Hip problems

Hip problems are common, especially among older adults, but hip-related issues also occur in middle-aged people and young athletes. Hip osteoarthritis is one of the most common reasons for joint replacement surgery in Finland, and a hip fracture is one of the most serious accidents among older adults. More than 10,000 hip replacement surgeries are performed annually in Finland.

The most common symptom is pain in the groin area or on the outer side of the thigh, which worsens when walking and on stairs. In osteoarthritis, the pain is often stiff in the morning and eases somewhat with movement, but worsens after exertion. In FAI, or hip impingement, the pain is felt in the front of the hip and worsens with flexion-rotation movements. In a hip fracture, the pain is sudden and movement is impossible.

In hip osteoarthritis, the cartilage surface wears down gradually, and contributing factors include age, excess weight, hereditary factors and previous injuries. FAI is caused by an abnormality in the bone anatomy of the hip, which leads to impingement in the joint during repeated movements. A hip fracture is almost always the result of a fall, and osteoporosis is the most important risk factor. Lack of exercise, excess weight and chronic diseases increase the risk of hip problems.

Diagnosis is based on a doctor’s clinical examination, which assesses hip mobility and the location of the pain. X-ray is the first-line imaging examination for detecting osteoarthritis and fractures. MRI is needed to assess soft tissues and early-stage changes. An orthopedist evaluates the need for surgical treatment.

Conservative treatment includes physiotherapy, muscle training, weight management and pain medication. Physiotherapy before joint replacement surgery improves recovery outcomes. Joint replacement surgery is a highly effective treatment for advanced osteoarthritis: it removes pain and restores mobility. A hip fracture usually requires surgical treatment as soon as it is safely possible.

After joint replacement surgery, rehabilitation begins as early as the next day. Most patients recover well and are able to return to normal life. It is advisable to seek professional assessment when hip pain limits walking or other movement, or when pain that disturbs sleep begins. Fall prevention and muscle-strengthening exercise are key in preventing hip problems in older adults.