When hip osteoarthritis pain makes everyday living challenging, or if other treatments do not provide adequate pain relief, surgery may be recommended. Surgery options include:

Total Hip Replacement (Hip Arthroplasty)

Illustration of total hip replacement for hip osteoarthritis

The most common and successful surgery to treat hip osteoarthritis is hip replacement. Read: Total Hip Replacement for Hip Arthritis

The most common and successful surgery to treat hip osteoarthritis is hip replacement. About 10% of people will get a hip replacement in their lifetime. ¹ Culliford DJ, Maskell J, Kiran A, et al. The lifetime risk of total hip and knee arthroplasty: results from the UK general practice research database. Osteoarthr Cartil. 2012;20(6):519–24. As cited in Murphy NJ, Eyles JP, Hunter DJ. Hip Osteoarthritis: Etiopathogenesis and Implications for Management. Adv Ther. 2016;33(11):1921–1946. doi:10.1007/s12325-016-0409-3.

See Indications and Eligibility for Total Hip Replacement Surgery

During hip replacement surgery, damaged cartilage and bony surfaces of the joint are removed and replaced with artificial prostheses. This is a major surgery, and most patients require between 6 weeks and 3 months to stop taking pain medication, regain the ability to walk normally, and fully return to daily activities.

See Total Hip Replacement Surgical Procedure

Hip Resurfacing

During hip resurfacing, the ball of the hip’s ball-and-socket, called the femoral head, is shaped and covered with a smooth metal cap. The goal is to reduce friction within the ball-and-socket, reducing hip pain and enhancing hip movement. Some research suggests this procedure benefits active males under the age of 55; however, there are concerns about the effects of the release of metal ions into the blood (resulting from wear and corrosion) as well as the risk of needing a second surgery (revision surgery) compared to a total hip replacement. ² Sehatzadeh S, Kaulback K, Levin L. Metal-on-metal hip resurfacing arthroplasty: an analysis of safety and revision rates. Ont Health Technol Assess Ser. 2012;12(19):1–63. As cited in Murphy NJ, Eyles JP, Hunter DJ. Hip Osteoarthritis: Etiopathogenesis and Implications for Management. Adv Ther. 2016;33(11):1921–1946. doi:10.1007/s12325-016-0409-3. ^, ³ Matharu GS, Pandit HG, Murray DW, Treacy RB. The future role of metal-on-metal hip resurfacing. Int Orthop. 2015;39(10):2031–6. As cited in Murphy NJ, Eyles JP, Hunter DJ. Hip Osteoarthritis: Etiopathogenesis and Implications for Management. Adv Ther. 2016;33(11):1921–1946. doi:10.1007/s12325-016-0409-3. ^, ⁴ Matharu GS, Pandit HG. Murray DW. Poor Surviviorship and Frequent Complications at a Median of 10 years after Metal-on-Metal Hip Resurfacing Revision. Clin Orthop Res Res 2017;475;304. ^, ⁵ Marshal DA, Pykerman K. et al. Hip resurfacing vs. total hip arthroscopy; a systematic review comparing standardized outcomes. Clin Orto[ Re;at Res 2014; 472:2217.

Hip Arthroscopy/Osteotomy

These are surgeries that may be recommended in very early arthritis or for prevention of developing worsening arthritis. They are not recommended to treat more severe hip osteoarthritis. ⁶ Tibor LM, Sink EL. Periacetabular osteotomy for hip preservation. Orthop Clin N Am. 2012;43(3):343–57. As cited in Murphy NJ, Eyles JP, Hunter DJ. Hip Osteoarthritis: Etiopathogenesis and Implications for Management. Adv Ther. 2016;33(11):1921–1946. doi:10.1007/s12325-016-0409-3.

Dr. Carolyn Marquardt is a physiatrist at Swedish Spine, Sports & Musculoskeletal Medicine in Seattle, WA. She specializes in sports medicine and has more than 20 years of experience providing non-surgical care for muscle and joint injuries.

Dr. Andrew Cole has 30 years of experience specializing in spine and joint pain management. Dr. Cole has held numerous medical appointments throughout his career, and recently served as the Executive Director of Rehabilitation & Performance Medicine Enterprise for Swedish Health Services and as Medical Director of Ambulatory Musculoskeletal Services for Swedish Medical Group.

1 Culliford DJ, Maskell J, Kiran A, et al. The lifetime risk of total hip and knee arthroplasty: results from the UK general practice research database. Osteoarthr Cartil. 2012;20(6):519–24. As cited in Murphy NJ, Eyles JP, Hunter DJ. Hip Osteoarthritis: Etiopathogenesis and Implications for Management. Adv Ther. 2016;33(11):1921–1946. doi:10.1007/s12325-016-0409-3.
2 Sehatzadeh S, Kaulback K, Levin L. Metal-on-metal hip resurfacing arthroplasty: an analysis of safety and revision rates. Ont Health Technol Assess Ser. 2012;12(19):1–63. As cited in Murphy NJ, Eyles JP, Hunter DJ. Hip Osteoarthritis: Etiopathogenesis and Implications for Management. Adv Ther. 2016;33(11):1921–1946. doi:10.1007/s12325-016-0409-3.
3 Matharu GS, Pandit HG, Murray DW, Treacy RB. The future role of metal-on-metal hip resurfacing. Int Orthop. 2015;39(10):2031–6. As cited in Murphy NJ, Eyles JP, Hunter DJ. Hip Osteoarthritis: Etiopathogenesis and Implications for Management. Adv Ther. 2016;33(11):1921–1946. doi:10.1007/s12325-016-0409-3.
4 Matharu GS, Pandit HG. Murray DW. Poor Surviviorship and Frequent Complications at a Median of 10 years after Metal-on-Metal Hip Resurfacing Revision. Clin Orthop Res Res 2017;475;304.
5 Marshal DA, Pykerman K. et al. Hip resurfacing vs. total hip arthroscopy; a systematic review comparing standardized outcomes. Clin Orto[ Re;at Res 2014; 472:2217.
6 Tibor LM, Sink EL. Periacetabular osteotomy for hip preservation. Orthop Clin N Am. 2012;43(3):343–57. As cited in Murphy NJ, Eyles JP, Hunter DJ. Hip Osteoarthritis: Etiopathogenesis and Implications for Management. Adv Ther. 2016;33(11):1921–1946. doi:10.1007/s12325-016-0409-3.