Knowing when to have a total hip replacement?

My BIL had his done in his late 30's - put up with it for as long as he could bear the pain. He's nearly 50 now and is walking and golfing plenty (he's not particularly sporty). It's a big op, but you'll get your life back after the recovery period.

I've not had mine done, but I have a couple of friends, plus my mam, who've had theirs done. Very big improvement in quality of life and pretty fast recovery.

I got my knee done when I was 48. Quality of life was pretty bad, as was sleep, and just general discomfort. I was struggling to keep working too. I don't regret it one bit.

From what you've said you mirror where I was with my knee. I'd get it done and get on with life. Hips are generally pretty quick recovery too compared to knees.

My wife had one of hers done @ 50. I think the biggest factor for her was sleep. Not being able to sleep for more that a short spell due to it being painful. For me it was the pain killers she was consuming just to carry on a normal life. Neither was sustainable. In my opinion she put it off for too long and it effected 'us' as we couldn't do the things we wanted to do. Post op and these days (coming up for 10 years later) all good. Although the other side is now causing some issues - don't think she will wait as long this time!

DOI I’m a GP.

Without knowing your age, it’s hard to tell you for sure. The long and short is that if you’re young (<~50) there’s a benefit to delaying a potential joint replacement, so that you don’t have to struggle with repeat “redo” operations in later life. Also the younger people are when they have hip replacements, the more that they tend to do with them, and so they may have a shorter lifespan.

Having said that, AFAIK, the indication for doing a hip replacement is when the arthritis in the hip stops you from doing your activities of daily living (ie the things that you want to do) despite taking the maximum tolerated analgesia.

Long and short of it is, if you’re not taking pain killers, get on them, and keep moving on the hip as much as possible. If you’re only taking them every now and again, take them regularly (cos they can work better) and keep doing as much as possible. If you’re already on the maximum painkillers and you can’t do what you want to do, then it’s probably time for a hip replacement.

How old are you? They last 15 years or so, give or take, and pretty much can only be redone once, so it's worth think about whether they'll last long enough. If you are walking 5 miles before it hurts then, normally, no.

Sorry I thought I had put my age in, I’m currently 49.

Pain killers, sometimes it’s nothing others it’s neproxen. Paracetamol doesn’t touch it when bad and neproxen / <b>anti-inflammatories even taken with food upset my stomach</b>

I understand the concerns re revisions but I almost would prefer to be a cabbage aged 85 than 50 which is what I feel at the minute

I understand the concerns re revisions but I almost would prefer to be a cabbage aged 85 than 50 which is what I feel at the minute

My feeling, and that of my surgeon when I had my knee done at 48. It'll be 5 in July!

Have you tried taking the paracetamol at maximum dose (two tablets four times a day) regularly?

There is a balance between quality of life now, and when we’re older. However having a failing hip or knee can make the difference between living independently when we’re older, or needing to be in a home, and in my experience that’s something that most people find very important as they age.

If it were me, I’d take as many pain killers as possible, whilst trying to maintain a reasonable quality of life. If I couldn’t then that’s when I’d have the op.

Slightly earlier in the journey here, approaching 48, had to give up running a few months ago, luckily can still cycle which is about the only time it doesn't hurt. Can just about walk 3-4 miles. Now waiting for the results of an x-ray to see what to do next.

Agree about mental health suffering when it hurts every step you take and find it very frustrating carrying bags around.

Good luck

Just do it!

You won't regret it.... But you will regret not getting it done.

Guy I work with put it off to what sounds like the point you're at now. He had it done 2 years ago, around your age. He's always benn pretty fit. Last year he walked 5000km (walks to and from work, the long way, walks at the weekend too, no kids). He doesn't regret it.

A friend has both done in his 40s, they left extra bone apparently as he'll need both done again at least once...

Made a massive difference to his quality of life....

I had a hip resurfacing 12 years ago (the one that Andy Murray had recently) and it has been superb so far with no problems at all.
Yearly check ups,X ray and blood test to check for metal in your bloodstream but so far so good.
Although it is a hip replacement they leave more bone on the femur which means if necessary you can have it done again.
I would have it done again in a heartbeat as the pain disappeared overnight and quality of life returned.

I was 50 when I had the op.

A hip resurfacing is different to a hip replacement. Not everyone is suitable though.

I had a replacement in 2020 aged 48.

I started to get a few niggling injuries & pains in my knee and achilles in my early 40's. I used to run a lot, played football, rugby and ex-forces so just thought it was a combination of those things and getting older.

I was generally OK while I was moving but really suffered when trying to sleep.

Went to see the GP after a fall on a snowboarding holiday. This is when I started to get sharp pains in my hip / groin. Sent straight for an x-ray and 4 weeks later was having surgery due to osteoarthritis and having no cartlidge left.

The other side is worn out too and getting to a point where I'm considering getting it done. The surgeon said come back when it stops you doing the things you enjoy.

Went snowboarding in Feb and suffered from the same hip / groin pain, know what it is this time so can cope with it. Managed the Lakes Jennride this weekend too 🙂

I'd rather have fun in my 50's and see what happens in my 70's.

I have the same or very similar injury. Maybe yours has progressed more than mine, but it did take me a fair bit of experimentation to get mine to hurt enough to crack on with life. Mountain biking was actually something I got into because I couldn’t do other stuff. Running was off the cards for years but off road up to 5km is now manageable. Basically had to make a bunch of adjustments, leave it a year without flaring it up, and then I was able to walk longer distances again. Adjustments were:
- Light weight flat shoes as all times. Lightest possible. Anything with any weight seems to pull at the hip joint.
- No carrying heavy things - Eg garden work, sacks of compost
- no carrying a backpack on a walk, even if very light. The weight seems to crush the hip joint.
- no extremes of movement in the hips, like in rock climbing, cyclocross dismounts, aggressive time trial positions, or some yoga positions, or er… use your imagination!
- no jumping over streams/ legs apart type jumping (Eg star jumps). Landing on one leg especially. Ouch.
- no running on the road, ever. Didn’t run at all for approx 5 years. Now only ever run on moors and uneven ground.
- avoid any repetitive walking, uneven ground seems more forgiving.
- avoid hard mattress/camping mattress. Seems to make hip joints press together.

Maybe you’re ahead of me and ready for the op, but perhaps some of the above might help you get more comfortable. Having figured out how not to aggravate it I can now do a lot more than before. Good luck!

I had a resurfacing done 6 years ago at the age of 60 after doing a lot of research as they did get some bad publicity . Theoretically the resurfaced hip should last longer than a total replacement and if you need the hip doing again in 20 years you still have the whole of your femur so can have a regular hip replacement . Somebody told me that they are no longer doing them in the UK but I don't know if that is true or not . Mine was definitely life changing and my symptoms were not as bad as yours sound when I had it done .

My brother in law had a replacement at 50 and it was needed. He has four children to bring up as a single parent and mobility was a challenge. It has been a great outcome. He’s walking now and has lost weight. He was a very good footballer as a youth and this may have exacerbated the onset.

By contrast, my father in law had a replacement replaced at 80. They weee unable to remove the original prosthetic, it led to a massive stroke in the OR, chronic disability and two years immobile in a nursing home before he starved himself to death.

Personally, I’d do all I can and hold out with available non-opioid pain relief.

My hip replacement was needed after breaking the hip, which the surgeon pinned, then unfortunately I got avascular necrosis and was in pain and struggled to walk.

Kramer - I wish my surgeon had explained later life problems as I may have 'hung on' a bit longer.
Frightening to think the replacement will last around 15 years, will keep fingers crossed that it lasts longer. The thought of going through the surgery again (after it being pinned, then full hip replacement a year or so later fills me with dread).

O.P only you can decide to go ahead or not. But I would personally pay for a really good 'sports physiotherapist' and see if they can work some magic.

Good luck.

MIL had 1 hip done 11 years ago, then the left knee, now the right knee, a few weeks ago.
Anyway, the point is, she was like a new woman after it (she’s 68), she can ride her bike, walk the dog, she was playing squash up until a year ago when she got the first knee done.
Keep going with the doctor, it’ll be worth it in the end.
Don’t downplay the pain you’re in, and don’t underestimate how much it can affect your wellbeing and quality of life.
The doctor will understand if you tell him/her that it’s having a negative effect on your mental as well as physical health.
Good luck

Had my replacement in Dec of 2017. Worked with a S&C coach and was back sprinting etc in 7 months. When they say “you’ll know when you need it doing” it was spot on for me. Basically on 8 Zapain a day and it wasn’t helping. Seeing the wincing faces of my year 11 pupils as I got up at the front of the class was the final straw alongside sleepless nights.

Am now back there again with the other one. Zapained up again, plenty or tears at bedtime and most importantly not able to do what I want to be doing (and was doing pre Christmas)

Good luck

My Mum had her first hip done 11 years ago and the second 2 years later in her mid 50s. She could hardly walk a mile by the time she finally got the op and now regularly cycles 30-60 miles (ok on an ebike but in the lowest setting as she is stubborn) and walks 5-12 miles. Massively quality of life improvement. However, she is really starting to notice the first hip now and thinks she is heading towards it having to be redone in the next couple of years or so, and given underlying health issues that isn’t an easy decision to make.

I had/have acetabular impingement in both hips. I had the right one replaced aged 53 after spending years on painkillers, eventually having to retire early as I was unfit for full duties, permanently stoned and unable to work in critical roles.

Up until the last year I was functioning ok on analgesics but I was eventually taking 1000mg paracetamol and 60mg codeine four times a day interspersed with ibuprofen, and even then I was pretty much unable to sleep and couldn’t put my socks on.

That was the point I decided to bite the bullet and have it done. Absolutely miraculous change to my well-being and happiness. Haven’t looked back at all. The left hip is now occasionally starting to bother me, and X rays show very little joint spacing, so it’s only a matter of time.

Don’t be afraid to take plenty of painkillers, they make a huge difference to your head as well as allowing you a bit more leisure choices. But don’t put off the op too long, as the pain and immobility can be sorted.

Unfortunately they don't allow you to keep the removed bone. So there goes most likely a good pot of soup.

@dyna-ti this thread was pretty grim reading, but I am dying now reading that 😂

I had no idea anyone could need a hip repalcement in their 40s... jeez

I am also now getting ankle pain, which I am convinced is linked to a change in angle of the hip.

Back in 2005 when i was playing competitive football and was playing on rock hard Brisbane pitches I started getting terrible knee and lower back/hip pain. Seeing a really good sports physio was virtually lifechanging. After he'd done some work he referred me to a podiatrist (who looked after international cricket players amongst others). The podiatrist identified the source of most of my issues was unequal leg length. He then made me custom insoles which corrected the balance by changing the angle of my feet and nearly 20 years later I know that when my right hip starts to give me grief, it's time to get my orthotics replaced.

Interestingly the last time I saw a podiatrist he noticed how much better my walking posture was since riding hard technical mtb trails.

OP, obviously you're in much worse shape than I was, but your comment made me think about the importance of angles.

If you have a physically strenuous job you will know when to have it done. I hung on far too long , eating painkillers for breakfast dinner and tea , can you tell I'm northern ? My GP practise kept telling me that I was too young but another month or so and I would have been walking with a stick and squirming in pain all day in an armchair. Do the Oxford test , you can find it online, be honest . A low score denotes severity , I had to get my GP to do one with me in the surgery and he didn't understand it! My consultant had no qualms about repeating the operation again even to the point of saying he would correct it if I wasn't happy with the first one. His mantra was ,quality of life comes first, and there were all ages in there when I went He was knocking out four per day , it's a pretty routine op nowadays. Had mine done in 2012 and it squeaks a bit now but has been a revelation . A friend who had the same work as myself spent a fortune on quack physio , sports massage , back doctors etc , I told him that his symptoms were identical to mine but he wouldn't have it until the pain became too much and hey presto his op last year has changed his life. On another note do you have a family history of hip problems because there is a strong genetic link. Do it , you will not regret it .
PS , I had pushed for X-ray the previous year which the GP said was fine , the consultant took one look at an old X-ray and said you need it done , and your other side has the same faults but don't bother until the pain becomes too much, however all good so far just occasional twinges but I will not wait so long for another one .

PPS you cannot push through the pain barrier if it is too much you can harm yourself in many other ways . I tried copper bracelets , vitamin supplements , walnut oil , lavender, strange exercises and more, the consultant told me that it's all a waste of time and money .

my sister inlaw had both hers done in her late 40s, maybe the 2nd one was early 50s.
Means she can now carry on her regular swimming and entering triathlons.
She wasn't even in that much pain beforehand, just annoyed it was getting in the way of her regular training.

Like bunnyhop - broken hip (hit by a car). Got it pinned. But luckily didnt get avascular necrosis (avn) and its still functioning.

However in the intervening time from surgery and waiting to see if id get avn. There was talk about hip replacements etc and longevity/prognosis.
Surgeon recommended at the time - as i asked him beforehand and did reading on the possible outcomes - that if it struck was to wait until as long as possible for a hip replacement due to being 'young' (i was 39 when it happened).

My findings were - which echo others here - wait as long as possible until the painkillers no longer work, and you really cant do what you need to do. Get a good physio to help strengthen the muscles area to support the hip joint.
In a 'young patient' a hip replacement can last a very short time due to activity. Id read/been told as little as 6 years before revision. Suposed to get 15-20 years but thats mainly seen in older, and more sedentary, patients.
What i read was that you can probably get 2 revisions max, at that point not much bone left to revise with with respect to the implant.

I investigated hip resurfacing too, which is much more sparing to the bone and would have been my preferred option (would have paid for it myself) if i was suitable.

Thanks all some interesting food for thought.

I am pretty certain its not a genetic thing. I skied to international level when young, and the damage is apparently consistent with that.

I am quite clearly not in the same level of pain as some people get in before they had theirs done. Mine appears to flare up rather than be a constant level of pain. Dont get me wrong there is always chronic low level pain but for example this last 2 weeks it has been more someone prodding me with a pointy stick pain and my ankle has been playing up for about 4 weeks.

I am 'lucky' that my job is desk based, as in that enables we relax the joints for 8hrs a day, if I had an active job I would be a cripple by now. A few weeks back my son was at a football tournament so I had to stand for 5-6 hrs. I was pilled up for 2 weeks or so after.

Basically anything other than doing the minimum flares it up, and at 50 is it right to be acting like an old aged person. My parents are in their 80's and in some ways do more than I do  (no disrespect to the elderly meant !)

Part of the reason I am asking here is because Mrs FD is an Orthopaedic Surgeon and done a few total hips in her time (although not her speciality). It makes discussing it all very difficult, as she is fully aware of clinical outcomes, and what can go wrong now or further down the line. She has always been in the 'your not ready camp'. However weirdly this week she said 2 things to me. Firstly was that she is seeing how this is effecting me mentally, and also how this is ageing me way beyond my years in terms of what i can do / cant do.

STWHannah - I had found the majority of the same stuff as you, although I found uneven ground made things much worse. I am sure my tear was brought on by moving to Shropshire and every 100 yds or so there being either fences or stiles that need getting over. It was always going to happen, I think this just brought it on sooner. Its very difficult not to have to do alot of the stuff you suggested ie moving heavy items etc etc. Until 3 years ago I did alot of off road half marathons. After my injury I got back to jogging 3 miles ish max, I am now down to about 2 miles and it is impossible to get under 10 min miles, however more recently this isnt even happening.

O.P only you can decide to go ahead or not. But I would personally pay for a really good ‘sports physiotherapist’ and see if they can work some magic.

I have had access to really good physio (same bloke who looks after Gee Atherton and the Welsh Football Team, amongst others) Its all a balance. Muscles stiffen up to protect the joint, which causes back pain, to some extent this makes things like putting socks on harder too, although some of that is the mechanics of whats happening. Every so often I go through phases of doing the right stretches etc. This releases the pressure on the back and other muscles but opens up the hip to more damage ( I am not saying it isnt the right thing to do)

I investigated hip resurfacing too, which is much more sparing to the bone and would have been my preferred option (would have paid for it myself) if i was suitable.

I asked this early doors and they said its beyond that as an option.

I've actually found this thread very informative but quite depressing too.

After a skiing holiday in 2022, I had trouble walking at the end of the day. A really good sports physio said my leg was now shorter (after being pinned in my first op, then the following year full hip replacement). She explained nowadays the surgeon will take a lot of care getting the legs 'even', but that hadn't been possible in my case.
Since then I've had acupuncture, exercises and an insole in the shorter leg shoe, they have all worked.
So many things to consider and so many things that one isn't told before surgery.

@SSS - it took longer for my recovery, as the pin holes have to heal (I think this is 6 wks as a broken/fractured bone). Good luck for the future. You can send me a message if you need to have a chat.

Cheers @bunnyhop
My broken hip was in 2011. Got a Dynamic Hip Screw (DHS) fitted. Screwed it all back together and waited 2 years to see if i got AVN. The hip screw is still in there.

I have to keep the joint mobilised. If i dont, it hurts and get a lot of referred pain down the leg. Likelyhood of hip replacement in future quite high on that hip - and with the DHS means its a 'complicated' case. But cross that bridge when it comes.

I found a 'broken hip thread' on BikeRadar invaluable in my recovery where real life accounts from younger patients in same situation. Broken Hip

My left hip is getting replaced in October, been on the priority list for 18 months, so finally going to get it done, from talking to others, it's a simple operation, done in an hour or two, back up on your feet later and released a day or two later. It'll be the prep for toilet, shower, etc that'll be annoying, but from discussions with ortho surgeons, they've moved on quite a bit over the last decade or two in terms of how invasive they are, and how reliable the materials and standards are, so less onerous on recovery than a few years back, and they now believe they will last longer than the old 10-15 year belief.

Go and see your doctor, get that appointment at the ortho dept and just get it checked out and down for a hip replacement if that's the option, i was getting checked every year in my late 30s and early 40s as they didn't want to replace at the age i was when it surfaced, but two years ago they put me down for the op as it was properly knackered, can't wait to be able to put socks on properly and tie my left shoelace when wearing work shoes!

OP something to note from your original post - more pain does not mean that you’re doing more damage with osteoarthritis, and recently the advice has changed because of that.

Previously we told people to avoid painful activities, these days we encourage people to continue doing them as much as possible, using pain killers if necessary, as although it may be painful, keeping the joint in motion is likely to be benefiting it. I don’t know whether this may change your thinking?

As Bunnyhop says, what a depressing thread.

So sorry to hear about this OP, and others with similar. Hope you get it sorted.

My neighbour had a resurface last summer, he is back doing Army Type fitness classes (Boot Camp - Beasting thing) It's full on, he is very fit. Had niggles but mostly back to much better than he was pre op.
My best mate and someone you would have raced against (on dry slope, back in the day) had a full replacement before Christmas. We skied together at Easter, we were with his young kids but he was able to ski. We did a run without the kids and he was tentative and was saying on the chair back up that he was at full gas, but was delighted to be out on skis again.
He rides lots too (on an e-bike)

The consultant comparing you to his own situation is unhelpful I think. He isn't doing what you do is he, his goals are different too.
I think when the time comes, do it sooner rather than later. You are younger, fitter and more able to recover post op, the outcome should be better if you have it done younger and do the physio.
Get recommendations, you wife can probably help with this. You need a safe pair of hands!
Good luck!

Previously we told people to avoid painful activities, these days we encourage people to continue doing them as much as possible, using pain killers if necessary, as although it may be painful, keeping the joint in motion is likely to be benefiting it. I don’t know whether this may change your thinking?

Yes and no - The last week I've had a nasty bug (could have been COVID) so I haven't done much moving ie a lot of being in bed or sitting in a chair. This has made it 100% worse! So I get the logic, now I am up and moving again it has released the pain some what

However (sweeping generalisation) perhaps people who require hips doing in the general population are not as active as I used to be. I see my exercise threshold dwindling away, so telling someone who used to be active to go and be active isnt really helpful.

Not a hip, but a knee with me; I'm 59.

Whilst I wasn't taking painkillers all day, it has got to the stage where I find difficulty walking normally for more than a mile, cycling hurts and I'm unable to go sailing or skiing. My job is pretty stressful and exercise was my way of managing this stress. I took the decision that my quality of life, both mentally and physically, was of utmost importance to me and my family right now. I have an operation for (hopefully) a partial knee replacement tomorrow afternoon - I say hopefully as there may be a chance I will need a total knee replacement.

Partial knee replacements seem to have greater longevity than hips - apparently 80% are still functional after 20 years (I've not delved into the stats to understand age distribution though).

All the best to the OP and other posters - joint pain is no fun.

OP not so much telling you to be more active, but reassuring you that you’re ok to be more active if you want to.

Lots of people with wear and tear type arthritis reduce their activity because of the pain, and that’s what they think that they need to do, often because they’ve been told to by healthcare professionals. Often it’s the reduction in activity that makes them unhappy, over and above any pain that they’re in. In some cases, reassurance that they’re not making things worse for themselves by being active, even if it causes pain, can be helpful to them in delaying or reducing the need for a joint replacement.

Kramer - sorry re read my last post and it may have come across wrong, the last comment wasnt aimed at you.

indeed my consultant said to try and keep running and exercising. Again its just the dwindling reduction in exercise tolerance that is mentally difficult to cope with. As above I have a stressful job (desk based), and out side of work spend a lot of time ferrying my son too and from football training and matches, exercise was the me time bit that helped me recharge and I used to fit this in with my sons training sessions, but I now struggle to jog let alone run 2 miles, and its painful to start with and painful after.

Surprised by the people who feel that this is a depressing thread , I found it very uplifting to know that a condition which has left generations of hard working people crippled by agonising pain in their later years can be cured by what is nowadays a simple and quickly recovered from operation. I read alot about the work of the pioneer of hip replacements a very clever and far sighted man , was he Prof Woodward based in Birmingham , we have much to thank him for ?

Professor Charnley.

That's the fella, what a man.

jamesco - it's depressing for me, as my hip replacement was in my 50's, meaning I may have to have another before I'm elderly and being a woman, this may not be possible. The thought of not being able to walk or enjoy outdoor past times, after years of working is worrying.
If I was elderly and had had some life, then It would be a godsend.
Yes I'll be forever grateful that I have some form of active life now, but most of the posters on this thread are not even old.

I hesitated to post yesterday as though my story is about hip pain, it is purely anecdotal and not about wear and tear / arthritic pain in later life, but it’s in keeping with some comments above so here goes:

I had a hip problem as a youngster, about 10 years old, that at first made it impossible to walk. Called Perthes disease if you care to google, it involves necrosis of the head of the femur. The prognosis at the time was a hip replacement by the age of 30, along with strict rules to avoid impact sport (running, football). Well, I didn’t like running or footbal anyway so I loved my sick note for PE. But I did develop a love of cycling. And I credit the relatively low-impact, high movement, and muscle/tendon strength developed by lots of cycling for helping me recover beyond expectations. I’m 38 now and still on my biological hip. Hurts occasionally, but can do long walks. Saw a consultant to check it out last year and I probably will be getting a replacement at some point in later life, possibly one of those injections first. But bottom line, in my experience, cycling has saved my hip and when I’m in good cycling health my hip feels stronger rather than “looser”. YMMV.

Sorry to hear that Bunnyhop ,but I like you was considered too young for a THR but it's been a revelation and I am optimistic that the massive leaps in modern health care and surgery will mean that one or maybe even two revisions could be a distinct possibility, I looked at it from the point that I could easily be dead before I got any relief, chin up, best wishes.

Will reply properly but i had mine done at 31..

Happy to have a proper chat over it

Also an orthopaedic surgeon (not spine).

Overall hip replacement is an amazingly successful operation.

Key things to factor into your thinking - a hip replacement doesn't give you a normal hip again, it gives you an almost normal one that doesn't hurt. Running/impact sport will lead to accelerated wear as its just a bearing surface and the more you load it...

It's really just very effective pain relief - so if the pain can be controlled with tablet pain relief that is better than operation pain relief. When tablet pain relief no longer works a hip replacement is a good operation.

A small (very small) number of patients have disastrous and life changing complications and end up worse than they were - it's small, and it's less likely in a young fit patient but it can happen. A really important thing to think about is 'could I handle it psychologically if I had a really bad outcome' Hard to work that out but you meet a small number of patients who are very very regretful about having had surgery and than can be very hard for them to deal with.

This isn't meant to be off putting, more about the stuff to have wrestled with!

Latest research I've seen says they are lasting more like 25 years which is great.

I forgot to mention, but my BIL had a 3D computer printed titanium hip replacement which was custom designed for a perfect fit of the old one. What I didn't say is that he had the entire operation under local anaesthesia (spinal block) because as a single parent, the children (who's mother had recently died), were worried about losing their father. Outcome has been great for all concerned.

We are massively over-engineered so it is possible to compensate for a worn joint by ensuring good control over it - working on balance, strength (including optimal recruitment patterns) & flexibility.
Modifying the loads on the joint can also have a huge effect - weight, activity & foot-ware choice.
Eventually you run out of the ability to compensate, are in constant /regular pain, your sleep is affected & your world effectively becomes a lot smaller. It is at that point, in my opinion, that a joint replacement becomes a sensible choice.
I had a new knee at 59. The initial problem was a poorly treated meniscal tear in my 20’s, not helped by continuing to play squash, going windsurfing & snowboarding. Shock loading the joint was the major issue for a long time. Initially sorbothane insoles/ springy soled shoes were enough, then I gave up squash, then slalom sailing, then wave sailing & snowboarding. Instead I did more yoga, cycling, surfing & paddle boarding. When things started to deteriorate more rapidly I contacted the surgeon that had been monitoring my knee & agreed to have it replaced. There was a 6 month wait, during which things got rapidly worse.
The new joint is great, I have virtually no discomfort in normal activities & I sleep well. It is not however the same as the original when it was in good condition, just a lot better than the old one by the time it was replaced. I was diligent with my rehab & went for my first surf 3 1/2 months after the surgery. High impact sports are now off my agenda, not because they are impossible but because I believe that they will use up the life of the replacement faster & I get enough enjoyment from the lower impact activities I now do.

I believe that the same would be true for a hip in terms of managing the joint. There is one important difference: in order to get anywhere one leg has to be behind you. In a normal gait this is mainly hip extension. Extension is often lost relatively early on an OA hip, resulting in over use of the lumbar spine. If you have reduced hip extension & a degenerate low back I would be tempted to have the hip replaced sooner rather than later.

If you have the op & can afford it private specialist rehab will be money well spent. NHS physio is woefully underfunded &, largely as a result of this, the expected level of function is well below optimal.

What I didn’t say is that he had the entire operation under local anaesthesia (spinal block)

As I understand it that's pretty much standard practice now. It makes sense that the risk of a full GA and its aftereffects means that spinal block is preferable

Mine was done under spinal block. It was also explained that they could add a longer lasting analgesic effect so it took longer to wear off, increasing post-op comfort. They offered me a sedative so I could sleep through the op. Not something I was going to refuse!

Full replacement done 3 years ago.
Saw the surgeon who told me I should not be walking
Had it done 2 weeks later.
When it is bad it is horrendous and painkillers are pointless. I was at that stage. And it was the best thing I have had done.
Currently waiting for my right one doing. Not as bad but still constant pain. Cycling keeps the pain at bay. Non weight bearing.

Also got a fused ankle and had a reconstructed knee. Which will need sorting somehow soon.

Osteoarthritis is a bas5tard.

This is a timely thread. I have severe osteoarthritis in my right hip.
I was first diagnosed with it back in 2015 at 53 years old & at that time my mobility wasn't too restricted & pain management was successful until last year.
Over the last 10 months or so, well, It's been getting worse & I've been putting up with the pain & decreased mobility until a couple of months ago, so after a doctors appointment & x rays, once my x ray results were in I was booked in for an appointment with the orthopaedic dept at the hospital last Wednesday. So, after 4 more x rays & a long chat with the consultant I'm scheduled for a total hip replacement. Consent form for the op signed, so I'm just awaiting a date.

seb84
Full Member
Latest research I’ve seen says they are lasting more like 25 years which is great.

Andy Murray had the same resurfacing op as me and I read that if he continues to play top level tennis then his hip would be expected to last for 7 years . Given the massive stresses that playing top level tennis puts on the hip then I would hope that mine will last at least 3 times as long which would mean that I would be into my 80s so mine will hopefully see me out . I cycle and swim but don't run as that hurts my knee and I am trying to minimise the impact on my hip as well so the only real damage is caused by walking but I expect that to be fairly minimal .

Bit of a further update.

After a nice holiday in Greece, my other hip has now joined in with sympathy and I have a labral tear in that (self diagnosed) its not half as bad as the right one was but still pretty uncomfortable. I kind of knew it was coming as I had all the same warning signs.

My right hip was already giving me more hassle prior to the left joining in, but now thats getting even worse. What it has shown me though is that I did have quite a lot of chronic pain as the 'sharp' pain in the left hip is actually quite a pleasant change from the chronic pain in the right. I didnt realise quite how chronic pain leaves you feeling tired and almost like with a constant headache.

Exercise is now reduce to a waddle down the road walking the dog with occasional shooting pains like someone is sticking a red hot poker up my arse !

I rang the consultant secretary last week and luckily I got a call yesterday from Outpatients to say they have a cancellation this week. Will see what the outcome is the orginal Xray's and MRI showed the left hip to be in a worse position that the right hip (the one that had the original tear)

I thought hip replacements were lasting 40+ years now?  the thing with the lifespan of the hip replacements is that they have not been around that long and its only in recent years we have seen younger and younger folk having them so there are not that many hip replacements around that are more than 25 years old rather than them not lasting more than 25 years.  NOt my field tho but thats what I thought

An ex colleague of mine - a physiotherapist had one in her 40s.

Only 3 months to go for me now, can't wait, it's proper knackered now, painkillers stopped doing anything a few months ago, i've been down for a replacement for years, stated i should try and keep going as i was in my early 40s, but 2 years ago it was done and put on the list, prioritised about a year ago after it got worse, will be a different world if i can actually start doing stuff again!

Unfortunately my trapped nerve has also come back this week, so my entire left side isn't having a good time just now 😂

As for the wear and tear, the surgeon told me recently they expect them to last a lot longer than the stated lifetime, as above, they've only been seeing data from replacement hips for a short time, and have changed materials and procedures as well, they'll always be pessimistic with the predictions, think he stated the only ones he's had to replace were due to incidents and accidents requiring surgery.

I thought hip replacements were lasting 40+ years now?

Thats an interesting one that. Just had a quick look at some more recent research.

From the Lancet

Among more than 60,000 people who had a hip replacement, only 4.4% required revision surgery in the first 10 years after surgery, but by the 20-year mark, 15% required revision.

Among nearly 55,000 people who had a knee replacement, only 3.9% required revision surgery within 10 years of surgery; by 20 years, 10.3% required revision.

Age did matter. Of those over 70 having hip or knee replacement, the lifetime risk of having a second operation on the replaced joint was about 5%. But this risk was much greater in younger individuals, especially for men. Up to 35% of men in their early 50s required a second operation.

Stating the obvious. If you do very little they will last longer. So for me my chances of needing a revision would look to be relatively high compared to the statistical norm of those who have thr.

Also the other side of it - fit younger folk would have stronger muscles that stabilise the joint more and they are more likely to do their physio?

My guess and thats all it is is a lot of those who require revision are sedentary - but thats a lay guess

My mum had both her hips done in the same year.  She was 84 at the time - but a very fit 84yr old and she did her exercises diligently both pre and post op.  She is miffed that 4 miles walking is about her limit!  That will be in the top few % of recoveries.  I have also seen folk of a similar age not do their physio, be sedentary and can barely walk to the kitchen a year post op

So an update on my hips!

It doesnt seam like 10 months since I last posted !

I did get an appointment, but it was only to see a Junior who arranged for me to have an injection in to my hip. Months past and finally got the appointment. However by this point because I had done zero exercise symptoms had pretty much gone away.

Actually turning down the injection, then did prompt a phone call from the consultant which resulted in re x-ray of my hips. This showed degeneration in both hips, but not severe enough to warrant hip replacement.

For the last 6 months I have been relatively pain free. Obviously I have pretty much torn away most of the labrum in both hips of the last 2-3 years and now its a nice steady process of bone on bone grinding until it gets to the point of being operated on.

I was told early doors that my hips were too far gone for any tear surgery, but boy its been a very very unpleasant period of time the random shoots of pain or the prolonged periods of soreness. Speaking to people who's hips have gone, they said the tear pain is very different to the actual arthritic 'replacement' pain so obviously I have that joy to come too 🙂

I'm 11yrs in at 42..

Currently riding in cromie.  My hips still great.

My weight general fitness not so much.

I know I'll need a revision as i had it so young but thats a future me problem.

Mine was due to a fracture at 25.  I had 6 yrs of painkillers injections physio. I had one physio ask how i managed to walk up stairs.

I lived on painkillers  to manage. They didnt help the pain but allowed me to push on renovating my house.  Was bloody awful.  The replacement was like a brand new life.

WRT to revisions, revisions are almost never as good as the first one and don't tend to last as long. Revision revisions and you really start to get into complexity of the operation and diminishing returns.

My ex-FiL had his first hip done 2 years ago at 74. Had increasing pain for 10+ years, physio and medical folks thought it was his knees again, he is on his 4th knee though, 2 on each side. First one in his early 30s latest about 12 years ago. The additional damage to the hip due to not identifying the problem in time meant his recovery was, and is, very slow. He'll likely never get to better than 75% of a healthy hip. As an additional ballache, the other hip is now past due, but it's also high risk due to the issues they found with the first one (porosity, micro fractures and an amount of necrosis), and they won't operate again until the first one reaches a certain level...

So regular visits to the hospital and when it flares up he's pretty much stuck between the living room, kitchen and spare bed (can't do stairs).

Get it done before it's critical.

On the plus side, i was told i'd need a new knee before 30 after a massive smash in my late teens. I'm now in my 50's and it's only just started mild twinging now. Do the physio!

naproxen, (anti-inflammatories even taken with food upset my stomach)

Are you not prescribed Omeprazol? I’m on Naproxen for my knee, and which is now also effective for my thumb joints, and my right hip has become very painful over the last few months, to the extent that getting my socks on has been difficult! Omeprazol was prescribed at the same time, however I don’t seem to have issues with Naproxen, ‘cos I’ve run out of the Omeprazol a few times and not noticed any difference. Friends of mine just can’t get on with it at all though.
I’ve been putting off making an appointment with my doctor, I do also have co-codamol/Zapain for my knee, but I’ve avoided taking it regularly, mainly because I could get away without having to take it, but Voltarol and Co-codamol are starting to become a regular part of my routine!
I’m 70 next month, btw.

Yeah, you usually get issued with Omeprazole or Lansoprazole depending on what's best with naproxen.

Had my hip replaced last October, pain has disappeared, it's a long road to recovery, but getting there, the hip joint is 100%, but it's the muscle wastage over the years and building up the strength again that's taking the time now, so gym twice a week to stretch and strengthen as well as stretching daily, was able to go back to activities in January/February and have had no issues cycling, golfing, etc.

My days of enduro are over though, so no booking BPW or Wind Hill, wheels on ground from now on.