Signs you may need a hip replacement

Understanding hip joint issues

The hip joint is one of the largest joints in the human body.

In a healthy hip joint, the ball and socket are connected by ligaments and surrounded by cartilage. The ligaments protect the bones from friction, and the cartilage cushions the bones and prevents them from rubbing against each other. This smooth interaction allows you to stand, walk, bend and stretch, without pain.  

However, certain conditions can cause pain, inflammation and damage to the hip joint.

In some cases, these conditions may result in the need for a hip replacement:  

• Osteoarthritis – often called ‘wear-and-tear’ arthritis, osteoarthritis develops when the cartilage erodes over time, causing the bones to rub against each other. This friction leads to swelling, pain and difficulty moving the joint
• Rheumatoid arthritis – caused by an overactive immune system, rheumatoid arthritis results in inflammation that can wear away the joint, cartilage and bone. Over time, this can cause the hip joint to become swollen, stiff and painful
• Osteonecrosis – this condition occurs when the blood supply to the ball portion of the hip joint is interrupted, which can lead to tiny fractures and eventual bone collapse. Pain may only occur when you put weight on the hip joint and tends to centre in the groin, thigh or buttocks
• Hip fractures – a fall or other accident can cause a fracture in the hip joint. In some cases, a hip replacement may be necessary to restore mobility and relieve pain

Key signs you may need a hip replacement

Your consultant may recommend that you have hip replacement surgery if:

• Your hip pain doesn’t stop – you rely on painkillers to manage your discomfort, but the pain continues to impact your daily life, including your ability to sleep
• Everyday tasks are challenging – your pain is affecting your ability to complete simple tasks, such as standing up, walking short distances, climbing stairs or putting on your shoes and socks
• You’re experiencing stiffness – you find it difficult to bend at the hip, lift your leg or put on shoes. Joint stiffness may be a sign of advanced osteoarthritis and should be assessed by an orthopaedic consultant
• Your joint is grating or rubbing – you may notice a grating, grinding or popping sound when you move your hip (crepitus), as well as redness and swelling on the outer surface of the joint. This could be caused by the bones in your hip joint rubbing against each other or air bubbles popping within the joint
• Other treatments haven’t worked – before recommending hip replacement surgery, your consultant will explore other treatments. If your pain doesn’t respond to these options, hip replacement surgery may be the next step  

When to see a specialist

If you’re experiencing any of the key signs above, it’s important to speak to an orthopaedic specialist.

They’ll be able to assess the condition of your hip joint in detail and suggest next steps. They might use advanced imaging techniques, such as X-rays, computed tomography (CT) scans or magnetic resonance imaging (MRI) scans.

Treatment options before surgery

Hip replacement surgery is rarely suggested as a first-line treatment for hip pain. Instead, your consultant will typically recommend less invasive options to support your recovery before considering surgical intervention.

Treatment options may include:  

• Physiotherapy – certain exercises can help strengthen the muscles around the hip joint, which may help preserve or restore the hip’s range of motion
• Hydrotherapy (also known as aquatic physiotherapy or aquatic therapy) – a form of physiotherapy that uses warm water for pain relief and management, involving specific exercises in a pool. Hydrotherapy has been shown to improve circulation, ease weight-bearing stresses and reduce pain. In particular, aquatic therapy can help osteoarthritis
• Steroid (hydrocortisone) injections – hydrocortisone helps reduce inflammation and can slow down an overactive immune system. As a result, it can reduce pain and swelling
• Acupuncture – by promoting increased blood flow to the area, acupuncture can support healing and help reduce inflammation
• Pain medications – while assessing whether other more targeted treatments are working, painkillers can be used to help manage your pain
• Weight loss – losing weight may help reduce the pressure and strain on your hip joint

What to expect during hip replacement surgery

Understanding the key steps involved in a hip replacement will help you feel more confident about what to expect before, during and after the surgery.

During hip replacement surgery

Before the surgery begins, you’ll either receive a general anaesthetic to put you to sleep or an epidural to numb your lower body. You’ll then be placed in the correct position for your surgeon to access the hip joint. The joint can be accessed through one of three approaches:

• Front – anterior hip replacement
• Side – lateral hip replacement
• Back – posterior hip replacement

Your surgeon will make an incision into the hip, remove the damaged joint and replace it with an artificial one. They’ll then bend and move your leg to ensure the new joint has a full range of motion.

Once the replacement is complete, the surgeon will use surgical glue and dissolvable stitches to close the incision. They may also inject a nerve-numbing medicine in or around the joint to help block pain after the surgery.

The procedure usually takes between one to two hours to complete.

After hip replacement surgery

You’ll be taken to the recovery room immediately after your surgery, where you’ll wake up before being transferred to your hospital room.

For the first few hours, while the anaesthetic or epidural wears off, your medical team will monitor your blood pressure, pulse, alertness and pain levels. Once it’s safe to do so, you’ll be encouraged to get up and move around.

Depending on your initial recovery from the surgery, you may be able to go home the same day or the following day. You’ll need someone to drive you home from the clinic.

Recovery from hip replacement surgery

Once you’re at home, you’ll need to:

• Keep the surgical area clean and dry
• Use a walking aid for a couple of weeks
• Attend physiotherapy to learn how to move with your new hip joint and rebuild muscle strength
• Avoid driving for a few weeks or as your surgeon advises

As you recover, you’ll gradually experience a significant reduction in pain and an improvement in your range of movement. The expected recovery time for a hip replacement is different for every patient, and muscle strengthening is very important.  

Hip replacement is a major surgery, and further surgery can be needed at any point if there is a significant issue. Based on national historical data, if you’re under 50 when you have your first hip replacement, you’re likely to need another hip replacement at some point. If you’re over 70, it is likely to be the only one you need. With modern techniques and implants, though, many hip replacements are lasting longer than they did in the past.

Next steps and how to seek help

Hip pain that doesn’t improve with medication and affects your quality of life may signal the need for hip replacement surgery.

Our world-class orthopaedic consultants at The London Clinic are here to provide a thorough assessment. They’ll work closely with you to identify the cause of your pain, evaluate the extent of joint damage and explore treatment options, including hip replacement surgery, that could be right for you. 

Get in touch today on 0203 553 1884 or enquire online.