Why does my knee hurt if the problem is my hip?

The hip and knee share some of the same nerve pathways, so pain from hip arthritis can sometimes be felt in the thigh or knee. If the knee examination and X-rays do not explain the symptoms, the hip should also be assessed.

Can hip arthritis be managed without surgery?

Yes. Earlier or less severe hip arthritis can often be managed with physiotherapy, activity modification, weight management, appropriate medication and, in selected patients, injections. These measures aim to control pain and maintain function. Surgery is considered when symptoms remain limiting despite appropriate non-surgical treatment.

How do I know when I need a hip replacement?

Hip replacement is considered when pain consistently interferes with daily activities, walking distance becomes significantly limited, sleep is affected, and appropriate non-surgical treatment no longer provides enough relief. X-rays are also considered, but the decision is based on the combination of symptoms, function and joint damage rather than the X-ray appearance alone.

Is hip replacement suitable for younger patients?

Age alone does not determine whether hip replacement is appropriate. In younger patients, joint-preserving options are considered where the condition allows. When replacement is necessary, implant selection and positioning are planned with the patient's activity level and longer-term requirements in mind.

Can I sit cross-legged after hip replacement?

Many patients can gradually return to sitting cross-legged after hip replacement. The timing and precautions depend on the surgical approach, implant stability, flexibility and individual recovery. Your surgeon and physiotherapist can advise when this movement is appropriate for you.

Does hip arthritis always get worse?

Hip arthritis often progresses gradually, but the rate varies considerably between individuals. Maintaining muscle strength, staying active with suitable low-impact exercise and managing body weight where appropriate can help control symptoms and maintain function. Regular assessment is useful if pain or mobility is progressively worsening.

Hip Arthritis Treatment in Mumbai

Introduction

Hip arthritis develops when the cartilage lining the hip joint gradually wears down, causing pain, stiffness and increasing difficulty with everyday movement. It often begins with groin pain or difficulty with activities such as putting on socks, sitting cross-legged or walking longer distances.

Dr. Vaibhav Bagaria, Director of the Department of Orthopaedics at Sir H. N. Reliance Foundation Hospital, Mumbai, evaluates and treats hip arthritis at different stages, from non-surgical management to robotic hip replacement when joint damage becomes advanced.

What is hip arthritis?

The hip is a ball-and-socket joint in which the surfaces of the ball and socket are covered with smooth cartilage. This cartilage allows the joint to move with minimal friction.

With arthritis, the cartilage gradually becomes thinner and the space within the joint narrows. As the condition progresses, the joint surfaces become irregular and movement becomes increasingly painful and restricted.

Osteoarthritis is the most common form and usually develops gradually. Hip arthritis can also occur after an old injury, because of hip impingement, childhood hip conditions, avascular necrosis or inflammatory joint diseases such as rheumatoid arthritis.

Symptoms

✓ Groin pain, often the first symptom
✓ Pain spreading into the thigh, buttock or knee
✓ Stiffness, especially after periods of inactivity
✓ Difficulty putting on socks or shoes
✓ Difficulty sitting cross-legged or using low chairs
✓ Reduced walking distance
✓ Limp or change in walking pattern
✓ Hip pain that becomes worse at night or at rest

What causes hip arthritis?

1. Age-related wear

Gradual cartilage wear over many years is the most common cause of hip osteoarthritis.

2. Previous hip injury

Previous fractures or dislocations can alter the mechanics of the hip and lead to arthritis later in life.

3. Hip impingement

Abnormal contact between the ball and socket can damage the labrum and cartilage over time.

4. Childhood hip conditions

Conditions affecting hip development during childhood can increase the risk of arthritis in adulthood.

5. Avascular necrosis

Damage and collapse of the femoral head caused by reduced blood supply can eventually result in arthritis.

6. Inflammatory arthritis

Conditions such as rheumatoid arthritis and ankylosing spondylitis can affect the hip joint.

7. Increased joint loading

Higher loads through the hip, including those associated with body weight and occupational demands, can contribute to joint wear.

When should you see a doctor?

✓ Hip or groin pain that continues for several weeks
✓ Increasing difficulty putting on socks or shoes
✓ Difficulty sitting cross-legged or getting out of a low chair
✓ Walking distance becoming progressively shorter
✓ Hip pain that disturbs sleep or occurs at rest
✓ Knee pain despite a normal knee examination

When is hip pain an emergency?

Seek urgent care for severe hip pain following a fall or injury, inability to bear weight, obvious deformity or shortening of the leg, or sudden severe pain associated with an apparent hip dislocation.

Hip pain accompanied by fever and a hot or swollen joint also requires prompt medical assessment because infection can cause significant joint damage.

How hip arthritis is diagnosed

Medical history

The doctor assesses the location and pattern of pain, walking distance, night symptoms, limitations during daily activities and any previous hip injury or childhood hip condition.

Physical examination

Examination includes hip movement, pain during rotation, gait, leg length and assessment of the knee and spine to determine whether the pain is actually coming from the hip.

Imaging and tests

X-rays are the main imaging test for assessing joint-space narrowing and other arthritic changes.
MRI may be used when early cartilage damage, AVN or hip impingement is suspected.
Blood tests may be recommended when inflammatory arthritis is suspected.

Why early assessment matters

The severity of cartilage damage, the effect on daily activities and the patient's goals all influence treatment. Identifying the cause and stage of hip arthritis helps determine whether non-surgical care, joint-preserving treatment or hip replacement is appropriate.

Hip arthritis treatment in Mumbai

Non-surgical treatment

Treatment is usually started without surgery when symptoms are manageable and the joint has not reached a stage where replacement is required:

✓ Physiotherapy to strengthen the muscles around the hip and maintain movement
✓ Activity modification with continued low-impact movement
✓ Weight management where appropriate
✓ Pain-relieving or anti-inflammatory medication where appropriate
✓ Walking aids such as a stick used in the opposite hand when needed
✓ Injections for selected patients

When surgery is considered

Surgery may be considered when hip pain continues despite appropriate non-surgical treatment, walking and everyday activities remain restricted, sleep is affected, and imaging shows advanced joint damage.

Treatment depends on the condition of the joint. The aim is to control symptoms and preserve function for as long as possible, while considering replacement when pain and joint damage significantly affect quality of life.

Surgical options

✓ Robotic hip replacement — used for advanced hip arthritis where the damaged joint needs to be replaced.
✓ Hip resurfacing — considered for selected younger patients where the bone and joint condition are suitable.
✓ Hip arthroscopy — may be appropriate where hip impingement is contributing to symptoms and cartilage damage remains limited.
✓ Revision hip replacement — performed when a previous hip replacement has failed and the implant requires correction or replacement.

The appropriate procedure depends on the extent of cartilage damage, the cause of arthritis, age, activity level and the condition of the rest of the hip joint.

Related conditions treated

Avascular necrosis of the hip

Hip impingement (FAI)

Knee arthritis

Hip fracture

Hip Arthritis
Treatment in Mumbai