Hip replacement alternatives start with movement and a clear hip exam

Gentle movement is worth trying before a procedure

Ease the movements that stir the soreness, but keep moving when you can. Several brief walks may be easier than one long walk.

Strength work can make the hip feel steadier during daily tasks. A physical therapist can guide the first exercises.

Try one home change at a time for several days. You'll know whether shorter walks, a firmer chair, or brief rests helped.

Stop when a move sends the soreness up quickly. Don't force the hip just to finish a set.

Medicine may help, but it can't conflict with your health or other pills. Ask your doctor to check that before you take it.

I'd judge each choice by one task you miss. Use sleeping, dressing, stairs, or walking to track a useful change.

A surgery visit can help when basic tasks stay hard

Hip surgery isn't the next step for every sore joint. It's worth discussing when rest hurts and basic tasks remain hard.

Talking with a surgeon doesn't commit you to an operation. Ask about expected gains, recovery time, and what waiting could mean.

To make platelet-rich plasma (PRP), the office spins your blood and keeps a concentrated part. Hip results aren't certain, so ask the doctor what the studies found.

Use the same missed task to check your progress after several days. If it hasn't improved, take those notes to your next visit.

Ask when any change might appear and how long it could last. Keep noting night rest, walking, and chores while you try the home steps.

Sources

1. The 2019 ACR/Arthritis Foundation guideline makes STRONG recommendations for exercise, weight loss in people with overweight or obesity, self-efficacy and self-management programs, tai chi, cane use, tibiofemoral bracing, topical NSAIDs, oral NSAIDs and intra-articular glucocorticoid injection in knee OA. Notably it does NOT strongly recommend any biologic injectable.

   Kolasinski SL, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.. Arthritis & rheumatology (Hoboken, N.J.), 2020. DOI: 10.1002/art.41142.

2. A randomized controlled study of 111 patients aged 18-65 with hip osteoarthritis compared three weekly ultrasound-guided injections of PRP, hyaluronic acid, or both. PRP had the lowest VAS at every follow-up and beat HA significantly at 6 months (mean VAS 21 vs 44). But the WOMAC advantage present at 2 and 6 months was NO LONGER significant at 12 months, and the combination arm did worse than PRP alone.

   Dallari D, et al. — Ultrasound-Guided Injection of Platelet-Rich Plasma and Hyaluronic Acid, Separately and in Combination, for Hip Osteoarthritis: A Randomized Controlled Study.. The American journal of sports medicine, 2016. DOI: 10.1177/0363546515620383.

3. A four-arm, multicentre, single-blind phase 2/3 randomized trial of 480 knee OA patients (KL II-IV) compared autologous bone marrow aspirate concentrate, autologous adipose stromal vascular fraction and allogeneic umbilical-cord-tissue mesenchymal stromal cells against a corticosteroid injection control. At 12 months NONE of the three orthobiologic injections was superior to another, or to the corticosteroid control, and none of the four groups showed a significant change in MRI osteoarthritis score from baseline. No procedure-related serious adverse events occurred.

   Mautner K, et al. — Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial.. Nature medicine, 2023. DOI: 10.1038/s41591-023-02632-w.

4. The RESTORE trial - a participant-, injector- and assessor-blinded RCT of 288 adults aged 50+ with symptomatic medial knee OA (Kellgren-Lawrence 2-3) - compared three weekly intra-articular PRP injections against saline placebo, with co-primary endpoints of 12-month knee pain and medial tibial cartilage volume on MRI. PRP did not beat placebo on either. It is the single best-designed test of the specific claim that PRP changes joint structure, and it was negative.

   Bennell KL, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial.. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

5. The AAOS evidence-based clinical practice guideline on Management of Osteoarthritis of the Hip states verbatim: STRONG evidence supports intra-articular corticosteroids to improve function and reduce pain in the SHORT TERM; STRONG evidence does NOT support intra-articular hyaluronic acid, because it does not perform better than placebo for function, stiffness and pain; STRONG evidence supports physical therapy for mild to moderate symptoms; STRONG evidence supports NSAIDs for short-term pain and function; and MODERATE evidence does not support glucosamine sulfate.

   American Academy of Orthopaedic Surgeons — Management of Osteoarthritis of the Hip: Evidence-Based Clinical Practice Guideline.. AAOS, 2017.

6. A Bayesian network meta-analysis of 11 randomized trials (1353 patients) in hip osteoarthritis found that at 2-4 months and 6 months NO injectable - corticosteroid, hyaluronic acid or platelet-rich plasma - significantly outperformed a saline placebo injection for pain or function. Pooled change from baseline exceeded the minimal clinically important difference in every arm including placebo.

   Gazendam A, et al. — Intra-articular saline injection is as effective as corticosteroids, platelet-rich plasma and hyaluronic acid for hip osteoarthritis pain: a systematic review and network meta-analysis of randomised controlled trials.. British Journal of Sports Medicine, 2021. DOI: 10.1136/bjsports-2020-102179.

7. Pooled analysis of national joint registries (Australia and Finland, 215,676 hip replacements) put 25-year all-cause construct survival at 57.9% (95% CI 57.1-58.7); pooled case series gave 77.6% (95% CI 76.0-79.2). The authors conclude patients and surgeons can expect a hip replacement to last 25 years in around 58% of patients.

   Evans JT, et al. — How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up.. The Lancet, 2019. DOI: 10.1016/S0140-6736(18)31665-9.