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What are the dangers of postponing hip replacement/resurfacing?

Q) I was diagnosed with osteoarthritis of the hip 10 years ago and was recommended for replacement. I decided to delay surgery. Currently I'm 61 and fairly active (I do long-distance cycling) but can't walk too well. However, I don't have much pain and just need an occasional aspirin to help me sleep. My affected leg is now at least half an inch shorter than the other. My question is: what are the dangers of postponing hip replacement/resurfacing further? Am I doing structural damage to my hip by continuing to cycle long distances that might complicate future surgery? Doctors seem to imply that I should get maximum value from my natural hip and only go for replacement if in serious pain.
Derek, Watford (Summer 2007

A) A difficult case. Surgeons are generally reluctant to operate unless the pain is bad. On the other hand, they want to be able to do a straightforward operation with the minimum of technical fuss. In your case, although you have little pain, it sounds as though you're making the damage in your hip worse, as evidenced by the leg shortening. I think it's time to have an up-to-date x-ray and to go back and see the surgeon to discuss the situation.

This answer was provided by Dr Philip Helliwell for the Summer 2007 edition of our magazine, Arthritis Today, and was correct at the time of publication.

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