Hip Replacement Alternatives: 8 Options

How it helps: Strengthens the muscles around your hip (especially the gluteal muscles), improves range of motion, and teaches movement patterns that reduce joint stress.

What to expect: A 6-12 week program focusing on hip strengthening, flexibility, and functional training. Studies show PT can reduce hip pain by 30-50% and significantly improve walking ability.

Medicare coverage: Part B covers medically necessary PT with a doctor’s referral. No visit limit as long as treatment remains medically necessary.

Best for: Mild to moderate hip arthritis, especially patients who have not tried structured PT before.

How it helps: Reduces mechanical stress on the hip and decreases systemic inflammation that worsens arthritis.

What to expect: Even a modest 10-15 pound weight loss can produce noticeable pain reduction. The effect compounds over time as reduced pain allows more activity.

Medicare coverage: Medicare covers obesity counseling (BMI 30+) and, as of 2026, certain weight management medications for qualifying patients.

Best for: Any hip arthritis patient carrying extra weight. Combines powerfully with every other treatment on this list.

How it helps: Delivers a powerful anti-inflammatory directly into the hip joint, reducing pain and swelling. Relief typically begins within days.

What to expect: Relief usually lasts 4-12 weeks. The hip joint is deep, so imaging guidance (ultrasound or fluoroscopy) is strongly recommended to ensure accurate placement. Most doctors limit cortisone to 3-4 injections per year per joint.

Medicare coverage: Covered under Part B when medically necessary. Minimal out-of-pocket cost after your deductible.

Best for: Acute flares, diagnostic confirmation (if cortisone helps, it confirms joint-based pain), and bridging to other treatments.

How it helps: Restores cushioning and lubrication to the hip joint. HA injections are FDA-approved for knee arthritis and used off-label for the hip based on increasing clinical evidence.

What to expect: Studies show HA injections can reduce hip pain for 3-6 months, with some patients experiencing longer relief. A 2022 meta-analysis found significant improvements in pain and function compared to placebo. Imaging guidance is essential for hip injections due to joint depth.

Medicare coverage: HA injections are covered by Medicare for the knee. Hip use is off-label, and coverage varies. Some Medicare Advantage plans and private insurers cover hip HA injections with prior authorization. Discuss with your provider.

Best for: Patients who respond well to cortisone but want longer-lasting relief without the cartilage concerns of repeated steroid injections.

How it helps: Uses concentrated growth factors from your own blood to reduce inflammation and potentially promote tissue healing.

What to expect: Some studies show pain improvement lasting 6-12 months. Results are variable, and the optimal preparation method is still being standardized. Requires imaging-guided injection into the hip.

Medicare coverage: Not covered by Medicare or most insurance. Typical out-of-pocket cost is $500-$1,500 per injection.

Best for: Patients willing to pay out-of-pocket who want to try a biologic approach, especially those who have not responded well to cortisone or HA.

How it helps: Reduces daily stress on the hip joint through smart adaptations.

Key strategies:

• Use a cane in the hand opposite your affected hip (reduces hip joint force by 20-30%)
• Switch from high-impact to low-impact exercise (swimming, cycling, elliptical)
• Use a long-handled shoe horn and sock aid to avoid deep hip flexion
• Consider a raised toilet seat and grab bars
• Avoid sitting in low chairs (use seat cushions to raise height)

Medicare coverage: Medicare Part B covers some durable medical equipment (canes, walkers) with a doctor’s prescription.

Best for: All hip arthritis patients. These modifications complement every other treatment.

Options include:

• Acetaminophen (Tylenol): First-line for mild pain. Safe for most people when used as directed.
• NSAIDs (ibuprofen, naproxen): More effective for hip arthritis pain. Use the lowest effective dose due to GI and cardiovascular risks with long-term use.
• Topical NSAIDs (Voltaren gel): Less effective for hip than knee because the joint is deeper, but worth trying with minimal side effects.
• Duloxetine (Cymbalta): An antidepressant that also treats chronic pain. FDA-approved for osteoarthritis pain.

Medicare coverage: Part D covers most prescription medications. Over-the-counter options (Tylenol, Voltaren gel) are patient-paid.

Best for: Pain management alongside other treatments. Medications rarely solve hip arthritis alone but can make other approaches more effective.

How it helps: Instead of removing the femoral head (ball of the hip), resurfacing caps it with a metal shell. This preserves more natural bone, which makes future revision surgery easier.

What to expect: Similar recovery timeline to hip replacement. The Smith & Nephew Birmingham Hip Resurfacing system has over 20 years of clinical data. Newer ceramic resurfacing options are also emerging.

Who is a good candidate:

• Younger, active patients (typically under 65)
• Adequate bone quality (no severe osteoporosis)
• Good femoral head size (men are better candidates due to larger anatomy)
• Not ideal for patients with femoral neck cysts or significant deformity

Medicare coverage: Covered similarly to total hip replacement.

Best for: Active patients under 65 who need a surgical solution but want to preserve bone stock for potential future revision.