Knee and Hip Problems
The knee and the hip are the two large joints that carry body weight. Symptoms in these joints arise from sources ranging from a sudden injury to wear developing over years. Correct treatment rests first on distinguishing whether the problem is mechanical or due to wear.
Conditions Covered Under This Heading
Knee
- Meniscus tear — catching, locking, pain on squatting
- Anterior cruciate ligament injury — giving way, sports injury
- Knee osteoarthritis — difficulty with stairs, morning stiffness
- Articular cartilage injuries
Hip
- Hip osteoarthritis — groin pain, difficulty putting on socks
- Developmental dysplasia of the hip and its consequences
- Femoroacetabular impingement and labral tears — see Hip Arthroscopy
Finding the Source of the Symptoms
Two points are often missed in knee and hip symptoms:
- Pain arising from the hip can be felt in the knee. In persistent knee pain with a normal knee examination, the hip must always be assessed.
- Pain arising from the back can radiate to the hip and leg. In groin pain, lumbar disc herniation, inguinal hernia and tendon problems are part of the differential diagnosis.
The examination is therefore not limited to a single joint; the back, hip and knee are assessed together.
Assessment
- History: mechanism of injury, locking and giving way, walking distance, night pain, swelling.
- Examination: range of movement, joint fluid, ligament stability, alignment, muscle strength and gait.
- Weight-bearing X-ray: more informative than a film taken lying down, because it shows the joint space under load.
- MRI: requested for meniscal, ligament, cartilage and labral problems; not routine in monitoring osteoarthritis.
Steps in Treatment
In both joints treatment generally proceeds in steps, and the great majority of it is non-surgical.
- Muscle strength: strengthening the quadriceps and the muscles around the hip directly affects joint load
- Weight control: among the steps with the best demonstrated effect on pain and function
- Activity modification; low-impact options such as cycling and swimming
- Pain management and, where needed, intra-articular injection treatments
- Where needed, knee or hip arthroscopy
- In advanced stages, joint replacement surgery
An important limit: arthroscopy is not a treatment for advanced osteoarthritis. Where there is no mechanical problem causing locking, it does not provide the expected benefit in widespread wear.
When Should You Seek Assessment?
- If your knee locks or gives way
- If you have had groin pain for a long time
- If putting on socks or tying shoelaces has become difficult
- If your walking distance has shortened or you have started to limp
- If pain interrupts your sleep at night
When to Seek Medical Help Without Delay
- Inability to bear weight on the leg after an injury, or obvious deformity
- After a fall, the leg appearing short and rotated outwards (suspected hip fracture)
- Redness, warmth and severe pain in the joint together with fever
- One-sided pain, swelling and tenderness in the calf
These findings require urgent assessment. Outside office hours, go to the nearest emergency department.
Frequently Asked Questions
My knee hurts but my X-ray is normal — why?
An X-ray shows bone; soft tissues such as the meniscus, ligaments and cartilage do not appear on it. An MRI may be needed depending on examination findings. In addition, because hip pain can be felt in the knee, the hip is also assessed.
Does walking wear out my joints?
No; regular walking within the limits of pain is recommended. Inactivity leads to muscle loss and joint stiffness, which increases symptoms. What is demanding is prolonged squatting, kneeling and impact activities.
Should I wait until I am older for a replacement?
The decision rests not on age but on how much pain restricts daily life, night pain, walking distance and the response to non-surgical treatment. Waiting too long can make recovery harder because of muscle loss and restricted movement.
Do intra-articular injections regenerate cartilage?
No. They may reduce symptoms in selected patients; however, they do not regenerate cartilage tissue and their effect varies from person to person.
Does arthroscopy treat osteoarthritis?
It does not. Arthroscopy is considered where there is a mechanical problem causing locking. It does not provide the expected benefit in advanced osteoarthritis.
I have groin pain — is it the hip or the back?
The differential diagnosis of groin pain is wide: hip osteoarthritis, femoroacetabular impingement, lumbar disc herniation, inguinal hernia and tendon problems can all give similar symptoms. The distinction is made with examination and appropriate imaging.
Academic Work
Assoc. Prof. Bertan Cengiz, MD has scientific work published in national and international peer-reviewed journals in the field of knee and hip surgery, arthroplasty and related areas. The publication list and verifiable academic sources are available on the Publications page.
Related Pages
- Knee Osteoarthritis (Gonarthrosis)
- Hip Osteoarthritis (Coxarthrosis)
- Meniscus Tear
- Knee Arthroscopy
- Joint Replacement Surgery (Knee, Hip and Shoulder Arthroplasty)
The information on this page is for general guidance and does not replace an in-person medical examination. Diagnosis and treatment require a physician’s clinical assessment. Outcomes of any treatment or surgical intervention may vary from person to person; no guarantee of a specific result or timeframe is given on this page.