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Arthritis Health Center

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Questions and Answers about Hip Replacement

What Are Alternatives to Total Hip Replacement?

Before considering a total hip replacement, the doctor may try other methods of treatment, such as an exercise program and medication. An exercise program can strengthen the muscles in the hip joint and sometimes improve positioning of the hip and relieve pain.

The doctor also may treat inflammation in the hip with nonsteroidal anti-inflammatory drugs, or NSAIDs. Some common NSAIDs are aspirin and ibuprofen. Many of these medications are available without a prescription, although a doctor also can prescribe NSAIDs in stronger doses.

In a small number of cases, the doctor may prescribe corticosteroids, such as prednisone or cortisone, if NSAIDs do not relieve pain. Corticosteroids reduce joint inflammation and are frequently used to treat rheumatic diseases such as rheumatoid arthritis. Corticosteroids are not always a treatment option because they can cause further damage to the bones in the joint. Some people experience side effects from corticosteroids such as increased appetite, weight gain, and lower resistance to infections. A doctor must prescribe and monitor corticosteroid treatment. Because corticosteroids alter the body's natural hormone production, patients should not stop taking them suddenly and should follow the doctor's instructions for discontinuing treatment.

If physical therapy and medication do not relieve pain and improve joint function, the doctor may suggest corrective surgery that is less complex than a hip replacement, such as an osteotomy. Osteotomy is surgical repositioning of the joint. The surgeon cuts away damaged bone and tissue and restores the joint to its proper position. The goal of this surgery is to restore the joint to its correct position, which helps to distribute weight evenly in the joint. For some people, an osteotomy relieves pain. Recovery from an osteotomy takes 6 to 12 months. After an osteotomy, the function of the hip joint may continue to worsen and the patient may need additional treatment. The length of time before another surgery is needed varies greatly and depends on the condition of the joint before the procedure.

What Does Hip Replacement Surgery Involve?

The hip joint is located where the upper end of the femur meets the acetabulum. The femur, or thigh bone, looks like a long stem with a ball on the end. The acetabulum is a socket or cup-like structure in the pelvis, or hip bone. This "ball and socket" arrangement allows a wide range of motion, including sitting, standing, walking, and other daily activities.

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