Signs and Symptoms
Hip arthritis symptoms usually come on gradually and may include:
- Pain in the groin or front of the thigh, sometimes spreading toward the knee
- Pain in the buttock or side of the hip
- Stiffness in the morning or after sitting
- Difficulty putting on socks and shoes, getting in and out of a car, or crossing your legs
- A limp, or needing to hold a railing on stairs
- Pain at night or at rest as the arthritis progresses
Because hip arthritis can cause knee pain, and back problems can cause buttock and hip pain, a careful exam is important to find the true source.
What Causes It?
The hip is a ball-and-socket joint. Smooth cartilage covers the ball at the upper end of the thigh bone and the socket in the pelvis. In osteoarthritis, this cartilage thins and roughens over time, the bone underneath thickens and bone spurs form.
- Age and genetics
- Differences in hip shape present from childhood, such as hip dysplasia (a shallow socket) or impingement (extra bone on the ball or socket rim)
- A past hip injury or fracture
- Inflammatory arthritis, such as rheumatoid arthritis
- Avascular necrosis, a loss of blood supply to the ball of the hip
How We Diagnose It at POPB
Your physician will ask about your pain, activity and goals, then check how your hip moves, how you walk and whether the pain might be coming from your back or knee. X-rays of the pelvis and hip are taken on site, usually at the same visit, and are often all that is needed to diagnose hip arthritis.
MRI and diagnostic ultrasound are available in our office when more detail is needed. Hip arthritis is treated by Dr. Martin, Dr. Kerr and Dr. Press, all of whom begin with non-surgical options when they are reasonable.
Non-Surgical Treatment Options
Non-surgical care aims to reduce pain and keep you moving:
- Physical therapy in our office for hip strength, flexibility and walking, with your therapist working from the same chart as your physician
- Low-impact exercise such as cycling, swimming and water exercise, plus weight management
- Anti-inflammatory medication or acetaminophen, if safe for you
- A cane in the hand opposite the painful hip to reduce load on the joint
- Image-guided cortisone injections into the hip joint, using ultrasound or fluoroscopy (live X-ray) to place the medicine accurately
Hyaluronic acid injections are FDA-approved for the knee, not the hip. When used in the hip they are off-label and usually not covered by insurance. If you have Medicare, you may qualify for our Care Management program for osteoarthritis, with monthly check-in calls and no extra office visits.
Surgical Options
When pain limits your walking, sleep or daily activities despite non-surgical care, total hip replacement is usually the recommended surgery. The worn ball and socket are replaced with implants that restore a smooth, stable joint.
Dr. Martin performs direct anterior and mini-posterior hip replacement and offers a fast-recovery program. Dr. Kerr is fellowship-trained in adult reconstruction, is trained on AI and robotic-assisted systems, and also offers minimally invasive direct anterior hip replacement. Your surgeon will explain which approach fits your hip and health.
Recovery
With non-surgical care, many people notice less pain within 6 to 12 weeks of regular exercise and therapy, though arthritis tends to progress over time.
After hip replacement, most people walk with support the same day or the next day. Many use a walker or cane for a few weeks and return to most daily activities within about 6 to 12 weeks. Physical therapy can be done in our office. Timelines vary.
Insurance and Cost
Medicare and most commercial PPO plans generally cover office visits, X-rays, physical therapy, cortisone injections and medically necessary hip replacement, subject to your co-pay, co-insurance and deductible.
Hyaluronic acid injections in the hip and PRP are usually not covered. HMO and managed-care plans require a referral from your primary care physician before your visit. Our staff verify your benefits when you call.
When to Be Seen
Call our office if hip or groin pain lasts more than a few weeks, makes you limp, or wakes you at night. If you fall and cannot stand or bear weight, or your leg looks shortened or turned outward, go to the emergency room or call 911, because these can be signs of a hip fracture.
