When Is It Time for Hip Replacement? An Oklahoma Patient’s Story
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After hip pain began limiting her daily life, Evelyn Schaefer worked with INTEGRIS Health Orthopedics and Jim Thorpe Rehabilitation to return to hiking, yoga, travel and time with her family.
Standing above the Grand Canyon, Evelyn Schaefer had plenty of reasons to take in the view.
Only months earlier, hip pain had made everyday movement difficult. She had limped, struggled to work out and wondered whether having hip replacement surgery in her 50s would leave her with even more limitations.
Instead, less than a year after her first total hip replacement at age 59, Evelyn was exploring the Grand Canyon. She even brought a photo from the trip back to David Rhodes, M.D., the fellowship-trained, board-certified surgeon at INTEGRIS Health Medical Group Orthopedics Edmond, who performed her surgery.
For Dr. Rhodes, that photo said almost everything. Seeing Evelyn return to something she once feared she might have to give up “made me super pumped, too,” he recalled.
For Evelyn, the experience reminded her how much she still wanted to see and do.
“Once I went to the Grand Canyon, I was just so inspired by nature and how much there is to see in the U.S. that I haven’t even seen,” she said.
Her list of adventures has continued to grow. She has climbed the demanding Manitou Incline in Colorado Springs, spent four days hiking in Moab and started thinking about a future trip to Yellowstone.
“I’ve got a lot of life left to live,” Evelyn said. “And I need to be able to do it.”
Her experience offers insight into when persistent hip pain deserves an evaluation, how doctors determine whether hip replacement may be appropriate and why rehabilitation is an important part of recovery.
When should you see a doctor about hip pain?
Evelyn was in her mid-50s when persistent hip pain began interfering with tennis, exercise and, eventually, everyday life.
She tried stretching. She changed how she ate. She hoped that if she stayed active and healthy enough, the pain might simply go away.
“I thought I could stretch it away,” she said. “I thought I could eat so healthy the hip pain would go away.”
It did not.
The hardest part, Evelyn said, was accepting that she might need a hip replacement at her age.
“I did cry when they told me I needed that,” she said. “But it just got to where it affected every aspect of my life.”
That effect on daily life is something Dr. Rhodes listens for when evaluating a patient.
“The thing that I listen for in a conversation with a patient is when they start telling me that it’s affecting them on a regular basis,” he said. “They can’t do what they like to do or what they need to do.”
Common reasons to seek an evaluation for hip pain may include:
- Pain that persists or worsens
- Stiffness or reduced range of motion
- Limping or changes in the way you walk
- Difficulty exercising, working or completing daily activities
- Pain that interferes with sleep
- Symptoms that do not improve with rest or initial treatment
An evaluation can help determine whether the discomfort is related to a temporary strain, arthritis or another condition that may require treatment.
What can cause persistent hip pain?
Osteoarthritis is a common reason someone may eventually need hip replacement, but it is not the only condition that can damage the joint.
Other possible causes of ongoing hip pain or joint damage include:
- Hip dysplasia
- Rheumatoid arthritis
- Traumatic injuries
- Avascular necrosis, which occurs when a loss of blood supply damages bone tissue
- Other conditions affecting the bones, cartilage or surrounding tissues
Because several conditions can cause similar symptoms, persistent hip pain does not automatically mean someone needs surgery. A medical evaluation may include a health history, physical examination and imaging to help identify the cause and severity of the problem.
Are you too young for hip replacement?
Hip replacement is often associated with older adults, but some people develop significant joint damage in their 40s or 50s.
For these patients, age is only one part of the decision. Doctors may also consider:
- The cause and severity of joint damage
- How frequently symptoms occur
- How pain affects work, movement and daily activities
- Whether nonsurgical treatments have provided relief
- The patient’s overall health
- Personal goals and expectations
- The potential benefits and limitations of surgery
- Implant longevity and the possibility of needing another procedure later in life
Improvements in hip replacement implants have expanded the conversation for some younger patients. However, long-term considerations remain an important part of deciding whether surgery is appropriate.
For Dr. Rhodes, the conversation is less about whether someone has reached a specific age and more about what hip pain is taking away from that person’s life.
If someone has a severely arthritic hip at 45, waiting another 10 or 20 years could mean spending those years with pain, limited movement and a reduced quality of life. On the other hand, surgery may not be the best or first option for every patient.
The decision requires an individualized conversation about symptoms, health, treatment history and long-term goals.
What treatments may be considered before hip replacement?
Hip replacement is not the first treatment for every person with hip pain. Depending on the underlying condition and severity of symptoms, a care plan may begin with nonsurgical treatment.
Options may include:
- Changes to activities that aggravate the joint
- Physical therapy
- Medications, when medically appropriate
- Assistive devices
- Injections
- Treatment of an underlying medical condition
- Other strategies to improve mobility and reduce stress on the joint
A specialist can help patients understand which treatments may be appropriate and how long to try them before considering another approach.
If pain continues to interfere with daily life despite nonsurgical care, hip replacement may become part of the discussion.
What do recovery and physical therapy after hip replacement involve?
For Evelyn, surgery was only one part of returning to the life she wanted.
She completed physical therapy through INTEGRIS Health Jim Thorpe Rehabilitation. Her goals went beyond walking with less pain. She wanted to return to tennis and yoga and regain the strength and range of motion needed to move confidently.
Rehabilitation needs differ for each patient, but physical therapy can support safe movement and help patients work toward meaningful recovery goals. After hip replacement, patients should work with their surgeon and rehabilitation team to understand:
- Which activities are safe at each stage of recovery
- How to complete recommended exercises
- How to rebuild strength and mobility
- Which precautions to follow
- When they may return to work, driving and other activities
- Which symptoms to report to their care team
A few years after Evelyn’s first hip replacement, arthritis progressed in her other hip. This time, she knew more about what to expect and had confidence in Dr. Rhodes and the rest of her care team.
“When the second one started acting up and Dr. Rhodes said I needed it, I just went, ‘OK, let’s do it,’” she said.
At 63, Evelyn underwent her second total hip replacement. Recovery took a little longer this time. When she struggled with some of her usual yoga poses, she returned to physical therapy. Her therapists helped her improve the hip strength and range of motion those poses required.
She continues to do many of her exercises each morning.
Returning to activity takes time and consistent effort. The appropriate pace depends on factors such as the patient’s overall health, surgical procedure and mobility before surgery. Evelyn’s recovery reflects her experience and should not be considered a standard timeline or expected result.
“We’re here to help people return to their life, and whatever that is for them,” Dr. Rhodes said. “We want to help them get through that and beyond it so they can go back and live the life they want to live.”
Establishing specific goals before treatment can help patients and members of their care team develop a recovery plan around the activities that matter most.
Evelyn’s next chapter
For Evelyn, an active life is about more than reaching the top of a mountain.
It means walking through old villages while traveling in Europe instead of seeing them from a window seat. It means climbing the stairs to a cathedral, walking her daughter’s dog and keeping up when her 11-year-old grandson wants to go somewhere.
“I don’t want to be like, ‘Oh well, Grandma will just sit here and watch,’” she said.
And she does not plan to. There is still Yellowstone to see, more trails to hike, more trips to take and more time to spend with her children and grandchildren. There is much more life left to live.
Find help for persistent hip pain
If hip pain is limiting your movement or keeping you from activities you enjoy, an orthopedic evaluation can help identify the cause and determine which treatment options may be appropriate for you.
Find an INTEGRIS Health orthopedic specialist near you.
