Initial treatment consists of tablets in the form of painkillers or anti-inflammatories. Some formulations are available over-the-counter whilst others require a prescription. Provision of a walking stick may be helpful and, as appropriate, weight reduction may be advised. Hip injection can afford temporary relief and may be useful when the diagnosis is in doubt.

Failure of a medical approach to adequately control symptoms brings surgery into consideration and two main options are available: the long-established technique of total hip replacement and the more recent development of hip resurfacing. In general terms total hip replacement is a reliable procedure for the relief of intractable pain in elderly, inactive patients whilst hip resurfacing is intended for younger, more active patients who are seeking a high level of function as well as pain relief.

Hip replacement implants (on the left) and those used for hip resurfacing.

The two operations are complementary in the sense that hip resurfacing may be preferable in some patients whereas total hip replacement (illustrated below) may be a better option for others.

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Obviously no individual can ever be guaranteed a perfect result ahead of operation. Although 95% of patients are pleased with the outcome of operation, major surgery can never be risk-free and around 5% of patients will experience an adverse event. Complications are often relatively trivial but not always so. The problems that most often arise relate to thrombosis (blood clots), dislocation and infection. Co-morbidity (other chronic illness) increases the risk of operation.