Should I have a hip replacement when my main problem is range of movement, rather than pain?

Looking for advice from anyone who has had similar symptoms to me. I was diagnosed with arthritis in both hips three years ago. At the time, I was suffering a lot of pain and was told that the only option moving forward would be a resurfacing or THR. For various reasons, I saw two specialists - one had practically booked me in to have the procedure the following week - the other said absolutely not to do it tat that time. So I didn't... Strangely since then, the pain has improved. I still get pain but it's totally bearable - I'm sports mad and still do three full on spin classes a week with no real issues. However, I've had to give up racket sports and running as I really can't do them without severe pain and seizing up (anything high impact really..) My MAJOR problem is a rapidly decreasing range of movement in my right hip - I can now barely put a sock on that foot or cut my toe nails. But should I have a hip replacement based on this, rather than pain? I've never heard of anyone doing that...Don't want to cause other damage, but don't want a major op if it's not needed. Any advice would be very gratefully received :-)

I'm 56 by the way! :-)

All I can say is I was about the same at your are..now 63 and have had my THR 12 weeks ago....movement is now almost back to normal and improving each day...don't wait for the pain to get worse...maybe squash will be out of the question but crrtainly softer raquet sports and running should be OK once you recover.....its a difficult decision but no regrets  from me!!

I too have arthritis in both hips, left one behaves normally, right one has very restricted movement, can't put socks on etc. no pain, never has been over the last 5 years, since it was diagnosed. I have seen 3 different specialists, all would like to have given me a hip replacement, but, I'm hanging on until the last minute! Also hoping that stem cell therapy may be advancing in my direction, anybody know about it?

My decision was based on pain and the way this was affecting my relationship with my kids.

I started having mild pain about 5 years ago and I saw a consultant as I had some plates in my femur due to other issues I'd had as a child. As I was only 44 at the time my consultant did not want to operate and instead went for some cortisone injections every 6 months which worked well for 2 years. About 3 years ago the pain got steadily worse to the point that I couldn't do anything energetic without significant follow up pain for several days. Throughout this period my consultant did not want to operate saying that the longer I left things, the less chance there was of my needing a further revision so I pushed through the pain and just stopped doing things that would cause any discomfort. 6 months ago I went back to my consultant and told him that because of the pain and the things it was stopping me from doing that I needed some treatment, he referred me to a new consultant who specialised in more complex hip operations (I had a metal plate in my femur which was now covered with bone). This guy was the same age as me and had kids too and immediately saw my perspective, wanting to have some quality years with my children...he offered to operate 5 days later, which I accepted.

So, although my reasons for pushing for replacement were pain related, I think the moral of my story is that you need to do this in order to maintain your quality of life. I was told that my titanium/ceramic prostheses should last 20 years if I look after it, and by this time I'm sure, there will be even better revision options.

Personally, I'd check with your consultant whether you are likely to have improved mobility and flexibility....most people are limited following replacement anyway (even though you can find YouTube clips of folks doing the splits after surgery!!). I have been severely limited in my mobility for 30 years and although I'm now out of pain it will take a long while before I can really stretch like someone with a normal hip joint. The worst case for you would be having surgery only to find that your range of motion does not improve.

Good luck, whatever decision you take.

Hate to say so, but it will only get worse.  Your story is pretty much my story.   Mine started in 2007 when my doctor showed me my xrays and said all cartilage was gone in both hips and that he never saw worse hips than mine.  I was crushed.  It was very strange for me to hear this because i was functioning normally...with 1-2 Advil a week.  But it got worse rapidly to a point where i felt like an invalid and that is when i seriously considered hip replacement.  

You don't say how old you are. You should be aware that activities involving high impact are NOT recommended after total hip replacement, for some reason women seem to do less well with hip resurfacing than men so do your research carefully before you make up your mind.

If your hip range of movement is causing muscle imbalance, especially apparent leg  length discrepancy then you need to get some physio and seriously think about replacement. Remember that you are talking about average lifetimes of 20-30 years  for people who use their hips within the guidelines and revisions are less successful. The figures are average, if the implant looks good at 1 year most people get 10, average means that 50% of the survivors have had their hips revised and while we all hope to be in the long life 50% some people are less fortunate.

Talk over your projected lifestyle with your surgeon to make sure that your aspirations are reasonable for the procedure he plans.

I say get the hip done.. I got mine done at 39. I have osteoarthritis in both hip and probably for about 5 years it didn't bother me it was mainly what u had said . Couldn't put on socks , cut toe nails, legs wouldn't open very wide. As time went on right hip did start to get sore and I had labrial tear after labrial tear until it was bone knocking off bone. Everyone was reluctant to do my hip because I was 39 but I eventually got referee to a specialist in young persons arthritis and he did a full right hip replacement ceramic on Germanic with titanium stem or something. Cement less .. Long recovery but the right leg is now quite flexible now and not near as much pain. Although high impact sports r not a good idea.. Hope that helps x

Thanks very much for the advice :-)

Thanks for the feedback :-)

Can't help you on the stem cell therapy unfortunately - but that's given me something else to Google!

Thanks for taking the time to write such an informative reply - really appreciate it. Your last piece of advice is particularly useful - I haven't really discussed post op range of movement, and I really should do. Definitely no point in doing it at this stage unless that's improved. Strangely, since posting my question I've been in more pain than usual with the hips!!! :-)

Thanks for the reply :-) Looking back, do you wish you'd had the op when you were first told and were not really in pain? 

Thanks for the very helpful info :-) I guess one of the reasons for hanging on is that I don't want to say goodbye to things like skiing until I really have to (I went this year without any real difficulty - a bit sore and stiff, but still very possible...). Not experiencing any leg length discrepancy yet either... so maybe I should continue to hang on. As far as you're aware, can NOT having the procedure cause additional complications (with spine, knees, etc)?

Thanks very much for the info - very helpful :-)

Well my knee was the initial problem and I was first offered a referral some 4 years ago. Meantime the hip crept up on the inside lane so to speak, masked by the pain killers I was using for the knee. Anyway about 18 months ago I decided the time had come so got approval for the surgery which I first put back for my own personal reasons and then there were the usual timing problems with the NHS.  Despite the pelvis problems pre-op, rehab has gone well although I am having to work on the abductors.  I will be getting my knee done in the next few weeks.

Additional problems tend to occur when you start to walk abnormally so throwing unusual loads on other joints. If you aren't limping and concentrate on moving well during day to day activities.you shouldn't do too much damage.  The pelvic problems I had can go with hip arthritis but it went to acute over a few weeks with me because of a flare up in a rheumatic condition I have. Once it had passed the tipping point we never managed to fully reverse it until the joint replacement.