Low-Dose Radiation Therapy for Hip Osteoarthritis

Low-dose radiation therapy (LDRT) is an outpatient treatment that directs a very small amount of radiation at an arthritic joint to calm inflammation in the joint lining. Hip osteoarthritis is one of the conditions patients and programs discuss LDRT for, alongside the knee, hands, shoulders, elbows, ankles, and feet.

What the Evidence Covers

Be aware: most of the published sham-controlled trial evidence for LDRT, including the 2025 Korean randomized trial^[1] and the 2019 Dutch trial^[6], specifically studied knee osteoarthritis. The evidence base for the hip specifically is thinner than for the knee. Hip patients are generally evaluated using the same overall dosing approach and candidacy framework used across joints, but a radiation oncologist is the right person to explain how the available evidence applies to the hip in particular.

Joint replacement surgery is also a well-established option for advanced hip osteoarthritis when pain and disability remain severe despite non-surgical care. Where LDRT may fit is generally after conservative treatments have been tried and before or instead of surgery is being weighed, for patients who want to discuss a non-surgical option with a radiation oncologist.

Typical Schedule

• Total dose of about 3.0 Gy, split into 6 treatments of 0.5 Gy each
• Treatments given 2 to 3 times per week, over about 2 to 3 weeks
• Outpatient, no hospital stay, no sedation or recovery period

Who May Be a Candidate

Programs generally consider adults with hip osteoarthritis who have not found enough relief from medications, injections, physical therapy, or other conservative treatments. As with other joints, many programs are cautious about younger patients, since radiation-related risk has more time to develop, and patients with more advanced structural damage may be less likely to improve. LDRT does not rebuild cartilage or restore a severely damaged joint.

References:
1. Kim BH, et al. Clinical Effectiveness of Single Course Low-Dose Radiation Therapy in Knee Osteoarthritis: Short-term Results from the Randomized, Sham-Controlled Trial. ASTRO 67th Annual Meeting Late-Breaking Abstract LBA 06. 2025. Abstract
6. Mahler EAM, et al. Effectiveness of low-dose radiation therapy on symptoms in patients with knee osteoarthritis: a randomised, double-blinded, sham-controlled trial. 2019. PubMed