Hip Replacement: Is the timing right?

Age is an important factor in deciding when to go ahead with a hip replacement because artificial hip implants have limited life spans. You can only put a certain number of miles on your new hip before it wears out. If you are overweight or very physically active, your new joint may wear out faster.

Given the average life span for Americans, many of the older adults who get a new hip in their 60s or 70s may never need to have it replaced.

This is why most people are encouraged to delay total hip replacement until at least their 60s, if possible. If you are in your 40s or 50s, a new hip is likely to wear out during your lifetime. Then you'll need to have revision surgery to take out the old one and replace it.

How much pain and disability do you have?

The pain and physical limitations of advanced hip arthritis can wear you down physically and emotionally. The decision to have a joint replacement is based on the amount of damage to the joint, your symptoms, and your overall level of disability. Here are some signs that it may be time to consider hip replacement:

Joint health

  • X-rays show advanced arthritis or other damage.
  • The joint is visibly deformed, bowing inward or outward.

Symptoms

  • You have significant pain daily.
  • Pain keeps you awake at night despite the use of medications.
  • Pain and swelling don't decrease with rest and medication.
  • Pain medications are causing severe side effects.

Loss of function

  • Pain and stiffness limit your ability to do normal, everyday activities.
  • It's difficult for you to bend or rotate your hips.

Are you healthy enough for surgery?

Before making your decision, you'll need to undergo a comprehensive medical evaluation by your primary care doctor or orthopedic specialist. Hip replacement might be too risky if you have any of the following conditions:

  • an active infection in the hip or elsewhere in the body
  • a significant medical condition, including recent heart attack, ongoing chest pain from heart disease, or heart failure
  • poor circulation that could interfere with healing
  • severely damaged or nonworking hip muscles or ligaments
  • damaged nerves in the hip
  • neuromuscular disease such as multiple sclerosis, Parkinson's disease, or stroke
  • an allergy to materials used to make artificial joints.

To learn more about the benefits and risks of hip replacement surgery, read Total Hip Replacement, an online guide from Harvard Medical School.

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