© iStock / Albina Gavrilovic

Hip pain rarely appears overnight. More often, it develops gradually: first, long walks become exhausting, then climbing stairs turns difficult, and eventually even simple everyday movements begin to cause discomfort. When every step feels like an effort and getting out of bed in the morning takes more and more energy, the usual rhythm of life starts to change.

Many patients find nighttime pain especially difficult to cope with, as well as discomfort that persists even at rest. If these symptoms continue for more than three months despite treatment, doctors may begin to consider surgery as the next stage of care.

The most common cause is osteoarthritis of the hip (coxarthrosis), a condition in which the joint cartilage gradually deteriorates. Surgery may also be necessary in cases of avascular necrosis of the femoral head, congenital disorders such as hip dysplasia, or after fractures — particularly fractures of the femoral neck.

The decision always begins with a thorough diagnosis: doctors assess the extent of joint damage and evaluate all available treatment options. Conservative therapies are usually tried first, including physiotherapy, targeted exercises, pain management, and, when needed, injections. If these measures no longer provide relief and the joint is severely damaged, hip replacement surgery may be recommended.

“Hip replacement is not a quick fix, but the result of a shared decision-making process,” explains Hagen Schmal, Medical Director of the Department of Orthopedics and Trauma Surgery at the Medical Center – University of Freiburg. “It’s not only the X-rays that matter, but also how much the pain limits a patient’s daily life.”

When pain becomes constant and mobility is significantly reduced, surgery can restore freedom of movement and improve quality of life. In specialized centers such as the Medical Center – University of Freiburg, modern minimally invasive techniques are now widely used to support faster recovery and rehabilitation.