Consultant, Orthopaedics & Joint Replacement, Artemis Hospital, Gurgaon
Part 8 of 12 in Spectrum of Orthopaedic Disorder - Evaluation and Management
When Is Hip Replacement the Right Treatment?
September 6, 2026
Asked directly which patients should be referred for hip replacement, Dr. Lamba gave a structured answer covering four categories of patients, drawn from the same cases discussed earlier in his Jivo Masterclass session.
Four categories of patients
The first category is congenital deformity, such as developmental dysplasia of the hip, where the joint has been out of its socket since birth. The second is a childhood problem, whether infection, Perthes disease, or a slipped epiphysis, that reshapes the hip and leads to arthritis years later. The third is avascular necrosis that has progressed to an advanced, arthritic stage in early adulthood. The fourth is a hip fracture that has healed in the wrong position, causing arthritis and ongoing pain.
A common thread across every category
What links all four categories is that the joint's own architecture, not simply the level of pain, has broken down beyond what medication or joint-preserving procedures can fix. Every case in this series, from the youngest DDH patient to the sickle cell disease cases, fits into one of these four groups.
This article is based on a Jivo Masterclass session conducted by Dr. Rohit Lamba, Consultant, Orthopaedics & Joint Replacement, Artemis Hospital, Gurgaon. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass: Dr. Rohit Lamba taught doctors across Africa on April 6, 2025.
FROM THE LIVE Q&A
Doctor on the call (name unclear from transcript)
Is there a definitive treatment for arthritis?
Dr. Rohit Lamba
Dr. Lamba answered on the assumption the question was about rheumatoid arthritis, since a network issue had cut off part of the question. In the early stage, before the cartilage is damaged, it can be managed well with disease-modifying antirheumatic drugs (DMARDs); cases that do not respond well can move to biological disease-modifying drugs, but only after full evaluation by an orthopaedic surgeon or rheumatologist. Once the cartilage is already damaged, the definitive treatment is hip replacement, and with current implants a patient can expect to stay pain-free and active for the next 30 to 35 years.
Frequently Asked Questions
Which group of patients is hip replacement surgery indicated for?▼
Dr. Lamba outlined four categories. The first is congenital deformity, such as developmental dysplasia of the hip, where the hip is out of the socket from birth. The second is a childhood infection, Perthes disease, or a slipped epiphysis that reshapes the hip and leads to arthritis later in life. The third is avascular necrosis that has reached an advanced, arthritic stage in early adulthood. The fourth is a hip fracture that has not united properly, healing in a poor position that causes arthritis and pain.
Is there a definitive treatment for arthritis?▼
Dr. Lamba answered on the assumption the question was about rheumatoid arthritis, since a network issue had cut off part of the question. In the early stage, before the cartilage is damaged, it can be managed well with disease-modifying antirheumatic drugs (DMARDs); cases that do not respond well can move to biological disease-modifying drugs, but only after full evaluation by an orthopaedic surgeon or rheumatologist. Once the cartilage is already damaged, the definitive treatment is hip replacement, and with current implants a patient can expect to stay pain-free and active for the next 30 to 35 years.
What are the four categories of patients who need hip replacement?▼
Congenital deformity such as DDH, a childhood problem such as infection, Perthes disease or a slipped epiphysis, advanced avascular necrosis, and a hip fracture that has healed in the wrong position.
Is pain alone enough to indicate hip replacement?▼
No. What matters is whether the joint's own architecture has broken down beyond what medication or joint-preserving procedures can fix.
Do all of Dr. Lamba's cases fit into these categories?▼
Yes, from the youngest DDH patients to the sickle cell disease cases, every case discussed falls into one of these four groups.
In This Series: Spectrum of Orthopaedic Disorder - Evaluation and Management
- 1.Spectrum of Orthopaedic Disorders
- 2.Understanding the Main Causes of Knee Arthritis
- 3.How Robotic and Computer-Navigated Systems Are Used in Joint Replacement
- 4.Developmental Dysplasia of the Hip: Treating a Childhood Hip Problem
- 5.Perthes Disease: When Childhood Hip Damage Surfaces Years Later
- 6.Avascular Necrosis of the Hip: Causes, Stages and Treatment
- 7.Hip Replacement and Sickle Cell Disease: Why Blood Transfusion Comes First
- 8.When Is Hip Replacement the Right Treatment?
- 9.ACL and Ligament Reconstruction: Grafts and When Surgery Is Needed
- 10.Treating Fracture Non-Union and Bone Infection with External Fixators
- 11.Reconstructing Severe Trauma: Distraction Osteogenesis for Bone and Limb Loss
- 12.Vitamin D Deficiency in Children: When Rickets Requires Corrective Knee Surgery