Hip Arthritis
Explanation of Diagnosis
The hip is a ball-and-socket joint lined with cartilage, a unique type of tissue that allows smooth, frictionless movement. Over time, the chemical and physical structure of cartilage changes—it becomes more brittle and begins to break down. As the cartilage thins and wears away, the underlying bone becomes exposed. The joint can also become inflamed, which heightens pain sensitivity within the hip. This degenerative cascade leads to osteoarthritis.
How did I get Hip Arthritis?
Hip arthritis is very common in the general population. While often associated with aging, certain factors can increase the risk of developing arthritis.
Femoroacetabular impingement (FAI) may cause repetitive damage to the labrum and cartilage, eventually leading to end-stage arthritis.
Obesity increases joint stress and accelerates degeneration.
Inflammatory conditions such as rheumatoid arthritis or psoriatic arthritis can lead to distinct forms of inflammatory joint disease.
Previous trauma, fractures, or infection can also damage cartilage and accelerate arthritic changes.
How is Hip Arthritis diagnosed?
Diagnosis begins with a thorough history and physical examination. The most common symptom is groin pain that worsens with activity. The hip may feel stiff, and pain may persist even at rest. Patients often walk with a limp to compensate for discomfort. Pain may radiate to the inner knee, lateral hip, or lower back, but hip arthritis typically does not cause “electric” pain down the leg—this is more characteristic of a pinched nerve in the lumbar spine.
If hip arthritis is suspected, specific X-rays are obtained to assess joint space narrowing, bone spurs, and cysts. A CT scan may be ordered for a more detailed evaluation of the joint anatomy.
A diagnostic hip injection with local anesthetic (numbing medication) may also be performed. Because multiple conditions can mimic hip pain, relief following the injection helps confirm the hip as the true source of symptoms.
Can Hip Arthritis Be Reversed?
Currently, no surgical procedure can reverse cartilage damage once arthritis has developed. Treatment focuses on improving pain and function rather than curing the condition. Over time, arthritis may continue to progress, and symptoms can gradually worsen. However, maintaining a healthy lifestyle and optimal body weight can significantly slow the rate of degeneration for many patients.
Nonsurgical Treatment
Initial treatment for hip arthritis is conservative and may include:
Activity modification to avoid aggravating movements.
Physical therapy to strengthen supporting muscles and improve joint mechanics.
Anti-inflammatory medications to reduce pain and swelling.
Weight loss, if appropriate, to decrease joint stress.
Injections (such as corticosteroids or other biologic options) to relieve pain and inflammation.
Not all patients with hip arthritis require surgery. Many individuals live comfortably with mild pain and stiffness through lifestyle changes and therapy. For those who fail conservative measures, total hip replacement may be recommended.
Surgical Treatment
Total hip arthroplasty (hip replacement) involves removing the damaged portions of the joint and replacing them with smooth, artificial bearing surfaces. The procedure can be performed through either a posterior or anterior approach.
Although hip replacement is a major surgery, advancements in preoperative optimization, anesthesia, and surgical technique have made the procedure safer, with faster recovery and improved long-term outcomes.
It is generally not recommended to perform hip arthroscopy (“keyhole surgery”) in arthritic hips, as simply “cleaning up” the joint does not significantly improve symptoms once cartilage loss is advanced.
