Fortnightly Review: Management of hip osteoarthritis

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Abstract
#### Summary points Osteoarthritis of the hip is a common disorder of white (but not black) people with a roughly equal incidence in both sexes. Although more common in elderly people, it may start at any age from the second or third decade. Most cases are idiopathic, even among younger people, though a minority are secondary to a congenital or childhood hip disorder (acetabular dysplasia, congenital dislocation, slipped epiphysis, or Perthe's disease) or to an inflammatory arthropathy.1 Other risk factors for osteoarthritis may include inequalities in leg length and certain occupations or patterns of use of the hip: for example, there is a strong association between farming and hip osteoarthritis in European men.2 The condition has a chronic, variable course and often causes considerable pain and disability. Good management depends on the doctor's ability to diagnose the condition early, appreciate factors that may affect the prognosis or complicate the disease, and make effective use of the many treatment methods available. The start of symptomatic hip osteoarthritis is usually insidious, although in a few cases …