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Total hip replacement is indicated in patients with significant hip pain or marked functional disability in whom conservative methods have been unsuccessful. Significant hip pain is that which disrupts sleep or severely limits exercise.

The age of the patient is important as implants tend to loosen with time. Currently, THR is usually reserved for patients over 60 years of age. Alternatives such as osteotomy and arthrodesis should be considered in younger patients. Exceptions might be patients with severe rheumatoid arthritis, especially if wheelchair bound.

Obese patients and those involved in physically demanding activities are not good candidates because of the associated stress. Sepsis is an absolute contraindication.

Last reviewed 01/2018