Should I have a hip replacement?

Bones, joints and muscles
1

Hello everyone, this is my first post here after I found the forums online. Apologies in advance for the long post.

I am 52 and have arthritis in my right hip which has got worse and worse over the last 5 or so years. Walking is quite painful (although this varies quite a lot, sometimes it is just a faint pain, other times it can be very uncomfortable to the point where walking is difficult, but most of the time it’s somewhere in between). I now walk with a slight limp.

I had an x-ray and saw an NHS consultant in a London hospital who advised that I will indeed need a hip replacement as the arthritis is quite advanced. However, he told me that since it is not painful when I’m not walking or lying down, then I should use painkillers and try physiotherapy until the pain becomes too much. He added that if I really want to go ahead, he would be happy to do the op. This was 10 months ago and I have worked hard at strengthening the muscles around my hip after seeing two physiotherapists.

However, while this has improved the pain (before physio there were occasions when I actually had to stop in the street due to the pain) it hasn’t changed things as much as I’d hoped. Mornings are particularly stiff and when I walk I still have the slight limp and feel varying levels of pain.

I also feel that the bad hip is impacting upon my general health and quality of life. I have lower back pain which I believe is due to my gait as a result of limping (I know there is no guarantee that this would be fixed after an op, but I suspect it would help). I try hard to get exercise walking but I feel I would be more active if I didn’t suffer with the pain.

So my question is, how bad do things need to be before going for a total hip replacement? Should I hang on a couple more years, minimising the chance of needing a second op in 15 or so years time? Or should I go ahead while I am relatively young? I’ll admit, the operation scares the life out of me (even the idea of sleeping on my back doesn’t sound fun as I’m a real turner in bed!) and the message from the consultant and physio seems to be that ‘this is a serious operation and you shouldn’t do it unless absolutely necessary’.

How did you guys decide whether to go ahead? I hover between wanting to go ahead and thinking maybe it’s not so bad and I should wait. It doesn’t help that there doesn’t seem to be anyone you can talk to in great detail. The doctors are all so busy, you only ever get 10 minutes with them.

Another factor that helps me is that I work in IT, meaning I can work from home during recovery (especially during covid as working from home is becoming the norm). Therefore loss of income is not an issue.

Once again, apologies for the long post, any advice much appreciated.

2

what do you think? I would want one. Pills and shots are temporary. They can last well over 20+ years. get the most experiienced surgeon regardless of the procedure and good luck. why be in pain

3

Thanks Steve. Well it would be on the NHS so I don't think I'd get to choose my surgeon!

4

I totally understand your hesitancy. I am 3 months out from my THR anterior and I am so happy that I went through with it and also that it is over since I thought about it for several long years. I found a surgeon who was extremely revered in the medical field in my city. He was the third surgeon I had consulted with. You are quite a bit younger than I am being 70 years old, but my symptoms seem very similar to what you are experiencing. I have been walking with a slight limp for several years and most of the time I was able to walk without too much pain, but the pain was starting to show up in my knee also. I now have no pain in the knee so I believe it was related to my hip. Also, there would be frequent occasions when I would be unable to walk and needed to wait and I don't know if this was from the bone spurs putting my leg into awkward positions at times. I also had found that I had a hard time standing up straight, again I think it may have been the large bone spur or spurs. Anyway, in my case it worked out well which I am very grateful for. Find a good surgeon by talking to people who have had it done in your area. I think that is the key. I have no regrets. Good luck to you!

5

It sounds as if the impact on your health and quality of life is now much more noticeable so it seems to make sense to go ahead with the op. Steve has said that the replacements can last over 20 years so this also seems to support going ahead. I am much older than you (71) and I don't think I would outlive a replacement! However, I still feel very similar to you in many ways. Most of the on line advice is the same as the advice you have been given and I do not feel that I am bad enough or that it is 'absolutely necessary'. I am still chewing things over as I know only I can decide. It's such a difficult decision. I hope you will find you can make the right one for you. Best wishes

6

As things are going at the moment, it is worth getting your name on the list as it could be a very long time before you actually get your op, based on the fact elective ops are being cancelled everywhere. You can always cancel or postpone when the time comes. As the others say make certain you have a good surgeon, that is the most important thing in my opinion. I was able to choose mine on the NHS. I then had him again recently privately for my other hip as I was in so much pain as I was not ready to wait. Even then the op was postponed from March to September as the NHS had contracted to take over the private hospitals for NHS beds. At the end of the day your hip will slowly go down hill sadly.

7

Thanks for your reply and positive advice Nancy and I'm glad everything has turned out well for you. Encouraging to hear that it also helped you with some of your ancillary issues too. The impact of the hip on other health areas doesn't seem to be taken much into account when you read about whether to go ahead.

8

Thanks Cherry, yes it is a difficult decision, partly because people seem to such different experiences of the operation. Some people seem to be absolutely fine, and up and about in no time, others seem to suffer ongoing issues. I wonder if it seems more risky just because the people who have problems are more likely to post in forums like this!

9

Thanks Ptolemy , I think that's good advice and I will do that. I'm hoping I can put my name down as the consultant said he would leave the case open for some time. It sounds like the wait is going to be a good year anyway, the way things are going.

I didn't know you could choose your surgeon on the NHS, I assumed that was just for private patients. I'm surprised, may I ask how that works? How do you evaluate a surgeon, is there somewhere you can find information about and choose your surgeon? I obviously have the name of the consultant that saw me so I'd be interested in knowing more about him.

10

Hi Im 35 & just had a THR 10 days ago. Sadly the pain only gets worse. like yourself I was in so much fear about it especially with being so young but i had no choice but to get it done. It got to a point where i was hardly going out because i literally could not walk or get on with things. im in recovery mode so hopefully just like the majority i too can say how greatful i am with my new hip 1 day very soon.

11

The surgeon I had, had done a lot of hips in my village and people spoke very highly of him. It is worth getting someone who has done lots of hips so they have had experience, this is all on the internet. A reasonable number per year I feel is important. You may find bad things about surgeons on the internet too, so keep away from them. Surgeons who do revision hips tend to be more experienced than those who have just have done primary replacements. A lot of people choose surgeons who do particular types of approaches to the operation. The most recent one is the Superpath approach. I personally think a good surgeon should come first though. Replacement hip surgery is supposed to be one of the most successful operations in the world.

12

That's really useful information ptolemy, thank you. I've had a look at the NHS websites (not very well organised are they) and the consultant that I saw has done less than 5 ops this year, but I have found one at the same hospital who has performed over 60 this year, including revisions as you suggested.

But the surgeon I saw was the one who's performed the fewer operations, can I just call the hospital and ask for a different surgeon? I must say I didn't know you could do that on the NHS so any advice on how I'd go about that would be most appreciated. Thank you again for your help.

13

Glad you got your operation and I hope you make a speedy recovery. Good luck.

14

I think we are entitled to ask for the surgeon we want. I asked for the surgeon I had when I went to my GP so it just happened. I would ask the hospital for the surgeon you want. At least they could tell you the situation.

15

Is the pain you have the same pain you had before the op or is it pain from the operation itself?

16

I just called the hospital and I have to call back tomorrow to speak to the nurse manager to change consultant which I'm told is a 'lengthy process' but I'll persevere. I'm really appreciative of your advice, I wouldn't have thought I could do this but fingers crossed. I've also asked for a GP telephone appt, perhaps they might be able to give me some help.

17

you hear more bad experiences here than good experiences. i would say the cast majority of outcomes are positive. Depends on the Surgeon and tour issues. Experience of the surgeon matters most

18

The work you have been doing to strengthen the muscles around your hip will really help your recovery (should you decide to go ahead with the op)

19

Thanks Dale, yes I'll make sure I keep up with my exercises whatever happens.

20

That is pretty good news. At least you can now be a bit more in control. My GP had to apply for funding for my hip op, did you get funding? When I got the funding I then saw the surgeon and he made the decision to put me on the waiting list.