Hip osteoarthritis

Osteoarthritis is a degenerative type of arthritis that occurs most often in people 50 years of age and older, though it may occur in younger people, too.

The cartilage in the hip joint gradually wears away over time. As the cartilage wears away, it becomes frayed and rough, and the protective joint space between the bones decreases.To make up for the lost cartilage, the damaged bones may start to grow outward and form bone spurs (osteophytes). Osteoarthritis develops slowly and the pain it causes may or may not worsen over time.

Who to refer, who not to refer, how to refer

Who to Refer

Those who have failed primary care management.

Urgent Referral Criteria

Avascular necrosis or bone death
Suspected infection or tumour
Severe pain despite opiates

Who Not to Refer

Those who have not tried Primary care management.

Additional Info

Unlikely to do THR unless has severe bone on bone OA
Unlikely to operate on BMI >40
Corticosteroid injection of hip mainly used as a diagnostic tool not treatment

How to refer

We accept referrals through SCI gateway for those who are based in Scotland.

We also accept e referrals through the below email address using the attached form for those who are based just on the other side of the border.

E- Referral Email address - bor.orthoreferrals@borders.scot.nhs.uk

Referral form - E-Referral to Orthopaedics (Non Sci-Gateway)

Primary care management

Education – LINK - PATIENT INFORMATION LEAFLET TO BE UPLOADED ONTO WEBSITE
Regular maximum multimodal analgesia
Walking aid
Physio rehab- strengthening over extended period
BMI >35 engage in wellbeing support

Imaging

Pelvic X-ray (Ideally < 1yr old)

Resources and links

Primary care Hip Pathway – developed by First Contact Practitioners - see link here

Local service details

orthopaedics@borders.scot.nhs.uk

bor.orthoreferrals@borders.scot.nhs.uk

Last reviewed: 31/07/2025

Next review date: 31/07/2027

Author(s): Mr Roshan Raghavan.

Author email(s): Roshan.Raghavan@nhs.scot.