When is Hip Replacement Surgery Needed?

Out of all orthopedic surgeries performed for any reason on any bone or joint, a hip replacement has the greatest patient satisfaction.

One of the reasons why hip replacements are so successful is due to careful patient selection; not everyone needs a hip replacement.

When deciding to undergo hip replacement surgery there are three main points to discuss.

  1. What is the pathology in the hip the hip replacement is treating?

Hip replacements are performed for many different reasons, the most common being osteoarthritis.

Osteoarthritis is due to degeneration of the smooth cartilage surface of the hip joint.

When the cartilage is lost the hip motion is painful and limited. Another but less common reason to undergo a hip replacement is for Avascular necrosis of the hip or AVN.

This occurs when blood supply to the head of the femur is lost and the bone begins die.

The bone death causes the femoral head (or the ball part of the ball and socket joint) to lose its spherical shape and collapse.

A third reason to undergo a hip replacement is for a hip fracture. This usually occurs in patients with osteoporosis who fall on their hip breaking the femoral neck.

  1. Have all the non-operative treatments been tried and exhausted?

If you have osteoarthritis of your hip the first treatment should not be a hip replacement.

Initial treatments include the following: physical therapy to strengthen the muscles supporting the hip joint.

Anti-inflammatory medications, which include Advil, Aleve, Motrin, and other prescription strength medication can also help with the pain caused by osteoarthritis.

Lastly an injection into the hip joint can be helpful as well. These injections are usually steroid injections aimed at decreasing inflammation in the joint which will help with pain.

  1. How much is the hip pain effecting the patient’s life?

I always tell my patient’s that they are ready for a hip replacement when their hip pain is effecting there regular daily activities and prohibiting them from participating in the activities they love to do.

The patient should always be the one making the decision to undergo a hip replacement, because only they truly know how much pain they have, and how much pain they are willing to live with.

If you have hip pain that is greatly effecting your life, make an appointment with your orthopedic surgeon at Westchester Sport and Spine to discuss treatment options.


Dr. Michael Gott is a Westchester orthopedic surgeon who is fellowship trained in sports medicine. He has also been an active member of the National Ski Patrol as well as a Member of the Windham Mountain Ski Patrol for 18 years.