When Is It Time to Have a Total Hip Replacement

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If patients have tried nonoperative treatments and are still suffering, below are some indications that it might be time for hip replacement.

Groin Pain

Most of the time, patients with substantial hip arthritis have pain deep down in the groin and this is the pain that is effectively relieved by hip replacement. In addition, many patients with hip arthritis also have knee pain because the nerves that supply the knee run by the hip and are affected by the inflammation. Hip arthritis can cause a patient knee pain when there is nothing wrong with the knee! Most of the time, both the groin pain and the knee pain associated with hip arthritis are dramatically improved with a hip replacement.

Buttock pain might be coming from the hip but can also result from the back. Pain that is being caused by low back problems can persist after hip replacement. Therefore, patients who have primarily buttock pain should maximize nonoperative treatment by allowing us to evaluate their back before they consider hip replacement.

Bone-on-Bone Arthritis

In general, it is best to wait until the arthritis progresses until the bones are touching, as shown on x-rays. Groin pain in a patient with bone touching bone is reliably relieved by hip replacement.

Some patients with the ball part of the ball and socket (femoral head) no longer round benefit from hip replacement, but this is on a case-by-case basis. Patients who have hip pain from arthritis but do not have bone touching bone shown on x-rays should maximize all nonoperative treatments before considering hip replacement.

Marked Interference with Daily Activities

Before proceeding with hip replacement, the hip arthritis should markedly impact your activities of daily living. Patients who have an inability to climb stairs, an inability to put on shoes and socks, or the need to use a cane should consider hip replacement. Patients who markedly change their activities or avoid social outings because of hip pain also should consider hip replacement.

Interference with Sleep

Patients who have hip pain at the end of the day that keeps them from sleeping despite the use of anti-inflammatory medications should consider hip replacement.

Choosing to Have Hip Replacement Surgery

Most of the time, hip replacement is an entirely elective procedure. The patient can choose to delay it for months or even years with no increased difficulty for the patient or surgeon. A person considering hip replacement should not let anyone tell him or her that hip replacement is needed because, for the most part, hip arthritis is not a life-threatening condition. The reasons to undergo hip replacement are to decrease pain and to improve function. Hip replacement is very successful at relieving the pain and disability associated with hip deterioration.

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