How do you decide when you absolutely must have hip replacement surgery?

[AlienShmalien]

I guess for most people the level of pain is the deciding factor.
I have osteoarthritis in my hips for about 6 years. I had X rays done back then and was told I would need hip replacement surgery in 1 to 5 years time.
However I'm still not in any real pain and could probably carry on like this for a few more years.
The main negative impact is that if I do long walks, say more than an hour, my hips will get sore. I also can't do steep hill walks as I used to before. Likewise I had to stop playing 7-a-side football and golf.
I do have limited movement/flexibility in my left hip in particular so things like cutting my toenails is difficult but that's not a big deal.

I guess it limits my life and limits my ability to participate in certain physical activities which in turn probably has a negative impact on my overall physical health and fitness.

Any thoughts or advice would be appreciated.

Anyone:)

I decided when the time had come for a knee replacement when the pain got too much and I ended up standing on the field at the school I taught in with tears streaming down my face thanks to the pain of getting down stairs and across the playground during a fire practice. This was in front of the whole school and I decided the time had come! Only you can decide when to have the op, but bear in mind that the recovery is quite challenging and the younger and fitter you are, the easier it will be. Good luck!

Thanks for your reply. Obviously I'm not in pain like you were but I'm 57.5 now and probably be at least 58 before I'd get it done.
Anyone had it done even though they weren't in great pain?

When I was 12 I had something called a slipped epiphysis. It's basically a growth spurt in the night and my hip dislocated.
Because the pain was in my knee, it was overlooked for a while and I ended up having it pinned.
It wasn't done correctly, so for the next 30 years, I was in pain all the time. I got used to it, I seem to have a high pain threshold!
The deciding factor for me was that I became unable to walk up even the smallest incline, it was totally impossible.
My GP said it was the best decision, as it was affecting my quality of life.
I had to leave it as long as I possibly could, as you can only have two replacements, so I had mine done at 43. 12 years on and I'm starting to get pain again. I'll have to hang on as long as I can with the pain, because the 2nd replacement will have to last the rest of my life.
I don't know if all that helps? But I'd definitely say if it's affecting your quality of life, then do it! Best thing I ever did.
Good luck 🌻

I didn't know there was a limit of two!
I thought modern artificial hips lasted for 15 to 20 years. Have you been unlucky or have you been quite active and that's why it's not lasted longer?

I have spinal osteoarthritis and keep being told that lots of people will also have it according to scans, but if mobile and not in pain, it doesn't matter.
Sadly I'm in pain, so I'd let pain and mobility be your guide. No need to rush into surgery.

I just had mine done at 52, I really recommend that you do it sooner rather than later as once the pain starts to ramp up it very quickly deteriorates. You'll also bounce back quicker if you have full mobility everywhere else.

My surgeon said it would last for at least 30 years, no need to worry about a 2 op limit anymore

You seem quite lucky so far, my lovely mum in her 50s needed sticks for a few meters within about a year of diagnosis.

Yes, maybe I am lucky in that sense. I can walk or cycle for almost an hour.

Generally when the pain can't be controlled despite regular painkillers, and when you have pain that regularly disturbs your sleep.

Some people, generally Yorkshirefolk describe what you have, which is more a seizing up of the joint rather than pain, but when that becomes a limit to activity, that's a softer reason to get it done.

Occasionally the bone may start wearing away and there may be a benefit to do it sooner, before it becomes too technically complex.

You can definitely have a hip replacement done more than once, but given the current metrics are measuring 95% implant survival at 30 years, at the age of fifty, chances are one will last a lifetime unless it gets infected or fractured through am accident.

My mate is 43 and having hers done shortly... She's not in huge pain unless she turns badly or sits badly then she screams tbh. But it's also stopping her doing all the sports, hiking, travelling Europe on a bicycle type stuff she loves so much. She can pootle about without too much difficulty.

My 72yo Dad is currently 4 days post-surgery for his first and will have the other one done in 3 months. He's been barely able to walk for years and has been a stubborn, cantankerous old goat for the entire time due to pain and inability to do what he wants. He needs assistance with so much and he hates it. He likes his mobility scooter though, and the dog loves getting a lift up the big hill on it! Hopefully he'll be back to his usual and less miserable self by Christmas.

So, it depends, basically! You have to decide when you've had enough, but you could then be waiting another year for NHS surgery after that decision....

The 95% implant survival at 30 years, isn't something I was aware of.
I think I'll book another chat with the physio at the hospital and see what he says.

I had both my hips replaced within 6 months. The first one was much as you describe, sometimes I could walk for a couple of hours comfortably but sometimes the pain would suddenly start and that would be it. Lack of flexibility in the joint was a nuisance too. Getting comfortable at night was a challenge. I took painkillers as and when but tried to limit their use as much as I could. Probably that was silly.

I had the first one done and within weeks I was more or less pain free and realised how uncomfortable the other hip was! Fortunately the surgeon was happy to book me in for the next op.

I did all the physio and walked loads as advised and both hips are now lovely. The process is a bit challenging and I can't say the first few weeks of building up distance was fun or pain free. But OMG it was so worth it.

I'm 70 now and my hips replaced about 8 years ago.

Any further questions - please ask.

If you can walk for an hour without pain, it sounds as if you do not need a replacement yet. I was diagnosed around 15 years ago with OA hip. It improved when I retired and is only now bothering me again but certainly do not think it is anywhere near bad enough for a replacement.
My back pain limits my walking to around thirty minutes. If I walk a lot, I struggle to sleep with the hip pain. The pain does not stop me pretty active with walking, housework, gardening etc. so feel no need yet for surgery.

It doesnt sound like you need it yet. I got to the point where i needed a mobility scooter for trips to the shops. Driving to work was painful (20 mins) The pain kept me awake at night. I could only walk for 10 minutes before the pain got too much. It was shit. And it was shit for my kids because it was too painful to do stuff with them. I got a new right hip 18 months ago and i have my life back. And they have their mum back. Im 49.

My DH had a dreadfully painful knee. He was too young for a knee replacement so had an operation where they break your leg, rotate it a few degrees so the worn bone is no longer pressing on the worn bone. It reduces his mobility and means he can't twist his leg or bend it properly but the pain is better. He was told it would last between 5-7 years. It's been 7 years and the pain is back and his mobility is very poor so I guess in the next year or so he'll get a knee replacement. He knows he could only have one more knee replacement after that in his lifetime. Like hip replacements knee replacements last about 12-15 years but can last longer. For DH the pain was the deciding factor for the first op. Lack of mobility and pain will determine knee replacement.

I've been more active since I had it done than I was before, but my problem is that I have no padding round it! They last 15 years, mines ceramic.

Had my hip replaced 2 years ago at the age of 34, I would get the ball rolling now, I had to wait something stupid like 18 months from gp referral to first ortho appointment. I had been in pain many years but deteriorated quickly in that time, taking very strong pain killers and walking with a stick

For my DH it was when the pain affected his sleep. I would say you should have xrays done and get on the waiting list if necessary.

I was on max painkillers and still in pain, struggled with 'locking' and it was severely impacting my life when I had mine done, for example I wouldn't go anywhere I wasn't confident I could park very closely or that I would get a seat. The op was great, instant relief from the pain. Obviously recovery was tough but worth it.
Mine are coming up for 20 years old now and are deteriorating but I hope to get a few more years. Others fail sooner, you don't really know so I don't think banking on a 30 year hip is very wise.
I still can't reach my feet etc. though but that's only partly the hips but also the dicky knees (which I am postponing replacing as long as possible).

Hello, I read the message you posted last year asking about having hip surgery despite still being fairly active. I wondered what decision you had made as I am in a similar situation. I can potter around the house fine, do pilates and swim, no pain at night but have stopped going for long walks or other intense exercise like skiing. Many of my friends and family say do the op, but I'm worried that things will be worse rather than better. One of the issues is not really knowing what movements you can or can not do afterwards and that this can vary from person to person.

Not a hip but my DH had a knee replacement and had it done when he couldn't walk for more than about 30 minutes without pain/stiffness.

The NHS will leave it until you can hardly move and then the outcome is poor.

I would wait until you are fed up with it, it is limiting your life a lot, but you are still fit enough to exercise and do the physio afterwards effectively. Then you give yourself the best chance of a good outcome. This assumes you have private insurance or can pay for it yourself, though.

A family member had theirs done after deteriorating quite quickly over 12 months. It was a revelation- pain gone within the day, home the next, looked years younger. Getting over the op took work and was a bit unpleasant but honestly taken hers off them and they said they didn’t realise how much it was grinding them down, they couldn’t walk more than an hour, couldn’t ski, do yoga, Pilates, sleep properly etc. If it is affecting your life by stopping you do the things that bring you joy then I say get on with it