Signs You May Need a Hip Replacement

Hip pain is common, and most of it is not a reason for surgery. Muscle strains, tendon problems and back pain can all be felt around the hip. But when the hip joint itself is worn out, usually by osteoarthritis, a hip replacement can relieve pain and help you move again. It is one of the most common joint operations worldwide. These are the signs that suggest it may be time to talk to an orthopaedic surgeon about it.

Pain when you walk, or at rest

Pain from the hip joint is often felt in the groin, and sometimes in the buttock, the outer thigh or down to the knee. At first it comes on with walking or standing for a long time. As the joint wears, it can start to hurt at rest and wake you at night. Pain that limits how far you can walk, or that stops you sleeping, is one of the clearest signs that a hip replacement may help.

Stiffness and everyday tasks

A worn hip gradually loses movement. You may find it hard to put on socks and shoes, cut your toenails, get in and out of a car, or climb stairs. Sitting on the floor, getting up from a low chair, or the positions of prayer may become difficult. Stiffness that keeps getting worse, especially when mornings are hardest, is a common sign of arthritis in the joint. Some people notice a grinding or catching feeling as the hip moves.

A limp

Many people with hip arthritis start to limp. Others notice it first: a family member may say you are walking differently. A limp shifts strain onto the back, the knees and the other hip, and it can make falls more likely. A leg that feels shorter, or a hip that gives way or feels unstable, is also worth having checked. A limp that comes and goes with pain, rather than after an injury, points towards the joint itself.

Treatment that is no longer helping

Most people try other treatments first: painkillers or anti-inflammatory tablets, physiotherapy and exercises to strengthen the muscles around the hip, losing weight if needed, and a walking stick held in the opposite hand. A steroid injection can help some people for a while. When these no longer control the pain, and X-rays show the joint is badly worn, a hip replacement is usually the next step to discuss. Swelling or tenderness around the hip can have other causes, such as bursitis, so a proper examination matters before any decision is made. Hip replacement is usually advised for pain from the joint itself, not for pain from the muscles or tendons around it.

What happens at the consultation

The surgeon asks how the pain affects your day, examines how the hip moves and how you walk, and reviews X-rays of the pelvis and hips. Other causes of pain, such as the lower back, are checked. If a replacement makes sense, you hear what it involves, the typical recovery and the risks, and you decide. A hip replacement usually takes one to two hours, and most people walk with help within a day or two. Many walk without support after about six weeks. Most hip replacements keep working for 15 to 20 years or more.

When to get help quickly

Sudden, severe hip pain after a fall, especially in an older person who cannot stand or whose leg looks shortened or turned out, may be a broken hip. Call 999 or go to the nearest emergency department. Hip pain with fever, or a hot, swollen joint, also needs urgent care. For hip pain that has slowly been limiting your life, book a consultation. Dr. Subhash Ushakoyala trained in hip and knee replacement on a fellowship in 2016 and can explain whether a replacement, or another treatment, suits your hip.