What is an outcome for a bone-on-bone hip joint that gives no pain?

@laughlin1947 I am not experiencing the "Over these past few years, it seems to me that surgeons want (eagerly) to operate and not offer other treatment options." that you mention. I went to my orthopedic surgeon expecting to schedule TKR, but despite sever bone-on-bone imaging he strongly encourage me to try HA injections and told me that his uncle delayed TKR for 5 years by using them.

Various TKR surgeons with videos on YouTube (eg Talking With Docs, two Canadians) all strongly recommend alternative therapies first.

@mackad2024 Thanks for your personal insights and experiences. I have enjoyed the Mayo Clinic blog immensely, primarily due to others who explain treatment options and their good/bad outcomes. Over these past few years, it seems to me that surgeons want (eagerly) to operate and not offer other treatment options. One personal example I have is that, in April 2025, I had arthroscopic surgery on my left knee due to sharp pain and some slightly rough cartilage. The surgeon did me no favors when he cut part of a torn meniscus that was keeping that joint from being bone on bone. Once he cut the meniscus edge off, the joint did of course become bone on bone, and it looked like I was destined for a TKR. I'm sure that was the objective the surgeon had. TKRs lead to much better paydays. I've been very reluctant to get a TKR due my age of 78years and not being a fan of PT. So, long story short, I went thru multiple epidurals and after having read articles online, I saw where hyaluronic acid injections were often successful. I tried three of those (low viscosity) and they were not successful. Then I saw where there is a version of high viscosity HLA (aka Durolane) that has been successful. I asked my knee ortho doctor why she hadn't offered that option and said it wasn't covered by Medicare. I said I didn't care, and I would pay the $450 out of pocket. Later I asked them to apply to Medicare to get it paid by the program and that effort was successful. I later went on to ask her if she knew about HLA oral capsules (a note from the Mayo Clinic patient blog) and she said she never heard of them. Not a believer! Well, that was several months ago and I'm still doing well with my knee pain. My difficulty is with walking with arthritic knees that ache a bit (I'm a tin man like you), so I'm relearning the finer points of easy walking (doing one hour each AM). I've also become a real fan of radio frequency ablation that is working well after 2 months, and I'm hopeful it will be as long as 6 months of relief.

I wonder why the original surgeon did not resurface the patella? It is a standard part of a TKR and my surgeon did it first thing and then tucked it away while he did the rest of the procedure.

I did a lot of reading and research over the past few years on hip replacement surgery, saw three different surgeons as well, and waited until the discomfort and pain from my left hip was interfering too much with my life (particularly my sleep) before finally going ahead with the left hip replacement surgery four months ago.

My own opinion is that, regardless of whether you are bone-on-bone, if you're still functioning fine (with little to no pain) and it's not interfering to any significant degree with your quality of life, then I certainly would not go through with the surgery at this time. Despite the overall improvements in joint replacement surgery and the overall patient satisfaction with the results, it is still major surgery and serious problems/issues can arise: e.g., infection, dislocation, nerve damage, constant pain. etc. If are having little to no pain and you're not debilitated to any degree, it seems unwise to me to take the risk of surgery.

@steveinarizona Steve, looks like you were commenting here on someone who has gotten a TKR. My problem is with a hip that I picture is deteriorating, unless I have really high density bones.

I wonder why the original surgeon did not resurface the patella? It is a standard part of a TKR and my surgeon did it first thing and then tucked it away while he did the rest of the procedure.