Is It Time for a Hip Replacement? Know the Signs
Key takeaways:
Hip replacement surgery can improve pain, mobility, and quality of life in people with hip arthritis.
Often, it’s best to first try non-surgical treatments. These include pain medications, physical therapy, weight loss (if needed), and joint injections.
Hip replacement surgery requires months of rehab. It might not be the right choice for someone with multiple medical conditions.
The hip joint is a real workhorse of the human skeleton. It’s a ball-and-socket joint, which allows for a lot of movement. It’s also strong enough to withstand your weight and physical activity for decades. It’s common to underestimate just how much your hip does for you — until it starts to hurt.
Hip replacement surgery (also known as hip arthroplasty) is becoming more and more common. That’s because it’s very effective at relieving pain and restoring mobility in people with hip arthritis.
While hip replacement surgery is effective, it’s not something to take lightly. So how do you know if you need a hip replacement?
What are the signs you need a hip replacement?
Hip arthritis is the main reason people need a hip replacement.
The symptoms of hip arthritis are:
Pain in the groin or thigh
Limited mobility
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If you notice these, it’s probably time to see a healthcare professional for further evaluation. This might be your primary care provider or an orthopedic specialist.
They’ll examine your hip and take X-rays. This will help them confirm a diagnosis of arthritis. Most commonly, this is osteoarthritis.
But other types of arthritis may be possible too — such as rheumatoid arthritis or psoriatic arthritis. Signs of these types of arthritis are:
Pain and stiffness in other joints
Skin rashes
Nail changes
Eye symptoms
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In this case, you may need to see a rheumatologist for further testing. It’s important to get the diagnosis right, because it will likely change the recommended treatment plan.
Let’s look at the three signs you may need a hip replacement.
1. Pain
The most common reason people get a hip replacement is pain. Pain from hip osteoarthritis usually:
Starts gradually over years
Occurs in or near the groin (but can radiate down the thigh)
Feels like an aching pain and/or stiffness
Gets worse with activity and better with rest
2. Limited mobility
Arthritis in your hip can decrease your range of motion over time. You might notice that you’re having trouble with:
Putting on socks and shoes
Getting in and out of a car
Going up and down stairs
Walking, like waddling or limping
3. Limited function
Most people can handle pain and some limited mobility. But over time, hip arthritis can start to cause pain when you’re resting. For example, your hip pain may start to limit your ability to move around and care for yourself. It can also keep you up at night. These are both signs that it’s time for a hip replacement.
Alternative options for treating hip pain and osteoarthritis
Hip replacement surgery is a big surgery, and it’s not right for everyone. Even if it’s right for you, it’s best to first try conservative (nonsurgical) treatments.
The best treatment plan for you will depend on many factors, including the severity of your symptoms, your activity level, and your overall health. These conservative treatment options won’t cure your arthritis. But they can help ease your symptoms and improve your mobility.
Physical therapy and exercise
With hip arthritis, it’s important to work on your strength, endurance, and balance. This will help with mobility and overall function. Exercises like yoga and tai chi can be helpful.
It’s best to work directly with a physical therapist, who can provide specific instructions. They can recommend ways to self-manage without risk of injury. And they can help with assistive devices. For example, raised toilet seats, handrails, and walking assistance with a cane can improve your independence.
Medication
Prescription and over-the-counter (OTC) medications can help with inflammation and pain. The best option for you will depend on any other medical problems you have and/or medications you’re taking.
Some medication options include:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or meloxicam
Acetaminophen (Tylenol) — an option for those who can’t take NSAIDs
Other prescription medications are available if you have rheumatoid arthritis or psoriatic arthritis.
Injections
Injections directly into the joint can be helpful for short-term pain relief.
An experienced healthcare professional can inject steroid (a powerful anti-inflammatory medication) and numbing medication into the hip joint. Usually, this is done with an ultrasound to help guide the injection into the right place.
Other injection options, such as hyaluronic acid, aren’t routinely recommended by experts since there’s not enough research backing them up.
Weight loss
Carrying excess weight can contribute to hip pain. The extra weight forces the joints to experience more force. So weight loss can improve symptoms, especially in combination with other treatments.
Excess weight can also increase the risk of complications from surgery, if you were to have a hip replacement. Because of that, surgeons often recommend that people try to lose weight before the procedure. That said, weight loss can be challenging, and it looks different for everyone. So don’t be afraid to ask for help.
Reasons not to have hip replacement surgery
Hip replacement surgery is a big surgery and because of that, it may not be right for everyone.
There are many aspects to consider, such as:
It requires general anesthesia, which can be risky for people with certain medical problems, like heart and lung disease.
The surgery itself comes with several risks, including blood loss and infection.
Recovery can take several weeks, but it depends upon your surgeon’s approach and the type of implant you receive.
You’ll have certain activity restrictions during your recovery period.
You’ll need at least a few months of rehab afterward, including muscle strengthening, balance work, and mobility exercises.
Because of this, it’s common to undergo medical evaluation before having hip replacement surgery. You must be healthy enough to withstand the risks of anesthesia and surgery. And you must also be healthy enough for the demands of recovery afterward.
Frequently asked questions
Generally, it feels achy, with worsening pain after activity. Gradually, you can start to have pain at rest, even without activity. Hip pain from arthritis is usually felt in the groin. But sometimes it can travel down the thigh or into the buttocks.
It’s not that simple. An X-ray will show if you have arthritis. Specifically, your healthcare team will look for changes in the bones and the space between the bones for clues. But not everyone with arthritis has pain or needs a hip replacement. In other words, an X-ray is an important piece of the puzzle, but it’s not the only piece.
Most people who undergo hip replacement surgery are between 50 and 80 years old. There are no absolute age requirements for hip replacement.
The surgery usually takes a couple of hours, followed by more time in recovery. You may go home the same day. Or you could stay in the hospital for a night or more. This depends on:
Your health
Your surgeon’s preferences
Where you have your surgery
How your procedure goes
The bottom line
Hip arthritis causes pain and mobility limitations that can impact your quality of life. Hip replacement surgery is an effective way to address these symptoms, but nonsurgical treatments are recommended first. These include pain medication and physical therapy. Take time to consider the demands of surgery and the rehab that follows before opting into hip replacement surgery.
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References
Dust, P., et al. (2022). Patient functional status as an indication for primary total hip arthroplasty: A systematic review and meta-analysis. The Journal of Arthroplasty.
Katz, J. N., et al. (2021). Diagnosis and treatment of hip and knee osteoarthritis: A review. JAMA.
Kim, C., et al (2015). Association of hip pain with radiographic evidence of hip osteoarthritis: Diagnostic test study. The BMJ.
Robson, E. K., et al. (2020). Effectiveness of weight-loss interventions for reducing pain and disability in people with common musculoskeletal disorders: A systematic review with meta-analysis. Journal of Orthopedic & Sports Physical Therapy.
Sheth, N. P., et al. (2022). Activities after total hip replacement. OrthoInfo.
Sheth, N. P., et al. (2024). Total hip replacement. OrthoInfo.
Skou, S. T., & Roos, E. M. (2019). Physical therapy for patients with knee and hip osteoarthritis: Supervised, active treatment is current best practice. Clinical and Experimental Rheumatology.
Tran, J., et al. (2022). Obesity, weight loss, and joint replacement surgery. OrthoInfo.
