There are several causes of hip pain, including arthritis, bursitis and tendonitis. In people who have osteoarthritis, wear and tear causes breakdown of the cartilage — the material at the ends of bones that provides cushioning in the joints. The loss of cartilage leads to pain and inflammation.
Pain due to arthritis in the hip is usually felt in the groin or thigh rather than the buttock; it may radiate down your thigh to your knee. Swelling in the joint can also make it harder for you to move your hip. Some people with arthritis in the hip eventually have symptoms that are severe enough that they would benefit from a hip replacement.
During hip replacement surgery, also called total hip arthroplasty, portions of your hip joint that have been damaged are removed and replaced with plastic, metal or ceramic parts.
Not everyone who has arthritis in their hip needs surgery right away. Usually, we start by treating the symptoms with acetaminophen or anti-inflammatory drugs. You may also benefit from physical therapy or steroid injections. Depending on your pain levels, you may be able to put off surgery for several years by using these approaches to improve your symptoms.
Some people go to pretty significant extremes to avoid having their hip replaced. They may pursue unproven treatments that aren’t well regulated. Unfortunately, we don’t have anything that truly reverses the process, or even slows it down, once the hip joint has begun to degenerate.
My goal is to try to manage patients’ pain for as long as possible without surgery. But if you get to the point where the pain is keeping you up at night or you’re not leaving the house because it hurts too bad to walk, then it’s probably time to fix it.
People often hesitate to have a hip replacement operation because they are scared to have any kind of surgery. The techniques used in hip replacement surgery have improved greatly in recent years. Overall, recovery is very rapid. Most importantly, hip replacement surgery can eliminate your pain and get you back to doing what you like to do.
Dr. Mathias Bostrom is Chief of the Adult Reconstruction and Joint Replacement Service and Chief Emeritus of the Hip Service at HSS. He is a specialist in hip and knee surgery, especially in complex reconstructions and the treatment of musculoskeletal infections.
