Hip osteoarthritis
The most common reason for a hip replacement. This page explains what happens in the joint, how it is diagnosed, and the steps from first symptoms to surgery.
What is happening
The hip is a ball and socket joint. A smooth layer of cartilage covers both surfaces so they glide against each other with almost no friction. In osteoarthritis, this cartilage gradually wears thin over years.
As the cartilage thins, the space between the ball and socket narrows, the surfaces become rough, and small bony growths called spurs can form at the edges. The result is pain, stiffness, and a hip that moves less freely.
How it feels
Pain
Often felt in the groin, and sometimes in the buttock, the outer hip, the thigh, or even the knee. It tends to be worse with activity.
Stiffness
A hip that feels tight after resting or first thing in the morning, and eases a little as you move.
Less movement
Trouble with tasks that need the hip to bend or turn, such as putting on socks and shoes or getting in and out of a car.
A limp
As the joint stiffens, walking can become uneven, and longer distances become harder. Pain at night can come later.
What raises the risk
- Age. Wear builds up over a lifetime, so osteoarthritis is more common later in life.
- Family history. A tendency to osteoarthritis can run in families.
- An earlier hip problem. A past injury, or a hip that formed with a shallow socket or an unusual shape, can lead to earlier wear.
- Load over time. Heavy, repeated loading of the hip and carrying extra weight add to the wear.
How it is diagnosed
Most hip osteoarthritis is diagnosed from your history, a physical examination, and a plain X-ray taken while standing. The X-ray shows the narrowed joint space and any bone spurs, and it helps plan treatment.
An MRI is not usually needed for typical osteoarthritis. It is more useful when the cause of hip pain is unclear.
The steps, in order
Treatment usually starts with the simplest measures and moves on only if symptoms are no longer controlled. Many people manage well for years before surgery is considered.
Stay active and strong
Regular low-impact exercise, hip and leg strengthening, and managing weight are the foundation. They protect the joint and keep it moving. See exercise and prehab.
Simple pain relief
Everyday medicines can help control pain so you can keep moving. See medications.
Hip replacement
When pain and stiffness limit your daily life despite the steps above, replacing the joint is a reliable option. There is no rush, and the timing is your decision, made with your surgeon. See anterior hip replacement.
Surgery is a quality-of-life decision
Osteoarthritis is not an emergency, and waiting does not usually harm the hip. The right time for surgery is when the loss of comfort and function matters more to you than avoiding an operation. Your surgeon will help you weigh it.
One hip, from arthritis to a new joint
These X-rays follow one right hip through the usual path: the worn joint, a guided injection for relief, the plan for surgery, and the finished replacement. They are shown as examples of what each step looks like.
These are de-identified teaching images used with permission to illustrate the steps. Your own X-rays and treatment will be discussed with you directly.