What is hip osteoarthritis (coxarthrosis)?

Hip osteoarthritis (coxarthrosis) is a degenerative-dystrophic disease in which the cartilage tissue covering the joint surfaces of the femoral head and acetabulum is destroyed.

This is the second most common osteoarthritis disease after knee osteoarthritis (gonarthrosis). According to the German Society for Orthopedics and Trauma (DGOU), hip osteoarthritis is diagnosed in 5% of the population over 60 years old. Over 230,000 hip replacement surgeries are performed annually in Germany.

Stages of hip osteoarthritis:

  • Grade 1 — slight narrowing of the joint space, initial osteophytes. Pain after exertion
  • Grade 2 — moderate narrowing of the joint space, pronounced osteophytes, subchondral sclerosis. Pain while walking
  • Grade 3 — sharp narrowing of the joint space, cysts, deformation. Pain at rest, limited range of motion
  • Grade 4 — complete disappearance of the joint space, pronounced deformation

Risk factors:

Facts about hip osteoarthritis

  • ICD-10: M16
  • Prevalence: 5% of population over 60 years
  • Joint replacement: 230,000+ surgeries/year in Germany
  • Prosthesis lifespan: 15-20 years
  • Revision: up to 10% of patients require repeat replacement

Symptoms of hip osteoarthritis

Early signs

  • Pain in the groin after physical exertion
  • Morning stiffness (15-30 minutes)
  • Discomfort with prolonged sitting
  • Joint crepitus during movement

Progression

  • Pain while walking radiating to the knee
  • Limp
  • Limited hip rotation and abduction
  • Limb shortening
  • Atrophy of thigh and gluteal muscles

Late Stages

  • Pain at rest and at night
  • Inability to walk more than 500 m
  • Need for support while walking
  • Significant limitation of mobility
  • Decreased quality of life

Joint Replacement vs regenerative treatment

Criterion Joint Replacement Hyaluronic Acid Regenerative treatment
Principle Replacement of the joint with an artificial one Joint lubrication Regeneration of cartilage with own cells
Anesthesia General / spinal None No general anesthesia (local anesthesia)
Hospitalization 7-14 days None None — home the same day
Rehabilitation 3-6 months None Several days
Joint Preservation ❌ Joint is completely removed ✅ Joint preserved ✅ Joint preserved and regenerated
Duration of Effect 15-20 years (then revision) 6-12 months 10-20+ years (regeneration)
Two Joints at Once ❌ Only one joint Possible ✅ Yes — both joints + spine

How regenerative treatment treats Hip Osteoarthritis (Coxarthrosis)

01

3D Diagnostics

MRI/CT of the hip joint is analyzed by the Navigation system system. The condition of the cartilage, subchondral bone, and joint capsule is assessed. A precise access plan is created.

02

Biomaterial Preparation

CGF — concentrate of growth factors — is obtained from blood. MFAT with mesenchymal stem cells capable of differentiating into chondrocytes (cartilage cells) is obtained from subcutaneous adipose tissue.

03

Intra-articular Injection

Under navigational control of, concentrates are injected directly into the joint — into areas of maximum cartilage damage, subchondral cysts, and joint capsule.

04

Chondrogenesis

Stem cells differentiate into chondrocytes and begin producing new cartilage. Growth factors stimulate angiogenesis and reduce inflammation. After 3-6 months — visible restoration of cartilage coverage on follow-up MRI.

Why regenerative treatment is effective for Hip Osteoarthritis (Coxarthrosis)

Until recently, it was believed that cartilage is incapable of regeneration. Traditional medicine offered only two options: painkillers (symptom masking) or joint replacement. Regenerative treatment has proven that a third option exists — biological regeneration of cartilage tissue with own stem cells.

Mechanism of Cartilage Regeneration:

  1. Chondrogenesis — mesenchymal stem cells (MFAT) differentiate into chondrocytes — cells that synthesize cartilage matrix (type II collagen, proteoglycans, hyaluronic acid)
  2. Anti-inflammatory Effect — CGF and MFAT suppress chronic joint inflammation (reduce levels of IL-1β, TNF-α), which accelerates cartilage destruction
  3. Restoration of subchondral bone — growth factors improve blood supply to subchondral bone, reduce edema and cysts
  4. Improvement of synovial fluid — stem cells normalize joint lubrication production, improving its tribological properties
  5. Strengthening of capsule and ligaments — growth factors strengthen the joint capsule and ligamentum teres of the femoral head

Key difference from hyaluronic acid: hyaluronic acid injections are "lubrication" lasting 6-12 months. Regenerative treatment initiates true cartilage regeneration, confirmed by follow-up MRI and continuing for years.

Regenerative treatment for Hip Osteoarthritis (Coxarthrosis)

  • Joint preservation — not replacement
  • Both joints at once — + knees + spine
  • Ultrasound guidance — ultrasound navigation for joints
  • Without general anesthesia — local anesthesia
  • No rehabilitation — walking the same day
  • Does not interfere with joint replacement — if needed in the future

Regenerative method Advantages

A broad range of indications

Regenerative methods are used for many orthopaedic and spinal conditions. Some cases still call for surgery.

No anesthesia or incisions

Outpatient treatment via 0.3-1.5 mm puncture. No general anesthesia or hospitalization.

No age restrictions

Regeneration at any age. Safe for chronic conditions and anesthesia intolerance.

Rapid improvement

Concentrates have analgesic and anti-inflammatory properties. Relief within days.

Multiple zones at once

Simultaneous treatment of multiple discs or joints in one procedure.

Home the same day

No crutches, braces or rehabilitation needed. MRI follow-up at 8-16 weeks.

Regenerative treatment Technology

Navigation system for minimally invasive access

Navigation system

Intraoperative robotic navigation system. Provides precise access to deep structures with 1 mm and 1 degree accuracy.

Ultrasound guidance during the procedure

Ultrasound guidance

Device for intervention under sonographic control. Eliminates open surgeries with real-time visual monitoring.

More about technologies →

Frequently Asked Questions about Hip Osteoarthritis (Coxarthrosis) Treatment

At what stage of hip osteoarthritis does regenerative treatment help?
Regenerative treatment is most effective at stages 1-3 of hip osteoarthritis. At stage 3 with significant cartilage destruction, it is possible to initiate regeneration and significantly reduce pain. At stage 4 with complete joint destruction, effectiveness is lower, but symptom relief is achievable. A clinic specialist will evaluate your images and determine treatment options.
Is it possible to treat both hip joints simultaneously?
Yes, this is one of the key advantages of regenerative treatment. In one procedure, both hip joints can be treated, as well as knee joints and the spine. With joint replacement, this is impossible — each joint is operated separately with a minimum interval of 3 months.
What if regenerative treatment does not help — can a prosthesis be placed later?
Yes, regenerative treatment absolutely does not interfere with subsequent joint replacement. Moreover, regenerative therapy improves the condition of surrounding tissues (muscles, ligaments, capsule), increasing the success of possible future surgery. regenerative treatment is a chance to preserve your own joint and delay or completely avoid prosthetics.
How does regenerative treatment differ from PRP therapy for joints?
PRP (platelet-rich plasma) contains only growth factors from blood. Regenerative treatment is a multicomponent therapy: CGF (5-10 times more growth factors than PRP) + MFAT (mesenchymal stem cells from adipose tissue capable of differentiating into chondrocytes). Additionally, delivery under navigation ensures precise targeting of concentrates to areas of maximum damage.
How quickly does improvement occur?
Anti-inflammatory effect appears in the first days — reduction of pain, morning stiffness, increased range of motion. Cartilage regeneration is a longer process: noticeable improvement in 4-8 weeks, continuing for 3-6 months. Follow-up MRI at 3-4 months shows the degree of cartilage restoration.
How soon after the procedure can you walk?
Immediately after the procedure. Patients leave the clinic independently on the same day. Crutches and walkers are not needed. It is recommended to limit intense physical activity for 2-3 days. Full physical activity — after 1-2 weeks. This fundamentally differs from joint replacement, where rehabilitation takes 3-6 months.

Other Hip Joint Conditions

Avascular Necrosis → Labral Tear → Hip Impingement → Hip Bursitis → Perthes Disease →

Useful Articles

Coxarthrosis Grade 3: Can It Be Managed Without Joint Replacement? Coxarthrosis Grade 3: Can It Be Managed Without Joint Replacement? Stem cells in joint treatment Stem cells in joint treatment

Other conditions: Hip Joint

Avascular NecrosisLabral TearHip ImpingementHip BursitisPerthes Disease

Also treated with regenerative methods

Herniated DiscSpinal StenosisOsteochondrosisSpondylolisthesis
All treatment areas: SpineKnee JointShoulder JointHand & WristFoot & Ankle
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