Hip pain, often stemming from conditions like severe osteoarthritis, can significantly diminish a person’s quality of life and mobility. The standard, highly effective treatment for end-stage joint disease is Total Hip Replacement (THR), a procedure that removes and replaces both the ball and socket of the joint. However, a total replacement is a major surgery, and for many patients—particularly those who are younger, highly active, or have less advanced degeneration—alternatives exist that can delay or entirely circumvent the need for a full prosthetic joint.
Conservative and Lifestyle Management
The first line of defense against hip pain involves non-invasive strategies focused on reducing stress on the joint and managing symptoms. Modifying daily activities is a simple yet impactful step, often meaning the avoidance of high-impact exercises like running or heavy lifting in favor of low-impact options such as swimming or cycling.
Weight management is a foundational component, as excess body mass multiplies the load on the hip joint with every step. Physical therapy is another element, focusing on strengthening the muscles surrounding the hip and core to provide better structural support and improve range of motion.
Pharmacological treatments, such as Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen or naproxen, can reduce inflammation and provide temporary pain relief. For some individuals, the use of walking aids, such as a cane, can redistribute body weight and significantly decrease the mechanical stress on the affected hip.
Targeted Injection Therapies
When conservative strategies prove insufficient, minimally invasive targeted injections can be utilized to deliver therapeutic agents directly into the joint space. Corticosteroid injections, commonly known as cortisone shots, are frequently used to provide temporary, potent anti-inflammatory relief. They reduce localized swelling and irritation, with benefits lasting from a few weeks up to six months.
Another option is Viscosupplementation, which involves injecting hyaluronic acid, a substance naturally found in healthy joint fluid, into the hip. The goal of this treatment is to improve the lubrication and shock absorption properties of the joint fluid. While its efficacy in the hip is still being actively studied, relief from hyaluronic acid can sometimes last between four and six months.
Emerging biologic therapies, such as Platelet-Rich Plasma (PRP) and stem cell injections, represent a regenerative approach. PRP is created by concentrating a patient’s own platelets from their blood and injecting them to release growth factors that may stimulate tissue healing and reduce inflammation. Though still considered experimental for hip osteoarthritis, PRP has shown potential to provide symptom relief that may last from six months to a year.
Surgeries to Preserve the Joint
For younger patients or those with mechanical hip problems rather than widespread arthritis, joint preservation surgeries offer a path to correct structural issues without replacing the joint components. Hip arthroscopy is a minimally invasive procedure where a surgeon inserts small instruments and a camera into the hip joint through tiny incisions. This technique allows for the treatment of specific internal pathologies, such as repairing a torn labrum, removing loose fragments of cartilage, or correcting a mild bony impingement.
Another set of procedures, called Osteotomies, involve cutting and realigning the bones of the femur or pelvis to improve the mechanical alignment of the joint. A Periacetabular Osteotomy (PAO), for instance, corrects hip dysplasia by freeing the socket (acetabulum) from the pelvis and repositioning it to better cover the femoral head (ball). By shifting the weight-bearing load away from damaged areas and distributing it more evenly, an osteotomy can alleviate pain and significantly delay the progression of arthritis.
Hip Resurfacing and Partial Replacement
When damage is too extensive for preservation techniques but a full replacement is not desired, surgical alternatives that are less extensive than a Total Hip Replacement (THR) can be considered. Hip Resurfacing is a bone-preserving procedure that involves shaving the damaged surface of the femoral head and capping it with a metal covering, similar to a dental crown. The socket side is also lined with a metal shell, but the majority of the bone in the femur’s neck and shaft is retained.
This bone preservation is the procedure’s main advantage, as it may make any potential future revision surgery less complicated than revising a traditional THR. Hip resurfacing is typically reserved for younger, more active patients with strong bone quality, as it allows for a larger femoral component that reduces the risk of dislocation. A Partial Replacement, or hemiarthroplasty, is another alternative, but it is generally used for acute fractures where only the femoral head is replaced, leaving the natural hip socket intact.