Who should have hip replacement surgery?

The most common reason for hip replacement surgery is arthritis. The most common variety of arthritis is osteoarthritis, sometimes also called “degenerative arthritis” or “degenerative joint disease.” Osteoarthritis is the “garden variety” of arthritis that almost everyone has to some degree by the age of 60. Less common causes of arthritis are rheumatoid arthritis, post-traumatic arthritis resulting from prior trauma, arthritis resulting from congenital/developmental disorders, and avascular necrosis (a loss of blood supply to the femoral head).

Arthritis pain usually responds initially to conservative treatments such as non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, heat, ice, heating rubs, massage, and the use of a cane. When pain is not controlled by these measures, or when pain and stiffness interfere with a person’s normal daily activities and ability to function, total hip replacement is often recommended.

Historically, hip replacement surgery is usually not recommended for patients under the age of 60. Standard total hip replacement components (metal and plastic) do not hold up well in younger, heavier, or more active patients. Recently, newer technologies (metal-metal, ceramic-ceramic) have provided more durable implants for use even in younger, more active patients. Nevertheless, total hip replacement components will not last a lifetime in some patients, and these patients may require revision total hip replacement sometime down the road.

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