Osteoarthritis, Inflammatory Arthritis and Degenerative Joint Disease of the Hip

Understanding the Hip Joint

The hip is the largest ball-and-socket joint in the body. It is formed by:

• The femoral head, the rounded top of the thighbone
• The acetabulum, the socket portion of the pelvis

These surfaces are covered with smooth articular cartilage that allows the joint to glide without friction. The labrum, a ring of cartilage around the socket, helps stabilize the joint. Strong muscles and ligaments surrounding the hip provide strength and control during walking, running and daily activities.

Hip arthritis develops when protective cartilage wears down or becomes inflamed, leading to pain, stiffness and joint damage over time.

What Is Hip Arthritis?

Hip arthritis refers to inflammation and degeneration of the hip joint. The most common form is osteoarthritis of the hip, often called wear-and-tear arthritis. As cartilage gradually breaks down, bones may rub against each other, causing pain and reduced motion.

Other forms of hip arthritis include:

• Rheumatoid arthritis and other inflammatory arthritis conditions
• Post-traumatic arthritis following injury or fracture
• Arthritis secondary to avascular necrosis, which occurs when bone loses blood supply and begins to collapse
• Arthritis related to hip dysplasia or structural abnormalities
• Ankylosing spondylitis and other inflammatory spine conditions that can involve the hip

Over time, arthritis can cause bone spurs, joint space narrowing and progressive stiffness.

Causes and Risk Factors

Several factors may increase your risk of developing hip arthritis:

• Aging and natural cartilage degeneration
• Prior hip injuries or fractures
• Femoroacetabular impingement
• Hip dysplasia
• Family history of arthritis
• Obesity or excess body weight
• Autoimmune disorders
• Avascular necrosis

Because the hip bears significant body weight, even small structural changes can lead to increased joint wear over time.

Symptoms of Hip Arthritis

Hip arthritis symptoms often develop gradually and worsen over time. Common symptoms include:

• Pain in the groin, thigh or buttock, especially with weight-bearing activities
• Pain that radiates to the knee
• Stiffness, particularly in the morning or after sitting
• “Start-up” pain when standing after prolonged sitting
• Decreased range of motion
• Difficulty putting on shoes or socks
• Pain when walking, climbing stairs or standing
• Limping or weakness
• Pain that interferes with sleep

Symptoms may be constant or may flare up periodically. In advanced stages, pain may persist even at rest.

When to See a Hip Specialist

You should seek evaluation if you experience:

• Persistent hip or groin pain
• Stiffness that limits daily activities
• Difficulty bearing weight
• Pain that worsens despite rest or medication
• Hip pain following an injury

Early evaluation allows for more effective treatment and may slow progression of joint damage.

How Hip Arthritis Is Diagnosed

Accurate diagnosis is essential for developing the right treatment plan. At OrthoTexas, evaluation typically includes:

Comprehensive Clinical Evaluation

• Detailed medical history
• Physical examination
• Assessment of hip motion, strength and alignment

Imaging Studies

• X-rays to evaluate joint space narrowing, bone spurs and arthritis progression
• MRI when soft tissue evaluation is needed
• CT scans in select cases to assess bone structure

Standing X-rays are often used to evaluate joint space narrowing and confirm osteoarthritis. In most cases, X-rays provide sufficient information for diagnosis. Advanced imaging may be used when additional detail is needed.

These imaging studies help determine the severity of arthritis and guide treatment decisions.

Non-Surgical Treatment for Hip Arthritis

In early and moderate stages, hip arthritis can often be managed without surgery. Conservative treatment options may include:

• Activity modification
• Weight management
• Anti-inflammatory medications, including nonsteroidal anti-inflammatory drugs when appropriate
• Physical therapy
• Exercise programs designed to improve hip strength and flexibility
• Low-impact exercise such as swimming or cycling
• Assistive devices such as a cane or walker
• Image-guided corticosteroid injections for temporary symptom relief

Physical therapy focuses on strengthening the muscles around the hip, improving flexibility and reducing stress on the joint.

While arthritis cannot be reversed, early treatment can help manage pain and slow progression.

Surgical Treatment Options

When conservative treatment no longer provides relief and arthritis significantly affects quality of life, surgery may be considered.

Hip Arthroscopy

In select early cases, minimally invasive hip arthroscopy may address associated problems such as labral tears or impingement that contribute to joint damage.

Total Hip Replacement (Total Hip Arthroplasty)

For advanced hip arthritis, total hip replacement is one of the most effective surgical treatments available. During this procedure:

• The damaged femoral head is removed
• The acetabulum is prepared
• Artificial components replace the ball and socket

Total hip replacement can relieve chronic pain, improve mobility and restore daily function. Modern surgical techniques may reduce muscle disruption and support faster recovery in appropriate candidates.

Recovery After Hip Replacement

Recovery varies by patient but often includes:

• Early mobilization with physical therapy
• Temporary use of a walker or cane
• Gradual return to daily activities
• Structured rehabilitation

Many patients resume routine activities within four to six weeks, though full recovery may take several months.

Long-Term Outlook

With proper treatment, many individuals with hip arthritis achieve significant pain relief and improved mobility. Early intervention helps preserve joint function, while advanced surgical options offer reliable long-term outcomes for severe arthritis.