Hip Arthritis & AVN

What is hip arthritis?

Hip arthritis occurs when the smooth covering of the hip joint becomes worn or damaged. As the joint changes, the hip can become painful and stiff, making walking and everyday activities increasingly difficult.

What is AVN?

AVN, or avascular necrosis, is a condition in which part of the bone at the top of the thigh loses its normal blood supply. If the condition progresses, the weakened bone can collapse and eventually lead to arthritis of the hip.

When AVN is diagnosed early, there may be options to try to preserve the hip, but these treatments are not successful in every patient. The outcome depends on how much of the bone is affected and whether the bone has started to collapse. This is why early assessment is important.

What are the symptoms of hip arthritis & AVN?

You may experience:

• Pain in the groin, hip, thigh or buttock

• Pain while walking

• Stiffness

• Difficulty putting on shoes or socks

• Difficulty getting in and out of a chair or car

• Difficulty climbing stairs

• Reduced walking distance

• Increasing difficulty with everyday activities

How are hip arthritis and AVN diagnosed?

Diagnosis begins with understanding your symptoms and examining the hip. X-rays are usually the first imaging test.

If AVN is suspected, an MRI may be recommended because it can detect the condition at an earlier stage, sometimes before changes are visible on an X-ray.

The stage of AVN is particularly important because treatment options can be different before and after the bone has collapsed.

Does everyone with hip arthritis need a hip replacement?

No. A diagnosis of hip arthritis does not automatically mean that you need a hip replacement.

When symptoms are mild or manageable, treatment may include exercise, activity modification, medication when appropriate and other non-surgical measures.

Hip replacement is considered when pain and stiffness become significant enough to affect your walking, sleep, work or everyday activities and other treatments are no longer providing enough relief.

Does everyone with AVN need a hip replacement?

No. The treatment of AVN depends greatly on how early the condition is diagnosed and whether the bone has collapsed.

When AVN is detected early, before the bone has collapsed, joint-preserving treatments may be possible in selected patients. Once the bone has collapsed and the hip has become painful and damaged, hip replacement may provide the most reliable way of relieving pain and restoring function.

Can AVN be treated without a hip replacement?

Sometimes. The possibility of preserving your own hip depends largely on how early AVN is diagnosed. When the bone is still structurally intact, selected patients may benefit from treatments designed to protect or improve the condition of the affected bone.

Once the bone has collapsed and the hip has developed significant damage, hip replacement may provide the most predictable relief of pain and restoration of function.

What happens if I don't have surgery?

For hip arthritis

Many people with hip arthritis can manage their symptoms without surgery for a considerable period of time. However, if pain and stiffness progressively interfere with walking, sleep or everyday activities, continuing without surgery may mean living with increasing limitations.

The decision to have a hip replacement should be based on how much the problem is affecting your life rather than simply on the appearance of the X-ray.

For AVN

The answer depends on the stage of the disease. Some early cases can be monitored or treated with the aim of preserving the hip. However, if AVN progresses and the bone collapses, the hip can become increasingly painful and develop arthritis. At that stage, delaying definitive treatment may allow further damage to occur.

When is hip replacement considered?

Hip replacement may be considered when:

• Pain is persistent or significantly affecting your daily life

• Walking has become difficult

• Hip stiffness is limiting normal activities

• Pain is affecting sleep

• Non-surgical treatment is no longer providing enough relief

• The examination and X-rays show changes that match your symptoms

There is no single age or X-ray finding that means everyone needs a hip replacement. The decision should take into account your symptoms, activity level, general health, expectations and the condition of the hip.

Will I be able to walk normally after hip replacement?

Yes. Most patients are able to walk independently and return to their usual daily activities after recovering from hip replacement. The main goals of surgery are to relieve pain, improve movement and restore the ability to walk and function comfortably.

Walking usually begins soon after surgery, initially with support if needed. As pain and swelling settle and strength improves, most patients progressively become more independent. Over the following weeks and months, walking distance, confidence and stamina continue to improve.

Many patients are able to return to activities that had become difficult because of hip arthritis, such as walking longer distances, climbing stairs and travelling. A successful hip replacement can make a substantial difference to mobility and quality of life.

When can I return to normal activities?

Recovery after hip replacement is gradual. Many patients can manage basic daily activities within the first few weeks, while strength, movement and stamina continue to improve over the following months.

Most patients can expect a substantial recovery within around 6–12 weeks, although further improvement can continue for several months. The exact timeline depends on your general health, muscle strength, mobility and progress with rehabilitation.

When can I return to work?

The timing depends on the type of work you do and how quickly you recover.

People with desk-based jobs may be able to return in around 4–6 weeks, while jobs involving prolonged standing, walking, climbing or physical work may require around 8–12 weeks or longer.

Your ability to travel to work, sit comfortably and perform the physical requirements of your job should be considered when planning your return.

When can I return to sports?

Most patients can gradually return to low-impact activities such as walking, cycling and swimming after recovery. Activities that involve running, jumping or repeated high-impact loading of the hip may not be suitable.

The timing depends on your recovery, strength, balance and the type of sport. Your surgeon can help you decide when and how to return safely to the activities you enjoy.

Can I return to an active lifestyle after hip replacement?

Yes. Hip replacement is designed to help people return to a more active and comfortable life. Most patients can walk, travel, cycle, swim and participate in many recreational activities after recovery.

The aim is not simply to replace the damaged joint, but to help you get back to the activities that are important to you. The choice of activities should take into account the type of activity, your overall health and the condition of the replacement hip.

When should I see an orthopaedic surgeon?

You should consider seeing an orthopaedic surgeon if hip pain or stiffness is beginning to interfere with walking, sleep, work, exercise or everyday activities.

You do not need to wait until the pain becomes severe. An early assessment can help identify the cause of the pain and discuss ways of managing it.

If you have been diagnosed with AVN, specialist assessment is particularly important because treatment options depend on how early the condition is detected and whether the bone has collapsed.