Hip arthritis: when is surgery required?

Written by: Mr Ravichandran Karthikeyan
Published: | Updated: 10/02/2022
Edited by: Lauren Dempsey

Hip arthritis occurs when the cartilage in the hip joint is damaged and worn away. It is a progressive disorder, meaning it worsens overtime. Leading Birmingham-based consultant orthopaedic surgeon, Mr Ravi Karthikeyan explains how hip arthritis occurs, what the main symptoms are and when surgery is required.  

How common is hip arthritis?

Hip arthritis is common and particularly prevalent as primary arthritis, in people who are in their 60s and 70s.  However, younger people can also experience secondary arthritis due to a specific trigger that exacerbates cartilage breakdown. This may be a result of trauma, such as an injury sustained to the hip socket, femoral neck or femoral head which disrupts the blood supply to this region, hip dysplasia or infection.

What are the main symptoms of hip arthritis?

The main problems caused as a result of hip arthritis are pain, stiffness and limited movement.

What happens if you leave hip arthritis untreated? 

If left untreated, the aforementioned symptoms would persist. Pain may be present at rest, as well as when moving like walking long distances, climbing stairs and fulfilling daily activities. Day-to-day life can be greatly disturbed as a result of pain and stiffness.

When is hip surgery required?

In the early stages, hip arthritis can normally be treated non-operatively. Although, if the pain becomes a persistent problem to the point that the patient is constantly on pain killers, or if they experience pain at rest or have to reduce daily activity as a result, surgery is recommended. Patients may also have a deformity, like a flexion deformity, meaning they are unable to straighten their hip well when they are lying down or when they are walking. This can lead to an alteration in the gate, called an antalgic gait or a painful hip gate. These are potential reasons why a hip replacement might be needed.

How often do periprosthetic fractures occur and where are they typically seen?

Periprosthetic fractures occur more often in people who have had revision surgery in the hips, when they have had a second or a third replacement. It is also more likely to happen in certain types of hip replacements, especially uncemented hip replacements, but the instances are less than 10% in most hip replacements. They usually occur a few years after a hip replacement has been done and when a patient sustains an injury as a result of a fall, or even novel activity. Periprosthetic fractures can be treated by fixing these fractures as they break, or even providing a revision hip replacement.

If you are currently experiencing one or more of the hip arthritis-related symptoms outlined above, you can consult directly with Mr Karthikeyan to find out what the most appropriate next step should be for you. Book an appointment with him via his Top Doctors profile. 

Mr Ravichandran Karthikeyan

By Mr Ravichandran Karthikeyan
Orthopaedic surgery

Mr Ravi Karthikeyan is a leading consultant orthopaedic surgeon who currently sees patients at BMI The Priory in Birmingham. His areas of expertise include, but are not limited to, complex pelvic and acetabular trauma, total hip arthroplasty, complex lower limb trauma and periprosthetic fractures.

Mr Karthikeyan completed his higher specialist training in orthopaedics from the West Midlands Orthopaedic Training Programme in 2010. He then went on to complete two fellowships. The first one was the reputable Cavendish lower limb arthroplasty fellowship at Sheffield Teaching Hospital. Where he was mentored by Professor Ian Stockley, Mr Andy Hamer, Mr Bob Kerry and Mr Simon Buckley. In 2012 Mr Karthikeyan also completed a pelvis and acetabular fracture reconstruction fellowship at the Queen Elizabeth Hospital, Birmingham.

Mr Karthikeyan was appointed as a Consultant Trauma and Orthopaedic Surgeon at the Queen Elizabeth Hospital Birmingham in 2013. Where he provides the West Midlands region with a tertiary regional service in pelvic and acetabular trauma at its Major Trauma Centre.

Mr Karthikeyan is actively involved in teaching and obtained his Postgraduate Certificate in Medical Education (PGCE) from the University of Birmingham. Mr Karthikeyan is a consultant trainer recognised by the GMC for foundation doctors, core surgical trainees, and specialist trainees in orthopaedics. He regularly contributes to teaching within the West Midlands Orthopaedic Specialist Training Programme.

Mr Karthikeyan is an Honorary Senior Clinical Lecturer at the University of Birmingham, and regularly teaches undergraduate medical students and is a senior academy tutor for the 5th year undergraduate medical students at the University of Birmingham.


  • Related procedures
  • Platelet-rich plasma
    Ozone therapy
    Botulinum toxin (Botox™)
    Abnormal gait
    Elbow
    Epicondylitis (tennis elbow)
    Elbow Pain
    Nerve Compression elbow
    Median nerve compression
    Radial nerve compression
    This website uses our own and third-party Cookies to compile information with the aim of improving our services, to show you advertising related to your preferences as well analysing your browsing habits. You can change your settings HERE.