7 Reasons NOT To Get a Hip Replacement —
When your hip pain takes over your life its natural for you to consider getting it replaced immediately. However, the other part of your brain likely has questions and concerns about getting the surgery done.
For some its an easy decision to get the hip replacement but for others not so much. My professional physical therapy experience has given me some important discussion points you can use to make your decision more informed.
For the most part I highly recommend getting a new hip if the pain is unbearable however this decision might not be the best for you. Below are 7 reasons NOT to get hip replacement anytime soon.
1. Age – Too Young To Get Your Hip Replaced
This is probably the boat most of you are in that found this article. Maybe you are in your 40s or 50s and had a traumatic injury from sports or an accident causing your hip arthritis.
Let’s rule out those who have both hips in bad shape from biological growth issues or non-injury reasons. If you are in this group, you should not consider age as a factor seeing that you will ultimately need both replaced. Get it done regardless of age.
For those who have one bad hip and you can still function well with other pain control methods, you should consider holding off. If using pain control methods like cortisone shots, ice/heat, shoe wear, compression support and stretching keeps your pain in check then I would take it year by year.
More than likely you will be getting a new hip at some point but age is definitely a factor. Your new hip will indeed limit your potential activity level in some manner.
Hip join technology continues to improve yearly so the longer you can hold off, the more likely your new hip will give you better mobility at your age.
2. Age – Too Old to Get Your Hip Replaced
Yes you heard this correctly, you can be too old to get your hip replaced. Most surgeons place an age limit on their risk tolerance to put you through the trauma of a hip replacement surgery. 90+ seems to be the age where I rarely if ever see a patient in my practice with an elective hip replacement.
If you are in you mid to late 80s and are having severe hip pain and your surgeon is willing to do the surgery, I would suggest getting a second opinion. If the second (respected) surgeon is also willing to do the surgery then I would feel more comfortable in the decision.
As you age your body simply cannot handle the effects of both the anesthesia and the surgery trauma itself. Recovery will be much longer and difficult and sometimes its not worth the risk of the surgery.
To be blunt, the chances of death during the procedure are much higher at an increased age and the reason why many surgeons refuse. Take your age into account and plan ahead accordingly.
3. Poor Medical Status to Limit Hip Replacement Safety
Regardless of age, if you have other medical issues ongoing you may want to think twice about getting a major elective surgery. Conditions such as heart disease, COPD, emphysema or severe diabetes will negatively affect your healing and make recovery difficult.
If you have a history of blot clots then you need to be on top of this and discuss with your surgeon beforehand. A strong regimen of anticoagulant medication will be needed after surgery to prevent clots.
You will need to decide if your medical condition is worth the risk of getting the surgery performed. Be sure to have complete trust in your surgeon as it could truly be the choice that affects your future.
Other medical conditions that would affect getting a hip replaced would include neuropathy, severe osteoporosis, blood disorders, cancer and severe autoimmune disorders.
4. All Pain Control Methods Not Considered Before Hip Replacement
You may think your pain level is enough that you must need a new hip but there’s a chance you have not explored all options to help with pain. This does not mean taking strong narcotics to mask the pain but looking at all other pain reduction methods instead.
Most orthopedic offices have someone in charge of pain management for those who are not quite at the stage where they need joint replacement. An evaluation with this physician should be on your priority list to find something that could work for you.
Everyone has heard of cortisone injections that their neighbor or dad had in their hip or knee. Did you realize that you can get cortisone shots for many years and have little to no negative impact on your body?
Normally physicians will allow a cortisone shot every 3 months to a joint if the pain is reduced significantly. If this works for you, there is no reason to go away from this unless it is causing other issues.
Don’t forget, you cannot get your hip replaced at least until 3 months after your last cortisone shot. Hopefully you can avoid the surgery all together however this is a consideration.
Other joint injections including hyaluronic acid can be performed in the hip to attempt to provide more longer term relief. One example of this is Durolane.
Finally, Stem Cell Therapy and PRP injections are currently being used in some capacity however not enough proof of effectiveness is available to comment on.
5. Not Mentally Prepared for Major Surgery of Hip Replacement
Even though you may be having serious hip pain, there’s a good chance you are just not ready to undergo a major surgery. Yes, elective hip replacement is considered a major surgery and this needs to be understood.
There are legitimate complications that can occur during your surgery and you need to be accepting of them. Your surgeon will have you sign off on this liability and should be up front with the possible issues that can occur.
If you are not mentally prepared to go through with this type of procedure then you 100% should not get your hip replaced at this stage. Many people in this situation choose to wait longer until they are ready to accept the entirety of a surgery like this, if ever.
You will likely need to reduce your activity level if your pain level is extremely high yet surgery is not an option. Don’t let others pressure you into a situation that is not medically necessary.
6. Too Heavy or Overweight for Hip Replacement Surgery
Yes it is possible to be too heavy or obese to have a successful hip replacement surgery. In fact some surgeons will not perform a total hip replacement if the patient’s Body Mass Index (BMI) is too high.
Why would this be the case? The issue is that obesity heading into this type of surgery leads to many additional complications and poor outcomes. In fact, numerous studies have been performed to show data on this subject.
Per a study by Issa et al (https://orthobuzz.jbjs.org/2016/02/04/new-studies-on-bmi-and-hip-replacement/), very obese 50+ BMI patients had a 4.5x higher odds ratio of needing a revision and 7.7x higher odds of surgical complications compared to normal BMI patients.
It would be wise to significantly reduce your body weight to as close to normal BMI as possible before your hip replacement. I would suggest starting down this path at least 6 months prior to surgery to allow ample time.
7. Your Mobility Is Too Good to Get a Hip Replacement
If you’re not at a stage where you are severely limited in your movement, you’re not ready to get a hip replacement. Hip replacements are meant to be a last resort to regain your mobility and decrease your pain level.
As a PT I will tell you that you will know when its time to get your hip replaced. If you’re not sure if its time or not, its definitely not time yet.
Hip replacements are meant for those who cannot perform or avoid basic activities they would otherwise do without concern. If you are performing your daily routine and not avoiding anything specifically, a hip replacement is not for you.
Final Thoughts on Reasons Not To Get Hip Replacement
Below are 7 Reasons to NOT Have Your Hip Replaced:
- Age – Too Young To Get Your Hip Replaced
- Age – Too Old to Get Your Hip Replaced
- Poor Medical Status to Limit Hip Replacement Safety
- All Pain Control Methods Not Considered Before Hip Replacement
- Not Mentally Prepared for Major Surgery of Hip Replacement
- Too Heavy or Overweight for Hip Replacement Surgery
- Your Mobility Is Too Good to Get a Hip Replacement