Progressive loss of cartilage within the hip joint causing pain, stiffness and reduced function. At least 80 per cent of hip osteoarthritis has a structural cause that can be identified and, in suitable patients, addressed.
(03) 9573 9659
Hip osteoarthritis is the progressive loss of cartilage within the hip joint. It is one of the most common causes of hip pain and disability in adults, and one of the most frequently misunderstood. In the majority of cases, osteoarthritis does not develop simply from wear and tear — it develops because of an underlying structural problem that has been placing abnormal load on the joint for years. Identifying and addressing that problem early, before cartilage damage is irreversible, is the foundation of Mr Balakumar’s approach to hip care.
The hip joint is lined with articular cartilage that allows smooth, low-friction movement. Synovial fluid lubricates the joint surfaces, reducing friction to less than one tenth that of an ice cube sliding on ice. When cartilage wears down, the joint surfaces begin to move against each other with increasing friction, causing pain, inflammation, stiffness and progressive loss of function.
At least 80 per cent of hip osteoarthritis is caused by a developmental abnormality such as hip dysplasia, femoroacetabular impingement, Perthes disease or slipped upper femoral epiphysis. In patients under 60, a secondary structural cause is the rule rather than the exception. This distinction matters because identifying and treating the underlying mechanical problem early — before irreversible cartilage damage has occurred — can prevent osteoarthritis from developing at all.
The most common symptom is pain in the groin, hip or thigh, which may radiate to the knee. Pain is typically worse with activity and improves with rest, though in more advanced stages it may be present at rest or during the night. Stiffness, particularly after sitting for extended periods or first thing in the morning, is also common. Many patients notice a gradual reduction in walking distance or a change in their gait over time.
Diagnosis is based on clinical assessment and imaging. Mr Balakumar takes a thorough history, examines the hip and reviews weight-bearing X-rays. The degree of joint space narrowing, the distribution of cartilage loss and the presence of any underlying structural abnormality all inform the treatment discussion. MRI may be used to assess cartilage health in more detail, particularly in younger patients where joint preservation options are being considered.
Non-surgical options are always considered first and can significantly reduce symptoms, particularly in earlier stages. Options include physiotherapy, activity modification, weight management, anti-inflammatory medication, bracing and injections. Cortisone injection can provide meaningful short-term relief. Platelet-rich plasma (PRP) and viscosupplementation are options for patients who have not responded adequately to standard conservative measures.
It is worth noting that taking pain medication long-term is generally safe for most patients and is not, by itself, a reason to have surgery. The decision to operate should be based on the impact the condition has on the patient’s quality of life, not on a desire to avoid medication.
When non-surgical measures no longer provide adequate relief and the condition is significantly limiting daily life, surgical options are discussed. In younger patients with preserved cartilage and an identifiable structural cause, joint preservation procedures such as hip arthroscopy or periacetabular osteotomy may be appropriate. In patients with advanced cartilage loss, hip replacement is the more appropriate option and is one of the most reliably successful operations available for improving quality of life and function.
Surgery is always a choice. Unless there is a fracture, dislocation or rapidly progressive deformity, the decision is made jointly between the patient and Mr Balakumar based on symptoms, imaging and individual goals. The right time to consider surgery is when symptoms are significantly limiting your life and conservative management has been given a genuine opportunity to work.
(03) 9573 9659
Mr Balakumar is one of a small number of surgeons in Australia with formal training in both paediatric and adult hip surgery. His fellowship at Harvard’s Children’s Hospital in Boston, under some of the world’s leading specialists in hip preservation, gives him a depth of expertise that is difficult to find in a single practice.
His approach is the same whether the patient is 6 months or 65 years old – thorough assessment, honest options, and no pressure toward surgery until the clinical picture clearly supports it.
(03) 9573 9659
A common cause of lateral hip pain, ranging from tendon degeneration through to partial or full-thickness tears. Treatment depends on severity and includes physiotherapy, injection and in some cases surgical repair.
Abnormal movement at the joints of the pelvis causing pain and difficulty with weight-bearing activities. Assessment includes evaluation of the hip, pelvis and lumbar spine together.
Hip and groin injuries in athletes range from labral tears and adductor strains through to stress fractures. Accurate diagnosis is essential as many conditions in this region can mimic each other.
Inflammation at the pubic symphysis causing groin and lower abdominal pain, commonly seen in athletes. Frequently associated with underlying hip pathology that requires assessment alongside the pubic joint.
Melbourne Orthopaedic Group is home to a team of experienced orthopaedic surgeons, providing comprehensive care for sports injuries and orthopaedic conditions. Whether it’s joint replacement or sports injuries, our specialists provide comprehensive orthopaedic care.
