Hip osteoarthritis, commonly referred to as coxarthrosis, is an insidious degenerative disease of the hip joint characterised by progressive cartilage degradation, sub-chondral bone changes, and joint dysfunction. Although it often presents in older adults, its origins span congenital, developmental, mechanical, metabolic and inflammatory pathways. This article examines the multifactorial etiology of coxarthrosis and explores evidence-based strategies for prevention. We begin by reviewing the principal causative factors—including joint dysplasia, traumatic injuries, femoral head necrosis, and chronic mechanical overload—and discuss how such factors compromise hip biomechanics, initiate cartilage damage and lead to subsequent joint degeneration. Risk factors such as ageing, obesity, joint malalignment, and muscle weakness are also highlighted. Following a literature review of more than two decades of hip osteoarthritis research, we focus on prevention: weight management, physical activity and muscle strengthening, early detection and correction of hip morphology abnormalities, injury prevention, and lifestyle modification aimed at preserving joint homeostasis. In addition, we outline a hypothetical research methodology to evaluate the effectiveness of a combined exercise and education programme in a high-risk population. Following the findings of recent cohort and retrospective studies, the article presents results indicating that early intervention and targeted preventive measures can significantly delay the onset or slow the progression of coxarthrosis. Finally, the conclusion synthesises these findings into a call for integrated, multidisciplinary prevention programmes emphasising risk factor modification and early hip health monitoring. Recognising the prevention of hip osteoarthritis as an achievable goal—not merely the management of advanced disease—could reduce disability, improve quality of life and reduce the burden on orthopaedic services.

Hip osteoarthritis, coxarthrosis, etiology, prevention, hip dysplasia, mechanical overload, weight management, muscle strengthening, trauma, joint biomechanics.

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