If you are in the early stages of arthritis, the cartilage in your hip joint is good. You might experience occasional aches or sharp pains in your hip, and there may be some stiffness after a resting period. Other symptoms include muscle weakness and intermittent swelling.
Osteoarthritis
The discomfort from cartilage wear and tear in a joint can increase over time. Ultimately, chronic pain may require expert intervention to find relief and improve mobility.
At HCA UK, we confirm diagnosis and provide treatment for osteoarthritis.
- Appointments with orthopaedic specialists are confirmed within 24 hours
- Diagnostic imaging results available within 48 hours
- Osteoarthritis treatment is offered at our state-of-the-art facilities
About osteoarthritis
Osteoarthritis is a joint condition that occurs when the cartilage surfaces of a joint, and the bone underlying it, begin to breakdown. Whilst all joints will tend to ‘wear’ this way through advancing age most commonly in the hip joint, injuries accrued through sport can sometimes accelerate this process.
Osteoarthitis in sports
Osteoarthritis in our joints can cause stiffness and swelling in the joints, pain after exercise (sometimes even a day or two later), and when severe, it can cause sport to be very painful. Sometimes it becomes difficult to perform a movement well in sport, and lead to a loss of performance. The good news is, movement and strength building has been shown to be beneficial in managing the symptoms of osteoarthritis, although you may be advised on modifying you exercise.
Physiotherapy and osteopathy are frequently recommended, and sometimes a joint injection (such as a guided corticosteroid injection) may be advised to help reduce swelling an assist with rehabilitation. In very severe cases which are not progressing with conservative treatment, surgery may be recommend (e.g. keyhole or joint replacement surgery).
What is osteoarthritis of the hip?
Osteoarthritis is often referred to as 'wear and tear'. It's a degenerative disease and is the most common form of arthritis, affecting the cartilage in the joints. It can occur in any joint, but it's mostly found in the knees, hip and spine, causing pain, stiffness and weakness in the affected area.
When osteoarthritis is present in the hip, the cartilage between the pelvic bones (the acetabulum) and the upper end of the thigh bones (the femur) becomes thin. The acetabulum is the socket of the hip joint and the femur is the ball.
The cartilage that covers the ball and socket of the hip is known as articular cartilage. This is a smooth substance that is designed to protect the joints and bones in the area, creating a cushioning effect and reducing friction.
The thinning of the articular cartilage can cause the bones in the hip joint to rub against each other. The cartilage frays and becomes rough. As this protective layer reduces, the joint doesn’t move as it should and the bones in the ball and socket of the hip start to rub together, causing pain. The damaged bones then begin to grow outwards, forming bone spurs that may cause stiffness.
What causes hip osteoarthritis?
There are two classifications for hip osteoarthritis:
- Primary osteoarthritis: Where the condition has no known cause (more common)
- Secondary osteoarthritis: When there is an underlying condition or it is the result of an injury, such as misalignment or trauma to the hip joint
You can suffer osteoarthritis in your pelvis if some of the following risk factors apply to you:
- Age: Osteoarthritis is more likely to occur as people get older because joints wear down over time. It predominantly affects adults aged over 50.
- Activity: Sports and job roles that put strain on your joints can lead to wear and tear
- Family history: In some cases, there is a genetic link. You may be at a higher risk if your parents or grandparents have been diagnosed with hip osteoarthritis
- Obesity: Being overweight can place more strain on your joints.
Conditions that can lead to secondary osteoarthritis are linked to improper growth of the hip joint and include hip dysplasia and congenital hip dislocation, suffered at birth.
What are the symptoms of hip osteoarthritis?
Hip osteoarthritis symptoms can vary. People may experience some or all of the following:
- Pelvic pain, including pain around the hip joint, groin, buttock or the front of the thigh. This pain can worsen during periods of movement or activity
- Daily activities such as walking or going up and down stairs become increasingly difficult.
- Stiffness in the hip, especially in the morning or after resting
- Grinding or locking of the hip
What are the four stages of hip osteoarthritis?
Stage 1
Stage 2
The cartilage is worn and there are signs of thinning. The symptoms at this stage include regular aches and the occasional severe pain. Periods of swelling last longer than before and muscles in the area are weaker.
Stage 3
At this level, there is very little cartilage in the hip joint. Where there is cartilage, it's extremely thin. Symptoms at this stage of hip osteoarthritis include a constant ache or pain in the hip, stiffness and swelling, and the muscles looking smaller and feeling very weak.
Stage 4
At this point, you'll be advised to undergo surgery when other treatment options for your hip osteoarthritis are no longer sufficient and you're unable to tolerate or manage the symptoms you're experiencing.
How is a hip osteoarthritis diagnosis confirmed?
To receive a hip osteoarthritis diagnosis, a full medical assessment is carried out. Your consultant will ask you about the pain you're experiencing, such as its severity and when it began. They'll also ask about any activities that make the pain worse, as well as any periods where you might feel stiffness in the joint.
Your consultant will also complete a thorough physical examination of your hip joint. This will include an assessment of your joint’s range of movement and an evaluation of other potential causes for pain in this region.
Our specialist radiologists will carefully evaluate your hips for features of osteoarthritis and other causes of hip pain. You might also have an MRI scan to confirm the hip osteoarthritis diagnosis. This test shows changes in soft tissues, including worn tendons and muscles and signs of thinning cartilage.
You can get an appointment with one of our hip specialists for the next working day and, if necessary, have imaging done on the same day.
What are the treatment options for hip osteoarthritis?
If you've received a hip osteoarthritis diagnosis, there are different treatment options available. The treatment you receive will depend on how advanced your symptoms are. Whatever symptoms you're experiencing, you'll first and foremost be advised to keep the joint mobile. From there, there are different treatment options available:
Self-management
Most symptoms of hip osteoarthritis are treated by modifying the way you move, changing your diet and exercising the hip joint. These include:
- Pacing your activities throughout the day
- Adapting activities that you find difficult or that cause you pain
- Avoiding both low seating and sitting in one position for long periods
- Wearing supportive footwear with cushioned soles
Physiotherapy
There are also physiotherapy exercises you may be able to do to strengthen your hip muscles. Your physiotherapist will work with you to create a plan that suits your needs. It will factor in the level of osteoarthritis you have and how mobile you are.
Pain management
Painkillers and steroid injections can also help relieve symptoms. Your doctor will take into account the amount of pain you're in and any other medical conditions you have before deciding on the painkillers that would be most effective. Some of these include paracetamol or non-steroid anti-inflammatory drugs such as ibuprofen. If the pain is severe, stronger painkillers such as codeine may be recommended. You may experience side effects from taking these, including drowsiness. Your consultant will discuss this with you.
In some cases, treatment for hip osteoarthritis can involve steroid injections. These contain an artificial version of the natural hormone cortisol and are applied to the hip joint. They can help reduce inflammation and pain in the affected area.
Surgery
If these initial measures don't work, the next step in the treatment process for osteoarthritis in the hip is surgery. There are different types of surgery available and the procedure you undergo will depend on your condition. Your consultant will keep you informed of your treatment options at every stage and advise you on what happens before, during and after surgery.
Hip arthroscopy
A hip arthroscopy is a minimally invasive procedure that is usually used as the first stage of hip surgery. An arthroscope, which is a small surgical camera, is used to allow your consultant to see inside your hip joint. During this procedure, tiny cuts are made to your hip to allow access for the camera and additional surgical instruments, if required.
An arthroscopy is used to diagnose and treat a range of hip problems, including osteoarthritis, without major surgery. It's usually a day case, which means you won’t need to stay in hospital overnight, and you will be given painkillers and crutches to help with mobility.
Hip resurfacing
Surgery usually lasts around 2 hours and can be performed under general or spinal anaethesia. During hip resurfacing, the surgeon makes an incision in the thigh. This is so they can access the hip joint. They then dislocate the ball (the femoral head) from the hip socket (acetabulum) and use surgical instruments to trim the head of the femur. This process reshapes the ball joint of your hip.
Next, the surgeon fits the femoral head with a metal covering. This keeps the head and neck of the thigh bone in place. A tool is used to remove the cartilage that lines the socket in your hip joint and the socket is then fitted with a metal shell, which is held in place by the friction between the bone and the metal. Your surgeon then positions the ball back into the socket and closes the incision with stitches.
After surgery, you will remain in hospital for between three and five days to recover. During this time, you will be encouraged to walk around with the aid of crutches. The physiotherapy team will also give you a set of exercises designed to strengthen the joint. As well as doing the exercises, you will need to use crutches or a walker when you go home.
Hip replacement surgery
Your consultant may recommend this option if your hip joint is particularly worn. In hip replacement surgery, the worn joint is replaced with a prosthesis. The consultant will advise on the type of prosthesis that is most suited to replace your hip. This is a long-term solution that restores mobility in the pelvis and relieves pain.
Surgery can be performed under general or spinal anaesthesia according to patient preferences and medical background. During a total hip replacement, the damaged femoral head is removed and replaced with a prosthetic. This comprises a metal stem that sits in the hollow centre of the femur. A metal or ceramic ball is placed at the top of the stem and replaces the damaged femoral head. A metal socket replaces the damaged cartilage on the surface of the acetabulum, and screws or a type of cement are used to hold the socket in place.
To ensure the prosthetic ball glides in the new socket, a spacer is added between the ball and socket. This is usually ceramic, metal or plastic. Once the new prosthetic ball and socket are in place, the surgeon checks the condition of the muscles and tendons surrounding the hip joint. They will then use stitches to sew up the incision.
You'll stay in hospital for a one to two days following the operation. Our physiotherapy team will encourage you to stand up and walk with the help of crutches. You'll also be given exercises to strengthen your hips and legs. After you've been sent home, you'll need to use crutches, a walker or walking sticks for a few weeks.
When should I see a hip specialist?
If you're experiencing symptoms and would like to get a hip osteoarthritis diagnosis, book an appointment with a consultant who specialises in this area.
Your consultant will request any necessary imaging tests and take you through the available treatment options for hip osteoarthritis. They know how to treat osteoarthritis in the pelvis and hip area and will recommend the most effective approach for you.
Use our consultant finder by typing in ‘hip and groin pain’ and you'll be able to view the profiles of all the relevant experts. You can filter by the most suitable outpatient or hospital location to see a consultant.
Hip osteoarthritis FAQs
Flare-ups can happen when there has been activity that impacts the hip joint, such as exercise or even everyday tasks like going up and down stairs. Some people find the pain is worse at night and they experience stiffness in the morning. Cold or damp weather have been reported by patients to worsen symptoms.
Arthritis is a group of conditions that causes pain, stiffness and inflammation of the joints. Osteoarthritis is part of that group and is degenerative. There are differences between the types of arthritis. For instance, some types of arthritis, such as rheumatoid arthritis, are an autoimmune disorder – osteoarthritis is not.
There is no cure for osteoarthritis, but it can be treated. There are different treatment options available if you're diagnosed with hip osteoarthritis, from basic pain management and lifestyle changes to surgery. Your consultant will work out the most effective treatment plan for you.
Although hip osteoarthritis is more prevalent in those aged 50 and over, the condition can affect young adults. The condition is often thought of as “wear and tear”, though in younger adults there may be a history of problems with hip development in childhood (dysplasia) or trauma.
If you're waiting on surgery to alleviate your hip osteoarthritis symptoms, it's important to keep your hip moving. Follow the advice your consultant gives you to manage your symptoms and aid your recovery after surgery.
The cost will depend on the tests and treatment for your level of hip osteoarthritis. A quote will be available to you or your medical insurance company. There are many different ways you can pay for the care you receive. Please get in touch if you'd like more information about pricing.
Why choose HCA UK for hip osteoarthritis treatment?
If you've experienced discomfort and pain in your pelvis for a while, you'll want to receive an accurate diagnosis and high-quality treatment for your hip osteoarthritis. We offer:
- Next-day appointments: You can receive quick access to leading hip consultants and state-of-the-art facilities, with next-day appointments available and same-day imaging if required
- Technologically advanced imaging: With the best imaging technology at our disposal, we can accurately diagnose your hip problem and recommend the most effective treatment
- Access to ITUs: Our services are supported by our onsite Intensive Care Units (ITUs), helping people with complex conditions or medical histories
- Trust: 97% rated our orthopaedic care as ‘very good’ or ‘excellent’. Additionally, 99% were likely or very likely to recommend us in our 2023 patient satisfaction survey.
Our osteoarthritis locations
The Harborne Hospital
Mindelsohn Way B15 2FQ Birmingham
The Lister Hospital
Chelsea Bridge Road, SW1W 8RH London
The Wellington Hospital
8A Wellington Place NW8 9LE London
London Bridge Hospital
27 Tooley Street SE1 2PR London
The Princess Grace Hospital
42-52 Nottingham Place W1U 5NY London
Book an appointment with a hip consultant
We have the experience and knowledge to accurately diagnose osteoarthritis in the hip and provide treatment, as well as support with your management of the condition.
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This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.