If you have been living with persistent hip pain and find yourself wondering whether you might eventually need surgery, you are not alone. Hip replacement is one of the most commonly performed orthopaedic operations in the UK, and for most patients it is genuinely life-changing. But how do you know when the time is right?
Mr Dennis Kosuge is a Consultant Orthopaedic Surgeon specialising in hip and knee surgery, based at The Rivers Hospital in Sawbridgeworth and The Princess Alexandra Hospital NHS Trust in Harlow. He sees many patients across West Essex and East Hertfordshire who arrive unsure whether surgery is the right option. Here, he shares the signs that suggest it may be time for a specialist assessment.
1. Your pain is affecting your daily life
The most important question is not how much pain you have on a good day, but how much it limits what you can do. If hip pain is stopping you from walking to the shops, getting a good night's sleep, climbing stairs without discomfort, or doing activities you enjoy, that is a significant quality-of-life issue worth addressing.
Mr Kosuge explains: "My main focus in a consultation is always the patient's quality of life. Pain scores alone don't tell the full story — what matters is how the hip is affecting your daily function, your sleep and your wellbeing."
2. Conservative treatments are no longer working
Most patients have already tried painkillers, physiotherapy, walking aids, weight management and sometimes joint injections before reaching a surgeon. If these have provided diminishing returns and your symptoms continue to worsen, it may be time to discuss surgical options.
Mr Kosuge reviews all non-operative treatments before recommending surgery and will discuss whether further conservative measures offer meaningful relief first.
3. You have been told you have osteoarthritis of the hip
Osteoarthritis is the most common reason for hip replacement in the UK. On X-ray, the joint space narrows as cartilage wears away, and the bones may begin to rub together. Symptoms include a deep groin ache, stiffness first thing in the morning, and pain that worsens after activity or prolonged sitting.
Not everyone with osteoarthritis on X-ray needs surgery — the degree of symptoms matters more than the X-ray appearance alone. But significant osteoarthritis combined with poor function is a strong indicator that replacement may offer substantial benefit.
4. You are struggling to put on shoes or socks
This sounds simple, but limited range of motion in the hip — making it difficult to bend, rotate or reach your feet — is a very telling symptom. It often indicates advanced joint degeneration and is something Mr Kosuge assesses directly in clinic.
5. You have been told to "wait until it gets worse"
Historically, patients were advised to delay hip replacement for as long as possible. The evidence has shifted. Modern implants are extremely durable, and delaying surgery too long can lead to muscle weakness, compensatory gait problems and a longer recovery. Mr Kosuge takes an individualised approach and will advise you on the right timing for your specific circumstances.
What happens at a consultation with Mr Kosuge?
At your first appointment, Mr Kosuge will take a detailed history of your symptoms, examine your hip and review any existing X-rays or MRI scans. He will explain your diagnosis clearly and discuss all available treatment options — both surgical and non-surgical — so that you can make an informed decision.
Mr Kosuge's patient outcome data is consistently above the national average for hip replacement surgery, and he has been awarded the Certificate of Excellence by iWantGreatCare every year from 2019 to 2025.
Ready to take the next step?
For more information about hip osteoarthritis or hip replacement surgery - Mr Kosuge offers private consultations at The Rivers Hospital, Sawbridgeworth and The Princess Alexandra Hospital NHS Trust, Harlow.
To book an appointment with Mr Kosuge:
Telephone: 01279 602675