Hip Arthritis
What is hip arthritis?
Hip arthritis is a degenerative condition where the cartilage in the hip joint wears away, leading to pain, stiffness, and inflammation.
The cartilage provides a lubricated, low-friction surface that allows smooth joint movement.
When it is damaged or lost, bones rub against each other, causing pain and limiting mobility.
Arthritis is one of the most common causes of hip pain, and it is a progressive disease, meaning symptoms typically worsen over time.
Whilst hip replacement can be performed on young adults, it is increasingly being performed on Australians in their 50s, 60s and older.
In 2019, Dr Markham successfully performed a partial hip replacement surgery on a 107-year-old patient, showcasing how effective treatment can restore quality of life, even at an advanced age.
Types of hip arthritis
There are five main types of hip arthritis:
- Osteoarthritis (includes post-traumatic arthritis): Wear and tear of the joint, common with age and activity.
- Rheumatoid Arthritis: An autoimmune disease causing joint inflammation.
- Seronegative Spondyloarthropathies: Includes conditions like ankylosing spondylitis and psoriatic arthritis.
- Avascular Necrosis: Bone tissue death due to loss of blood supply.
- Fractures: Injuries that compromise the hip’s blood supply can lead to arthritis.
Arthritis affects around 3 million people in Australia*, representing about 15% of the population, It is more common in females (10%) than males (6.1%).* Based on International Radiological Survey data, the Australian Institute of Health and Welfare (AIHW) estimates that there are about 27,000 new cases of radiological OA in women and about 15,500 new cases in men each year.*
Professional athletes are particularly vulnerable; Athletes involved in football codes have been shown to have an incidence of hip arthritis 10 times higher than age-matched controls.*
Pain: Felt in the groin, hip, lower back, or radiating to the thigh or knee (referred pain).
Stiffness: Difficulty reaching feet to put on shoes, difficulty getting out of a chair or car.
Morning Stiffness: Pain often improves with activity but worsens with prolonged use.
Difficulty Walking: Limping or reduced mobility over time.
Diagnosis typically involves:
Medical History: Identifying pain patterns and mobility issues.
Physical Examination: Checking for joint irritability and range of motion.
Imaging Tests: X-rays, CT or MRI to detect joint damage.
Blood Tests: Occasionally used to identify autoimmune-related arthritis.
Non-Surgical Treatments
- Exercise: Strengthens muscles supporting the hip.
- Weight Management: Reduces joint stress.
- Assistive Devices: Walking aids to ease movement.
- Medications: Anti-inflammatories to control pain and swelling.
Surgical Treatments
- Hip Replacement: Effective for arthritis and can be indicated for labral tears in older patients.
- Hip Arthroscopy: Not recommended for established osteoarthritis.
Experimental Treatments
PRP
One study on 185 patients reported by the Royal Academy of Medicine in Ireland looked at the effect of platelet rich plasma in patients with early hip osteoarthritis. It found a similar efficacy to hyaluronic acid, but authors said that as PRP had not been compared to approved treatments such as steroids, “further studies comparing PRP to steroid would be of benefit to determine the value of PRP injections in hip OA.”
May stimulate cartilage regeneration but remains experimental and carries significant risks.
Autologous Conditioning Serum (ACS): Another experimental option that may show promise for osteoarthritis.
However Dr Markham cautions against experimental approaches, stating: “Although these treatments sound promising, they are still largely experimental.
“PRP and hyularonic acid to date seem safe and have been used for many orthopaedic conditions, yet effectiveness for hip arthritis needs further validation.
“However other therapies such as stem cell therapies may pose significant risks.
“Arthritis Australia advises that these risks include ectopic tissue growth (tissue forming in the wrong place), infections, and allergic reactions. Until there is more robust evidence supporting its safety and efficacy, I do not recommend stem cell therapy, nor do most orthopaedic surgeons.”
Dr Markham advises patients to focus on proven treatments with established outcomes, such as physiotherapy, weight management, and for advanced cases, hip replacement surgery.
Untreated hip arthritis can lead to chronic pain, reduced mobility, difficulty walking, and even interfere with intimacy and daily activities like shopping or cleaning.
95% are functional at 10 years.
85% last at least 20 years.
Hip arthritis is a manageable condition with appropriate treatment. Whether through lifestyle changes, non-surgical therapies, or surgical intervention, patients can experience significant pain relief and improved mobility. For those with symptomatic arthritis, hip replacement surgery offers an effective treatment, If you’re experiencing hip pain, stiffness, or difficulty walking, consult Dr Philip Markham to explore your treatment options. Book here.
