Hip arthritis treatment in St. Louis does not have to start with a replacement. Hip osteoarthritis usually hurts in the groin, not the outer hip. At our office we place PRP, bone marrow concentrate or microfragmented fat into the joint under image guidance, then fix the load and metabolic terrain that wore the cartilage down.
The hip is a ball in a socket, lined with cartilage as smooth as wet ice. Arthritis roughens that ice. Every step grinds a little more, the lining of the joint gets inflamed, and the bone under the cartilage starts taking load it was never built to carry. The pain is real. The usual menu is thin: pills, a cortisone shot, and a date with a surgeon.
The patient stuck in the middle is the 55-year-old who still works on his feet, has had two shots that each wore off sooner, and was told he is too young for a new hip. That patient has more options than he was told.
Location tells most of the story. True hip joint pain lives deep in the groin and the front of the thigh. It shows up putting on socks, getting out of a car, or crossing your legs. Read more on why hip joint pain shows up in the groin.
Many patients have two of these at once. We examine the hip and the back, read the X-ray, and use a diagnostic numbing injection when the source is still unclear.
Cartilage has no blood supply. It lives on the joint fluid that gets squeezed in and out as you move. Three forces decide how fast it wears:
A steroid shot calms the inflamed lining. It does nothing for the cartilage or the bone. A 2024 network analysis of 16 randomized trials (1,735 patients with hip arthritis) found steroid beat a saltwater injection for pain at three months. By six months the difference was gone. Each repeat shot buys a shorter window, and steroid is hard on cartilage and blood sugar. We explain the trade-offs in cortisone shot side effects.
A hip joint injection is still a useful tool. It is a poor long-term plan.
Each one sends a different crew into the joint. We place it under ultrasound or X-ray, because the hip sits deep and an intra-articular injection only works if it lands inside the capsule.
The pattern across the studies is consistent: the earlier the joint, the better the result. Waiting until bone grinds on bone narrows every option.
Hip PRP works when two things are done right, and most clinics skip both. The first is the platelet count actually delivered. PRP is not one product: a weak spin can leave barely more platelets than ordinary blood, and the hip sits so deep that a blind injection often lands outside the joint. We prepare a high platelet dose and place it inside the capsule under image guidance, because the repair workers only count if enough of them reach the job. See how we prepare PRP injections.
The second is the collateral rehab. The platelets calm the joint; the muscles around it decide how much load the cartilage takes every step afterward. Your plan rebuilds the glutes and hip stabilizers, restores the motion the joint lost, and corrects the walking pattern that wore it down, alongside the metabolic work that sets your healing budget. An injection without that rehab is a repair crew sent to a building that is still being knocked down.
A hip replacement is excellent surgery for a joint that is finished. If the X-ray shows bone on bone, the hip has collapsed, or you can no longer walk a block, we tell you so and help you get there. Arthroscopy, the scope that trims a torn labrum or reshapes the hip, works best in young hips with little arthritis. In a joint that is already worn, a scope rarely fixes the pain.
Timing matters most for younger patients. A population study of 63,158 hip replacements found the lifetime risk of needing a second surgery was about 5% for patients over 70. For men in their early 50s it climbed to 35%. If you are too young for a new hip, the goal is to buy years with a joint you already own.
The procedure is done under local anesthetic. You are awake, there is no sedation, and most patients drive themselves home. PRP soreness lasts about 48 hours. Protect the hip for the first few days and follow the rehab plan.
The number of treatments follows clinical need. Some feel better in three weeks; others need a second or third treatment, decided by how the tissue responds. You can’t make a carrot grow faster than it grows.
The injection is not the whole treatment. Lifestyle and behavior are 40 to 50 percent of our protocol: hip and core strengthening, laser therapy, and metabolic optimization built on fasting insulin, glucose and inflammation markers. Fix the terrain and the repair has somewhere to land.
More on this condition from Dr. Padda on YouTube:
Yes, for most hips that still have cartilage left. Orthobiologic injections, strength work and metabolic repair can calm pain and delay replacement. A hip that has collapsed needs surgery.
The hip joint sits deep in front, behind the groin crease. Pain on the outer hip is usually a tendon problem.
Younger patients carry a much higher lifetime risk of a second surgery. That is a strong reason to try joint-preserving treatment first.
Steroid works faster and fades by about six months. PRP works on the inflamed joint over months and has beaten gel shots on pain at a year.
Because the platelet dose and the rehab vary. A low-platelet preparation, an injection that misses the capsule, or no strengthening plan afterward all weaken the result. We control all three: a high platelet dose, image-guided placement inside the joint, and a rehab plan built for your hip.
No. We use local anesthetic, you stay awake, and most patients drive themselves home.
These treatments are not billed to insurance. HSA and FSA funds are generally eligible.
If your hip shots keep wearing off and you were told to wait for a replacement, ask what can be done for the joint you have. Over 90% of our accepted case-study patients see significant improvement. These are practice-reported figures from our own population, not trial outcomes, and individual results vary. Request the orthobiologics guide above, or call our office at 4477 Woodson Rd in St. Louis at (314) 481-5000 to find out whether your hip is a candidate.
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