Many patients with severe hip arthritis delay seeking help because they fear surgery, are unsure whether their pain is 'bad enough', or have been told to simply wait. This guide helps you understand what hip arthritis feels like at each stage, what the clear indicators for surgery are, and what modern hip replacement actually involves — so you can have an informed conversation with your surgeon.
The hip is a ball-and-socket joint — the round head of the femur (thigh bone) fits into the acetabulum (socket) of the pelvis. A smooth layer of cartilage lines both surfaces, allowing near-frictionless movement. Hip osteoarthritis occurs when this cartilage wears away, leading to bone-on-bone contact, pain, stiffness, and loss of mobility.
Hip pain often presents in characteristic ways that distinguish it from other causes of groin or leg pain:
Age-related cartilage wear — the most common cause. Typically affects patients over 55.
Loss of blood supply to the femoral head, leading to collapse of the hip joint. A relatively common cause in Kerala and India, sometimes linked to steroid use or alcohol.
Inflammatory arthritis that can affect the hip in addition to other joints.
Conditions such as developmental dysplasia, Perthes disease, or slipped capital femoral epiphysis can lead to arthritis in adult life.
Previous femoral neck fractures — common in older patients — can damage the hip joint and lead to AVN or arthritis.
Abnormal contact between the femoral head and acetabular rim that causes early cartilage damage — increasingly recognised as a cause in active adults.
You should consult an orthopaedic surgeon if hip pain has been present for more than a few weeks and is affecting your movement, sleep, or daily activities. Early assessment allows proper diagnosis, appropriate non-surgical management if suitable, and monitoring of progression.
Do not wait until you are unable to walk. The outcomes of hip replacement surgery are generally better when patients are not severely debilitated, as overall fitness and muscle strength contribute to recovery.
Hip replacement surgery is considered the appropriate treatment when:
Total hip replacement (THR) involves removing the damaged femoral head and acetabular cartilage and replacing them with a prosthetic implant. The implant typically consists of:
Modern implants are designed to last 20–25 years or longer. The surgery is performed under spinal or general anaesthesia and takes approximately 60–90 minutes. Minimally invasive techniques have reduced blood loss, tissue disruption, and recovery time significantly.
I perform robotic-assisted hip replacement, which uses preoperative CT planning and real-time robotic guidance to position the acetabular cup with a degree of precision that is not achievable by hand alone. Cup position is one of the most important determinants of long-term outcomes, dislocation risk, and bearing surface wear. Robotic assistance consistently achieves target angles that fall outside the safe zone in a significant minority of conventional cases.
You can learn more about robotic joint replacement at our Robotic Knee Replacement Guide — the technology is the same platform applied to both knee and hip.
Most patients stand with physiotherapy support on Day 1 after surgery. Early mobilisation reduces clot risk and accelerates recovery. Hospital stay typically 2–4 days.
Gradual reduction in crutch use as strength returns. Wound healing and swelling settling. Light home activities resume.
Most patients clear to drive at 6–8 weeks (left hip earlier than right). Return to desk work possible. Physiotherapy ongoing.
Most patients feel dramatically better at 3 months compared to pre-surgery. Walking distances increase. Pain significantly reduced or absent.
Full strength and range of motion typically restored. Return to swimming, cycling, golf, and similar low-impact activities. Recommended activity restriction: high-impact sports such as running.
A question I am asked frequently by patients in Kerala is whether they can return to floor-level activities — sitting cross-legged, namaz, floor sleeping — after hip replacement. This is a genuinely important quality-of-life consideration in our cultural context.
Traditional hip replacement precautions (particularly after the posterior approach) restrict deep hip flexion and rotation to reduce dislocation risk. However, with modern implant designs and increasingly with the anterior approach, range-of-motion restrictions are less severe and some patients can return to these activities.
This should be discussed specifically before your surgery — the choice of surgical approach and implant type can be guided in part by your functional goals.
I perform hip replacement surgery in Thrissur, including robotic-assisted hip replacement. Pre-surgery consultations are available at DH Clinic Ayyanthole and Dr. Haneefa's Clinic, Kechery. If you are based in Kochi or Ernakulam, I consult at Medical Trust Hospital on Saturdays.
For patients with avascular necrosis (AVN) of the femoral head — a condition I see frequently in practice — early assessment is particularly important, as some cases can be managed without joint replacement if caught early enough.
An X-ray and a clinical assessment clarify what stage your hip is at and what the right treatment option is for you.
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