Purpose of Hip Replacement Surgery

The main purpose of hip replacement surgery (a.k.a. hip arthroplasty) is to restore the integrity of the ball-and-socket joint between the thigh bone and pelvis, typically in patients with hip arthritis. The goals of this are to reduce persistent hip pain and/or disability that can occur when the hip is compromised.

Diagnoses Related to Hip Replacement Surgery

The most common diagnosis for patients undergoing hip replacement surgery is osteoarthritis (OA). OA develops when the smooth cartilage that normally cushions the hip joint deteriorates. Over time, this deterioration leads to pain and loss of the hip's normal range of motion.

Besides osteoarthritis, other diagnoses that may warrant a hip replacement include:

• Post-traumatic arthritis (arthritis that results from a hip injury)
• Inflammatory arthritis, such as rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis
• Femoroacetabular impingement syndrome
• Developmental hip dysplasia
• Legg-Calvé-Perthes disease
• Slipped capital femoral epiphysis
• Severe hip trauma (e.g., dislocation or fracture)
• Hip osteonecrosis
• Metastatic bone disease

This major operation, which involves removing damaged cartilage and bone and replacing it with prosthetics, is considered when multiple non-surgical therapies have been tried without success.

These often include:

• Taking non-steroidal anti-inflammatory drugs (NSAIDs)
• Corticosteroid injection into the hip joint
• Physical therapy
• Using an assistive device, like a cane or walker
• Weight loss (if overweight or obese)
• Taking a disease-modifying antirheumatic drug (DMARD) if you have inflammatory arthritis

Criteria

There are no formal criteria (including related to age or weight) for determining who is a proper candidate for a hip replacement.

Instead, surgery is a last resort option—one that is indicated when patients continue to have hip pain and/or difficulties performing activities of daily living despite trying various conservative treatments for several months or more.

More specifically, and from a more practical standpoint, you may be a candidate for a hip replacement if any of the following apply:

• You have hip pain that keeps you awake or awakens you at night.
• Hip pain limits your ability to get up from a chair, put on shoes and socks, climb stairs, or get in and out of a car.
• The pain makes it less possible to engage in simple activities that give you pleasure, such as walking, shopping, or swimming.

As important as the above factors are, they are not the only ones that need to be taken into account when considering a hip replacement. While an often life-changing procedure in terms of comfort and quality of life, you and your surgeon will need to discuss the potential risks of the surgery in your case.

Additionally, your overall health, including any conditions that may contraindicate surgery (e.g., having an active infection or heart failure), will need to be considered.

Tests and Labs

Before undergoing hip replacement surgery, your orthopedic surgeon will perform a comprehensive evaluation.

This evaluation often includes:

• A medical history: Your surgeon will review your symptoms (e.g., pain, stiffness, and level of functioning).
• A physical examination: Your surgeon will thoroughly examine your hip, as well as your knees, spine, and pelvis. They will also check your pulse and perform a sensory nerve examination on your legs and feet.
• Special tests: A leg length measurement and various tests, including the Trendelenburg sign (a test of whether one side of your pelvis drops when you stand on the opposite side's leg) and straight leg raise, will be performed.
• Imaging tests: X-rays and sometimes magnetic resonance imaging (MRI) of your hip can help your surgeon understand the extent of damage present.

If your surgery is decided upon and scheduled, you will need to undergo several tests for medical and anesthesia clearance.

These tests often include:

• Laboratory studies, such as a complete blood count (CBC), basic metabolic panel, a coagulation panel, and a blood type and screen
• Electrocardiogram (ECG)
• Chest X-ray
• Urinalysis

A Word From Verywell

The maxim used to be that hip replacement surgery should only be pursued when you, as the patient, "cannot stand the pain anymore." Today, with advances in the procedure, the rationale may not be as relevant, but it does hint at how serious a decision to undergo this operation is.

If you and your surgeon decide that a hip replacement is a sensible next step in your care, please take your time discussing and understanding the possible risks of the surgery, as well as what your recovery and rehabilitation will entail.