Diagnosing Who Needs Hip Replacement

Dr. Bassam Masri, MD, FRCSC, discusses diagnosis and treatment of hip replacement.

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Dr. Bassam Masri, MD, FRCSC, discusses diagnosis and treatment of hip replacement.
Video transcript

Featuring Dr. Bassam Masri, MD, FRCSC

Duration: 2 minutes, 29 seconds

For patients who have pain who might think that they require surgery, what they will be experiencing is that the pain they have been having for some time is gradually getting worse to the point that they may have some significant limitations in walking tolerance, they can only walk a few blocks now, they have some rest pain and in particular they might have some night pain.

If a patient has any of that progression of symptoms then the first thing that should happen is they should get an X-ray. Preferably the X-ray should be of the pelvis. In that way we have a comparison view of one hip versus the other hip, to see what the joint space looks like because that's an indicator of the severity of the arthritis.

n mild arthitis you may not see complete obliteration of the joint and just a subtle irregularity of the joint may be an indicator of the beginnings of arthritis, and that would be the diagnostic test for osteoarthritis of the hip.

Many patients feel that an MRI is a really important test and the recommendation is that if an X-ray's abnormal and shows arthritis, an MRI is not indicated, then money should not be wasted on an MRI if the diagnosis is obvious on a regular X-ray.

So once the diagnosis of osteoarthritis has been made and a patient might be considering surgery and they're waiting to either see an orthopedic surgeon or they're waiting for surgery, they need to continue with non-operative treatment usch as the anti-inflammatories, Tylenol, and sometimes a cane used in the opposite hand would be of great benefit to offload the affected side.

It's a common misconception that the cane should be on the affected side but in reality it should be in the hand on the opposite side of the arthritic hip. Patients ask what is the role of physical therapy while you're waiting for a joint replacement or a hip replacement.

There's really no strong evidence to support physical therapy apart from a patient remaining as active as possible, so formal physical therapy is not really necessary while someone is awaiting a joint replacement.

Once the diagnosis of osteoarthritis has been made and the pain is significantly interfering with the patient's day-to-day activities and causing significant pain,then a referral to an orthopedic surgeon may be necessary.

And of course if a patient has any questions about the diagnosis of osteoarthritis of the hip they should talk to their primary care doctor.

Presenter: Dr. Bassam Masri, Orthopaedic Surgeon, Vancouver, BC

Local Practitioners: Orthopaedic Surgeon

Video Quiz ( 148 participated.)

Test your knowledge by answering the following questions:


A patient may need to see an orthopaedic surgeon if their hip pain is worsening at rest, the pain presents at night and interferes significantly in normal daily activities.


An MRI is the best tool to diagnose the severity of osteoarthritis in the hip joint.


An X-ray is the key diagnostic tool when determining whether a patient is eligible for hip replacement surgery.

This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.

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