Hip Osteoarthritis (OA)

Hip arthritis is where the smooth cartilage that lines the ball and socket joint is wearing/worn out. It is easy to understand this like the tyres on a car wearing out, but it is more complicated than this. There is a complex set of changes that occur, chemical and biological, which combine with mechanical damage to lead to thin/eroded cartilage, thickening of the bone below the cartilage (subchondral sclerosis), extra bone formation (osteophytes) and cyst formation. All of this leads to inflammation and pain.

The xrays here show the difference between a healthy, ‘normal’ hip and a hip with significant arthritis. The complicating factor is that some patients who have xrays which look bad may not have bad symptoms, whereas some patients will have mild xray changes but severe symptoms. The patients with the worst symptoms are the ones with the worst arthritis.

If you have hip arthritis there are a number of signs and symptoms that you may experience:

• Pain in the groin (most commonly), buttock or around the outside of the hip. Many patients will experience pain in the knee or thigh. This can feel like a deep aching pain or like toothache. For some patients, knee pain is the only pain they experience, which can be quite confusing.
• Pain at night – this may make it difficult to get to sleep or wake you up and make it difficult to get comfortable. This is often when pain is at its worst.
• Feeling like your leg is giving way.
• Restricted range of movement – this might mean difficulty cutting your toenails, putting on shoes and socks, getting up from a seated position or getting in and out of a car.
• Limited walking distance, especially on slopes.

You may have had to give up some of your activities or hobbies, or just find them very challenging. Many patients have had to cut down on their forms of exercise. It might be interfering with your job or stopping you from working. You may have had to stop working in the garden or the allotment. Many patients will find looking after young children/grandchildren difficult, especially trying to get up from the floor.