Hip Arthritis: Causes, Symptoms & Surgical Options

Overview

Hip arthritis is one of the most common orthopaedic conditions affecting Australians over 50. It occurs when the cartilage lining the hip joint gradually wears away, causing the bones to rub together. The result is pain, stiffness and reduced mobility that can significantly impact quality of life.

What Causes Hip Arthritis?

The most common cause is osteoarthritis, age-related degeneration of joint cartilage. Other causes include rheumatoid arthritis (an autoimmune condition), post-traumatic arthritis following a hip injury or fracture, and avascular necrosis, where the blood supply to the femoral head is disrupted.

Risk factors include increasing age, obesity, previous hip injury, and a family history of arthritis.

Symptoms

• Deep groin or outer hip pain, often worse with activity or after rest
• Morning stiffness lasting 30–60 minutes
• Reduced range of movement — difficulty putting on shoes or socks
• A grinding or grating sensation in the joint
• Limping, particularly after sitting for a period
• Referred pain down the thigh to the knee

Diagnosing Hip Arthritis

Diagnosis is confirmed with a clinical examination and plain X-rays, which typically show joint space narrowing, bone spurs (osteophytes), and subchondral sclerosis. An MRI may be requested if there is uncertainty or if soft tissue pathology (such as a labral tear) is suspected.

Non-Surgical Treatment

For mild to moderate hip arthritis, we recommend trying conservative treatments first:

• Physiotherapy — strengthening exercises to stabilise the joint
• Weight management — reducing load on the joint
• Anti-inflammatory medications
• Walking aids (cane or walker)
• Corticosteroid injections — for short-term pain relief

Surgical Options

When conservative measures no longer provide adequate relief and arthritis is severe, surgery is considered. The gold standard is total hip replacement (THR), in which the damaged joint is replaced with a prosthetic implant.

Dr Liew performs total hip replacement using the Direct Anterior Approach, a muscle-sparing technique that avoids cutting through major muscles, resulting in faster recovery and a lower dislocation risk. Robotic-assisted hip surgery using the Mako™ system is also available, providing highly precise implant positioning personalised to your anatomy.

What to Expect

Most patients experience significant pain relief and improved mobility after total hip replacement. Hospital stay is typically 2–4 days, and most patients are walking with minimal assistance within days of surgery. Full recovery, including return to recreational activities, usually takes 3–6 months.

Further Reading

Dr Liew has written in more detail about this topic on his own site: hip arthritis and diagnosing and treating hip arthritis.