From the first experimental hip replacement by Gluck in 1891 to the first total hip replacement by Professor John Charnley in 1958, hip surgery has become one of the most common orthopaedic procedures globally and has given a new lease of life to thousands of recipients worldwide each year. Over 100,000 hip replacements are performed per year in the United Kingdom (UK) and this number is increasing with the demand for hip replacements predicted to increase.1
But how do you know if you or a loved one may need hip replacement surgery? Learning about the signs and symptoms of needing a hip replacement can help you recognise if you might need hip surgery. Consulting a healthcare professional can help determine whether a hip replacement is the best solution for restoring function and quality of life.
Here we discuss some signs and symptoms to look out for that may indicate you need a hip replacement.
How do you know if you need a hip replacement?
There are a number of symptoms of needing a hip replacement. In this article we outline the ten most common signs and symptoms associated with needing a hip replacement. Symptoms can vary from patient to patient so it’s important to talk to a doctor to get a diagnosis if you are experiencing any of the symptoms listed below.
1. Chronic and persistent hip pain
It may seem obvious, but the most important and debilitating indication that you may require hip replacement surgery is pain: pain around your hip, groin or even radiating down to the knee. No two hip pains are the same.
Your hip pain may be made worse by exercise or by being at rest. It may be more painful in the morning or in the evening. It may be calmed down with simple pain killers or strong prescribed pain relief may have no effect. Hip pain can make it hard to rest and fall asleep or it can wake you in the night.
Localised pain between your hip and knee during or after exercise may restrict your usual physical activities and might be a sign of hip arthritis. If you feel a grating of your hip, are compensating with a limp, relying on a walking stick, or needing painkillers to manage the pain of walking or other physical activities you should speak to a specialist.
2. Stiffness
Reduced flexibility and movement in a stiff hip joint can turn otherwise simple tasks into chores. Getting up and down from chairs and out of bed may be difficult. Sitting too long may cause your hip to stiffen and make movement difficult. Bending over to pick something up from the floor may become increasingly difficult. More complex manoeuvres such as getting into and out of car seats may become prohibitive.
If you have chronic hip stiffness that persists indefinitely, it may be a sign that your hip joint is damaged and you should seek medical attention. Your doctor can assess your hip joint, make a diagnosis, and create a treatment plan.
3. Limited range of motion
As well as hip pain you may also become less mobile than you want or used to be. This loss in range of motion in your hip can make life and all the activities you enjoy doing more difficult. Everyday tasks may become more challenging and eventually impossible, such as dressing yourself, shopping, driving, and getting in or out of a chair or bath. You may find you are not able to walk as far as you used to and this may continue to reduce.
4. Difficulty walking and standing
Difficulty walking and standing can be a significant symptom indicating the need for a hip replacement. As hip joints deteriorate due to arthritis, injury, or wear and tear, they can become stiff and painful, limiting mobility. Simple activities like standing up from a chair, walking short distances, or climbing stairs may become challenging and increasingly uncomfortable. This loss of mobility and stability can greatly affect your daily life, making it hard to perform routine tasks or maintain independence.
5. Difficulty performing the one leg test
The one-leg test is a quick and simple home test that can indicate whether you should see a doctor about your hip problem. The test involves standing on your problem leg for around a minute using a chair, table top or door frame for balance. If you can’t support yourself then you may have a problem with the hip on that side of your body.
Other exercises you can try at home that are useful to help you determine if you could benefit from hip pain treatment include:
- Lying on your back or sitting and bringing your knee to your chest. You can use your hands to assist if you need to.
- Lying on your back and seeing if you can move your leg out to the side without moving the rest of your body.
- Sitting on a chair and placing your ankle on the opposite knee and seeing how far your knee can drop down.
6. Reduced quality of life
Your hip pain may become so severe that it has a detrimental effect on your quality of life. It can make it difficult to sleep, to enjoy hobbies, exercise and activities, to work, and to socialise with friends and family. This can greatly affect your mood and leave you feeling depressed with your pain and inability to do things.
7. Impact on emotional wellbeing
Living with hip pain can take a toll on your emotional well-being, as it often limits mobility and interferes with everyday activities. The frustration of being unable to perform simple tasks or engage in favorite hobbies can lead to feelings of helplessness or sadness. Chronic pain can also disrupt sleep, increase stress, and contribute to anxiety or depression over time. Seeking proper care and support for hip pain is vital not only for your physical recovery but also to maintain a positive outlook and emotional resilience.
8. Swelling and tenderness
Swelling and tenderness in the hip are common signs of internal joint damage and can be one of the signs you need a hip replacement. These symptoms often stem from increased friction within your joint due to cartilage deterioration, fluid buildup caused by bursitis or other masses, or inflammation associated with arthritis. Persistent swelling and tenderness, especially when accompanied by limited mobility or chronic pain may signal that your hip joint has sustained significant damage.
9. Other treatments are ineffective
Many hip problems, including certain types of arthritis, can be managed or resolved without hip replacement surgery. Your doctor will usually recommend non-surgical solutions first to help you manage your pain and increase your mobility. These include:
- Painkillers and anti-inflammatory medication - reduces swelling and pain. You can use over the counter medication such as paracetamol and Ibuprofen.
- Physiotherapy - uses a variety of low-impact exercises that will strengthen your hip joint and increase your mobility.
- Exercise - joints need to be exercised regularly to keep them healthy and this can reduce hip pain symptoms. You could consider Pilates and yoga and aerobic exercises such as swimming, cycling and walking depending on your symptoms, preferences, and any other health conditions you have.
- Steroid injections - injects hydrocortisone into your painful hip joint to relieve the pain. They are often helpful as a short-term option and to assist in gaining muscle strength and mobility through physiotherapy or exercise.
If non-surgical treatments are ineffective, then hip replacement surgery may be recommended.
10. Your health professional has ruled out other options
Hip pain, lack of mobility and stiffness may be caused by problems with parts of your body other than your hip joint including your back, spine or knees.
Tight muscles, tendon inflammation and irritation, sprains and strains, and fibromyalgia are some problems that can also cause hip pain.
If your doctor has already ruled out other conditions, then you may need a hip replacement. Your doctor will advise you on the best treatment for your hip pain.
What causes these hip pain symptoms?
There are several causes of hip pain. They include:
- Hip joint damage – due to osteoarthritis and also known as ‘wear and tear’ is most common. You don't have to be elderly for this to happen - a recent report by NBC news draws attention to the fact that people in their forties are opting for total hip replacement to treat chronic hip pain.
- Fracture
- Hip labral tear
- Bursitis
- Tendinitis
- Sprains and strains
- Rheumatoid arthritis
- Disorders of bone growth.
How do I get a diagnosis for hip replacement surgery?
Your GP will refer you to a hip specialist if you have the above signs that a hip replacement is needed. You can also book a private appointment with an orthopaedic hip surgeon for a rapid assessment and treatment for your hip pain and related mobility problems.
We are often asked ‘will an X-ray show if I need a hip replacement?’. Your hip specialist may request an X-ray or MRI scan to determine the condition of your hip and to see if a hip replacement or other non-surgical treatment options are recommended.
Your hip surgeon will talk through the reasons for hip replacement including the benefits and disadvantages of having or delaying hip replacement surgery. This discussion will take into consideration your age, if you’re well enough to cope with major surgery and rehabilitation post-operatively, your lifestyle and the amount of activity you would have normally done.
What does hip replacement surgery involve?
The three main types of hip replacement are total hip replacement, partial hip replacement, and hip resurfacing. Your surgeon will discuss the best option for you.
Hip replacement surgery involves the surgeon removing the damaged rounded head of the femur bone as well as the socket surface against which the head usually rests. The head of the femur is replaced by a prosthetic ball, the surface of the socket by a choice of materials including metal, ceramic or polyethylene. Surgery usually takes around an hour and a half and is performed under an anaesthetic or with an epidural.
What are the benefits of hip replacement surgery?
Hip replacement surgery is a transformative procedure that can help patients regain independence and enjoy an active lifestyle. Most people experience a wide range of benefits, especially if they commit to a rehabilitation programme.
The benefits include:
- Pain relief - alleviates your chronic hip pain, significantly improving comfort.
- Improves mobility - restores your range of motion and joint function.
- Enhances quality of life - enables you to resume daily activities, work, and hobbies that have been limited by hip pain.
- Increases strength and stability in your hip
- Better sleep.
- Improves posture.
- Long-lasting - hip joint replacements usually last around 15 years, which makes the time and money invested in hip replacement surgery well worth it.
- Reduces dependence on medication.
- Boosts emotional well-being.
Hip Replacement Surgery with Ramsay Health Care
At Ramsay Health Care we are proud to work in partnership with some of the highest qualified and experienced specialists including consultant orthopaedic surgeons, neurosurgeons, pain management consultants and physiotherapists in the UK. Our holistic hip surgery care offers you the best treatment for your hip replacement.
There is no wait for an appointment or for your hip replacement surgery at Ramsay.
Your treatment may be covered by medical insurance and self-pay packages are available. We have first class facilities and all self-funding and most privately insured patients can enjoy our Private Patient Pledge offering exclusive benefits including superb food, a relaxing environment, priority access and appointments to suit your lifestyle. Our aim is to help you feel like a guest as well as a patient.
Contact us today to learn more about your options for hip replacement surgery at your nearest Ramsay hospital.
References
1 Hip arthroplasty practice across the Organisation for Economic Co-operation and Development (OECD) over the last decade. Available from: https://pubmed.ncbi.nlm.nih.gov/37652085/