Signs That You're Ready for a Hip Replacement

Deciding when not to have surgery is just as important

hip replacement time
Your surgeon can help you decide if the time is right for hip replacement. John Fedele / Getty Images

A total hip replacement is a major surgery and something you shouldn't take lightly. For all of its benefits, the procedure does come with certain risks and demands a program of rehabilitation you would need to commit to.

The old 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 underpin how serious a decision this is.

Here are some general tips to help you assess whether now is the right time for a hip replacement.

Signs You Are Ready For Hip Replacement

As a rule of thumb, replacement surgery is indicated when a hip problem is significantly reducing your quality of life and restricting your ability to perform everyday tasks that others in your age group can. That's a pretty broad description and deciding whether or not you meet the criteria is often subjective.

From a more practical standpoint, a hip replacement is typically indicated if you experience all of the following:

  • You have hip pain that keeps you awake or awakens you at night.
  • The pain limits your ability to get up from a chair, climb stairs, or get into a car.
  • The pain makes it less possible to activities to engage in simple activities that give you pleasure, such walking, shopping, or swimming.
  • You have tried other treatments for several months or more and still have persistent pain.

    As important as these factors are, they are not ones that factor into a decision. You and your doctor would also need to access how well you would tolerate the surgery, taking into consideration such things as your age, your bone density, and your overall health (including any conditions that may contraindicate surgery).

    Signs You Are Not Ready For Hip Replacement

    Deciding when not to have a surgery is just as important as deciding when it is. Generally speaking, hip replacement surgery is less of an imperative under the following circumstances:

    • Your hip pain may slow you down, but it does not actually limit normal activities.
    • You can get relief from less invasive treatments such as medications or therapy.
    • You have not yet tried any less invasive treatments.
    • You can still do things like walking, swimming, and shopping even if you cannot do more strenuous activities like skiing, running, or bowling.

    People who meet these criteria are usually advised to seek more conservative, non-surgical treatments such as physical therapy, ambulatory aids, pain relief medications, and rest.

    One of the important aspects of arthritic hip pain is that the symptoms tend to wax and wane in their severity. While arthritic pain can often be severe, the decision to have a joint replacement should not be made based on the occasional flare-up but on persistent pain which causes significant disability and fails to respond to noninvasive treatments.

    What to Do Next If Surgery Is Indicated

    If you get to the stage where you are ready and eligible for a hip replacement, the next step would be to sit with your doctor to outline the plan of action.

    This includes the full disclosure of what the surgery and post-operative care will entail. Among the topics of discussion:

    • You should review which hip replacement implants are most appropriate for you.
    • Understanding the procedure itself is key to recovery. The more you understand what lies ahead, the better you'll be prepared for the challenges and any hiccups you may encounter.
    • The risks of surgery should also be detailed in order for you to make a fully informed choice. This includes the risk of infection, nerve injury, blood clots, and anesthesia complications.
    • You should be walked through the steps from what happens the day before surgery right through to when you are delivered to the recovery room.
    • Finally, based on a review of your general health, you should have an in-depth discussion about what post-operative recovery and rehabilitation entail. This requires commitment on your part to not only follow the rehabilitation program as prescribed but to work with your insurer to obtain physical therapy and home health care assistance, if needed.

    Working out these details in advance can pay off significantly in terms of a smoother recovery and greater peace of mind. If you are not able to get the information that you need, do not hesitate to seek a second opinion from a qualified orthopedic surgical specialist.

    Source:

    Schairer, W.; Nwachukwu, B.; McCormick, F.; et al. "Use of Hip Arthroscopy and Risk of Conversion to Total Hip Arthroplasty: A Population-Based Analysis." Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2016; 32(4):587-593.

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