In the past, arthritis of the hip has been accepted as a painful disability. Many people were resigned to living in a wheelchair. Over the past thirty years, advances in the treatment of hip arthritis, as well as hip replacement surgery, have allowed many patients to return to a normal life. A damaged hip joint can occur because of simple wear and tear, which creates the condition known as osteoarthritis. It can also be caused by chronic disease such as rheumatoid arthritis, prior fracture of the hip, or the extensive use of alcohol or steroid medications that results in a reduced blood supply to the bone, a condition called avascular necrosis. 
The hip joint is a large ball and socket joint. It allows us to walk, squat and turn. The ball and the socket are both covered with articular cartilage. This cartilage functions as a cushion and shock absorber and is extremely smooth, allowing for a painless, gliding motion where the thigh bone connects to the pelvic bone. The osteoarthritic hip wears through the articular cartilage so that movement is bone-against-bone. This creates ongoing inflammation and pain with motion. Eventually, a person has pain even when standing still or lying down.
Symptoms of Hip Arthritis
A primary care doctor usually refers a patient to an orthopedic surgeon when a person's pain begins to interfere with activities. The orthopedic surgeon takes a medical history to assess the cause of the injury to the hip. Typically, the arthritic hip will present with ongoing discomfort within the groin or, more rarely, the buttocks. Physical examination frequently reveals a diminished range of motion of the hip joint, and often the surgeon can see that the patient cannot walk normally.
X-rays of the hip joint frequently will show significant wear. The joint space between the ball and the socket is markedly diminished. Bone spurs will also be apparent on the x-rays. MRIs are not routinely ordered except in the diagnosis of avascular necrosis, when they are useful in demonstrating the extent of the damaged bone due to the altered blood supply.
Treatment of Hip Arthritis
A treatment plan is established by the patient and the surgeon. Anti-inflammatory medications are extremely useful in bringing down the discomfort and allowing activities to continue. These medications do not increase the space between the two bones. They simply bring down the accompanying swelling of the joint lining. Common anti-inflammatories are aspirin, ibuprofen and Naprosyn. Other anti-inflammatory medications can be used as well. Physical therapy is frequently recommended to strengthen the muscles around the hip joint, to reduce pressure on it. Weight reduction is recommended, since the hip joint is a weight bearing joint.
If conservative treatment fails, surgery is recommended. The damaged ball and socket are removed and replaced with a metal or plastic socket and a metal ball with a shaft which extends within the marrow of the thigh bone. Postoperative care includes the extensive use of pain medications for the first few days and then extensive work with the physical therapist as the patient begins walking again with crutches or a walker. The new hip must be protected from injury for the first several months, and patients are taught how to prevent dislocating the new hip joint. The exercises that patients do at home, after discharge from the hospital or rehabilitation center, are very important to the success of the surgery. In most cases, after a month or two, the patient can walk with a cane, and after three months can walk with no support.