The best treatments for arthritic hips if you want to avoid a hip replacement

Telegraph

13-05-2025

Arthritic hips are no walk in the park. The first signs of trouble can creep up subtly with morning pain and stiffness. Before you know it, even bending down to put on your socks is a monumental pain. You may even notice a popping sound, a clicking or crunching when moving a troublesome hip. Or gradually realise that you've developed a change in your gait and are limping.
Studies suggest that 10-25 per cent of adults experience hip pain at some point in their lives, with higher rates among older individuals. Estimates suggest that osteoarthritis (OA), one of the most common hip disorders, affects about 10-15 per cent of adults aged over 60 years worldwide. In the UK alone, approximately 1.4 million people are estimated to have hip OA.
Osteoarthritis involves the wear-and-tear degeneration of cartilage, leading to pain and stiffness, whereas rheumatoid arthritis is an autoimmune condition causing joint inflammation and can affect younger people. Around 7 per cent of men and 11 per cent of women will eventually need surgery.
But thankfully, if your symptoms aren't sufficiently controlled by anti-inflammatories, gels and supplements such as turmeric or cod liver oil, there are many treatments that can alleviate pain without resorting to a full-blown hip replacement.
Non-invasive treatments
Red light, laser therapy or a combination of both
£150-£500
Also known as photo-biomodulation, this uses specific wavelengths of light to stimulate the body's natural healing processes, potentially reducing pain and inflammation, and promoting tissue regeneration. Red light therapy uses a broad range of light to cover larger areas, while laser therapy focusses a narrow beam of light with a single wavelength for more targeted treatment.
Kineon is one such company selling devices, their Move+ Pro's red light and laser therapy. Kineon report positive outcomes with 60-80 per cent of patients experiencing less pain and improved function. Risks are minimal, including mild skin irritation, redness, or temporary discomfort at the treatment site.
Worth trying?
Rarely available on the NHS, devices cost between £150-£500. Having tried the Kineon MOVE+ Pro it was effective in expediting recovery time following sporting activity.
Shockwave therapy
£100-£250
Shockwave therapy ses sound waves administered with a type of gun to stimulate healing in damaged tissues. As the name implies, it's uncomfortable but not excruciating and can reduce inflammation and pain in joints affected by arthritis, particularly osteoarthritis. The therapy has demonstrated success rates ranging from 60-87 per cent for hip pain conditions.
Worth trying?
GPs can refer you for this on the NHS when chronic symptoms persist for at least three to six months. Privately, shockwave therapy sessions for arthritis can cost between £100 to £250.
Injectable treatments
Corticosteroid (steroids)
£120-£200
Anti-inflammatory medicine is injected directly into the hip joint to reduce pain and inflammation. Studies indicate approximately 50 per cent of patients experience immediate pain relief lasting up to two weeks, while relief extends beyond two weeks for 30 per cent.
However, about 20 per cent may not respond at all while after three months any beneficial effect is likely to decline. The least expensive injectable, privately costing £120-£200 per injection, its side effects include potential bruising and facial flushes, but are generally minimal. Injections are widely available but expect waiting times of four months and upwards if opting for the NHS route.
Dale Naylor of DJN Physios states: 'I see the efficacy of steroids when combined with rehab to alleviate pressure across the hips, by suppressing inflammation and relieving pain.' Steroids represent a good option for patients with moderate to severe osteoarthritis, bursitis or labral tears. If the hip joint is infected, steroids are considered dangerous and not advised (also to be avoided in prosthetic joints due to infection risk); steroids can also spike blood glucose levels significantly, so can be problematic for diabetics.
Worth trying?
It has minimal side effects and cheap when obtained privately, steroids can relieve pain for up to several months. Injections should be spread out every few months and used no more than three to four times per year, according to the Mayo Clinic.
Hyaluronic acid
£250-£500
A gel-like substance also used on skin, hyaluronic acid acts as a shock absorber when injected into the hip joint providing lubrication and cushioning, aiming to reduce pain and improve mobility. Only available privately, costing between £250-£500 per hip and quickly administered, 60-70 per cent of patients experience improvement that may last several months. ​
Mr Rama Mohan, a UK-based hip and knee surgeon says: 'Hyaluronic acid is a naturally occurring gel-like substance that lubricates your hip joint. As the joint wears away, the arthritic hip joints lose this lubricant. You can think of the injection like WD-40 for your joints.'
Generally, patients receive a series of injections (usually two to five) over a few weeks. Severe reactions are rare, though temporary pain or swelling may occur. In the UK the NHS doesn't offer this treatment, mainly because of cost-effectiveness considerations and limited evidence of long-term benefits.
Worth trying?
More commonly used in knees but more beneficial than steroid injections alone with the added benefit of a cushioning effect on the affected hip. Affordable and helpful for those wishing to get back to sporting activities.
Prolozone therapy
£200 to £500
This is a regenerative therapy which involves injecting a concentrated form of oxygen into joints to stimulate the body's healing process. It is often used to treat hip labral tears and other hip conditions.
Pain levels for treatment are minimal and – having recently had the treatment carried out on my own hips at the ProHealth Clinic, one of the UK's leading Prolotherapy & Prolozone Therapy clinics – I can attest to a reduction in pain and soreness in less than a week. 'One of the benefits is it's such a thin substance so spreads easily to surrounding areas,' says Mr Eaton.
Costs per session vary depending on the clinic and specific treatment protocol, typically ranging from £200 to £500. After a couple of sets of injections over the course of a month, for arthritis Mr Eaton recommends waiting 12 months for a single top-up, while for anything soft tissue-related the treatment should last longer as the patient's blood supply takes over.
Worth trying?
Prolozone achieves results in a faster timeframe than many options. It's not available on the NHS.
Platelet-rich plasma (PRP) therapy
£250-£600
This treatment uses the patient's own blood (platelets) to reduce inflammation and promote tissue regeneration. As well as managing pain, it can make moving easier. It's best suited to those with early or moderate hip osteoarthritis in otherwise good health, who are looking to delay surgery.
Dr David Porter, a sports medicine physician, says: 'PRP is administered with the aim of reducing pain, restoring the function of the hips, and preventing further cartilage damage.' Recent studies show over 70 per cent of patients experience positive outcomes, particularly in the short to medium term (up to 12 months), though two to three injections of PRP may maximise benefits for patients. PRP involves a viscous substance which might not spread as well as newer treatments like Prolozone therapy. A 2021 analysis found PRP was more effective than hyaluronic acid, especially in early to moderate stages. Available at certain NHS Trusts with a wait time or privately cost between £250-£600 in the UK.
Worth trying?
Beneficial for promoting healing and reducing pain if other methods haven't worked for those under 70, and available on the NHS. While private treatment is affordable, often multiple injections are required. PRP is generally not recommended for older patients with advanced joint degeneration, those with severe cartilage loss, active infection, cancer or severe diabetes.
Stem cell therapy
£4,000-£7,000
Stem cells are extracted from bone marrow or fat tissue then processed in a laboratory and injected into the afflicted joint. While regarded as something of an alternative therapy in the UK and not covered by the NHS, the practice is gaining in popularity. Jorja Healthcare, a UK-based regenerative medicine clinic, states: 'Between 65 per cent and 75 per cent of all patients treated have had a positive outcome with improvements in both pain scores as well as functional scores.' Beyond the budgets of many, and not covered widely by insurance, costs range from £4,000 to £7,000 per hip treated although cheaper clinics can be found abroad in India, and Mexico.
Worth trying?
Involves significant cost beyond the means of many, from £4,000-£7,000. While anecdotal evidence is promising, controlled trials are needed and patients should conduct extensive research on the clinic's results.
Five alternatives to full hip replacement surgery
Beyond injectable solutions, more radical forms of minimally invasive surgeries could present the next logical step in improving symptoms and hip mobility while avoiding a total replacement.
Hip resurfacing
£8,000-£15,000
This is a surgical procedure that involves removing the damaged surface of the femoral head (the ball part of the hip joint) and capping it with a metal prosthesis instead of replacing the entire hip joint. Resurfacing preserves more of the natural bone and full recovery can be achieved in just three months. This is available privately or offered on the NHS for suitable candidates, particularly younger, active patients or privately between £8,000 to £15,000. Success rates are roughly 90-95 per cent up to five years and still 85-90 per cent after a decade.
Worth trying?
It's generally available on the NHS but often with a lengthy waiting time. Success rates are excellent.
Arthroscopy
£5,000-£10,000
A form of 'keyhole' surgery that allows surgeons to address problems within a joint. Studies report largely positive outcomes and success rates while, but costs are significant, between £5,000 to £10,000. Risks are minor but include infection, nerve injury or even reoperation.
Mr Giles Stafford, a consultant orthopaedic hip surgeon in London, says: 'One year after surgery, approximately 80 per cent of patients are satisfied that the procedure has improved their symptoms. Unfortunately, 15 per cent may feel no change in their condition and 5 per cent feel that their symptoms have in fact become worse.' Patients need to take care with physio and rehabilitation afterwards.
Worth trying?
It's good for certain conditions and available privately or on the NHS (expect a lengthy waiting time), risks are minor while success rates are strong. However, patients over 40 years old or those with significant OA may experience less favourable results.
Autologous chondrocyte implantation (ACI)
£10,000-£20,000
This uses healthy cartilage from the patient's own body by harvesting cartilage cells, culturing them, and implanting them back into the damaged area to promote new cartilage growth. ACI has reported success rates of around 70-80 per cent at five years, with many patients experiencing significant pain relief and improved joint function, while after a decade studies suggest that about 50-60 per cent of patients maintain good results.
The British Editorial Society of Bone & Joint Surgery suggests ACI could be a viable option for the treatment of cartilage defects in the hip. ACI is available on the NHS for treating knee cartilage defects, but is not typically used for hip joints, while private costs range from £10,000 to £20,000, depending on procedure specifics. The ideal candidate should be less than 50 years old and not suffering from advanced osteoarthritis.
Worth trying?
Particularly effective in younger individuals with early-stage cartilage defects but costs can be prohibitive for most. Generally safe, risks include infection, graft failure, and complications related to the surgery.
Osteochondral grafting
£8,000-£16,000
Autograft transplantation involves harvesting healthy cartilage and bone from a non-weight-bearing area of the patient's own joint and transplanting it to the damaged area of the hip. Typically, it's considered particularly for younger patients where conservative treatment options haven't worked.
Alternatively, allograft transplantation uses donated cartilage tissue to reconstruct large joint cartilage lesions in the hip joint. Both can improve joint function and reduce pain, while delaying or even preventing the need for a hip replacement and can be performed on arthritic hips, particularly when there aren't widespread degenerative changes. Limitations exist with the amount of available tissue when taken from your own body, making this approach more suitable for smaller defects.
Dr Benjamin Domb, an orthopaedic surgeon specialising in hip preservation believes, 'appropriate patient selection is crucial. Factors such as defect size, patient age, activity level, and the presence of osteoarthritis significantly influence the procedure's effectiveness'.
Availability on the NHS is based on an evaluation of the patient's age, activity level, size and location of the cartilage defect, and overall joint health. Privately, autograft and allograft costs in the region of £8,000 to £16,000. Success rates of approximately 70-90 per cent at five years, diminishing at 10 years.
Worth trying?
Particularly effective in younger individuals with early-stage cartilage defects but costs can be prohibitive if unavailable on the NHS. Ideal for patients with hip fractures and no arthritis in the socket.
Partial hip replacement
£8,000-£13,000
This surgical option replaces the ball of the hip joint (the top of the thigh bones) while leaving the socket intact. Most commonly used for patients who have a hip fracture, limited mobility or aren't good candidates for full hip replacement, the damaged femoral head is removed and replaced with a prosthetic implant. A partial hip replacement is often used in patients with osteoporosis who have fractured a hip.
While short to mid-term outcomes are good (implant survival rates are 85 per cent at five years, long-term success is variable and may not last as long as total hip replacements in more active patients. Treatment is available on the NHS especially for elderly patients or emergency treatment following hip fractures, while private costs range from £8,000-£13,000.
Worth trying?
Ideal for patients with hip fractures and no arthritis in the socket; minor risks include infection, blood clots, implant loosening, or leg length difference. The hospital stay is usually two to five days depending on recovery and patient health.