Hip Osteoarthritis in Sydney

What is hip osteoarthritis?

Hip osteoarthritis is one of the most common causes of persistent hip pain, stiffness and reduced mobility in adults. As the smooth cartilage within the hip joint gradually wears away, everyday activities such as walking, climbing stairs, getting in and out of a chair, or putting on shoes may become increasingly difficult. Symptoms often develop gradually and can affect quality of life, work, recreation and overall independence.

Many people are unsure whether their symptoms are caused by arthritis or another hip condition. At our hip and knee osteoarthritis clinic, patients receive a comprehensive assessment to identify the cause of their symptoms and discuss the most appropriate management options. Treatment is tailored to the individual and may include education, physiotherapy, exercise, medication, injections or surgery where appropriate.

This page explains what hip osteoarthritis is, the symptoms to look for, how it is diagnosed, and the range of treatment options that may be considered. It also outlines when surgery may become appropriate and what patients can generally expect throughout assessment, treatment and recovery.

Hip osteoarthritis, also known as hip arthritis or osteoarthritis of the hip, is a degenerative joint condition that occurs when the protective cartilage covering the ends of the bones gradually breaks down. Cartilage normally allows the hip joint to move smoothly with minimal friction. As this surface deteriorates, the bones may begin to rub against one another, contributing to pain, stiffness and reduced movement.

The hip is a ball-and-socket joint formed by the femoral head (the ball) and the acetabulum (the socket) of the pelvis. Healthy cartilage, surrounding muscles, ligaments and joint fluid all work together to provide stability and smooth movement. Osteoarthritis can affect these structures over time, leading to changes within the joint including cartilage loss, narrowing of the joint space and the formation of bone spurs known as osteophytes.

Although hip OA is more common with increasing age, it can also develop following previous injury, abnormal hip anatomy, childhood hip disorders or longstanding mechanical changes within the joint.

Types and causes of hip osteoarthritis

Primary Hip Osteoarthritis

Primary hip osteoarthritis develops gradually over time without a single identifiable cause. Age-related changes, genetics and cumulative wear may all contribute to its development.

Secondary Hip Osteoarthritis

Secondary osteoarthritis develops as a result of another underlying condition. Previous fractures, hip dysplasia, femoroacetabular impingement (FAI), avascular necrosis or childhood hip disorders may increase the likelihood of developing arthritis later in life.

Persistent Hip Pain Affecting Daily Activities

Treatment may also be appropriate for people experiencing ongoing pain, stiffness or reduced mobility that limits walking, work, exercise or recreational activities and has not improved with appropriate conservative management.

Symptoms of hip osteoarthritis

Hip osteoarthritis symptoms often develop gradually and may worsen over months or years. The severity of symptoms does not always match the appearance of arthritis on imaging, making clinical assessment an important part of diagnosis.

• Groin pain
• Pain in the buttock or outer hip
• Pain that radiates into the thigh or knee
• Morning stiffness
• Reduced range of motion
• Pain when walking longer distances
• Difficulty climbing stairs
• Limping
• Difficulty putting on socks or shoes
• Reduced participation in sport or exercise

Because several other conditions can cause similar symptoms, an accurate assessment is important before deciding on the most appropriate treatment.

Imaging

Weight-bearing X-rays are usually the first imaging investigation and often provide sufficient information to diagnose osteoarthritis. They may demonstrate narrowing of the joint space, bone spurs and other arthritic changes.

An MRI is not routinely required for established hip osteoarthritis but may be recommended if another condition is suspected or symptoms are not fully explained by X-ray findings.

When should hip osteoarthritis be assessed?

Treatment may be considered when hip pain begins affecting normal daily activities, work, sleep or recreational pursuits. Many patients seek assessment after symptoms have gradually progressed despite modifying their activity or using simple pain relief.

Not everyone with hip osteoarthritis requires surgery. In many cases, a combination of conservative treatments may help reduce symptoms and improve function for an extended period.

Regular review is important because treatment needs may change as symptoms evolve.

How is treatment selected?

Management recommendations are individualised and depend on several factors rather than age alone.

• Severity of symptoms
• Clinical examination findings
• X-ray or MRI results
• Impact on daily life
• Activity goals
• General health
• Previous treatments
• Overall joint condition

The aim is to identify the most appropriate treatment pathway for each individual while balancing symptom relief, mobility and long-term joint health.

Non-surgical treatment options

Most patients begin with non-surgical management. Conservative treatment often improves pain, mobility and function, particularly during the earlier stages of osteoarthritis.

Depending on your situation, treatment may include:

• Education about hip osteoarthritis
• Physiotherapy
• Exercise programmes
• Exercise physiology
• Weight management where appropriate
• Activity modification
• Pain-relieving medication
• Anti-inflammatory medication where suitable
• Corticosteroid injections in selected cases
• Walking aids when required

The aim of conservative treatment is to help patients remain active, improve movement and reduce symptoms while delaying or avoiding surgery where possible.

When might surgery be considered?

Before Surgery

If surgery becomes a consideration, patients undergo a comprehensive assessment including imaging, review of previous treatments and discussion of expectations. Your orthopaedic surgeon will explain whether surgery is likely to provide meaningful benefit based on your symptoms, examination findings and overall health.

When Surgery Is Appropriate

When significant arthritis continues to cause pain and disability despite appropriate non-surgical care, hip replacement surgery may be considered. Modern techniques, including hip replacement surgery, may be appropriate for selected patients depending on their individual anatomy, health and treatment goals.

After Surgery

Following surgery, patients begin mobilisation under the guidance of their treating team. Rehabilitation focuses on restoring walking ability, improving strength and gradually returning to everyday activities while protecting the new joint.

Benefits and goals of treatment

The primary goal of hip osteoarthritis treatment is to reduce pain, improve mobility and support participation in everyday activities. For many patients, conservative treatment provides meaningful improvement without surgery.

Where surgery becomes appropriate, the goals may include improving joint function, reducing arthritis-related pain and helping patients return to activities that have become difficult because of advanced joint damage. Outcomes vary between individuals and depend on factors such as overall health, severity of arthritis, rehabilitation and adherence to postoperative advice.

Risks and considerations

All medical treatments and surgical procedures involve potential risks. While many people achieve meaningful improvements in pain and function, outcomes vary depending on factors such as the severity of arthritis, overall health, existing medical conditions and commitment to rehabilitation.

Non-surgical treatment may not completely relieve symptoms for every patient, and some people may continue to experience progressive joint changes over time. If surgery is recommended, your orthopaedic surgeon will discuss the potential benefits, limitations and risks in relation to your individual circumstances.

Risks associated with hip replacement surgery may include infection, blood clots, bleeding, nerve or blood vessel injury, joint stiffness, leg length difference, dislocation, implant loosening, fracture around the implant and the possible need for further surgery in the future. Although these complications are uncommon, understanding them is an important part of informed decision-making.

Recovery and rehabilitation

Recovery following hip osteoarthritis treatment depends on whether management is non-surgical or surgical. Regardless of the approach, rehabilitation plays an important role in improving movement, restoring strength and supporting long-term joint function.

Early Recovery

Patients receiving conservative treatment often begin a structured rehabilitation programme soon after assessment. This may include exercises to improve flexibility, strengthen the muscles surrounding the hip and reduce pressure on the affected joint.

Following hip replacement surgery, most patients begin walking with assistance on the day of surgery or shortly afterwards, depending on their overall health and their surgeon's recommendations. Early movement helps promote recovery while reducing the risk of certain complications.

Physiotherapy and Rehabilitation

Physiotherapy is an important part of recovery. Rehabilitation commonly focuses on restoring hip movement, rebuilding muscle strength, improving balance and gradually returning to everyday activities. Exercise programmes are progressed according to individual recovery rather than fixed timelines.

Patients are encouraged to follow their rehabilitation programme closely and attend scheduled follow-up appointments so progress can be monitored and treatment adjusted if required.

Return to Work

The time required before returning to work varies considerably depending on the type of employment, physical demands and whether surgery has been performed. People with office-based roles may return sooner than those whose work involves heavy lifting, prolonged standing or repetitive physical activity.

Your treating team can provide guidance based on your recovery and the specific requirements of your occupation.

Return to Sport and Physical Activity

Many patients gradually return to low-impact recreational activities such as walking, cycling, swimming and golf once adequate strength and mobility have been restored. Higher-impact activities may not be appropriate for everyone following advanced hip arthritis or hip replacement surgery. Recommendations should always be discussed with your treating surgeon and rehabilitation team.

Comparing hip osteoarthritis treatment options

Hip osteoarthritis is managed using a range of treatment options, with the most appropriate approach depending on the severity of symptoms, imaging findings, lifestyle and individual goals.

For people with early or moderate arthritis, education, physiotherapy, exercise therapy, weight management and appropriate pain relief often provide meaningful symptom improvement and may delay the need for surgery.

When advanced arthritis significantly affects quality of life and conservative treatment is no longer providing adequate relief, hip replacement surgery may be considered. Unlike treatments that aim to manage symptoms, hip replacement removes the damaged joint surfaces and replaces them with artificial components designed to restore smoother movement.

Not every patient with hip osteoarthritis will require surgery. A comprehensive assessment helps determine which treatment pathway is likely to offer the greatest benefit based on each person's individual circumstances.

Questions to ask your clinician

• Is hip osteoarthritis the main cause of my symptoms?
• How severe is the arthritis shown on my imaging?
• What non-surgical treatments are appropriate for me?
• Would I benefit from physiotherapy or exercise physiology?
• At what point should surgery be considered?
• Am I a suitable candidate for anterior hip replacement?
• What results can I realistically expect from treatment?
• How long is recovery likely to take in my situation?
• When may I be able to return to work, driving and recreational activities?
• What are the potential risks and long-term considerations?

Assessment for hip osteoarthritis in Sydney

Hip osteoarthritis is a common cause of persistent hip pain and reduced mobility, but effective management is available across every stage of the condition. Many people achieve meaningful improvements through education, physiotherapy, exercise and other non-surgical treatments, while hip replacement surgery may be appropriate when symptoms continue to significantly affect daily life despite appropriate conservative care.

If hip pain, stiffness or loss of function is affecting your quality of life, an assessment by an experienced orthopaedic team can help determine the cause of your symptoms and develop an evidence-based treatment plan. Understanding your diagnosis and discussing all available management options allows you to make informed decisions about your ongoing care.

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Frequently asked questions