but inflammatory and post-traumatic types also occur. Symptoms range from groin pain and stiffness through to a grinding sensation and limp.
Hip joint anatomy
The hip is a ball-and-socket joint. The femoral head (ball) at the top of the thigh bone fits into the acetabulum (socket) of the pelvis. Both surfaces are lined with smooth articular cartilage that allows the joint to glide painlessly.
In arthritis, this cartilage thins and breaks down, exposing the underlying bone surfaces.
Types of hip arthritis
- Osteoarthritis — by far the most common; age-related wear-and-tear
- Rheumatoid arthritis — inflammatory; immune-mediated
- Post-traumatic arthritis — secondary to prior fracture or significant joint injury
- Secondary arthritis — from dysplasia, FAI, AVN, infection
Risk factors
- Age
- Family history
- Prior hip injury or surgery
- FAI or dysplasia
- Excess body weight
- High-impact occupational or sporting load
Symptoms
- Groin pain — the most characteristic symptom
- Stiffness, especially in the morning or after sitting
- Grinding or catching sensation
- Pain referred to the buttock, thigh, or knee
- Difficulty putting on shoes, socks, or getting in and out of a low car
- Limp
Diagnosis
Diagnosis is primarily clinical, supported by a plain X-ray of the pelvis and hip. The X-ray shows joint-space narrowing, sclerosis (bone hardening), osteophytes (bone spurs), and subchondral cysts. MRI is occasionally needed if soft-tissue pathology is suspected.
Non-surgical treatment
Non-surgical management is the first step for most patients:
- Physiotherapy — strengthening the muscles around the hip and improving range of motion
- Weight loss — even modest loss reduces joint load substantially
- NSAIDs — non-steroidal anti-inflammatory medication, used carefully
- Activity modification — swap high-impact for low-impact (cycling, swimming, gym)
- Walking aids — a cane in the opposite hand can offload the affected hip
Surgical treatment
When non-surgical measures no longer give adequate relief, total hip replacement is the definitive operation. For suitable candidates, an anterior approach offers a faster recovery and the lowest dislocation rate.
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Bring a GP referral, prior imaging, and any ACC claim information.