Hip Osteoarthritis

Hip osteoarthritis is a joint disease characterized by groin pain, joint stiffness, and limited range of motion due to the degeneration of the cartilage surfaces that form the hip joint. Articular cartilage enables smooth and pain-free joint movement. In hip osteoarthritis, this cartilage becomes worn down and damaged, leading to pain and restricted motion originating from the hip joint.

When determining the treatment plan for hip osteoarthritis, the patient's level of pain and mobility are key considerations. Initial treatments focus on symptom management and may include weight loss, pain medications, and intra-articular injections. These methods aim to reduce the pain caused by the cartilage damage. However, the definitive treatment for advanced hip osteoarthritis is total hip replacement surgery.

What Is Hip Osteoarthritis?

Hip osteoarthritis occurs when the smooth cartilage surfaces of the hip joint wear down or become damaged for various reasons. This degradation prevents the joint from moving normally and causes pain and stiffness, especially in the groin area.

This condition is also referred to as coxarthrosis or hip osteoarthritis.

What Causes Hip Osteoarthritis?

The most common cause of hip osteoarthritis is primary osteoarthritis, a form of joint degeneration associated with aging. It is typically seen in individuals over the age of 60, and its exact cause is often unknown. Other contributing factors include:

• Being overweight

• Advancing age

• Female gender (women are more commonly affected)

• Avascular necrosis of the hip

• Family history of hip osteoarthritis

• Previous fractures involving the hip joint

• Angular deformities of the leg bones

• Inflammatory conditions such as rheumatoid arthritis

• Developmental disorders such as developmental dysplasia of the hip (DDH)

• Femoroacetabular impingement (FAI) – a condition that causes abnormal contact between the femoral head and the hip socket

These factors increase the risk of developing osteoarthritis in the hip joint.

Once cartilage degeneration begins in the hip, disease progression is often inevitable. The final outcome of the above conditions is the loss of cartilage, resulting in bone-on-bone contact and ultimately, hip osteoarthritis.

What Are the Symptoms of Hip Osteoarthritis?

Groin Pain

The most common symptom of hip osteoarthritis is groin pain. This pain often radiates to the front and inner parts of the thigh. In some cases, the pain caused by hip arthritis can even be felt in the knee.

The pain typically develops gradually and worsens over time, but it can also begin suddenly. Stiffness and discomfort are usually more pronounced in the morning or after sitting or resting for an extended period. As the disease progresses, groin pain may become more frequent, even during rest or at night.

Characteristics of Pain in Hip Osteoarthritis

• Pain that starts in the groin and radiates down the front of the thigh

• Knee pain: although less common, some patients may report pain that extends to the knee

• Pain that worsens with activity, especially after walking even short distances

• Joint stiffness that makes walking, bending, or getting dressed more difficult

• A locking or catching sensation in the joint, often caused by damaged cartilage or joint debris

• Reduced range of motion, making walking difficult and potentially causing a noticeable limp

• Pain that tends to increase in cold or rainy weather

Limited Range of Motion

As the cartilage in the hip joint deteriorates, normal joint function is impaired, leading to reduced mobility. Pain caused by the arthritis also contributes to this limitation, as patients tend to avoid movement to minimize discomfort.

How Is Hip Osteoarthritis Diagnosed?

During a physical examination, pain triggered by hip rotation movements is a key indicator of joint-related issues in the hip. In patients with hip osteoarthritis, this type of discomfort is commonly observed.

In most cases, a standard pelvic X-ray clearly reveals signs of hip osteoarthritis, making diagnosis relatively straightforward for experienced specialists.

How Is Hip Osteoarthritis Treated?

Once cartilage degeneration has occurred in a joint, there is currently no known treatment that can restore the cartilage to its original healthy state. This is also true for the hip joint.

Today, the only definitive treatment for hip osteoarthritis is hip replacement surgery. However, there are several treatment options that can effectively reduce pain and improve quality of life until surgery becomes necessary.

Non-Surgical Treatment Options

• Activity Modification: Avoid activities that worsen pain. Use an elevator instead of stairs, and consider cycling instead of walking to reduce joint stress.

• Weight Loss: Losing weight helps relieve pressure on the hip joint. This not only reduces pain but also slows the progression of osteoarthritis.

• Physical Therapy: Strengthening the muscles around the hip joint helps to reduce the load on the joint, resulting in less pain and better mobility.

• Pain Medication: Pain relievers can be used under medical supervision. Prolonged use may lead to unwanted side effects, especially involving the kidneys, digestive system, and heart.

• Ultrasound-Guided Intra-Articular Injections: Many patients benefit from joint injections performed under ultrasound guidance, which enhances precision and effectiveness.

Injection Therapy for Hip Osteoarthritis

There are several effective injection-based treatments available for managing hip osteoarthritis, including:

• Corticosteroid Injections: Used to reduce inflammation and relieve acute pain.

• Hyaluronic Acid Injections (Viscosupplementation): Helps lubricate the joint and improve mobility in some patients.

• Platelet-Rich Plasma (PRP) Therapy: Uses the patient's own blood components to promote tissue healing.

• Autologous Cytokine-Rich Serum (Sanakin Therapy): Targets inflammation using the body's own anti-inflammatory proteins.

• Exosome Therapy: A cutting-edge regenerative option derived from stem cell secretions.

• Stem Cell Therapy: Stem cells harvested from fat tissue or bone marrow are injected into the joint to support regeneration and reduce inflammation.

Definitive Solution for Hip Osteoarthritis

Regardless of the underlying cause, when hip osteoarthritis reaches a point where pain and loss of function significantly impact daily life, the gold standard treatment is total hip replacement surgery.

Hip Osteoarthritis Surgery

When hip osteoarthritis progresses and no longer responds to conservative treatments, surgical intervention becomes necessary. At this stage, total hip replacement (THR) is considered a highly effective solution.

This surgery aims to relieve pain and restore mobility by replacing the damaged surfaces of the hip joint with artificial components. In advanced stages of osteoarthritis, the joint surfaces are often too damaged to be treated with non-surgical methods.

If you want to learn more about this surgery, click here to read our detailed guide on total hip replacement.

What Helps with Hip Osteoarthritis?

Hip osteoarthritis, medically known as coxarthrosis, occurs when the cartilage in the hip joint wears down over time. This leads to joint stiffness, pain, and difficulty walking. While it cannot be completely reversed, many effective treatments are available to reduce pain and improve quality of life:

• Exercise and Physical Therapy: Strengthening the surrounding muscles and improving joint mobility can significantly reduce pain.

• Weight Management: Losing excess weight decreases the load on the hip joint, which helps relieve pain and slows down disease progression.

• Pain Relievers and Anti-Inflammatory Medications: Paracetamol and NSAIDs can reduce pain and inflammation but must be used under medical supervision.

• Physical Therapy Modalities: Techniques such as ultrasound therapy, electrical stimulation (TENS), and hot-cold applications help ease discomfort.

• Orthopedic Supports: Walking aids like canes, walkers, and supportive footwear can improve weight distribution and mobility.

• Injection Treatments: Intra-articular injections including corticosteroids, PRP, or hyaluronic acid provide temporary relief by reducing inflammation and improving joint lubrication.

• Surgical Treatment: In advanced cases, hip replacement surgery offers a permanent solution by eliminating the source of pain.

Patient Experiences – Real Stories from Hip Osteoarthritis Patients

Reading experiences shared by other patients with hip osteoarthritis can be incredibly helpful in forming realistic expectations about the treatment journey.

• Ayşe (Age 54, Istanbul)"Thanks to Dr. Utku Erdem Özer's treatment approach, my hip pain has significantly decreased. Regular physical therapy and pain medication have helped me return to daily activities with more comfort."

• Mehmet (Age 60, Istanbul)"Dr. Özer created a personalized exercise plan for me. The pain I used to feel during physical activities has greatly improved, and I can now stay active with much less discomfort."

“Frequently Asked Questions About Hip Osteoarthritis”

Can Hip Osteoarthritis Cause Pain at Night?

Yes. In early stages, pain often occurs during or after activity. But as the condition progresses, patients may experience persistent pain even at rest, including nighttime pain that can interfere with sleep. This is usually a sign that joint damage is advanced and surgical treatment may be considered.

How Is Hip Osteoarthritis Diagnosed?

Diagnosis is based on:

·       Patient history (location, duration, and nature of pain),

·       Physical examination, especially pain during hip rotation,

·       X-rays to detect joint space narrowing, bone spurs, or cartilage loss.In some cases, MRI may be used to evaluate soft tissue damage and early cartilage degeneration.

What Age Does Hip Osteoarthritis Usually Begin?

Hip osteoarthritis is more common in people over 60 years of age, but it can also affect younger adults, especially those with:

·       Previous hip injuries,

·       Hip dysplasia,

·       Avascular necrosis,

·       Femoroacetabular impingement (FAI),

·       A family history of osteoarthritis.

What Does the Pain Feel Like in Hip Osteoarthritis?

The pain is typically described as:

·       A deep, aching sensation in the groin,

·       Sometimes radiating to the thigh or knee,

·       Worse in the morning, or after prolonged sitting,

·       Triggered by activity, especially walking, climbing stairs, or standing for long periods.

Does Weather Affect Hip Osteoarthritis?

Yes. Many patients report that symptoms worsen in cold, damp, or rainy weather. Changes in barometric pressure are thought to affect joint fluid pressure and inflamed tissue, increasing pain and stiffness.

Can Hip Osteoarthritis Be Prevented?

While it may not be completely preventable, the risk can be reduced by:

·       Maintaining a healthy body weight,

·       Regular low-impact exercise,

·       Avoiding repetitive strain on the hip,

·       Treating conditions like hip impingement or dysplasia early,

·       Ensuring good posture and body mechanics during daily activities.

Can I Walk with Hip Osteoarthritis?

Yes — but with limitations. Short walks are often recommended to maintain mobility, but long walks or walking on uneven surfaces may worsen the pain. Using walking aids (like a cane or walker) can help reduce joint stress and improve safety.

Will I Need Surgery for Hip Osteoarthritis?

Not always. Many patients can manage their symptoms for years with non-surgical treatments. However, if:

·       Pain becomes constant,

·       Mobility is severely restricted,

·       Daily activities are affected,then hip replacement surgery is usually recommended.

How Long Is the Recovery After Hip Replacement Surgery?

Most patients:

·       Begin walking with assistance within 24 hours,

·       Return home in a few days,

·       Resume light activities within 4–6 weeks,

·       Achieve full recovery in 3–6 months depending on age, health status, and physical therapy compliance.

Are There Risks with Hip Injections?

Like all procedures, intra-articular injections carry minimal risks, such as:

·       Temporary pain or swelling,

·       Infection (very rare with sterile technique),

·       Skin discoloration or fat atrophy (with repeated steroid use).Ultrasound guidance significantly improves safety and precision.

How Effective Is PRP for Hip Osteoarthritis?

PRP (Platelet-Rich Plasma) injections use the patient’s own platelets to:

·       Reduce inflammation,

·       Stimulate tissue healing,

·       Delay the need for surgery.PRP is most effective in early to moderate stages of hip osteoarthritis.

What Is the Role of Hyaluronic Acid Injections?

Hyaluronic acid (viscosupplementation) injections:

·       Improve joint lubrication,

·       Reduce friction,

·       Provide cushioning within the joint.Although not a cure, they may improve symptoms in selected patients — especially when NSAIDs are contraindicated.

Can Weight Loss Really Help with Hip Osteoarthritis?

Yes. Each kilogram of body weight lost reduces 3–5 kg of pressure on the hip joint during walking. Weight loss:

·       Reduces inflammation,

·       Improves mobility,

·       Delays the progression of osteoarthritis.

Can I Still Exercise If I Have Hip Osteoarthritis?

Absolutely — but the right type of exercise is critical. Low-impact exercises like cycling, swimming, aqua aerobics, and resistance band workouts are ideal. Avoid high-impact sports such as running or jumping, which can accelerate joint damage.

Is There a Cure for Hip Osteoarthritis?

Unfortunately, there is no cure that can regenerate damaged cartilage. Current treatments focus on:

·       Pain management,

·       Improving function,

·       Delaying progression.Total hip replacement remains the only permanent solution when conservative options fail.

What Type of Exercise Is Best for Hip Osteoarthritis?

The most beneficial exercise for patients with hip osteoarthritis is cycling. Because it’s a low-impact activity, cycling places minimal stress on the hip joint, helping to avoid pain during and after the workout.Swimming is another excellent option, as it allows full-body movement without putting weight on the joints. Both exercises also contribute to weight control, which is crucial in managing osteoarthritis symptoms.

Conclusion

In this article, we discussed the causes, symptoms, and treatment options for hip osteoarthritis, a condition typically characterized by groin pain, joint stiffness, and restricted mobility.

When determining the best treatment approach, both the severity of pain and the patient’s mobility level are key factors.

Available treatment options include weight management, pain-relief medications, intra-articular injections, and in advanced cases, hip replacement surgery.

Innovative injection therapies such as corticosteroids, hyaluronic acid, PRP, Sanakin, and stem cells derived from fat or bone marrow offer additional options for symptom relief and improved joint function.

If conservative methods are no longer effective, surgical treatment may provide a long-term solution and dramatically improve quality of life.

Thank you for reading.To explore more, feel free to visit the homepage of Dr. Utku Erdem Özer.