Ask the Expert: Dr. Geoffrey Westrich, Orthopedic Surgeon, Answers Your Questions About Hip Arthroplasty vs. Hip Arthroscopy

Q1. I need hip surgery – what determines if I need arthroplasty or arthroscopy surgery?

If you have hip arthritis, arthroplasty (hip replacement) is needed to remove the diseased hip structures and replace them with an artificial implant. Hip arthroscopy is a minimally invasive procedure to repair hip injuries, using small cameras that are fit through tiny incisions in order to view the hip. However, while this procedure is successful for many patients, such as those with labral tears, it does not have a good outcome if you have arthritis, even if you have a tear in the labrum, which is a rim of rubbery cartilage around the hip socket that seals in joint fluid and maintains lubrication and nutrition.

Q2. I had a total hip replacement three years ago and recently I started experiencing some discomfort and swelling in the immediate surgical area. Is this a sign of infection or rejection?

There are many causes of pain several years following hip replacement surgery. Some are relatively easy to solve and some are more complex. If you’re experiencing pain it is always best to visit with your surgeon for an evaluation as soon as you can. This should include a physical examination as well as x-rays. If an infection is suspected, your surgeon should consider blood tests and possibly an aspiration of the hip under fluoroscopy, which involves removing fluid from the hip joint to test for infection.

Q3. What is the recovery like for hip arthroscopy and arthroplasty surgery?

For hip arthroscopy, recovery may vary depending upon the patient, the extent of the surgery and what was found at the time of surgery. Traditionally, patients can walk with crutches and put weight on the limb after leaving the hospital. However, depending upon the specific surgery that was performed during the hip arthroscopy, patients may need to remain on crutches for several weeks. For a hip arthroplasty, patients are usually able to bear full weight and are generally sent home after the surgery with a cane.

Q4. I am an athlete. How likely is it that I will be as active after hip arthroplasty surgery?

Most patients who are active will continue to be very active following hip arthroplasty. In many cases, patients can return to many of the activities that they have been unable to do for years. However, orthopedic surgeons still recommend non-impact activities, like biking, swimming, golf, double tennis, and caution over high-impact type activities, such as running and jumping. It is always best to review this with your surgeon both before and after surgery so that the patient has realistic expectations.

Q5. Will my arthritis pain improve after my hip arthroscopy surgery?

Your arthritis pain will likely not improve and may even worsen following hip arthroscopy surgery. Hip arthroplasty is recommended to treat patients with hip arthritis pain. Please refer to my answer to the first question.

Dr. Geoffrey Westrich, Orthopedic Surgeon, specializes in knee and knee replacement, including revision surgery and complex cases at Hospital for Special Surgery. He is director of research of the Adult Reconstruction and Joint Replacement Service at HSS. 

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.


  1. 21 months ago I had hip replacement Never a day without pain my surgeon referred me to a spine dr and I received 3 pain blocks. Even though I had back pain my severe pain was in my hip. I was referred to a new Dr for my 3rd pain block(the burn) and he was shocked that my hip Dr had never requested an MRI of my hip. After the MRI I was told I had a encapsulations and would need to have the two stage revision surgery. My hip Dr has referred me To Dr Thomas Bradbury at Emory but my appointment is Aug 18.. My question is can I wait that long or am I in danger of the infection causing damage during this extended wait period?? Thanks

  2. Dr. Westrich- I had a total hip replacement 12/18/13. Since that time, I have had worse pain than before. I have NO QUALITY of life since the replacement. I walk with a limp. I’ve been back to the surgeon regarding the pain and he pretty much brushes me off. He tells me to give it time. I’d think after 2 years & 4 months, that is more than enough time. I wonder if it would be possible to make an appointment with you to discuss this further & see if there’s any chance that a revision would be of any help. Thank you!

  3. Is it possible to get information on the angle at which the DePuy Pinnacle Metal on Metal hip should be implanted? My husband had to have a second surgery because he had issues for over a year and when a second surgeon looked at it, he advised that it was implanted at incorrect angle. After his second surgery, my husband has had remarkable improvement and is back to “normal”. He walked out of the hospital two days after surgery. The first time he couldn’t walk without the use of a cane for more than a year. He was still using cane the day he was admitted for second surgery and after the second surgery he never had to use the cane!! Is there something you can email me or mail to me? It was inserted at 26-27% and we were advised it should be 40%-45% but we can”t find solid proof.

If you’d like to consider HSS for treatment, please contact our Patient Referral Service at 888-720-1982. For general questions and comments, reach us on Facebook or Twitter.