Hip osteoarthritis (OA) is a progressive, degenerative joint disease that predominantly affects the elderly but can also impact younger individuals, especially those with a history of joint injury, obesity, or genetic predisposition. This condition, characterized by the gradual deterioration of cartilage within the hip joint, results in pain, stiffness, and diminished function, often leading to significant disability. As one of the most prevalent forms of arthritis, hip osteoarthritis is a critical public health issue, and early diagnosis and intervention are key to managing symptoms and maintaining mobility. Despite its importance, public awareness and understanding of hip osteoarthritis remain limited, particularly in rural and semi-urban areas [1-4].

Globally, the incidence of hip osteoarthritis is on the rise, driven by factors such as aging populations, obesity, and increasingly sedentary lifestyles. In India, where access to healthcare and health education is often limited, particularly in rural regions like District Kangra in Himachal Pradesh, the condition may be underrecognized and inadequately managed. District Kangra, known for its population engaged in agriculture and physically demanding occupations, presents a unique setting for examining public knowledge and awareness of hip osteoarthritis. The physically strenuous nature of work in this area, coupled with limited access to specialized healthcare, may contribute to both the onset and worsening of hip osteoarthritis. However, a lack of awareness and delayed intervention often results in greater disability [5-9]. Public awareness of hip osteoarthritis in District Kangra is crucial for developing effective health strategies. Proper management of the condition, beginning with early identification, can prevent severe disability, lower healthcare costs, and improve quality of life. Unfortunately, misconceptions and limited knowledge about hip osteoarthritis hinder timely diagnosis and treatment, particularly in rural settings. This study aims to address this gap by assessing the awareness and knowledge of hip osteoarthritis among adults in District Kangra, Himachal Pradesh.

The primary objective of this study is to evaluate the public's awareness and knowledge of hip osteoarthritis, focusing on symptoms, risk factors, preventive measures, and treatment options. This cross-sectional survey seeks to identify gaps in understanding and provide insights that will inform targeted public health strategies. By promoting early diagnosis, preventive care, and effective management of hip osteoarthritis, the findings from this study aim to enhance the health and functional independence of individuals in District Kangra and similar rural regions.

Objectives of the Study

The primary objective is to gauge awareness and knowledge about Hip Osteoarthritis among general public of District Kangra, Himachal Pradesh. 

Research Approach

Descriptive

Research Design

Cross-sectional survey design

Study Area

District Kangra, Himachal Pradesh

Study Duration

Between January 2024 to May 2024

Study Population

The study's target population encompassed all adults aged 18 and above who had been residents of Himachal Pradesh for a minimum of 12 months

Sample Size 

A robust sample size of 400 adults was determined using a 95% confidence level, an estimated knowledge level of 50% regarding Preventive Factors and Practices for elbow Pain, a precise 5% absolute error margin, and a conservative 5% non-response rate. 

Study Tool

A google form questionnaire consisting of questions regarding socio-demography and knowledge regarding Preventive Factors and Practices for elbow Pain was created. The questionnaire was initially pre-tested on a small number of participants to identify any difficulty in understanding by the respondents. 

Description of Tool

Demographic Data Survey Instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education and many more.

Questionnaire

The questionnaire contains 20 structured knowledge related questions regarding Preventive Factors and Practices for elbow Pain. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as >80% (16-20) = very good, 60-79% (12-15) = Good, 41-59% (8-11) = Fair, <40% (< 8) = poor

Validity of Tool 

By the experts in this field

Data Collection

Data was collected under the guidance of supervisors. The google form questionnaire was circulated among the residents of Himachal Pradesh for responses using online modes like e-mail and social media platforms like WhatsApp groups, Facebook, Instagram and LinkedIn till the 400 responses were collected. 

Data Analysis

Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage. 

Ethical Considerations

Participants confidentiality and anonymity were maintained. 

The study conducted among 400 participants in District Kangra, Himachal Pradesh, provides a detailed examination of socio-demographic characteristics and the level of knowledge regarding hip osteoarthritis.

As shown in Table 1, the participants were distributed across different age groups, with 30.3% aged 18-30 years, 25.0% aged 31-40 years, 22.0% aged 41-50 years, and 22.8% aged above 50 years. The gender distribution was relatively balanced, with 48.5% males and 51.5% females. Regarding marital status, the majority of participants were married (56.8%), while 39.5% were single, and 3.7% fell into the "others" category. The religious composition revealed that most participants were Hindu (83.0%), followed by Muslims (7.3%), Sikhs (7.8%), and others (2.0%). Employment status showed that 49.8% of the participants were employed, 26.0% were unemployed, and 24.2% were students. Educational levels varied, with 34.3% of participants being graduates, 27.0% having completed high school, 25.0% holding postgraduate or higher degrees, and 13.8% having education below high school.

Table 2 indicates a relatively high level of awareness regarding the symptoms of hip osteoarthritis. A significant 79.0% of participants had heard of the condition, showing good general awareness. Specifically, 72.3% of participants knew that hip osteoarthritis could cause hip pain, while 68.8% recognized stiffness as a symptom. Additionally, 65.8% were aware that the condition could cause difficulty in walking, and 64.3% knew that it could lead to a decreased range of motion. These results suggest a decent understanding of the primary symptoms of hip osteoarthritis among the population.

Table 3 highlights participants' awareness of the causes and risk factors associated with hip osteoarthritis. While 61.8% understood that aging increases the risk of developing the condition, 59.8% were aware that obesity 

is also a risk factor. Knowledge about previous hip injuries leading to hip osteoarthritis was held by 58.0% of participants, while 55.3% recognized the role of genetics. The least recognized cause was repetitive stress on the hip joint, known by 53.8% of participants. These findings reveal moderate awareness of the risk factors, though there are areas where further education is needed, particularly concerning repetitive stress and genetics.

Table 4 shows that knowledge regarding the prevention of hip osteoarthritis was relatively low among participants. While 53.5% knew that maintaining a healthy weight could help prevent the condition, only 52.5% were aware that regular low-impact exercises could also be preventive. Awareness about avoiding repetitive stress on the hip was at 50.5%, and knowledge of maintaining good posture was slightly lower at 48.3%. The least recognized preventive measure was balanced nutrition, known by only 45.0% of participants. These results indicate significant gaps in knowledge about effective prevention strategies for hip osteoarthritis.

Table 1: Socio-Demographic Characteristics of Study Participants (n = 400)

Table 2: Knowledge Regarding Symptoms of Hip Osteoarthritis (n = 400)

Table 3: Knowledge Regarding Causes and Risk Factors of Hip Osteoarthritis (n = 400)

Table 4: Knowledge Regarding Prevention of Hip Osteoarthritis (n = 400)

Table 5: Knowledge Regarding Treatment and Management of Hip Osteoarthritis (n = 400)

Table 6: Overall, Knowledge Score Categories for Hip Osteoarthritis (n = 400)

As shown in Table 5, knowledge about the treatment and management of hip osteoarthritis was limited. Less than half of the participants (47.5%) were aware that medications could help manage symptoms. Knowledge of the benefits of physical therapy was known to 45.3%, while only 42.8% knew that exercises targeting the hip muscles could help manage the condition. Awareness of assistive devices and their role in alleviating symptoms was low, at 40.3%, and only 37.3% of participants knew that surgical intervention might be necessary in severe cases. These findings suggest a need for better education on the various treatment options available for managing hip osteoarthritis.

Table 6 categorizes participants' overall knowledge scores regarding hip osteoarthritis. The results show that 26.0% of participants demonstrated very good knowledge, scoring between 16-20 points. A slightly larger proportion, 29.0%, had good knowledge, scoring 12-15 points. However, a significant portion of the population had fair knowledge (27.3%, scoring 8-11 points), and 17.8% of participants fell into the poor knowledge category, scoring below 8 points. This distribution highlights the variability in knowledge levels among the population, indicating that while some individuals possess a solid understanding of hip osteoarthritis, a considerable percentage still requires improved education and awareness.

This study provides a comprehensive evaluation of the awareness and knowledge regarding hip osteoarthritis among the general population of District Kangra, Himachal Pradesh. The findings shed light on both the strengths and gaps in public understanding of this prevalent condition, which has significant implications for public health in rural and semi-urban settings.

The socio-demographic characteristics of the study participants reveal a diverse representation across age, gender, marital status, religion, employment status, and education levels. The balanced gender distribution (48.5% males and 51.5% females) and a wide age range ensure that the findings are reflective of the general population in District Kangra. The presence of participants across various age groups is particularly important, as hip osteoarthritis primarily affects older adults but can also impact younger individuals, particularly those with risk factors such as obesity or previous joint injuries. The educational background of participants, with a significant proportion (34.3%) being graduates and 25.0% holding postgraduate or higher degrees, suggests that the population has a reasonable baseline capacity for health literacy. However, despite this, there remain considerable gaps in knowledge, particularly regarding the causes, prevention, and management of hip osteoarthritis, indicating the need for targeted educational interventions [3-5].

The study reveals a relatively high level of general awareness regarding hip osteoarthritis, with 79.0% of participants having heard of the condition. This is encouraging, as it suggests that hip osteoarthritis is recognized as a significant health issue within the community. However, the knowledge of specific symptoms shows some variability. While 72.3% of participants were aware that hip osteoarthritis can cause hip pain, fewer participants recognized other key symptoms such as stiffness in the hip (68.8%) and decreased range of motion (64.3%). The fact that only 65.8% were aware that hip osteoarthritis could lead to difficulty in walking is concerning, as this is one of the most debilitating consequences of the condition. These findings highlight the need for public health campaigns to emphasize the full spectrum of symptoms associated with hip osteoarthritis, as early recognition of these symptoms is crucial for timely intervention and management [6-8].

The study also explores participants' knowledge of the causes and risk factors associated with hip osteoarthritis. The findings reveal a moderate level of awareness, with 61.8% of participants recognizing that aging increases the risk of developing the condition. However, knowledge of other significant risk factors, such as obesity (59.8%), previous hip injuries (58.0%), and genetics (55.3%), was lower. Notably, only 53.8% of participants were aware that repetitive stress on the hip joint could lead to hip osteoarthritis. This gap in understanding is concerning, particularly in a region like District Kangra, where many individuals are engaged in physically demanding occupations that could contribute to repetitive stress on the joints. These results suggest a need for targeted education that highlights the role of modifiable risk factors, such as maintaining a healthy weight and avoiding repetitive joint stress, in preventing hip osteoarthritis [7-9].

One of the most significant findings of this study is the relatively low level of knowledge regarding the prevention of hip osteoarthritis. While over half of the participants (53.5%) recognized that maintaining a healthy weight could help prevent the condition, awareness of other preventive measures was notably lower. For example, only 52.5% were aware that regular low-impact exercises could be beneficial, and even fewer participants knew about the importance of avoiding repetitive stress on the hip (50.5%) or maintaining good posture (48.3%). The least recognized preventive measure was balanced nutrition, known by only 45.0% of participants. These findings underscore the need for public health initiatives to focus on educating the population about practical strategies for preventing hip osteoarthritis. This could include promoting regular physical activity, ergonomic practices, and dietary guidelines that support joint health [10,11].

The study also highlights significant gaps in knowledge regarding the treatment and management of hip osteoarthritis. Less than half of the participants were aware that medications (47.5%) and physical therapy (45.3%) could help manage symptoms. Even fewer participants knew about the benefits of exercises targeting the hip muscles (42.8%) or the use of assistive devices (40.3%) to alleviate symptoms. The lowest awareness was related to surgical intervention, with only 37.3% of participants recognizing that it might be necessary in severe cases. This lack of knowledge about available treatment options could lead to inadequate self-management and delayed care, resulting in worse outcomes for individuals with hip osteoarthritis. These findings highlight the need for improved communication between healthcare providers and patients, ensuring that individuals are fully informed about their treatment options and the importance of early and ongoing management of the condition [7-10].

The overall knowledge scores of participants demonstrate a wide distribution, with 26.0% of participants exhibiting very good knowledge and 29.0% showing good knowledge. However, a significant portion of the population still falls into the fair (27.3%) and poor (17.8%) knowledge categories. This variability indicates that while some individuals have a strong understanding of hip osteoarthritis, a considerable percentage of the population still lacks adequate knowledge. This disparity underscores the importance of targeted educational interventions that address specific gaps in knowledge, particularly among those with lower overall awareness. Ensuring that all segments of the population are well-informed is crucial for preventing and managing hip osteoarthritis effectively [9-11].

The findings of this study have important implications for public health strategies in District Kangra and similar rural regions. There is a clear need for comprehensive educational campaigns that address both general awareness and specific knowledge gaps related to hip osteoarthritis. Public health initiatives should prioritize the dissemination of information on modifiable risk factors, prevention strategies, and treatment options, with a focus on practical, actionable advice that can be easily implemented by the general public. Additionally, healthcare providers in the region should be equipped with the tools and resources to educate their patients about hip osteoarthritis, emphasizing early diagnosis and effective management. Community-based interventions, such as workshops, health camps, and workplace ergonomic assessments, could be effective in raising awareness and promoting healthy practices that prevent and manage hip osteoarthritis.

In conclusion, while there is a foundational level of awareness about hip osteoarthritis among the population of District Kangra, significant gaps in knowledge regarding the causes, prevention, and management of the condition remain. These knowledge gaps, particularly concerning modifiable risk factors such as weight management and preventive strategies like regular exercise, highlight the need for targeted educational interventions. Improving public understanding through community-based programs and healthcare provider outreach can empower individuals to take proactive measures in managing their joint health. Additionally, enhanced healthcare communication is essential to ensure timely diagnosis and access to appropriate treatment options, thereby reducing the overall burden of hip osteoarthritis on both individuals and the healthcare system. By addressing these challenges, we can promote better quality of life and functional independence for those at risk of or living with hip osteoarthritis.

1. “Osteoarthritis of the hip.” Johns Hopkins Medicine, Johns Hopkins University, www.hopkinsmedicine.org/health/conditions-and-diseases/hip-arthritis. Accessed 2025.

2. “Osteoarthritis of the hip.” OrthoInfo – American Academy of Orthopaedic Surgeons, AAOS, orthoinfo.aaos.org/en/diseases--conditions/osteoarthritis-of-the-hip/. Accessed 2025.

3. “Hip osteoarthritis.” Physio-Pedia, www.physio-pedia.com/Hip_Osteoarthritis. Accessed 2025.

4. “Hip Osteoarthritis (Degenerative Arthritis of the Hip).” WebMD, www.webmd.com/osteoarthritis/hip-osteoarthritis-degenerative-arthritis-hip. Accessed 2025.

5. “Hip osteoarthritis.” Orthobullets, www.orthobullets.com/recon/5005/hip-osteoarthritis. Accessed 2025.

6. “Osteoarthritis (OA) of the hip.” Versus Arthritis, versusarthritis.org/about-arthritis/conditions/osteoarthritis-oa-of-the-hip/. Accessed 2025.

7. Yadav, A.C. and A. Sood. “Prevalence of hip joint osteoarthritis in elderly persons in a district of central Uttar Pradesh: A cross-sectional study.” International Journal of Research and Review, vol. 3, no. 4, 2016, pp. 31–35.

8. Fan, Z. et al. “The prevalence of hip osteoarthritis: A systematic review and meta-analysis.” Arthritis Research & Therapy, vol. 25, 2023, article 51.

9. Fu, M. et al. “Global, regional, and national burdens of hip osteoarthritis from 1990 to 2019: Estimates from the 2019 global burden of disease study.” Arthritis Research & Therapy, vol. 24, 2022, article 8.

10. Singh, A. et al. “Burden of osteoarthritis in India and its states, 1990–2019: Findings from the global burden of disease study 2019.” Osteoarthritis and Cartilage, vol. 30, no. 8, August 2022, pp. 1070–1078.

11. “Navigating Life with hip arthritis: A Patient’s Guide to Awareness and Empowerment.” Trinity Hospital, trinityhospital.in/navigating-life-with-hip-arthritis-a-patients-guide-to-awareness-and-empowerment/. Accessed 2025.