Activity modification, medications and physiotherapy can treat osteoarthritis conservatively in the short term. Long term relief however, requires surgical intervention.
There are two basic types of surgical treatment for advanced hip arthritis: Hip replacement and hip resurfacing.
In hip replacement where the ball and socket of the hip are replaced, because the ball (the top of the thigh bone) is removed it is replaced by a stem that goes down into the thigh bone to support a new ball. This stem maybe cemented into the thigh bone or uncemented (bone grows into the metal stem). One of the advantages of these stems is that we have been using them for 30-40 years and they are generally reliable, especially in older, less active patients. A disadvantage in younger active people is that they wear out an artificial hip (sometimes within 10 -15 years). As the artificial hip wears, bone is lost around the hip (osteolysis) and this causes stems and socket to eventually loosen and fail. Then they have to be replaced. When they are replaced they can be difficult to remove and require a longer stem to be inserted. Each time this means more thigh bone is damaged and eventually extensive bone graft replacements are need. The surgeries for this are much bigger and the results not as good as the first hip replacement. Eventually we may run out of bone for surgery meaning revision is not possible. This is not a major problem in older patients who do not wear out their artificial hips.