Hip Osteoarthritis

Dr Kau Chung Yuan (许医生)

Orthopaedic Surgeon in Singapore

MBBS (S’PORE)

MRCS (Ireland)

MMed (Ortho)

FRCSEd (Ortho)

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Anatomy Of The Hip

The hip is a ball-and-socket joint that connects the pelvis to the thigh bone (femur). It is one of the largest joints in the body. It is responsible for bearing weight and enabling movements such as walking, running, and jumping.

The hip joint consists of two main parts: the acetabulum, which is a socket in the pelvis, and the femoral head, which is the rounded end of the femur that fits into the acetabulum. The joint is also lined with a layer of cartilage called articular cartilage, which allows for smooth and pain-free joint movement.

What is Hip Osteoarthritis?

Hip osteoarthritis is the wear and tear and deterioration of cartilage within the hip joint and is also known as degenerative joint disease. It occurs slowly over time and is more common in patients above 50, but it can also happen in younger people with previous hip injuries.

When the cartilage around the hip joint erodes, it narrows the protective layer between the bones. The bones surrounding the cartilage will begin to rub against each other, causing pain and stiffness in the hip. The length of the affected leg can become short over time, and it may gradually become painful even with walking short distances.

What Are The Symptoms of Hip Osteoarthritis?

As the cartilage wears and tears, the most common symptom is pain in the hips and groin.

Other symptoms include:

Difficulty in certain activities (getting up from a chair, taking the stairs, walking long distances)
Deformity (e.g. shorter leg on the affected joint)
Stiffness

Symptoms of inflammatory arthritis include:

Joint pain and stiffness after long periods of inactivity, especially in the morning.
Painful, warm, red and swollen joints
Other organ involvement for inflammation (e.g. heart and lungs)

Three of the more common forms of inflammatory arthritis of the hip include:

Rheumatoid Arthritis: This is an autoimmune condition where the body’s antibodies attack its own cells. Patients can feel stiffness and pain, especially after waking up in the morning. Women are more commonly affected. It can affect patients of all ages and is not age dependent. Young people can develop rheumatoid arthritis as well.
Psoriatic Arthritis: As the name suggests, it can occur in patients who have a skin condition known as psoriasis. The rash can appear red, scaly and over any part of the body. It is often chronic, and patients can develop joint pains over time.
Ankylosing Spondylitis (AS): This condition afflicts males more often than females. It is less common but can cause low back, hip, and neck pain. The lower back and hip can become very stiff. Symptoms develop slowly over time.

What Are The Causes And Risk Factors Of Hip Osteoarthritis?

A few causes and risk factors increase the likelihood of hip osteoarthritis. These include:

Age
The risk of developing osteoarthritis increases with age.
Hip dysplasia
This is an abnormality between the acetabulum (socket) and the femoral head. Often the socket is shallow and produces abnormal joint forces. Over time the cartilage in the joint becomes damaged and has accelerated wear, leading to arthritis.
Obesity
Extra weight stresses the hip joint and increases the risk of osteoarthritis.
Trauma
A previous accident, sports injury or dislocation of the hip joint causes cartilage damage at the initial injury. This worsens over time and quickens the development of osteoarthritis.

Hip osteoarthritis is a chronic condition that progressively worsens over time. As the condition progresses, the joint may become severely damaged, leading to complications that can impact daily life.

Possible complications include:

Bone death
Hip joint deformity
Hip bursitis
Infection in joint
Bone spurs

How Can Hip Osteoarthritis Be Prevented?

While it is not completely possible to prevent hip osteoarthritis as it results from continuous use of the joint, there are certain precautions to take to minimise its risk.

Maintain a healthy body weight: Excess weight can put stress on your hip joints.
Exercise: Keeping active can help prevent joints from becoming stiff. Walking is a beneficial exercise for hip arthritis.
Control blood sugar levels: High blood sugar levels and diabetes may increase the risk of osteoarthritis. Get it checked regularly and manage them with the help of your doctor.
Avoid injuries: Hip injuries can increase the risk of osteoarthritis. Care for your joints by warming up before exercising and using exercise equipment correctly.

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How Is Hip Osteoarthritis Diagnosed?

If you have gradual worsening symptoms, you should see an Orthopaedic Surgeon for an assessment. Your doctor will access your medical history and conduct a physical examination of your hip. Your doctor will check for tenderness in the area, range of motion and any signs of injury.

To confirm the diagnoses, your doctor may order imaging tests such as:

X-rays: To detect hip dysplasia, osteoarthritis and other inflammatory arthritis of the hip
MRI scan: To assess the soft tissue structures around the hip joint, including the labrum and tendons.

What Are The Stages Of Hip Osteoarthritis?

The severity of hip osteoarthritis is grouped into four stages, from Stage 1 to Stage 4. Depending on the stage, the treatment for the condition will differ.

Stage 1
The hip joint has minor wear and tear and bone spurs but will not cause much pain.
Stage 2
The cartilage starts to break down, but the space between the bones is not too severe. Some pain, stiffness and discomfort are common.
Stage 3
The cartilage wear and tear becomes more severe, and the space between the bones narrows. Everyday activities like walking may be challenging and can cause pain.
Stage 4
This stage is the most severe form of hip osteoarthritis where the cartilage is almost completely lost. The bones are constantly rubbing against each other, causing chronic inflammation, pain and even loss of mobility.

How Is Hip Osteoarthritis Treated?

Osteoarthritis has a spectrum of symptoms depending on the severity of the condition. Many patients have mild to moderate symptoms, and this is usually well managed with periods of rest and activity modification.

Some non-surgical treatment options include:

Physical therapy: Useful in managing pain and improving motion and strength of the knees
Medications: Non-steroidal anti-inflammatory medications to help alleviate pain and swelling during acute flares
Weight loss
Walking aids or supportive devices
Intra-articular injections with steroids or hyaluronic acid

In severe cases where the above recommendations have been unsuccessful, surgery is an option to treat osteoarthritis of the hip. A total hip replacement surgery may be recommended to remove hip pain and restore motion to help the patient walk and resume normal activities.

Dr. Kau Chung Yuan

Orthopaedic Surgeon in Singapore

MBBS (S’pore)

MRCS (Ireland)

MMed (Ortho)

FRCSEd (Ortho)

Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.

He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.

Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
Master of Medicine (Orthopaedics), Singapore (MMed) 2013
Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
Bachelor of Medicine and Surgery (MBBS, Singapore) 2004

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Patient Feedback

Ethan Chan

Dr. Kau is an exemplary doctor who is experienced in his field and is very patient with his patients. He walked me through the details of my knee condition and addressed all my concerns. Thanks to Dr. Kau, I had a better understanding of my ACL and MCL injury and the various treatment options available. His advice and treatment have been very valuable to me.

Ming Lee Chua

Dr Kau was very careful and explained clearly the surgery procedures. After surgery, the care while I was in hospital was closely monitored and he even came during weekends! The hip so far has recovered and healed. His ‘predictions’ of when what can happen are so accurate. Trust him.

Teo Pek Suan Diana

I had a very successful total hip replacement done by Dr Kau 4 years ago. 4 months after the operation I was back walking, cycling and swimming. The beautiful job gave me much confidence Dr Kau is most professional and has such great doctor patient communication.