Hip Osteoarthritis

Hip osteoarthritis is the gradual loss of the smooth cartilage that lines the ball and socket of the hip, together with changes in the underlying bone, bony spurs at the joint edges and low-grade inflammation of the lining. The joint space narrows, the hip stiffens and movement becomes painful. It is one of the leading causes of disability in people over 60.

Cartilage does not regrow, and no tablet, supplement or injection has been shown to rebuild it. Exercise, weight management and pain relief control symptoms for years in many people. When pain and stiffness seriously limit life despite those measures, total hip replacement is among the most successful operations in medicine, although it remains major surgery with real risks.

Symptoms

• Pain in the groin or front of the thigh, sometimes felt in the buttock or referred to the knee
• Stiffness after rest that eases within about 30 minutes
• Difficulty putting on socks and shoes or cutting toenails
• Reduced inward rotation of the hip
• A limp, or the feeling that one leg has become shorter
• Pain at night in more advanced disease
• Reduced walking distance and trouble with stairs or getting out of a car

Causes and risk factors

Age and inheritance are strong influences. Subtle shape problems of the hip account for much so-called primary disease: a shallow socket (dysplasia), femoroacetabular impingement, and childhood conditions such as Perthes disease or slipped upper femoral epiphysis. Other contributors are obesity, years of heavy manual work or farming, high-impact sport at elite level, previous fracture or dislocation, avascular necrosis and inflammatory arthritis. Women are affected somewhat more often than men.

How it is diagnosed

• Clinical examination: Loss of internal rotation with reproduction of groin pain is the characteristic finding. Gait and leg lengths are checked.
• Weight-bearing pelvic X-ray: Shows joint space narrowing, spurs, sclerosis and cysts. X-ray severity and pain do not always match.
• MRI: Used when X-rays look normal but symptoms suggest avascular necrosis, a labral tear or a stress fracture.
• Diagnostic injection: Local anaesthetic placed in the joint under imaging clarifies whether pain comes from the hip or the spine.
• Blood tests: Only when inflammatory arthritis or infection is a possibility.

Treatment options

• Exercise therapy: Strengthening of the hip and core muscles with aerobic exercise such as cycling or swimming; the first-line treatment at every stage.
• Weight loss: Reduces load on the joint and improves the safety of any later surgery.
• Walking aids and footwear: A stick held in the opposite hand meaningfully unloads the hip.
• Pain relief: Topical or oral anti-inflammatories at the lowest effective dose, and paracetamol. Strong opioids are best avoided.
• Steroid injection into the joint: Gives relief for weeks to a few months during a flare. It should not be given within about 3 months of planned replacement because of infection risk.
• Total hip replacement: The worn ball and socket are replaced through a posterior, lateral or direct anterior approach, with cemented or uncemented components.
• Hip resurfacing: An option for some younger, larger-framed active men; less used now because of metal-on-metal concerns.
• Joint-preserving surgery: Arthroscopy or pelvic osteotomy for impingement or dysplasia before arthritis is established. These do not help once arthritis is advanced.

When it is urgent

Sudden inability to bear weight, especially after a fall, may be a fracture and needs an emergency department. A hot, very painful hip with fever suggests joint infection. After a hip replacement, a sudden painful shortening or twisting of the leg (dislocation), calf pain and swelling, chest pain or breathlessness all need emergency care locally.

Travelling to Türkiye for treatment

Hip replacement is a common and sensible reason to travel, because it is planned, the hospital stay is about 3 to 5 days and results are predictable. Allow around 10 to 14 days before flying home, discuss clot prevention for the journey, and arrange physiotherapy at home in advance. Ask which implant is used and for the implant record. Non-surgical care, which is exercise and weight management over months, has to happen where you live. Hyaluronic acid, PRP and stem cell injections for the hip lack convincing evidence.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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