The pain and physical limitations of advanced hip arthritis can wear you down physically and emotionally. The decision to have a hip replacement is based on the amount of damage to the joint, your symptoms, and your overall level of disability. Here are some signs that it may be time to consider hip replacement:

x-rays show advanced arthritis or other damage

the joint is visibly deformed, bowing inward or outward

significant pain daily

pain keeps you awake at night despite the use of medications

pain and swelling don't decrease with rest and medication

pain medications are causing severe side effects

pain and stiffness limit your ability to do normal, everyday activities

difficulty bending or rotating your hips.

Before making your decision, you'll need to undergo a comprehensive medical evaluation by your primary care doctor or orthopedic specialist. Hip replacement might be too risky if you have any of the following conditions:

an active infection in the hip or elsewhere in the body

 a significant medical condition, including recent heart attack, ongoing chest pain from heart disease, or heart failure

poor circulation that could interfere with healing

severely damaged or nonworking hip muscles or ligaments

damaged nerves in the hip

neuromuscular disease such as multiple sclerosis, Parkinson's disease, or stroke

an allergy to materials used to make artificial joints.

If you are considering a hip replacement, age is an important factor to consider. That's because artificial hip implants have limited life spans. You can only put a certain number of miles on your new hip before it wears out. And if you are overweight or very physically active, your new joint may wear out faster.

This is why most people are encouraged to delay total hip replacement until at least their 60s, if possible. Given the average life span for Americans, many of the older adults who get a new hip in their 60s or 70s may never need to have it replaced.

If you are in your 40s or 50s, a new hip is likely to wear out during your lifetime. Then you'll need to have revision surgery to take out the old one and replace it.

For more on strategies for pain-free hips, read  T otal Hip Replacement , a Special Health Report from Harvard Medical School. 

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