Do You Really Need A Hip Replacement?

By Eliana Osborn

If your hips hurt, every position is uncomfortable. Sitting or standing, walking or even lying down—nothing gives you relief. These joints sit near your core and are essential to so much of our movement. No wonder 2.5 million Americans are living with total hip replacements, according to Mayo Clinic research.

However, there may be an alternative.

There’s no doubt that hip replacements can be the best solution for some people, says Dr. Derek Ochai of the Nirschi Orthopaedic Center, in Arlington, Virginia: “Hip replacement is replacing the entire hip joint with metal and plastic parts. This is major surgery. [But] if you have debilitating pain from hip arthritis, this can be a life-changing positive surgery.”

Medical advances have made hip replacement increasingly common for people at younger ages. These new joints are more durable than older varieties when the surgery was first invented back in the 70s, and hospital stays have gotten shorter and shorter. The number of people choosing hip replacements doubled between 2000 and 2010.

But is there a way to avoid needing new joints in the first place? “The number-one thing people can do to decrease/avoid hip degeneration is to keep their weight down,” Ochai says. For instance, pressure on the hip with stair climbing is four to six times your body weight, so even minimal increases or decreases in body weight can have either a negative or positive effect.”

Another important move is to pay attention to how your hips feel during activities. If you start getting some pain during running, for example, Ochai suggests making changes to stride length or foot impact to put less pressure on the hips. “People can also switch from just doing one type of activity to cross training, to vary the pressure on their hips. In general, stationary bikes, elliptical trainers, in-line skating, and swimming put far less pressure on the hip joint than running.”

Osteoarthritis pain—that’s when the cartilage has broken down and bones start rubbing against each other—can start small, and lifestyle changes are crucial at that stage, especially when considering the cost of total hip replacement. In Los Angeles alone, the procedure ranges from $17,000 to $40,000. Blue Cross of North Carolina says the cost is between $32,000 and $44,000 for the surgery. Yet despite the expense, more than 90% of those who get a hip replacement say they are glad they did it and wish they had done it sooner.

But there is another option: Ochai and others offer an early intervention surgery called hip arthroscopy that can delay or even prevent the need for something as drastic as a total hip replacement. Arthroscopy means looking inside a joint through a small incision: Instead of taking out the whole joint, work can be done just on the parts that need it.

“Arthroscopic surgery can treat conditions that can potentially lead to arthritis,” Ochai says. “That is why if you are having pain in your hip, it would be important to get evaluated before your hip progresses to arthritis, since arthroscopic surgery can sometimes cure the condition that can lead to arthritis. Then replacement would not be necessary.”

“Many professional athletes have hip arthroscopy, and return to that sport. Hip arthroscopy is certainly not as common as hip replacement, and the number of surgeons expert at hip preservation arthroscopy is far fewer than with hip replacement.” The costs for this minimally invasive surgery are far less than hip replacement, under $10,000 and often even lower, and rarely does a patient even spend the night in the hospital.

The bottom line: If you want to avoid major surgery, you have to pay attention to your body and the first signs of joint distress. Early treatment and intervention give you options like hip arthroscopy. If you wait till the damage is done, you may have to turn to a more costly and dramatic procedure.