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Patient Education Center · Hip

Understanding Hip Arthritis

Hip arthritis is one of the most common causes of groin pain and loss of mobility as we age. Fortunately, there are many effective treatments available — from physical therapy and medications to modern hip replacement surgery.

My goal is to help you understand what is happening inside your hip so you can make informed decisions about your treatment. These are the same conversations I have with patients every day in clinic.

Table of Contents
What Is Hip Arthritis?
Short AnswerHip arthritis develops when the smooth cartilage covering the ball and socket gradually wears away.

Think of your hip like the tires on a vehicle.

The cartilage is similar to the tread that helps the joint move smoothly and handle the miles of daily life. Just like a tire, that tread doesn't wear down at the same rate for everyone.

How long it lasts depends on many factors, including genetics, previous injuries, alignment, activity level, body weight, and normal aging.

As the cartilage wears down, the joint becomes rougher, stiffer, and more painful. Eventually, the smooth gliding surface may become significantly worn, much like a tire that has lost its tread.

Your hips are built to last a lifetime — most people are born with two good tires meant to go 70-plus years. But just like a tire, wear and tear happens, and the average age for hip replacement in the U.S. is around 65.

Bone Doc Tip

Healthy cartilage is like a tire with full tread — smooth and quiet. Arthritis is what happens when that tread wears down to bald.

What Causes Hip Arthritis?
Short AnswerMost hip arthritis develops gradually over time because of aging and genetics, although previous injuries and structural problems can accelerate the process.

Hip arthritis rarely has one single cause.

Common contributors include:

  • Aging
  • Genetics
  • Previous fractures
  • Childhood hip disorders
  • Hip dysplasia
  • Femoroacetabular impingement (FAI)
  • Avascular necrosis
  • Previous surgery
  • Obesity
  • Inflammatory arthritis

Some patients develop arthritis despite living a healthy lifestyle.

Others never develop arthritis despite years of heavy activity.

Often, several factors work together.

Bone Doc Tip

Arthritis usually develops from years of accumulated wear — not from one bad day.

Where Does Hip Arthritis Hurt?
Short AnswerMost patients feel pain in the groin. Pain may also travel into the thigh, buttock, or knee.

One of the most surprising things about hip arthritis is where it hurts.

Many patients expect pain over the outside of the hip.

Instead, arthritis most commonly causes:

  • Groin pain
  • Front of the thigh pain
  • Buttock pain
  • Knee pain

Because nerves overlap, some patients believe they have a knee problem when the hip is actually responsible.

Pain over the outside of the hip is more commonly caused by bursitis or tendon problems rather than arthritis.

Bone Doc Tip

Groin pain usually points toward the hip. Outside hip pain usually points toward the tendons.

What Are the Symptoms?
Short AnswerPain, stiffness, and loss of motion are the most common symptoms.

Patients commonly notice:

  • Groin pain
  • Difficulty putting on shoes and socks
  • Trouble getting into a car
  • Pain walking long distances
  • Difficulty climbing stairs
  • Limping
  • Loss of flexibility
  • Night pain

As arthritis progresses, everyday activities gradually become more difficult.

Many patients stop doing the activities they enjoy without realizing how much their world has slowly become smaller.

Bone Doc Tip

Arthritis often steals motion before it steals strength.

Can Hip Arthritis Be Reversed?
Short AnswerUnfortunately, no. Once cartilage has worn away, today's treatments cannot reliably restore it.

Many patients ask whether there is an injection or medication that can regrow cartilage.

Unfortunately, the answer is no.

Current treatments can:

  • Reduce inflammation
  • Improve strength
  • Improve flexibility
  • Decrease pain
  • Improve function

But none have been shown to reliably restore advanced cartilage loss.

When arthritis becomes severe, hip replacement provides the most reliable long-term relief.

Bone Doc Tip

We can't regrow worn cartilage — but we can replace the worn surface when the time is right.

When Is It Time for a Hip Replacement?
Short AnswerWhen hip pain consistently limits your quality of life despite appropriate non-surgical treatment.

The decision to have surgery should never be based on an X-ray alone.

Instead, I ask patients:

"How much is your hip limiting your life?"

If you're avoiding:

  • Walking
  • Golf
  • Exercise
  • Travel
  • Sleeping
  • Family activities

despite trying reasonable conservative treatments, it may be time to discuss hip replacement.

When the joint surface is severely worn and symptoms significantly affect your quality of life, hip replacement resurfaces the damaged joint with new bearing surfaces — essentially putting new tread back on, rather than continuing to patch a tire that's already bald.

The goal isn't to create a perfect hip.

The goal is to help you return to the life you want to live.

Bone Doc Tip

We don't replace X-rays. We replace painful hips.

What Non-Surgical Treatments Help?
Short AnswerMany patients improve with conservative treatment before surgery becomes necessary.

Going back to the tire analogy: early treatment is a lot like adjusting your driving habits, improving alignment, or reducing load on the tire to help preserve whatever tread remains.

Treatment may include:

  • Physical therapy
  • Weight management
  • Activity modification
  • Anti-inflammatory medications
  • Assistive devices
  • Occasionally injections

These treatments may reduce pain and help manage symptoms.

They do not regrow cartilage that has already worn away.

As arthritis progresses, they often become less effective — much like a tire with little tread left, no amount of careful driving can restore what's already worn down.

Bone Doc Tip

These treatments preserve the tread you have left. They can't put new tread back on.

Why Does My Knee Hurt If My Hip Is Bad?
Short AnswerBecause the nerves supplying the hip and knee overlap.

Referred pain is extremely common.

Many patients are surprised when X-rays show only mild knee arthritis but severe hip arthritis.

After hip replacement, many patients notice that their "knee pain" disappears because the true source of the pain was the hip all along.

A careful physical examination usually identifies the correct source.

Bone Doc Tip

Not every painful knee has a knee problem.

Still Have Questions?

Every hip is different. If hip pain is limiting your life, schedule an appointment to discuss your symptoms and treatment options with Dr. Jadye Kee.

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