Professor Phong Tran

Hip Osteoarthritis

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Hip osteoarthritis is a common condition causing pain, stiffness and limping.

Your hip joint is covered by a smooth and glistening covering called articular cartilage. This cartilage helps your hip move and glide smoothly. Over time, your articular cartilage can wear away. This is called osteoarthritis.

The pain in hip osteoarthritis is most commonly felt in the groin. However, it can also be felt in the buttock and thigh. Some people also have only referred pain and only feel it in the knee or lumbar spine.

Osteoarthritis is usually diagnosed with a xray. However, in some patients an MRI is necessary.

When mild, osteoarthritis is best treated with conservative measures, such as weight loss, physiotherapy, water based exercises, lifestyle and activity changes and analgesia.

When severe, osteoarthritis of the hip can be very successfully treated with a total hip replacement.

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di-hip-oa-vs-normal

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Hip osteoarthritis is most common in people older than 55. However, it can also occur at younger ages, especially in people who have injured their joints or have hip abnormalities such as FAI or hip dysplasia.

The risk factors for developing hip osteoarthritis include:

  • age
  • overweight
  • injuries to the hip such as labral tears
  • family history of arthritis

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Unfortunately, there is no cure for hip osteoarthritis. However, there are many options for treatment that will help with the symptoms.

Exercise

Regular exercise is very important. Low impact exercises are the best so keep the muscles around your hip strong without further damaging the joint. Exercises and activities to consider are:

  • Muscle strengthening exercises (it may help to see a physiotherapist for a program)
  • Walking
  • Tai Chi
  • Cycling
  • Yoga
  • Aquatic exercises
  • Swimming

Healthy Weight

Maintaining a healthy weight is also very important. The extra weight puts pressure on your hip joint and surrounding muscles. Being overweight worsens the symptoms of hip arthritis and also worsens the progression.

Other Options

  • Massage
  • Walking aid such as a walking stick, crutches, walking frame
  • Heat packs and hot water bottles

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Medications – Recommended by Scientific Evidence

  • Anti-inflammatories (e.g. ibuprofen or Voltaren)
    • These can be effective but should be used for short periods and taken with food. Be aware of possible stomach and kidney side effects. Your GP can prescribe longer-acting options (e.g. Meloxicam/Mobic).
  • Anti-inflammatory creams and ointments
    • Try for one week; if it doesn’t help, stop using it.

Medications – Lack of Evidence

There are many complementary medicines and supplements sold at pharmacies that have not been proven to work.

  • fish oil
  • avocado/soybean
  • Indian frankincense (Boswellia serrata extract)
  • turmeric
  • pine bark extract

Injections

Some injections can have short-term benefits but are generally not recommended for the management of hip osteoarthritis
Options include:

  • Steroid injections (cortisone)
  • PRP injections
    • Not enough evidence to provide a recommendation.
  • Lubricant injections (viscosupplementation / hyaluronic acid)
    • Brand names – Synvisc, Durolane, Euflexxa
    • Not recommended for hip osteoarthritis, but may have some benefit in knee osteoarthritis.
  • Stem cell (expensive, no evidence that it works)

Other Therapies

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Surgical options should only be considered after you have tried non-surgical options and your pain has become significant.

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Hip arthroscopy - Melbourne

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Arthroscopy

Hip arthroscopy is very useful for treating injuries such as labral tears and improving the shape of the hip such as in FAI. However, arthroscopy is not useful for the treatment of hip arthritis.

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Hip Replacement

Hip replacement is a very successful treatment for severe hip osteoarthritis. Most hip replacements last over 20 years.

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GP Guidelines for the Management of Hip and knee osteoarthritis

Management of Osteoarthritis of the hip – Evidence based clinical practice guideline (American Academy of Orthopaedic Surgeons)

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