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Arthritis: Should I Have Hip Replacement Surgery?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Arthritis: Should I Have Hip Replacement Surgery?
1Get the | 2Compare | 3Your | 4Your | 5Quiz | 6Your Summary |
Get the facts
Your options
- Have hip replacement surgery.
- Don't have your hip replaced. Continue to manage your joint pain and other symptoms with other treatments.
This decision tool is for people considering hip replacement surgery. If you are considering other types of surgery for your arthritis, talk to your doctor.
Key points to remember
- Most people can manage osteoarthritis pain with medicine, exercise, physical therapy, and weight loss (if they are overweight). If these things don't work, then surgery to replace the hip is an option.
- Arthritis may get worse over time. But it may stay the same or even get better.
- Most people have hip replacement only when they can no longer control pain with medicine and other treatments and when the pain prevents them from doing daily activities.
- People who have this surgery usually have much less pain than before. And they can usually return to activities they enjoy.
- Most artificial hip joints last for at least 15 years. And more than half last for 25 years or more. But this can depend on how much stress you put on the joint and how well your new joint and bones mend.
- If you wait so long to have a hip replacement that you have already lost much of your strength, endurance, and ability to be active, then after the surgery you might have a harder time returning to your normal activities.
What is osteoarthritis?
Osteoarthritis is a problem that affects all parts of the joint. For example, when cartilage breaks down, the bones start to rub against each other. This rubbing damages your tissues and bones.
The symptoms of osteoarthritis include joint pain, stiffness after you sit or lie down, and not being able to move freely.
Arthritis may get worse over time. But it may stay the same or even get better.
What is hip replacement surgery?
Hip replacement surgery replaces damaged parts of your hip joint with new metal, ceramic, or plastic parts. It can help with severe pain. It may also improve how well the joint works and moves. This type of surgery is an option for people with severe osteoarthritis who have lost a lot of cartilage and do not get pain relief from other treatments.
Most artificial hip joints last for at least 15 years. And more than half last for 25 years or more. But this can depend on how much stress you put on the joint and how well your new joint and bones mend.
What treatments other than surgery are available?
There are many treatments for osteoarthritis. But what works for someone else may not help you. Work with your doctor to find what is best for you. Often a mix of things helps the most.
Treatments other than surgery include:
- Medicines. If your pain is mild, over-the-counter pain medicines may help. These include acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs, such as ibuprofen (for example, Advil, Motrin) or naproxen (for example, Aleve). But if these don't help your pain, you may need a stronger prescription medicine.
- Exercise. It can help keep your muscles strong and your joints moving well.
- Ice or heat. Heat may help you loosen up your joints before an activity. Ice is a good pain reliever after activity or exercise.
- Physical therapy. This includes specific exercises that can help you stretch and strengthen your muscles and reduce pain and stiffness.
- Walking aids. A cane, crutches, or a walker can help take some of the stress off of your hip and make it easier to get around.
- Losing weight, if you're overweight. Losing weight helps take some of the stress off of your joints.
- Steroid shots. If you have inflammation, steroid shots can help reduce pain for a while. The relief usually lasts weeks to months.
Some other things that you may try include:
- Acupuncture. It involves putting very tiny needles into your skin at certain places on your body to try to relieve pain. Some people find that acupuncture helps. But there is not a lot of medical research to support the use of acupuncture for hip arthritis.
- Dietary supplements, such as glucosamine and chondroitin, fish oil, or SAM-e. Some people feel that these supplements help. But medical research does not prove that they work. Talk to your doctor before you take these supplements.
What should you expect after surgery?
Most people get out of bed with help on the day of surgery. You will start physical therapy right away. You will do special exercises and may need crutches for several weeks. It usually takes people 2 to 3 months to get back to doing their usual activities. But it may take a little longer than that for some people. A full recovery may take 6 to 12 months.
After you have recovered, you will probably be able to do your daily activities more easily and with less pain. You may find it easier to climb stairs, walk without getting tired, and do other activities that you did before surgery.
What are the risks of total hip replacement surgery?
All surgery has risks, such as complications from anesthesia. And after any major surgery, there is always a small chance of a blood clot or a heart attack.
With total hip replacement, there is also a small risk of infection or hip dislocation. And some people, over time, may have other problems. These include the feeling that one leg is longer than the other, loosening of the parts of your new joint, or sensitivity to metal. If you are allergic to certain metals, tell your doctor.
What do numbers tell us about the benefits and risks of hip replacement?
Pain relief with surgery
- The evidence about hip replacement surgery suggests that most people are happy with the results.
- Take a group of 100 people who have the surgery. Six months after hip replacement, about 90 out of 100 people have less pain and can do more activities than they could before surgery.footnote 1
Need for repeat surgery
- Most artificial hips last for many years. But they can wear out or have other problems. Some people have to repeat the surgery to have the joint replaced again.
- Take a group of 100 people who have the surgery. Within 15 years after the surgery, 10 out of 100 will need to have the hip replaced again. More than half of hip replacements last for 25 years or more.footnote 3
Problems after surgery
The evidence suggests that, like most surgeries, hip replacement may have some risks.
Take a group of 100 people who have the surgery. About 4 out of 100 people have a serious complication like a joint infection, a blood clot, or a heart attack within 3 months after surgery.footnote 5 If you are older or have other health problems, your risk may be higher. footnote 7footnote 6, footnote 2
Why might your doctor recommend hip replacement?
Your doctor might recommend hip replacement if:
- You have very bad pain, and other treatments have not helped.
- You have lost a large amount of cartilage.
- Your hip pain is keeping you from being active enough to keep up your strength, flexibility, balance, or endurance.
- You don't have health problems that would make it dangerous to have surgery.
Compare your options
Compare
What is usually involved? |
| |
|---|---|---|
What are the benefits? |
| |
What are the risks and side effects? |
|
- You will have spinal or general anesthesia. You may be able to get out of bed with help on the day of surgery. Most people will have a short hospital stay or go home the day of surgery.
- You will need several weeks of physical therapy, including exercises you can do at home.
- It usually takes people 2 to 3 months to get back to doing their usual activities. But it may take a little longer than that for some people. A full recovery may take 6 to 12 months.
- You will likely have less pain, be able to do your daily activities, and have a better quality of life.footnote 4
- You may need to have another surgery to replace the artificial hip.
- All surgery has risks, such as bleeding, infection, heart attack, and risks from anesthesia. Other risks of hip replacement surgery include blood clots and problems with wound healing.
- Your age and your health can also affect your risk.
- You try medicines, steroid shots, home treatment, or other methods to relieve pain.
- You can decide to have the surgery later if the pain gets worse and medicines don't help.
- You avoid the cost and risks of surgery.
- You avoid several months of physical therapy and rehabilitation.
- Medicines can cause side effects such as upset stomach, stomach bleeding, heartburn, and skin rashes.
- You may not be able to relieve your pain enough with medicines or home treatment to do your daily activities.
- If you decide to have surgery later, and if your limited activity has already caused you to lose strength, flexibility, balance, or endurance, it may be harder to return to your normal activities.
Personal stories about hip replacement surgery for osteoarthritis
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I've always been active. I worked on the farm and also worked nights at the hospital for over 30 years. The pain in my hips has gotten so bad that it's really hard for me to work, take care of the garden, or go for walks with my grandkids. I've seen people in the hospital with hip replacements, and I know what to expect. It's not going to be easy, but I'm determined to get back to doing the things I enjoy—with less pain.
Carrie, age 66
I never pictured myself as the type who would use a cane. But it helps a lot. I know that surgery is an option, but I don't know who would take care of my sister at home while I was recovering in the hospital. And I don't want to spend any time in a rehabilitation center. So I'll get by with my cane and my pain relievers as long as I can.
Elliot, age 73
I don't remember when I had a good night's sleep. My hip hurts when I walk, sit, or lie down. My doctor and I have talked about replacing my hip, and I know I may have to do that one day if things get worse, which my doctor says may or may not happen. I want surgery to be the last resort because the new hip could wear out before I die. For now, my doctor and I are going to try some different pain pills.
Gardner, age 54
I thought I'd fixed the dysplasia problems in my hip when I had an osteotomy about 10 years ago. But my osteoarthritis seems to be getting worse. I've decided to go ahead with hip replacement surgery. My husband and I have been planning a special anniversary, and I want to get the surgery and rehab done so that I can really enjoy it.
Carma, age 68
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have hip replacement surgery
Reasons not to have hip replacement surgery
I'm in too much pain to do my daily activities.
I'm able to manage my pain and do my daily activities.
I think I can complete a long rehabilitation program.
I don't think I can go through a long rehabilitation.
If I need another hip replacement later, I'll be glad to get it.
I'm worried about needing another hip replacement later.
I'll do whatever it takes to feel better, including surgery.
I don't want to have surgery for any reason.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having surgery
NOT having surgery
What else do you need to make your decision?
Check the facts
Decide what's next
Certainty
1. How sure do you feel right now about your decision?
Your Summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Your decision
Next steps
Which way you're leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits and References
| Author | Ignite Healthwise, LLC Staff |
|---|---|
| Clinical Review Board | Clinical Review Board All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. |
- Beswick AD, et al. (2012). What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open, 2(1). DOI: 10.1136/bmjopen-2011-000435. Accessed April 24, 2016.
- Cram P, et al. (2011). Clinical characteristics and outcomes of Medicare patients undergoing total hip arthroplasty, 1991-2008, JAMA. 305(15): 1560-1567. Accessed March 17, 2017.
- Evans JT, et al. (2019). How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet, 393(10172): 647–654. DOI: 10.1016/S0140-6736(18)31665-9. Accessed September 15, 2020.
- Lozada CJ (2013). Treatment of osteoarthritis. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology 9th ed., vol. 2, pp. 1646–1659. Philadelphia: Saunders.
- Middleton A, et al. (2017). Outcomes over 90-day episodes of care in Medicare fee-for-service beneficiaries receiving joint arthroplasty. Journal of Arthroplasty, 32(9): 2639–2647.e1. DOI: 10.1016/j.arth.2017.03.040. Accessed February 18, 2021.
- Phillips CB, et al. (2003). Incidence rates of dislocation, pulmonary embolism, and deep infection during the first six months after elective total hip replacement. The Journal of Bone and Joint Surgery. American Volume, 85-A(1): 20–26. http://jbjs.org/content/85/1/20.long. Accessed May 25, 2016.
- Singh JA, et al. (2011). Cardiac and thromboembolic complications and mortality in patients undergoing total hip and total knee arthroplasty. Annals of the Rheumatic Diseases, 70(12): 2082–2088. DOI: 10.1136/ard.2010.148726. Accessed May 25, 2016.
Arthritis: Should I Have Hip Replacement Surgery?
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the Facts
Your options
- Have hip replacement surgery.
- Don't have your hip replaced. Continue to manage your joint pain and other symptoms with other treatments.
This decision tool is for people considering hip replacement surgery. If you are considering other types of surgery for your arthritis, talk to your doctor.
Key points to remember
- Most people can manage osteoarthritis pain with medicine, exercise, physical therapy, and weight loss (if they are overweight). If these things don't work, then surgery to replace the hip is an option.
- Arthritis may get worse over time. But it may stay the same or even get better.
- Most people have hip replacement only when they can no longer control pain with medicine and other treatments and when the pain prevents them from doing daily activities.
- People who have this surgery usually have much less pain than before. And they can usually return to activities they enjoy.
- Most artificial hip joints last for at least 15 years. And more than half last for 25 years or more. But this can depend on how much stress you put on the joint and how well your new joint and bones mend.
- If you wait so long to have a hip replacement that you have already lost much of your strength, endurance, and ability to be active, then after the surgery you might have a harder time returning to your normal activities.
What is osteoarthritis?
Osteoarthritis is a problem that affects all parts of the joint. For example, when cartilage breaks down, the bones start to rub against each other. This rubbing damages your tissues and bones.
The symptoms of osteoarthritis include joint pain, stiffness after you sit or lie down, and not being able to move freely.
Arthritis may get worse over time. But it may stay the same or even get better.
What is hip replacement surgery?
Hip replacement surgery replaces damaged parts of your hip joint with new metal, ceramic, or plastic parts. It can help with severe pain. It may also improve how well the joint works and moves. This type of surgery is an option for people with severe osteoarthritis who have lost a lot of cartilage and do not get pain relief from other treatments.
Most artificial hip joints last for at least 15 years. And more than half last for 25 years or more. But this can depend on how much stress you put on the joint and how well your new joint and bones mend.
What treatments other than surgery are available?
There are many treatments for osteoarthritis. But what works for someone else may not help you. Work with your doctor to find what is best for you. Often a mix of things helps the most.
Treatments other than surgery include:
- Medicines. If your pain is mild, over-the-counter pain medicines may help. These include acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs, such as ibuprofen (for example, Advil, Motrin) or naproxen (for example, Aleve). But if these don't help your pain, you may need a stronger prescription medicine.
- Exercise. It can help keep your muscles strong and your joints moving well.
- Ice or heat. Heat may help you loosen up your joints before an activity. Ice is a good pain reliever after activity or exercise.
- Physical therapy. This includes specific exercises that can help you stretch and strengthen your muscles and reduce pain and stiffness.
- Walking aids. A cane, crutches, or a walker can help take some of the stress off of your hip and make it easier to get around.
- Losing weight, if you're overweight. Losing weight helps take some of the stress off of your joints.
- Steroid shots. If you have inflammation, steroid shots can help reduce pain for a while. The relief usually lasts weeks to months.
Some other things that you may try include:
- Acupuncture. It involves putting very tiny needles into your skin at certain places on your body to try to relieve pain. Some people find that acupuncture helps. But there is not a lot of medical research to support the use of acupuncture for hip arthritis.
- Dietary supplements, such as glucosamine and chondroitin, fish oil, or SAM-e. Some people feel that these supplements help. But medical research does not prove that they work. Talk to your doctor before you take these supplements.
What should you expect after surgery?
Most people get out of bed with help on the day of surgery. You will start physical therapy right away. You will do special exercises and may need crutches for several weeks. It usually takes people 2 to 3 months to get back to doing their usual activities. But it may take a little longer than that for some people. A full recovery may take 6 to 12 months.
After you have recovered, you will probably be able to do your daily activities more easily and with less pain. You may find it easier to climb stairs, walk without getting tired, and do other activities that you did before surgery.
What are the risks of total hip replacement surgery?
All surgery has risks, such as complications from anesthesia. And after any major surgery, there is always a small chance of a blood clot or a heart attack.
With total hip replacement, there is also a small risk of infection or hip dislocation. And some people, over time, may have other problems. These include the feeling that one leg is longer than the other, loosening of the parts of your new joint, or sensitivity to metal. If you are allergic to certain metals, tell your doctor.
What do numbers tell us about the benefits and risks of hip replacement?
Pain relief with surgery
- The evidence about hip replacement surgery suggests that most people are happy with the results.
- Take a group of 100 people who have the surgery. Six months after hip replacement, about 90 out of 100 people have less pain and can do more activities than they could before surgery.1
Need for repeat surgery
- Most artificial hips last for many years. But they can wear out or have other problems. Some people have to repeat the surgery to have the joint replaced again.
- Take a group of 100 people who have the surgery. Within 15 years after the surgery, 10 out of 100 will need to have the hip replaced again. More than half of hip replacements last for 25 years or more.3
Problems after surgery
The evidence suggests that, like most surgeries, hip replacement may have some risks.
Take a group of 100 people who have the surgery. About 4 out of 100 people have a serious complication like a joint infection, a blood clot, or a heart attack within 3 months after surgery.5 If you are older or have other health problems, your risk may be higher. 76, 2
Why might your doctor recommend hip replacement?
Your doctor might recommend hip replacement if:
- You have very bad pain, and other treatments have not helped.
- You have lost a large amount of cartilage.
- Your hip pain is keeping you from being active enough to keep up your strength, flexibility, balance, or endurance.
- You don't have health problems that would make it dangerous to have surgery.
2. Compare your options
| Have hip replacement surgery | Don't have your hip replaced | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
Personal stories
Personal stories about hip replacement surgery for osteoarthritis
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I've always been active. I worked on the farm and also worked nights at the hospital for over 30 years. The pain in my hips has gotten so bad that it's really hard for me to work, take care of the garden, or go for walks with my grandkids. I've seen people in the hospital with hip replacements, and I know what to expect. It's not going to be easy, but I'm determined to get back to doing the things I enjoy—with less pain."
— Carrie, age 66
"I never pictured myself as the type who would use a cane. But it helps a lot. I know that surgery is an option, but I don't know who would take care of my sister at home while I was recovering in the hospital. And I don't want to spend any time in a rehabilitation center. So I'll get by with my cane and my pain relievers as long as I can."
— Elliot, age 73
"I don't remember when I had a good night's sleep. My hip hurts when I walk, sit, or lie down. My doctor and I have talked about replacing my hip, and I know I may have to do that one day if things get worse, which my doctor says may or may not happen. I want surgery to be the last resort because the new hip could wear out before I die. For now, my doctor and I are going to try some different pain pills."
— Gardner, age 54
"I thought I'd fixed the dysplasia problems in my hip when I had an osteotomy about 10 years ago. But my osteoarthritis seems to be getting worse. I've decided to go ahead with hip replacement surgery. My husband and I have been planning a special anniversary, and I want to get the surgery and rehab done so that I can really enjoy it."
— Carma, age 68
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have hip replacement surgery
Reasons not to have hip replacement surgery
I'm in too much pain to do my daily activities.
I'm able to manage my pain and do my daily activities.
I think I can complete a long rehabilitation program.
I don't think I can go through a long rehabilitation.
If I need another hip replacement later, I'll be glad to get it.
I'm worried about needing another hip replacement later.
I'll do whatever it takes to feel better, including surgery.
I don't want to have surgery for any reason.
My other important reasons:
My other important reasons:
4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having surgery
NOT having surgery
5. What else do you need to make your decision?
Check the facts
1. Is hip replacement the only option for treating osteoarthritis?
- Yes
- No
- I'm not sure
2. After surgery, will you be able to resume your daily activities?
- Yes
- No
- I'm not sure
3. Will a new hip last forever?
- Yes
- No
- I'm not sure
Decide what's next
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
Certainty
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
- I'm ready to take action.
- I want to discuss the options with others.
- I want to learn more about my options.
| By | Ignite Healthwise, LLC Staff |
|---|---|
| Clinical Review Board | Clinical Review Board All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. |
- Beswick AD, et al. (2012). What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open, 2(1). DOI: 10.1136/bmjopen-2011-000435. Accessed April 24, 2016.
- Cram P, et al. (2011). Clinical characteristics and outcomes of Medicare patients undergoing total hip arthroplasty, 1991-2008, JAMA. 305(15): 1560-1567. Accessed March 17, 2017.
- Evans JT, et al. (2019). How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet, 393(10172): 647–654. DOI: 10.1016/S0140-6736(18)31665-9. Accessed September 15, 2020.
- Lozada CJ (2013). Treatment of osteoarthritis. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology 9th ed., vol. 2, pp. 1646–1659. Philadelphia: Saunders.
- Middleton A, et al. (2017). Outcomes over 90-day episodes of care in Medicare fee-for-service beneficiaries receiving joint arthroplasty. Journal of Arthroplasty, 32(9): 2639–2647.e1. DOI: 10.1016/j.arth.2017.03.040. Accessed February 18, 2021.
- Phillips CB, et al. (2003). Incidence rates of dislocation, pulmonary embolism, and deep infection during the first six months after elective total hip replacement. The Journal of Bone and Joint Surgery. American Volume, 85-A(1): 20–26. http://jbjs.org/content/85/1/20.long. Accessed May 25, 2016.
- Singh JA, et al. (2011). Cardiac and thromboembolic complications and mortality in patients undergoing total hip and total knee arthroplasty. Annals of the Rheumatic Diseases, 70(12): 2082–2088. DOI: 10.1136/ard.2010.148726. Accessed May 25, 2016.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
Current as of: July 31, 2024
Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
