Thomas P. Sculco, Surgeon-in-Chief at the Hospital for Special Surgery in New York, explains the treatment options available to arthritis patients but admits that surgery is often necessary is the joint is mechanically affected.

Dr. Sculco Surgery is always the failure really of all other forms of treatment. Very commonly when I see a patient with hip arthritis, we'll treat the patient with exercise, weight reduction, anti-inflammatory medication, sometimes injections. If the arthritis is not severe. Surgery is always the failure really of all other forms of treatment. However, if the patient comes in, is disabled, is in pain. And if the X-ray really confirms that the joint is destroyed, then many times there is no other option except for hip replacement. I mean the way to look at this is that arthritis really has two separate characteristics. One is the inflammatory component, one is the mechanical component. The inflammatory component can be treated with medication, injections, and some of these conservative measures. And the patient may get better. Once the arthritis in the hip, for example, has become advanced and the problem is mechanical, then the only way to deal with it is to fix the mechanics. And thats a hip replacement.