Osteoarthritis of the hip is the progressive loss of articular cartilage from the femoral head and the acetabulum, with secondary changes in the underlying bone. It is the commonest reason for hip replacement and one of the leading causes of disability in adults over sixty.
Primary osteoarthritis develops with age and has a strong genetic component. Secondary osteoarthritis follows an identifiable cause: hip dysplasia, femoroacetabular impingement, avascular necrosis, previous fracture of the acetabulum or femoral head, childhood conditions such as Perthes disease or a slipped epiphysis, inflammatory arthritis, or septic arthritis. Obesity and heavy manual work accelerate progression.
Pain is felt in the groin and often radiates to the front of the thigh and the knee — hip pain that presents as knee pain is a classic pitfall. Buttock and lateral pain also occur but should raise the possibility of a spinal cause. Typical features are stiffness after sitting or in the morning that eases within thirty minutes, difficulty putting on socks and shoes or cutting toenails, a shortening walking distance, a limp, and night pain in advanced disease. Loss of internal rotation is usually the first sign on examination.
Weight-bearing anteroposterior pelvic and lateral hip radiographs are the mainstay: joint space narrowing, subchondral sclerosis, cysts and osteophytes. MRI is reserved for early disease with normal radiographs, or when necrosis or a labral tear is suspected. Because hip and lumbar spine pathology frequently coexist, a careful examination and, where necessary, a diagnostic intra-articular injection help identify the true source of pain.
Weight loss reduces joint loading substantially. A structured programme of hip abductor and core strengthening, cycling and hydrotherapy maintains function. Paracetamol and, in short courses, non-steroidal anti-inflammatories control pain. A walking stick used in the opposite hand meaningfully unloads the joint. Image-guided intra-articular corticosteroid injection can provide temporary relief and has diagnostic value. Conservative treatment does not reverse cartilage loss, but it can postpone surgery for years in mild and moderate disease.
When pain persists at rest or at night, walking distance is severely limited and quality of life is affected despite conservative measures, total hip replacement is the definitive treatment. Performed with the minimally invasive ASI technique, patients mobilise on the day of surgery and most return to normal daily activities within a few weeks. In young patients with dysplasia or impingement, joint-preserving surgery may be considered before arthritis becomes established.
Groin pain lasting more than a few weeks, a limp, or difficulty with shoes and socks deserve assessment. Early diagnosis widens the range of options. Contact the practice to arrange an appointment or a second opinion.
to guide you about your condition, to choose the best possible treatment.
