Severe hip arthritiscan cause pain and difficulty walking. Many people who have these debilitating symptoms because of hip arthritis will elect to undergototal hip replacement surgery. However, total hip replacement is not without its own risks and concerns, and therefore many people wonder if there are alternatives to hip replacement.

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Man holding his hip in pain on a couch

Nonsurgical Treatment

Not having surgery is an option. Hip replacement surgery is an elective treatment that people can choose to have if the timing is right for them. People who have severe arthritis of the hip but function adequately can choose to live with their condition.

Some people cannot have surgery due to medical conditions that make surgery or anesthesia higher risk. Many people opt to have surgery when nonsurgical treatments are not helping adequately.

There are effective treatments for hip arthritis that may help people avoid the need for a total hip replacement. Among these are physical therapy, walking aids, anti-inflammatory medications, cortisone injections, hyaluronic acid injections, and joint supplements.

In general, hip replacement surgery is not an urgent procedure, and most often there is no harm in delaying surgery until you feel the time is right. With some exceptions, a hip replacement is an elective surgery.

Hip Resurfacing

Hip resurfacing surgery is an alternative to standard total hip replacements for patients with severe arthritis. In a hip resurfacing surgery, the implant is smaller, and less normal bone is removed. Hip resurfacing is gaining interest, especially in younger patients.

During the hip resurfacing procedure, the “ball” of the hip joint (femoral head) is trimmed and covered with a metal cap. A metal socket is placed in the pelvis, similar to the hip replacement procedure. This hip resurfacing preserves much more normal bone than a standard total hip replacement.

Hip resurfacing surgery has become much less common in recent years because of concerns about using so-called metal-on-metal joint replacements. These metal-on-metal replacements include all current hip resurfacing implants.

Metal-on-metal replacements have had some well-known recalls and problems causing both doctors and their patients to be very wary of these procedures and these implants.​

Hip Resurfacing Surgery as a Replacement Alternative

Partial Hip Replacement

A partial hip replacement (hemiarthroplasty) is not commonly performed for hip arthritis. During this surgical procedure, only the ball of the ball-and-socket hip joint is replaced. This is an effective treatment for certain types of hip fractures when only the ball of the hip joint is damaged.

The problem for people with severe hip arthritis is that the socket of this hip joint is also damaged, and therefore also needs to be addressed. For this reason, partial hip replacements are generally not a good option for hip arthritis surgery.

Hip Fusion

Hip fusions are usually done in young patients who are heavy laborers. The hip fusion does not wear out like total hip replacements would in these patients. The hip fusion allows the patient to perform physically demanding tasks that could lead to early wear on a total hip replacement.

The problem with hip fusion is that patients will have no motion of the hip, they will walk with a limp, and may eventually need further surgery to convert to a total hip replacement.

How Arthrodesis (Joint Fusion) Can Treat Advanced Arthritis

Resection Arthroplasty

A resection arthroplasty (Girdlestone procedure) is a procedure where the bone around the hip joint is removed and the joint space is allowed to fill with scar tissue. This procedure is usually done in patients with a severe infection that cannot be controlled, or in patients whose physical condition is such that they have little chance of normal walking.

Patients who undergo a Girdlestone resection arthroplasty will likely need some device (crutches or walker) for walking.

Hip Osteotomy

Hiposteotomyis a procedure that is done to realign the bones of the hip joint. The osteotomy can be performed on the thigh bone (femur), the pelvis, or both. Osteotomies are usually performed on patients with an underlying problem that has led to early arthritis of the hip joint.

For example, developmental conditions such aship dysplasiacan lead to early hip arthritis. Hip dysplasia occurs in infants and leads to malaligned bones around the hip. The osteotomy helps to realign the bones and relieve thesymptoms of early arthritis. These procedures must be done in carefully selected patients.

A Word From Verywell

These are some of the options for people who have severe hip arthritis who may be looking for a treatment alternative to a replacement. While not all of these options may be advisable or helpful depending on your lifestyle and the cause of your arthritis, if you have an interest in one of these options, you should discuss it with your surgeon.

Is Walking Good for Hip Arthritis?

7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lespasio MJ, Sultan AA, Piuzzi NS.Hip osteoarthritis: A primer.Perm J. 2018;22:17–084. doi:10.7812/TPP/17-084Moe RH, Haavardsholm EA, Christie A, Jamtvedt G, Dahm KT, Hagen KB.Effectiveness of nonpharmacological and nonsurgical interventions for hip osteoarthritis: An umbrella review of high-quality systematic reviews.Physical Therapy. 2007;87(12):1716-1727. doi:10.2522/ptj.20070042Morse KW, Su EP.Hip resurfacing arthroplasty for patients with inflammatory arthritis: a systematic review.HIP International. 2018;28(1):11-17. doi:10.5301/hipint.5000558Wang Z, Bhattacharyya T.Outcomes of Hemiarthroplasty and Total Hip Arthroplasty for Femoral Neck Fracture: A Medicare Cohort Study.J Orthop Trauma. 2017;31(5):260–263. doi:10.1097/BOT.0000000000000814Stover MD, Beaul?? PE, Matta JM, Mast JW.Hip arthrodesis: A procedure for the new millennium?Clinical Orthopaedics and Related Research. 2004;418:126-133. doi:10.1097/00003086-200401000-00020Sharma H, Dreghorn C, Gardner E.Girdlestone resection arthroplasty of the hip: Current perspectives.Current Orthopaedics. 2005;19(5):385-392. doi:10.1016/j.cuor.2005.06.005Clohisy JC, Schutz AL, St John L, Schoenecker PL, Wright RW.Periacetabular osteotomy: A systematic literature review.Clin OrthopRelat Res. 2009;467(8):2041–2052. doi:10.1007/s11999-009-0842-6Additional ReadingNho SJ, Kymes SM, Callaghan JJ, Felson DT.The burden of hip osteoarthritis in the United States: Epidemiologic and economic considerations.J Am Acad Orthop Surg. 2013;21 Suppl 1: S1-6.

7 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lespasio MJ, Sultan AA, Piuzzi NS.Hip osteoarthritis: A primer.Perm J. 2018;22:17–084. doi:10.7812/TPP/17-084Moe RH, Haavardsholm EA, Christie A, Jamtvedt G, Dahm KT, Hagen KB.Effectiveness of nonpharmacological and nonsurgical interventions for hip osteoarthritis: An umbrella review of high-quality systematic reviews.Physical Therapy. 2007;87(12):1716-1727. doi:10.2522/ptj.20070042Morse KW, Su EP.Hip resurfacing arthroplasty for patients with inflammatory arthritis: a systematic review.HIP International. 2018;28(1):11-17. doi:10.5301/hipint.5000558Wang Z, Bhattacharyya T.Outcomes of Hemiarthroplasty and Total Hip Arthroplasty for Femoral Neck Fracture: A Medicare Cohort Study.J Orthop Trauma. 2017;31(5):260–263. doi:10.1097/BOT.0000000000000814Stover MD, Beaul?? PE, Matta JM, Mast JW.Hip arthrodesis: A procedure for the new millennium?Clinical Orthopaedics and Related Research. 2004;418:126-133. doi:10.1097/00003086-200401000-00020Sharma H, Dreghorn C, Gardner E.Girdlestone resection arthroplasty of the hip: Current perspectives.Current Orthopaedics. 2005;19(5):385-392. doi:10.1016/j.cuor.2005.06.005Clohisy JC, Schutz AL, St John L, Schoenecker PL, Wright RW.Periacetabular osteotomy: A systematic literature review.Clin OrthopRelat Res. 2009;467(8):2041–2052. doi:10.1007/s11999-009-0842-6Additional ReadingNho SJ, Kymes SM, Callaghan JJ, Felson DT.The burden of hip osteoarthritis in the United States: Epidemiologic and economic considerations.J Am Acad Orthop Surg. 2013;21 Suppl 1: S1-6.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Lespasio MJ, Sultan AA, Piuzzi NS.Hip osteoarthritis: A primer.Perm J. 2018;22:17–084. doi:10.7812/TPP/17-084Moe RH, Haavardsholm EA, Christie A, Jamtvedt G, Dahm KT, Hagen KB.Effectiveness of nonpharmacological and nonsurgical interventions for hip osteoarthritis: An umbrella review of high-quality systematic reviews.Physical Therapy. 2007;87(12):1716-1727. doi:10.2522/ptj.20070042Morse KW, Su EP.Hip resurfacing arthroplasty for patients with inflammatory arthritis: a systematic review.HIP International. 2018;28(1):11-17. doi:10.5301/hipint.5000558Wang Z, Bhattacharyya T.Outcomes of Hemiarthroplasty and Total Hip Arthroplasty for Femoral Neck Fracture: A Medicare Cohort Study.J Orthop Trauma. 2017;31(5):260–263. doi:10.1097/BOT.0000000000000814Stover MD, Beaul?? PE, Matta JM, Mast JW.Hip arthrodesis: A procedure for the new millennium?Clinical Orthopaedics and Related Research. 2004;418:126-133. doi:10.1097/00003086-200401000-00020Sharma H, Dreghorn C, Gardner E.Girdlestone resection arthroplasty of the hip: Current perspectives.Current Orthopaedics. 2005;19(5):385-392. doi:10.1016/j.cuor.2005.06.005Clohisy JC, Schutz AL, St John L, Schoenecker PL, Wright RW.Periacetabular osteotomy: A systematic literature review.Clin OrthopRelat Res. 2009;467(8):2041–2052. doi:10.1007/s11999-009-0842-6

Lespasio MJ, Sultan AA, Piuzzi NS.Hip osteoarthritis: A primer.Perm J. 2018;22:17–084. doi:10.7812/TPP/17-084

Moe RH, Haavardsholm EA, Christie A, Jamtvedt G, Dahm KT, Hagen KB.Effectiveness of nonpharmacological and nonsurgical interventions for hip osteoarthritis: An umbrella review of high-quality systematic reviews.Physical Therapy. 2007;87(12):1716-1727. doi:10.2522/ptj.20070042

Morse KW, Su EP.Hip resurfacing arthroplasty for patients with inflammatory arthritis: a systematic review.HIP International. 2018;28(1):11-17. doi:10.5301/hipint.5000558

Wang Z, Bhattacharyya T.Outcomes of Hemiarthroplasty and Total Hip Arthroplasty for Femoral Neck Fracture: A Medicare Cohort Study.J Orthop Trauma. 2017;31(5):260–263. doi:10.1097/BOT.0000000000000814

Stover MD, Beaul?? PE, Matta JM, Mast JW.Hip arthrodesis: A procedure for the new millennium?Clinical Orthopaedics and Related Research. 2004;418:126-133. doi:10.1097/00003086-200401000-00020

Sharma H, Dreghorn C, Gardner E.Girdlestone resection arthroplasty of the hip: Current perspectives.Current Orthopaedics. 2005;19(5):385-392. doi:10.1016/j.cuor.2005.06.005

Clohisy JC, Schutz AL, St John L, Schoenecker PL, Wright RW.Periacetabular osteotomy: A systematic literature review.Clin OrthopRelat Res. 2009;467(8):2041–2052. doi:10.1007/s11999-009-0842-6

Nho SJ, Kymes SM, Callaghan JJ, Felson DT.The burden of hip osteoarthritis in the United States: Epidemiologic and economic considerations.J Am Acad Orthop Surg. 2013;21 Suppl 1: S1-6.

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