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Hip ReplacementSecond Opinion Guide

Should you get a second opinion for total hip replacement?

Hip replacement is one of the most successful orthopedic surgeries performed, but it is still a major procedure. A second opinion is reasonable if surgery is being recommended before you have tried physical therapy and activity modification, if you are under 55 (implants wear and may require revision), or if the recommendation came after a brief evaluation without review of your imaging.

Red flags - consider a second opinion if you notice these

  • No discussion of hip preservation techniques, particularly for younger patients with labral tears or impingement
  • Surgeon could not explain why anterior vs. posterior approach was chosen for you
  • Surgery recommended without prior trial of physical therapy or injections
  • Your imaging was not reviewed during the appointment
  • The surgical facility was not mentioned or seemed unfamiliar to you

Questions to ask the second surgeon

  1. 1Am I a candidate for hip preservation surgery instead of replacement?
  2. 2What approach will you use (anterior, posterior, lateral) and why is it best for me?
  3. 3How many hip replacements do you perform annually?
  4. 4What implant materials do you use, and what is the expected lifespan?
  5. 5What is your personal dislocation rate?
  6. 6What happens to my options if I wait another year?

What to expect from a second opinion visit

A second opinion visit for hip replacement follows the same process as your initial consultation. Bring your hip X-rays (weight-bearing views are most useful) and MRI if one was obtained. The second surgeon will examine you and review your imaging. Many academic medical centers and large orthopedic groups have dedicated hip preservation programs that may offer additional non-replacement options for appropriate patients.

Common questions

Is anterior hip replacement always better than posterior?
Not necessarily. Both approaches have comparable long-term outcomes in experienced hands. The anterior approach may allow slightly faster early recovery, but the posterior approach gives the surgeon better visualization in some patients. Surgeon experience with the approach matters more than the approach itself.
What is hip preservation surgery and am I too old for it?
Hip preservation surgery - including labral repair, periacetabular osteotomy, and hip arthroscopy - aims to fix structural problems before the joint deteriorates enough to need replacement. It is typically most effective in patients under 50 with specific underlying issues like dysplasia or femoroacetabular impingement. A hip preservation specialist can tell you whether you are a candidate.
How long do hip implants last?
Modern hip implants last 20-25 years or longer in most patients. Younger and more active patients tend to wear implants faster. This is one reason getting a second opinion matters more for patients under 60 - a revision surgery later is more likely, and that conversation should happen before the first surgery.

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