Conditions That Can Lead to Hip Replacement Surgery

Hip replacement surgery can alleviate severe hip pain caused by conditions like osteoarthritis, rheumatoid arthritis, and hip fractures. Learn more!

Hip replacement surgery may be recommended for individuals suffering from severe hip pain and disability caused by traumatic and degenerative conditions. The most common cause of hip surgery is osteoarthritis of the hip. It has a prevalence rate in Ireland of around 12.9% – increasing with age.

However, osteoarthritis isn’t the only condition that may require hip replacement surgery. Several other disorders and traumatic injuries are considered risk factors for hip surgery. Below, we provide key information about these conditions, including what to look for, why it happens, and how it’s treated.

In this article:

  • Osteoarthritis
  • Rheumatoid Arthritis
  • Avascular Necrosis
  • Hip Fractures
  • Post Traumatic Arthritis


Osteoarthritis (OA) is a progressive condition that occurs when the cartilage covering the ends of the joint begins to wear down. While the initial symptoms are mild, as the cartilage continues to erode, it can become extremely painful and debilitating.


The underlying cause was long suspected to be “wear-and-tear.” But new evidence indicates that the condition isn’t so simple. Marathon runners, for example, carry no greater risk of OA. However, excessive squatting and manual labour are risk factors.


OA symptoms include:

  • Pain in the groin, thigh, or buttocks
  • Stiffness, especially in the morning or after inactivity
  • Reduced range of motion
  • Swelling and tenderness
  • Creaking or grating sensation
  • Limping
  • Muscle weakness
  • Pain at rest, including night pain

Symptoms worsen over time as the cartilage erodes. The condition is assessed in four stages, starting with mild pain and progressing to severe pain, chronic inflammation, and stiffness as bone rubs against bone.

Diagnosis & Treatment

Osteoarthritis of the hip is diagnosed by X-ray. Narrowing of the joint space, extra bone growth, and bony spurs are characteristic of the condition.

Initially, the condition is treated conservatively with anti-inflammatory medication like NSAIDs and steroids. Physical therapy, weight loss, and exercise are also advised to reduce pressure on the joint and improve the strength of surrounding muscles and ligaments.

If symptoms continue, hip replacement surgery is advisable. The damaged section of the hip is removed and replaced with a prosthetic. Post-surgery, physical therapy is required to improve function and strength. The outcomes are usually excellent, enhancing mobility and quality of life.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune condition that occurs because the immune system wrongly flags the body’s own tissues as a threat. Unlike OA, RA is characterised by chronic inflammation that leads to permanent joint damage and deformities. Pain, stiffness, and reduced mobility are common symptoms in the hip.


The exact cause of RA is unknown – however, it’s believed to involve a combination of genetic and environmental factors. Certain genes may increase the risk of developing RA, and infections and other environmental exposures may trigger the onset of the disease in genetically susceptible individuals.

Smoking and obesity are also known risk factors.


RA symptoms in the hip include:

  • Persistent pain in the hip joint, which can radiate to the groin, thigh, or buttocks
  • Morning stiffness lasting more than an hour
  • Swelling and tenderness in the hip joint
  • Fatigue, fever, and loss of appetite
  • Reduced range of motion and difficulty walking
  • Symmetrical symptoms, meaning both hips can be affected simultaneously

Diagnosis & Treatment

RA diagnosis is quite complicated. Initially, it’s based on medical history, physical examination, and blood tests for specific antibodies (such as rheumatoid factor and anti-CCP). Next, your physician may schedule imaging studies like X-rays or MRI to assess joint damage.

Treatment begins with a combination of medications to control inflammation and suppress immune system overactivity. These include disease-modifying antirheumatic drugs (DMARDs) and biologics. Physical therapy and lifestyle modifications, including exercise and a healthy diet, can also help manage symptoms.

When conservative treatment options begin to fail, hip replacement surgery may be necessary. During the surgery, the damaged section is replaced with a prosthetic implant. Post-surgery, physical therapy is critical to restore mobility and strength.

Avascular Necrosis

Avascular necrosis (AVN) of the femoral head, or osteonecrosis, refers to the death of bone tissue due to a lack of blood supply. AVN is especially common in the hip as the blood supply to the femoral head is limited.


AVN is caused by any condition that slows or stops blood flow to the bone. Common risk factors include excess alcohol consumption, smoking, high doses of corticosteroids, and childhood diseases (including Legg-Calve Perthes disease).


The most common symptom of AVN is hip pain. The pain limits movement, spreads down into the knee, and worsens over time (as microfractures form).

Diagnosis & Treatment

AVN is primarily diagnosed by imaging studies. X-rays, MRI scans, and CT scans help your doctor to visualise the damage, determining the best course of action.

Depending on your age and the severity of the damage, AVN is either treated with medication or surgery. Bisphosphonate medications can help with mild AVN, strengthening the bone and preventing the collapse of the hip.

Surgery is the final option. Potential surgical procedures include core decompression (removing part of the inner bone layer), transplants, and bone reshaping. Hip replacement surgery is an option for people where the bone has collapsed, or other treatments aren’t helping.

Hip Fractures

Hip fractures are breaks in the upper part of the femur (thigh bone) often caused by falls or severe trauma, particularly in older adults with osteoporosis.


Common causes include falls, direct blows to the hip, and weakening of the bone due to osteoporosis or other medical conditions.


Symptoms of hip fracture include:

  • Hip pain
  • Inability to move or bear weight on the affected leg
  • Swelling
  • Bruising
  • Outwardly turned leg

Diagnosis & Treatment

Diagnosis of a hip fracture is confirmed through medical history, physical examination, and imaging tests such as X-rays or MRI.

Treatment inevitably involves surgery. If possible, surgeons will try to repair the hip joint. But, if the damage is severe enough, a full hip replacement may be necessary. Post-surgery physical therapy is needed to regain mobility and strength.

Choose Kardiolita Hospital for Hip Replacement Surgery Abroad

Kardiolita Hospital is a trusted orthopaedic surgery centre with an impressive track record of success. It boasts an exceptionally low complication rate and helps patients to get back on their feet.

Best of all, the waiting list is much smaller and the costs much lower than in Ireland. Compared to the hip surgery price in Ireland, you can expect to pay around a tenth of the cost. That makes hip replacement surgery abroad a real possibility.

Want to learn more? Get in touch with our skilled team to discover how we can help you.

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