Hip osteoarthritis
By The Treatment Registry editors
Degenerative joint disease of the hip, characterised by progressive cartilage loss, joint-space narrowing, osteophyte formation, and pain. Symptoms typically include groin pain on weight-bearing, stiffness after rest, and progressive functional limitation. Treatment is staged from lifestyle and medical management through intra-articular injection and finally hip replacement for end-stage disease.
Treatment ladder
Conservative options are first-line where appropriate; surgical options are typically reserved for cases where lower-tier options are unsuitable or have failed. Decisions are individual and depend on clinical assessment.
Conservative
- Weight management and physiotherapy
First-line for all symptomatic patients. Each kilogram lost reduces hip load substantially; supervised exercise improves pain and function in early-to-moderate disease.
- Analgesia (paracetamol, NSAIDs)
Topical NSAIDs preferred for localised symptoms; systemic NSAIDs effective but with cardiovascular and gastrointestinal risk profiles to consider in older patients.
- Walking aid (cane, walker)
A cane held in the contralateral hand reduces hip load by approximately 25%. Often deferred by patients but a meaningful intervention.
Procedural
- Intra-articular corticosteroid injection
Short-term symptomatic relief (weeks to months). Repeated injections may accelerate joint deterioration and are not a long-term solution.
- Hyaluronic acid (viscosupplementation) injection
Less established evidence for hip than for knee; some patients report symptomatic improvement.
Surgical
- Total hip replacement · View procedure page
Definitive surgical treatment for end-stage hip osteoarthritis. Modern implant survivorship at 15 years exceeds 90% in registry data.
- Hip resurfacing arthroplasty
Bone-conserving alternative to total hip replacement; metal-on-metal bearings limit current usage to selected younger male patients due to historical concerns about metal-ion debris.
- Hip arthroscopy (for early labral pathology)
Minimally invasive treatment of femoroacetabular impingement and labral tears in earlier disease; not appropriate for advanced osteoarthritis.