Arthritis is a common condition that can affect nearly any joint in the body; however, when it involves the hip, it often significantly impacts mobility and overall quality of life. Everyday movements, like walking, climbing stairs, or getting in and out of a car, can become painful or difficult. Over time, this may affect activity levels and overall well-being.
This article explores the treatment options available for hip arthritis, from conservative approaches to non-surgical procedures. Understanding these options may help patients take the next step toward improved comfort and function.
Understanding Hip Arthritis
Hip arthritis refers to inflammation or degeneration of the hip joint, which can stem from various causes. The most common type, hip osteoarthritis (OA), is a progressive “wear-and-tear” condition in which cartilage that cushions the joint gradually breaks down. As this protective layer wears away, bones may rub together, causing pain and reduced mobility.[1]
While cartilage damage is central to OA, the disease affects the entire joint. It can lead to changes in the bone underneath the cartilage, bony overgrowths, joint looseness, muscle weakness, and sometimes inflammation of the joint lining. These changes cause joint stiffness, reduced function, and discomfort during daily activities.
Symptoms often include groin pain, stiffness after rest, and limited range of motion. As the condition progresses, pain may appear during activity or even at rest. Primary hip OA occurs without a clear cause, often in older adults. Secondary hip OA may result from prior injury, joint abnormalities, metabolic conditions, or other identifiable factors.
Risk factors for hip OA include age, genetics, obesity, and occupational or physical strain. Although commonly associated with aging, the condition can also affect younger individuals, particularly when underlying structural or mechanical issues are present.
How Diagnosis Shapes Treatment
Because hip arthritis can present in varying ways, treatment must be customized for each patient. Therefore, a thorough diagnosis is a critical first step.
Understanding the root cause, stage, and extent of joint damage helps determine whether a patient may benefit most from conservative care, interventional orthopedics, or surgical intervention. A thorough diagnostic process often includes the following:
- Thorough Physical Examination: Assesses pain, joint mobility, gait, and muscle strength to identify physical signs of arthritis or biomechanical dysfunction.
- Imaging Tests: X-rays assess joint space, bone spurs, or alignment issues. MRI may be used to evaluate soft tissues or rule out other causes.
- Medical History: Reviews previous injuries, family history, lifestyle factors, and symptom progression to help classify arthritis type and guide treatment planning.
Non-Surgical Treatment Options For Hip Arthritis
Many people living with hip arthritis can manage symptoms and preserve function without surgery. Non-surgical options are often recommended as a first step, especially in the earlier stages of joint degeneration. The right approach depends on several factors, including the cause of arthritis, the extent of joint damage, age, activity level, and overall health.
Several non-surgical strategies are commonly used to help manage hip arthritis and support long-term joint health:
Lifestyle Modifications And Self-Management
Lifestyle factors can help manage symptoms. Losing excess weight may reduce joint pressure. Avoiding high-impact activities and using joint-friendly routines can reduce strain. Supportive footwear, pacing, and gentle movement throughout the day can help improve comfort and mobility.
Physical Therapy And Functional Support
Targeted physical therapy can help strengthen muscles around the hip, improve range of motion, and restore movement patterns. Therapists may also recommend walking aids, orthotics, or bracing to help reduce load on the joint and improve stability during daily activities.
Medications
Several medications may be used to help manage pain and inflammation. These may include acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) when appropriate, as well as topical pain relievers. While medications don’t stop the progression of arthritis, they may help improve day-to-day comfort and function when used as part of a comprehensive care plan.
Surgical Options For Advanced Hip Arthritis
When hip arthritis progresses to a point where conservative care no longer provides meaningful relief, surgical intervention may be considered. Surgery is typically recommended in cases where joint damage is extensive, mobility is significantly impaired, and pain interferes with daily activities even when non-surgical treatment is used.
The decision to proceed with surgery depends on factors such as the type and extent of joint damage, the patient’s overall health, and their activity goals. Common surgical approaches used in advanced cases can include:
Hip Arthroscopy
Hip arthroscopy is a minimally invasive procedure used to treat certain structural problems in the hip, such as labral tears or impingement. This approach is typically considered for younger patients who have mild joint damage and no significant arthritis.
While it may provide relief in carefully selected cases, outcomes can vary. Some research suggests that patient selection is critical, with one study indicating that a subset of patients required additional hip surgery within one year..[2] Factors such as age over 40, existing osteoarthritis, and certain lifestyle factors may increase the risk of requiring additional surgery. Proper patient selection is essential.
Osteotomy
Osteotomy may be considered when hip arthritis is associated with structural issues, such as hip dysplasia, which can cause abnormal joint stress. The procedure realigns the hip joint to reduce stress on damaged areas.
A systematic review of patients undergoing periacetabular osteotomy (PAO) found that hip function scores, which measure pain and mobility, improved from an average of 69 before surgery to 89 after.[3]
The review also reported that approximately 76% of hips were preserved at the five-year mark. Outcomes were better in younger patients with minimal arthritis. Risk factors for poorer results included pre-existing joint damage, poor post-surgical alignment, and joint surfaces that did not fit together properly.
Hip Replacement (Total Hip Arthroplasty)
Total hip arthroplasty (THA) replaces the damaged hip joint with an artificial implant to relieve pain and restore motion in advanced arthritis. While THA is a typical option, a review of nearly 2.8 million patients found that complications may occur, such as postoperative anemia.[4] Risks may rise with conditions like hypertension, obesity, diabetes, and chronic lung disease.
Revision hip replacement, which is performed for issues such as implant loosening or dislocation, has a higher complication rate and longer recovery. Careful patient optimization and precise surgical technique may help achieve lasting outcomes.
Potential Risks And Complications Of Surgery
While hip surgery, particularly total hip replacement, can help to reduce pain and improve mobility, like all surgeries, it can carry certain risks. Complications should be discussed with the treating physician before proceeding:
- Infection: Surgical site infections can occur and may require antibiotics or additional procedures.
- Nerve Injury: Damage to surrounding nerves may lead to numbness, tingling, or muscle weakness.
- Dislocation: The new joint may dislocate, especially in the early weeks after surgery.
- Implant Wear or Loosening: Over time, artificial joints can wear down or shift, possibly requiring revision surgery.
- Blood Clots: Deep vein thrombosis (DVT) is a risk after surgery and may lead to serious complications if untreated.
- Long Recovery Time: Healing and rehabilitation may take several months and temporarily limit mobility.
Understanding these risks may help individuals prepare for the recovery process and make informed decisions.
Is There A Safer, Less Invasive Approach?
For those seeking alternatives to hip replacement, physicians in the licensed Regenexx network provide procedures using orthobiologics that may help support the body’s natural healing process. These non-surgical options utilize precise, image-guided injections that may help reduce inflammation, support tissue repair, and improve joint function. This approach is associated with less downtime and discomfort compared to surgery.
At the core of this approach are the Regenexx proprietary methods, which are tailored to specific orthopedic conditions. These treatments are a key part of the care offered by New Regen Orthopedics.
Regenexx-SD (Bone Marrow Concentrate Therapy)
Regenexx SD injectate uses concentrated cells derived from the individual’s own bone marrow, which contains stem cells and other healing agents. These cells are collected from the back of the pelvis, processed on-site using Regenexx processes, and then precisely injected into the hip joint using real-time imaging.
The goal is that this therapy may help support the repair of damaged cartilage, slow degenerative changes, and can also help reduce chronic inflammation. This therapy is typically considered for individuals with moderate to severe arthritis who still have some joint space remaining.
Regenexx-SCP (Platelet-Rich Plasma Therapy)
This treatment involves drawing a small amount of the individual’s blood and processing it to concentrate the platelets, which are natural healing agents that release growth factors. The resulting injectate is then delivered directly to the hip joint using image guidance.
Regenexx SCP injectate may help reduce inflammation, improve joint lubrication, and support soft tissue healing. It is often used for individuals in the earlier stages of arthritis or in combination with other treatments to support the recovery process.
Consequences Of Untreated Hip Arthritis
If left untreated, hip arthritis can advance, which could lead to long-term consequences. Chronic joint damage, cartilage loss, and increased inflammation may limit mobility and independence. Over time, the following complications may occur:
- Persistent Pain: Pain becomes more frequent and severe, interfering with daily activities and sleep.
- Joint Stiffness: Range of motion decreases, making it difficult to walk, bend, or perform routine tasks.
- Muscle Weakness: Inactivity from pain may lead to muscle atrophy and imbalance around the hip.
- Postural Changes: Compensation for pain may alter gait and posture, potentially affecting the spine and knees.
- Reduced Quality of Life: Loss of mobility may affect activity levels and overall well-being.
- Permanent Joint Damage: Advanced degeneration may result in bone-on-bone contact. At this stage, surgical intervention is often the primary treatment option.
Early diagnosis and treatment may help prevent these outcomes and preserve joint health.
Take The Next Step Toward Lasting Hip Relief
For individuals seeking to avoid surgery or explore non-surgical procedures, the Regenexx approach may provide relief and improved mobility. Physicians in the licensed Regenexx network provide customized care that targets the cause of pain using the individual’s own healing agents. This approach is a key part of interventional orthobiologics.
If considering interventional orthobiologics or other non-surgical procedures, a thorough evaluation is essential. An assessment can determine candidacy for procedures using Regenexx injectates. Scheduling a consultation at New Regeneration Orthopedics is the first step toward understanding potential treatment options.
Sources:
- MJ, Sultan AA, Piuzzi NS, Khlopas A, Husni ME, Muschler GF, Mont MA. Hip Osteoarthritis: A Primer. Perm J. 2018;22:17-084. doi: 10.7812/TPP/17-084. PMID: 29309269; PMCID: PMC5760056. https://pmc.ncbi.nlm.nih.gov/articles/PMC5760056/
- Baron JE, Westermann RW, Bedard NA, Willey MC, Lynch TS, Duchman KR. Is the Actual Failure Rate of Hip Arthroscopy Higher Than Most Published Series? An Analysis of a Private Insurance Database. Iowa Orthop J. 2020;40(1):135-142. PMID: 32742221; PMCID: PMC7368532. https://pmc.ncbi.nlm.nih.gov/articles/PMC7368532/
- Akhtar M, Razick DI, Wen J, Kamran R, Ansari U, Kamran K, Khalil R, Syed B, Karabala M, Preiss-Farzanegan S. Patient-Reported Outcomes and Factors Impacting Success of the Periacetabular Osteotomy. Cureus. 2023 Apr 9;15(4):e37320. doi: 10.7759/cureus.37320. PMID: 37181987; PMCID: PMC10167773. https://pmc.ncbi.nlm.nih.gov/articles/PMC10167773/
- Patel I, Nham F, Zalikha L, El-Othmani MM. Epidemiology of total hip arthroplasty: demographics, comorbidities and outcomes. Arthroplasty. 2023 Jan 3;5(1):2. doi: 10.1186/s42836-022-00156-1. PMID: 36593482; PMCID: PMC9808997. https://pmc.ncbi.nlm.nih.gov/articles/PMC9808997/
