As a patient, only you can decide when you are ready for surgery. Doctors and surgeons may make recommendations, but the call is ultimately yours. So, what if you just opt to deal with the pain in your hip, and postpone surgery? As with many medical situations, the recommendations of your surgeon should be taken seriously. Assuming your surgeon has recommended surgery, the risks associated with delaying that surgery may include deterioration of the hip joint, increased pain and lack of mobility, and not to be overlooked, and the possibility that less invasive methods of surgery, such as hip resurfacing, are no longer an option.
Unless you have an advanced stage of joint disease, doctors will usually first attempt to treat arthritis with less invasive, non-surgical methods. If those methods fail, or are inappropriate for the situation, a doctor may recommend a total hip replacement. Is the pain you’re experiencing severe enough to justify the surgery? Only you know. There are some legitimate health-related reasons for which a doctor may recommend delaying surgery, but if your condition is degenerative, and current levels of pain are only a sign of what is to come, postponing surgery has its risks.
The greatest risk to delaying surgery is the deterioration of joint tissue and the progression of joint disease such as osteoarthritis. As the arthritis progresses, the diseased joint will continue to grind away. This means that pain is more likely and so is the possibility of a deformed joint. In younger hip patients, this risk may be even greater. Within a certain time-frame, earlier in the development of the arthritis, hip patients may be eligible for a resurfacing procedure, but with the passage of time this option becomes less of a possibility.
There is particular risk to delaying surgery if a patient has become sedentary and can no longer carry out normal, everyday activities. Not being able to play tennis four days a week does not warrant hip replacement surgery; but not being able to comfortably leave your chair and go to the bathroom may. It is important that patients who are living a sedentary lifestyle because of joint disease consult their doctor.
Studies do show that there may be an optimal time to have hip replacement surgery. For example, patients who are healthier when they get their surgery often do much better than those who have waited and allowed their joints to worsen. An article by the University of Toronto* states that “timing of surgery may be more important than previously realized and, specifically, that performing surgery earlier in the course of functional decline may be associated with better outcome.” In other words, surgery early is usually better than surgery later.
According to Dr. Ian Clark, medical researcher and founder of Peterson Tribology Laboratory for joint replacement at Loma Linda University, most patients delay hip replacement surgery for several perceptual reasons:
- fear of the unknown
- fear of surgery
- fear of ‘losing’ a body part
- fear of the post-operative surgery pain
- fear that they may end up worse off than before they started
After hip replacement surgery, however, most patients report they wish they had done it sooner. “The most common thing that patients say to me,” Dr. Clark writes, “If I only knew then what I know now, I would have done this years ago.”
- Timing of total joint replacement affects clinical outcomes among patients with osteoarthritis of the hip or knee (ncbi.nlm.nih.gov)
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