When is too early for total hip replacement?

How old are you? Are you a male? If so, look into hip resurfacing. You will be able to stay more active. I’ve had my right one for almost 16 years with no problems. There are 3 or 4 professional hockey players that are playing in the NHL with them so they must be pretty solid. I’m not sure if they will do it if you have a lot of space, but then again they usually won’t do a replacement either.

@madzik09: Thank you for sharing your concerns at Mayo Clinic Connect on the basis of conflicting opinons and your findings. You are correct that they don't fit the typical criteria many orthopedics use as qualifying factors for a total hip replacement (THR) - which I myself will be undergoing in early September. I will share that in my case I do have decreased joint space and advanced OA (osteoarthritis) that was hastened by avascular necrosis - bone death following the placement of screws to treat a broken hip some years ago.

I suspect the rationale for not doing surgey by the doctor who stated you may not have a good outcome may be due to some uncertainty as to the hip being the actual pain generator for the discomfort you're experiencing. There are many factors to be considered prior to resorting to surgery that medical professionals usually want to evaluate or rule out first, such as prior conservative treatment - such as you have had and stated have not yielded benefit - and how this impacts your daily functioning. Have you had to modify your daily activity? Rely on pain medications on a regular basis? Use an assistive device? Have you undergone or discussed all diagnostic testing, such as hip arthrogram or explored the possibility of spinal issues contributing to this pain? It's very frustrating in such cases to try to narrow down the cause but before undergoing surgery it does help to know the risks and benefits, as well as the potentential limitations.

This is information that Mayo has on the topic of THR that may provide some additional guidance: https://www.mayoclinic.org/tests-procedures/hip-replacement/about/pac-20385042

Ultimately it comes down to your decision based upon the discomfort you're in, the knowledge you have along with informed consent and the trust in the provider you choose. Keep in mind that people who undergo THRs do have various outcomes no matter what the underlyi ng cause, most with positive experiences, but no one can predict with any degree of certainty what your individual response may be. However, it does help to be as informed as possible as it appears you have been and are doing. Does this information assist with formulating a plan?

@closer0043 I’m 48/ female so resurfacing isn’t an option as far as I know. Thank you for that feedback.

@grammato3 thank you for the link. I will look into it. The arthroscopies also revealed some low back issue in L4/L5 region for which I’ve taken injections. So I have a dual problem going on. My hip pain is most pronounced when sitting. I have some piriformis pain as well. I received shots in my SI joint and bursa. I have a lot more pain since my surgeries than what I had prior so I’m very scared to undergo another procedure.

@madzik09 From the Cleveland Clinic:
The size of your hip bones is an important part of whether or not hip resurfacing will be a good option for you. Men typically have larger bones than women. This means people men are usually better suited to hip resurfacing than women. But your bone size is more important than your sex.

@madzik09: From everything you're describing - the pain that's more pronounced when sitting vs. standing/walking or arising, imaging findings, ortho recommendation and past experience - I can understand why you'd be reluctant to undergo a THR at this point. May I take it that you've been treating with pain management?

I have been taking OTC mostly. I had one cortisone injection which caused a flare up and a trip to ER. I feel like there’s a pinched nerve somewhere in my joint which refers to the back near the piriformis muscle. The joint itself feels spongy and a bit unstable. But also stiff at times.

I’m scheduled for THR in Oct. I Honestly don't know if this is hip or SI related..
I’ve had one hip injection that didn’t do much, and then an epidural two months later that relieved 75% of my pain. I’m weaker on bad left hip side, and will lead with right leg when going up steps. I go to PT, and he works on my SI to loosen it up, and always feels much better.
I’ve had continuing shin pain for 4 yrs, on both legs, and ice frequently when I’ve been unusually active.
Is THR premature? I take two Tylenol a day, one in am and one pm.

@ginger123 It could be both!
I can only tell you that I was SURE my problem was my spine, and injections helped a lot with the pain, but an MRI by my primary confirmed that I also had a badly deteriorated hip. Hip replacement surgery was a game changer for me. Now 20 years later, the replaced hip is fine, but spinal stenosis and nerve impingement have returned and we are working to treat it.

Would you consider getting a second opinion from an orthopedist or neurologist who is not a surgeon? This could give you some clarity about the path to take.