Hip Arthritis

This is typically osteoarthritis, although other forms such as rheumatoid arthritis are occasionally seen.

This is characterised by pain and stiffness due to cartilage degrading away, leaving the bone exposed underneath. Cartilage is soft, well lubricated and has no nerve supply. A normal joint is supple and due to the lack of nerve supply, weight-bearing is painless. As that cartilage degrades, the exposed bone underneath bears the weight and the exposed nerves cause pain. It is like rubbing your knuckles together with your entire body-weight.

Arthritic hip pain tends to manifest deep in your groin, sometimes on the side of the hip and buttock, and occasionally down the thigh and into the knee. Spinal conditions like sciatica can masquerade as hip pain, so it is important to be assessed properly before considering treatment.

Hip arthritis in its mild forms should be managed first with the following measures:

• Weight management
• Physical therapy
• Pain management with non-opiate medication such as non-steroidal anti-inflammatory medication
• Corticosteroid Injection in limited situations

At this stage, biological treatments, augmenting injections, cartilage preservation surgery and stem cell ideas are without merit.

In its more severe form, hip arthritis is managed exclusively by hip replacement surgery. This was named the operation of the century for a reason: it is the most reliable and effective surgery we offer. Even at young ages (below 18), hip replacements are tolerated exceptionally and have extreme longevity. For this reason, preservation surgery of the hip joint has an extremely limited scope.