Condition
Understanding hip osteoarthritis and planning treatment together
You used to put your shoes on without a second thought. Now you have to work out the best way to reach your foot. Perhaps you plan your routes around places to sit along the way. A diagnosis of hip osteoarthritis often raises two questions: what can I still influence myself, and when will I need a joint replacement?
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Assessing progress against your goals
We would like to agree on specific things to monitor with you. Can you walk a particular distance again? Is it easier to stand up? Are your nights more restful? Changes like these show whether treatment is moving in the desired direction. Improvement cannot be predicted for every measure or every person.
Do not automatically attribute sudden, severe new pain to your known osteoarthritis. Prompt medical help is needed if you cannot bear weight after a fall, or if you have a fever and feel significantly unwell. Call 112 for a serious injury or emergency. For other changes, please arrange a medical assessment.
Understanding
A closer look
Hip osteoarthritis, also known medically as coxarthrosis, does not follow the same course in everyone. We discuss how your findings and symptoms fit together, which non-surgical options are useful and how you can recognise a helpful change.
What changes within the hip joint
In the hip joint, the head of the thigh bone moves within the socket of the pelvis. Cartilage covers the joint surfaces. Osteoarthritis changes this system: cartilage may become thinner, the bone responds, and the joint capsule and surrounding muscles may also be involved.
The expression “wear and tear” makes it sound as though movement is inherently harmful and the joint will eventually be used up. It is not that simple. Movement remains important in treatment. Non-surgical treatment cannot reliably restore lost cartilage, but it can influence symptoms and function. What it can achieve in everyday life is assessed against your individual starting point.
Considering symptoms and imaging together
Pain in the groin is typical, for example when walking or rotating the leg. Some people feel it more in the thigh or knee. The first few steps after resting can be difficult. Mobility may decrease, making dressing or getting into the car harder.
The extent of the changes on an X-ray does not, on its own, show how much you are affected. We therefore ask how far you can walk, how you sleep, whether you use aids and which activities you have already given up. Imaging findings provide important information; your personal limitations and goals are equally part of the decision.
Further information
Which investigations are useful
The examination assesses mobility, your walking pattern and other findings that could explain your symptoms. An X-ray can show changes in the bone and narrowing of the joint space. Additional investigations are used when a question remains unanswered or another cause needs to be considered.
Existing images and reports help us with this. You do not need new imaging solely because you are changing practices. If an MRI or CT scan becomes medically appropriate, we will arrange it. Please also tell us if surgery has already been recommended: this helps us discuss the reasons and any outstanding questions with you more specifically.
Planning exercise that fits into everyday life
Adapted movement and exercises can help reduce pain and improve function in hip osteoarthritis. They may focus on strength and mobility, for example. Guidance from a physiotherapist can help you choose suitable exercises and perform them safely.
What matters is a plan you can actually put into practice. If longer distances are difficult, a shorter route may be more realistic initially. Whether cycling, exercise in water or another activity suits you also depends on what you enjoy and what is accessible. Discuss significant symptoms or symptoms that continue to worsen instead of carrying on with a programme unchanged. There is no fixed exercise dose that suits everyone.
Weighing up ways to reduce strain and relieve pain
Aids can make certain activities easier. A correctly adjusted walking stick or a dressing aid can support your independence, even though it does not change the condition of the joint. If you are overweight, achievable weight loss can help reduce the load. This should not be a source of guilt; what matters is what is realistic, taking your health into account.
Anti-inflammatory painkillers may be an option, but they must be suitable for your existing conditions and other medicines. Stomach, kidney and cardiovascular conditions are relevant examples. Please therefore include over-the-counter products in your medicine list as well. Do not change your existing medicines solely on the basis of a website.
Why injections are assessed differently for different joints
In selected cases of hip osteoarthritis, we also discuss an injection of hyaluronic acid, which may be combined with a corticosteroid depending on the findings. In our practice, patients report less pain and better mobility after this treatment. Clinical studies also describe improvements following this combination. However, results are inconsistent, and it is uncertain how much hyaluronic acid adds to the effect of the corticosteroid. A corticosteroid injection alone may be considered particularly for short-term relief. Together, we weigh up which approach suits your symptoms, findings and previous treatments. We discuss the treatment goal, possible risks, alternatives and the limits of the benefit that can be expected.
Neither ACP nor PRP has been proven to restore lost hip cartilage. If you have been advised to have a particular injection, bring that recommendation with you. What matters is its intended purpose, how robust the evidence is for your particular joint and what alternatives are available. A diagnosis does not automatically lead to an injection or a course of treatment.
When a hip replacement becomes part of the discussion
If suitable non-surgical measures do not help enough and pain and limitations remain substantial, a surgical consultation may be helpful. The decision depends on your findings, your health and how you manage everyday life. The X-ray alone does not determine the timing.
A joint replacement can significantly improve symptoms and function, but it also involves surgical risks and a period of recovery afterwards. You need a clear explanation of these from the surgical team treating you. Tell us which questions remain unanswered before you make this decision. Continuing with non-surgical care should be as well justified as deciding on an operation; delaying surgery at any cost is not a recommended treatment goal. We want to help you stay mobile and active.
Your consultation at OrthoCoast
Bring previous reports, access to your images and an up-to-date medicine list. Details of previous physiotherapy, exercises and their effects are also helpful. Priv. Doz. Dr. med. habil. Richard Kasch, Dr. med. Christoph Jährling, Björn Weidemann and Dipl. med. Matthias Dallmann provide non-surgical care for your hip symptoms. Appointments with Mr Dallmann are arranged as part of individually agreed cover arrangements.
“Appointments & enquiries” will direct you to the appropriate way to contact us. If an additional self-funded service is discussed, we explain its scope and likely costs beforehand. For patients with German statutory health insurance (GKV), we provide a self-funded service that is not covered by their insurer only after issuing a cost estimate and receiving signed consent.
Our doctors in this specialty
Priv. Doz. Dr. med. habil.Richard Kasch
Specialist in orthopaedics and trauma surgery
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Dr. med.Christoph Jährling
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
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Björn Weidemann
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
View profileMeet our doctors who treat joint symptoms here. What matters to you when moving and in everyday life is part of the conversation.
Frequently asked questions
Does hip osteoarthritis inevitably mean a joint replacement?
No. The course of the condition and the limitations it causes vary. Surgery is considered when its expected benefit justifies the risks in your situation and other suitable measures are not helping enough.
Can an injection make cartilage grow back?
The injections discussed here have not been shown to reliably restore lost hip cartilage. A possible treatment goal and a promise of regeneration are different things.
Why should I exercise despite having osteoarthritis?
Appropriate movement and exercise can support function and relieve pain. The level of activity must suit your symptoms and abilities. Moving does not mean using up more of your joint.
When should I discuss the current plan again?
Reassessment is helpful if symptoms increase, you cannot tolerate the measures being used or you are no closer to your agreed everyday goal. New, acute warning signs should not wait for a routine follow-up.
What should I bring if another provider has recommended treatment?
The recommendation and its reasoning, previous findings and your experience of treatments so far are helpful. We first assess these medically before planning another treatment appointment.
Your next step
