I have my own personal theory about how fast hips decline and why. For OA, you've got this layer of cartilage sitting in there absorbing shock and friction. As it wears out tiny little spots wear through and begin being inflamed and/or bone on bone. They hurt.
As time goes on they get larger.
I imagine it like this: At some point that cartilage is super-worn. Like a piece of paper. At that point, the parts that are damaged and inflamed and painful are many and the rate of their destruction becomes super-fast.
My pain was about 2 years. It started as an occasional twinge. Then that twinge was more common. That lasted about a year.
For the last year, it was a constant pain, increasing constantly for about 8 months. I had an injection in February one year before surgery. That injection allowed me to go (painfully, but possible) skiing last year.
The pain reduction from this injection lasted about 10 weeks or more and then faded quickly.
Six months later, the pain is worse, and I had another injection in August. By this time, I had begun limping a little and had significant reduction in range of motion to the point where I had to park my motorcycle. I could still WALK, but separating my knees, tying my shoes, putting on socks, etc was very painful.
This injection worked well and I hiked in yellowstone for 34 miles in the back country with a 50# pack. Still had a range-of-motion problem, but got through it.
This time, the injection was only effective for about 3 weeks and faded VERY fast. The limp got worse, all my daily activities begin being affected and the pain was constant including while sleeping.
My doctor told me that the efficacy of the injections was going to continue to diminish, so there wasn't much point for me to continue with injections. I made the surgery appointment in Oct for January.
I would rather have a fulfilling life for the next 15 years and get a revision in my seventies than miss out on all the things I enjoy doing while I'm still young enough to do them.
I agree with this sentiment completely. I could have walked with a limp, given up my favorite activies (skiing, hiking, motorcycle riding, walking, etc) OR I could get a bilateral THR.
@
M1ke. You live in the PNW with access to the UW.
I also live in the PNW and went to see a guy named Fuchs at Evergreen General Hospital in Kirkland, but i didn't hit it off with him. I just didn't feel comfortable. Maybe it was him, maybe it was that I wasn't quite ready mentally, but either way, I didn't feel it.
I put the word out to friends and was recommended another surgeon by THREE different people all of whom knew someone this OS has worked on and who were very happy.
His name is Philip Downer and he works at Swedish Hospital in Ballard. He does the Direct Anterior Approach and does has ridiculous amounts of experience (His team told me that he does between 2 and 8 hips EVERY WEEK).
Anyway...most people, myself included, have no experience with multiple doctors. I just went with this one because it felt right, he was recommended by multiple people (one of which works in the industry) and he has experience in a tried and tested method (DAA).
I can't attest to the final product yet, because it's too soon, but I can say that I already have superior range of motion and the bone-on-bone pain is gone. Now I need to rehab the muscles and hopefully lose the surface-numbness. Success is, I believe, imminent.
United States
That's because it's an expectation, based upon recent statistics of implant longevity allied to advances in metallurgy, implant design and manufacture and surgical techniques. But those surgeons at the 'cutting edge' of this business most certainly are pretty confident that the 'forever' hip is with us already. I know because like Jaycey, I too have heard them expounding that philosophy at conferences. But we won't know that for sure until another 40 years have passed! 
