• What are the causes of hip osteoarthritis?
• What are the most common symptoms associated with hip osteoarthritis?
• Treating hip osteoarthritis

Written by Charlee Sumettavanich, M.D., specialist in orthopedics, arthroplasty, and sports orthopedics at Bumrungrad International Hospital.

Age-related physical deterioration is an unavoidable fact of life and, unfortunately, when that degeneration affects bones and joints, it can become extremely painful, often having a significant impact on the patient’s quality of life. People suffering from hip joint problems is common and people suffering from it often have questions they need answering. Therefore, I wrote this article to provide some insights into how best to manage and treat osteoarthritis of the hip.

What are the causes of hip osteoarthritis?

Hip osteoarthritis differs from knee osteoarthritis in that the latter condition is caused by the continuous reliance on the knee joint since infancy, leading to a gradual deterioration that usually reaches the osteoarthritic stage past 60 years of age. Indeed, osteoarthritis of any joint is generally caused by prolonged use. However, hip osteoarthritis – especially in those with Asian ethnicity rather than Caucasian or Afro-Caribbean ethnicity – tends to be a result of underlying issues or deformities affecting the hip joint. The four most common causes among Thais are

1. Osteonecrosis of the femoral head, can be caused by alcohol consumption with the use of steroidal drugs can lead to reduced circulation in the region, eventually causing necrosis and  articular surface collapse where its surface becomes rougher, leading to hip osteoarthritis. Unfortunately, this condition tends to occur relatively early on in life, with those aged between 30–40 years at risk of developing the condition, particularly among those who regularly consume alcohol.
2. Developmental hip dysplasia, when the joint does not develop and grow properly, thus causing abnormal loading of the joint, is another major cause for hip osteoarthritis in Thais and those of Asian ethnicity. When a hip joint is subject to overuse, because of abnormal articulation, the increased load placed on the joint can easily lead to osteoarthritis. Hence, this factor is similar to knee osteoarthritis in that it usually causes issues to start occurring at around 50–60 years of age and beyond.
3. Another significant cause of hip osteoarthritis is a previous injury, such as a fractured hip, fractured pelvis, or dislocation of the hip. Such injuries can lead to tears affecting the tiny blood vessels serving the hip joint that cause deterioration of the hip joint.
4. Infections of the hip joint are the fourth biggest cause, although one that is not quite as common as the three preceding it. Such infections can lead to cartilage destruction, resulting in the development of osteoarthritis.

What are the most common symptoms associated with hip osteoarthritis?

The first sign of the condition is aching pain around the hip area. Although this pain may not extend to the legs or feet initially, it can often be radiating to the knee joint, eventually leading to prolonged bouts of serious pain that is most severe in the groin area. In addition to the initial pain, the biggest indicator that the condition has developed is pain associated with activity, meaning that it begins when exercising or when placing weight through the hip joint. Such pain may subside once the patient sits or lays down to rest, which shows that the pain is mechanical and the cause that is related to activity.   

How to tell if symptoms are caused by hip osteoarthritis

Patients suffering from osteoarthritis of the hip experience hip pain, especially in the groin region, which tends to increase when the hip is being exerted, such as when walking. Pain can radiate to the knee but generally does not involve numbness in the legs or does not extend to the feet. Other symptoms are stiffness and decreased range of motion. The pain becomes more apparent over time, meaning that walking and general use of the joint can become more difficult as the joint gradually ceases up.

Diagnosing hip osteoarthritis

Before starting any treatment, medical staff will perform a full body check-up that is particularly focused on the hip area. This may involve examining the patient walking, as well as undergo an x-ray, CT scan, or MRI of the hip to analyze the severity of any degeneration.

Treating hip osteoarthritis

Hip arthroplasty may be considered in cases where the condition is significantly affecting the patient’s daily life. Should this be necessary, doctors and patients will first consider the type of surgery to utilize, with the patient’s safety, rehabilitation times, and replacement hip longevity and quality at the forefront of their decision-making.

How safe are hip arthroplasty procedures?

Although the result of hip replacement is now extremely effective, there are always risks associated with surgery. Therefore, patients should carefully consider which surgical team to select based on surgeon’s experience and expertise before undergoing hip or knee arthroplasty. High quality prosthetics should be chosen, because trying to cut costs on such materials could lead to reduced survivorship of the prosthesis. Additionally, if innovation are available for use in surgery, it can increase accuracy and reduce overall risk. An experienced team and proper facilities are important to reduce post-surgery complication rates. All of this means that patients should only rely on medical institutions with an excellent reputation for their procedures.

Post-surgery advice

• For the first six weeks, during the surgical wound healing, patient should avoid positions that are prone to dislocation, such a bending hips more than 90 degrees, or internal rotation of the hip.  Patients are also advised to use crutches to provide support during the initial stages following surgery.
• Patients should exercise according to the recommendations of their physiotherapist to help strengthen the hip muscles, as well as to improve the range of motion to avoid the joint stiffness.

How to prevent hip osteoarthritis

While we cannot avoid the physical deterioration that comes with age, there are certain things we can do for ourselves to help delay this process

1. Avoid consumption of alcohol because this increases the risk of avascular necrosis of the femoral head developing, which is by far the biggest cause of hip osteoarthritis.
2. Practice sports that does not involve heavy impacts, such as cycling, walking, aqua aerobics, and regular swimming.
3. Manage your body weight, because being overweight increases the risk of both, hip osteoarthritis and knee osteoarthritis.

Despite following this advice, many people will still be unable to avoid the onset of hip osteoarthritis. Fortunately, the condition can be managed with treatment, which is capable of restoring a certain quality of life to the patient.


The Sports Medicine and Joint Center at Bumrungrad International Hospital offers premium care and treatment for hip osteoarthritis and knee osteoarthritis. Our team of expert doctors, who have more than 15 years’ of experience in performing joint arthroplasty procedures, treated and replaced the joints of over 2,000 patients to date. The prosthetics used are of the highest quality and the technologies we have at our disposal represent the latest innovations in the field of medicine. Moreover, our team of doctors and medical staff ensure that each patient is carefully prepared for surgery and that they receive the appropriate rehabilitative care once the procedure is complete.
Surgeons at the Sports Medicine and Joint Center are highly regarded specialists in their field of medicine, recognized throughout Thailand and Southeast Asia.
 
The team is working in a comprehensive multidisciplinary team available to provide specialist care and advice. These team members cooperate effectively and efficiently to ensure our patients receive the best care possible, from the moment they enter the hospital for their procedure through to post-surgery care and rehabilitation.
 
This article was written by Charlee Sumettavanich, M.D., specialist in orthopedics, arthroplasty, and sports orthopedics at Bumrungrad International Hospital.