It is always preferred to attempt treatment with conservative, or non-operative, modalities prior to considering surgery. As a first line, simple anti-inflammatory medications, weight loss, a home exercise program, physical therapy, and occasional use of a cane may help to control the majority of symptoms. Subsequently, patients may benefit from a cortisone injection, which is a powerful steroid anti-inflammatory medication that is injected into the joint. Gel injections, also known as visco-supplementation, may be appropriate in certain patients.
Ultimately, the decision to proceed with joint replacement surgery is made after an earnest attempt to exhaust all the conservative options, in a patient who continues to have a significantly impaired quality of life due to arthritis of the hip or knee.