When Is Hip Surgery Considered?

By Your Health Magazine Contributor

Your Health Magazine Contributor

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When Is Hip Surgery Considered?

Hip pain can affect walking, sitting, climbing stairs, sleep, work, exercise, and daily activities. Some hip conditions may be managed with non-surgical care, such as medication, physiotherapy, injections, activity changes, or walking aids. However, hip surgery may be considered when symptoms persist, function is limited, or there is structural damage that needs surgical assessment.

Hip surgery is not a single procedure. It may refer to hip replacement, hip arthroscopy, fracture fixation, repair of damaged structures, or surgery for specific hip conditions. The right option depends on the diagnosis, severity of symptoms, imaging findings, age, general health, activity level, and treatment goals.

What Is Hip Surgery?

Hip surgery refers to procedures performed to treat conditions affecting the hip joint and nearby structures. The hip is a ball-and-socket joint made up of the femoral head at the top of the thigh bone and the acetabulum in the pelvis.

Hip surgery may be considered to:

• Replace a damaged hip joint
• Repair a fracture
• Treat joint damage
• Address labral tears
• Manage hip impingement
• Remove loose fragments
• Improve joint stability
• Reduce pain linked to structural hip disease
• Support mobility when non-surgical care is no longer suitable

The type of surgery depends on the cause of hip pain and the condition of the joint.

Does Hip Pain Always Need Surgery?

No. Many hip conditions can be managed without surgery, especially in the earlier stages or when symptoms are mild.

Non-surgical treatment may include:

• Activity modification
• Medication
• Physiotherapy
• Strengthening exercises
• Weight management advice, where relevant
• Walking aids
• Injections, where suitable
• Rest from aggravating activities
• Review of sport or work demands

Surgery may be discussed if these measures do not provide adequate symptom control, or if the condition is unlikely to recover with non-surgical care.

When Is Hip Surgery Considered?

Hip surgery may be considered when symptoms affect daily function, when hip structure is damaged, or when non-surgical treatment does not provide enough relief.

Patients may be assessed for surgery if they have:

• Persistent hip pain despite suitable non-surgical care
• Pain that affects walking or standing
• Hip pain at rest or at night
• Stiffness that limits movement
• Difficulty putting on shoes or socks
• Difficulty climbing stairs
• Reduced walking distance
• Limping
• Hip arthritis affecting daily activities
• Hip fracture or injury
• Labral tear with ongoing symptoms
• Hip impingement with pain and movement restriction
• Reduced independence due to hip pain

The decision is based on clinical assessment and imaging, not symptoms alone.

1. Hip Arthritis

Hip arthritis is one of the reasons hip surgery may be considered. Arthritis can damage the smooth cartilage that covers the ends of bones in the joint. When cartilage wears down, movement may become painful and stiff.

Symptoms of hip arthritis may include:

• Groin pain
• Buttock or thigh pain
• Hip stiffness
• Pain when walking
• Difficulty standing after sitting
• Reduced hip movement
• Pain at night
• Limping
• Difficulty with stairs

Hip replacement may be discussed when arthritis causes persistent pain, stiffness, and daily activity limitations despite non-surgical treatment.

2. Hip Fractures

A hip fracture is a break in the upper part of the thigh bone near the hip joint. It may occur after a fall, accident, or trauma. In older adults, a fall from standing height can sometimes cause a hip fracture, especially when bone strength is reduced.

Symptoms may include:

• Sudden hip or groin pain
• Inability to stand or walk
• Pain after a fall
• Shortened or rotated leg
• Swelling or bruising
• Pain when moving the hip

A suspected hip fracture needs prompt medical assessment. Treatment may involve surgery to fix the bone or replace part or all of the hip joint, depending on the fracture type and patient factors.

3. Hip Labral Tears

The labrum is a ring of cartilage around the hip socket. It helps support the joint and contributes to hip stability. A labral tear may occur from hip impingement, sports activity, trauma, structural hip differences, or repetitive movement.

Symptoms may include:

• Groin pain
• Clicking or catching in the hip
• Pain during twisting movements
• Stiffness
• Pain after sitting for long periods
• Reduced sports tolerance

Some labral tears may be managed with physiotherapy, activity changes, and medication. Hip arthroscopy may be considered if symptoms persist and imaging or examination findings suggest a treatable labral problem.

4. Femoroacetabular Impingement

Femoroacetabular impingement, often shortened to FAI, occurs when extra bone shape around the hip joint causes abnormal contact between the ball and socket during movement. This may irritate the labrum or cartilage.

Symptoms may include:

• Groin pain
• Pain during deep bending or squatting
• Pain with twisting or pivoting
• Hip stiffness
• Reduced range of motion
• Pain after sport or prolonged sitting

Non-surgical care may be tried first. Surgery may be considered if symptoms continue and the hip structure is suitable for surgical treatment.

5. Avascular Necrosis of the Hip

Avascular necrosis occurs when blood supply to the femoral head is reduced. This can lead to bone damage and collapse of the joint surface in some cases.

Symptoms may include:

• Groin or hip pain
• Pain with weight-bearing
• Limping
• Reduced movement
• Pain that worsens over time

Treatment depends on the stage of the condition. Surgery may be discussed if the joint surface is damaged or if pain and movement limitations become difficult to manage.

6. Hip Dysplasia or Structural Hip Problems

Hip dysplasia occurs when the hip socket does not fully cover the femoral head. This may increase stress on the joint and can contribute to pain or earlier joint wear in some patients.

Symptoms may include:

• Groin pain
• Hip instability
• Pain during activity
• Limping
• Reduced range of motion
• Early arthritis symptoms

Surgery may be considered in selected cases, depending on the patient’s age, degree of joint damage, hip structure, and symptoms.

Types of Hip Surgery

The type of hip surgery depends on the diagnosis and severity.

1. Total Hip Replacement

Total hip replacement involves replacing the damaged ball and socket surfaces with artificial components. It is often considered for hip arthritis, severe joint damage, or selected fracture-related cases.

The procedure may be discussed when pain, stiffness, and reduced movement affect daily activities despite suitable non-surgical treatment.

2. Partial Hip Replacement

Partial hip replacement replaces the femoral head while preserving the natural socket. It may be used in selected hip fracture cases, depending on the fracture type and patient factors.

3. Hip Arthroscopy

Hip arthroscopy is a keyhole procedure that uses small incisions and a camera to view and treat structures inside the hip joint. It may be considered for selected labral tears, hip impingement, loose bodies, or cartilage-related concerns.

Suitability depends on the condition of the hip joint, degree of arthritis, symptoms, and imaging findings.

4. Hip Fracture Fixation

Fracture fixation uses screws, plates, rods, or other devices to hold broken bone in position while it heals. This may be used for selected hip fractures.

The treatment choice depends on fracture location, bone quality, patient health, and mobility needs.

How Is the Need for Hip Surgery Assessed?

A hip specialist will usually assess symptoms, medical history, physical examination findings, and imaging results before recommending surgery.

Assessment may involve:

• Discussion of pain location and duration
• Review of daily activity limitations
• Walking pattern assessment
• Hip movement testing
• Strength testing
• X-rays
• MRI scans, where needed
• CT scans, where needed
• Blood tests if inflammatory or infection-related causes are suspected
• Review of previous treatment tried

The doctor may also consider the patient’s general health, medication use, work needs, caregiving duties, and recovery support.

Questions to Ask Before Hip Surgery

Before deciding on hip surgery, patients may wish to ask:

• What is my diagnosis?
• Why is surgery being considered?
• Are there non-surgical options I can still try?
• What type of hip surgery may be suitable?
• What are the risks in my case?
• What happens if I delay surgery?
• How long may I stay in hospital?
• What type of anaesthesia may be used?
• Will I need physiotherapy?
• When can I walk after surgery?
• When can I return to work?
• When can I drive?
• What activities should I avoid during recovery?
• What costs may be involved?
• Can insurance or MediSave apply?

These questions can help patients understand the treatment plan and prepare for recovery.

What Recovery May Involve

Recovery depends on the type of surgery and the patient’s overall health. Some procedures require a short hospital stay, while others may require a longer recovery period.

Recovery may involve:

• Pain control
• Wound care
• Walking aids
• Physiotherapy
• Hip movement exercises
• Strengthening exercises
• Swelling management
• Follow-up appointments
• Medication review
• Gradual return to daily activities

Patients should follow activity restrictions and rehabilitation instructions given by their healthcare team. Returning to sport, work, or driving should be discussed with the doctor.

When Should Hip Pain Be Assessed Promptly?

Patients should seek medical advice early if they have:

• Severe hip pain after a fall
• Inability to stand or walk
• Sudden hip deformity
• Hip pain with fever
• Worsening swelling or redness
• Numbness or weakness
• Pain that affects sleep
• Persistent groin pain
• Limping that does not settle
• Hip pain that limits daily activities

Urgent care may be needed after trauma, especially if a fracture or dislocation is suspected.

Hip surgery may be considered when hip pain, stiffness, injury, or structural joint damage affects daily activities and non-surgical care is no longer suitable. Common reasons include hip arthritis, hip fractures, labral tears, hip impingement, avascular necrosis, and selected structural hip problems.

The type of surgery depends on the diagnosis. Options may include hip replacement, hip arthroscopy, fracture fixation, or other procedures. A doctor will assess symptoms, examination findings, imaging results, medical condition, and treatment goals before making recommendations.

Patients in Singapore considering hip surgery should ask about diagnosis, alternatives, risks, recovery, physiotherapy, costs, insurance, and MediSave eligibility before deciding.

This article is for general information only and should not replace medical advice from a qualified healthcare professional.

FAQ

When is hip surgery usually considered?

Hip surgery may be considered when hip pain, stiffness, injury, or structural joint damage affects daily activities and does not respond adequately to non-surgical treatment.

Does hip arthritis always need surgery?

No. Hip arthritis may be managed with medication, physiotherapy, activity modification, walking aids, injections, or other non-surgical options. Surgery may be discussed when symptoms continue to affect daily function.

What type of hip surgery may be recommended?

The type depends on the diagnosis. Options may include total hip replacement, partial hip replacement, hip arthroscopy, or fracture fixation.

Is hip replacement the same as hip surgery?

Hip replacement is one type of hip surgery. Other procedures include hip arthroscopy, fracture fixation, labral treatment, and surgery for selected structural hip conditions.

When should hip pain be checked urgently?

Urgent assessment may be needed for severe pain after a fall, inability to stand or walk, sudden deformity, fever with hip pain, numbness, weakness, or suspected fracture.

Will I need physiotherapy after hip surgery?

Physiotherapy is often part of recovery after hip surgery. It may help with walking, movement, strength, balance, and return to daily activities.