If you maintain a healthy weight and exercise regularly, but pain from your hip osteoarthritis (OA) is still debilitating, surgery may be in your future. This guide to common surgical options, developed with information from leading medical organizations, including the Mayo Clinic and National Institutes of Health, can help you have an informed discussion with your doctor about which type is best for you.

Arthroscopy

What is it? A technique using small incisions, specialized instruments and a tiny camera, it’s generally employed to fix a tear in the soft tissue around the hip socket and remove broken cartilage pieces.

Best candidates: Active people younger than 40.

Pros: Often immediate improvement in symptoms, including pain and limited range of motion.

Cons: May delay or eliminate the need for an artificial hip. “The jury is still out as to whether it can actually stop the further deterioration of the joint,” says Mathias P. Bostrom, MD, an orthopaedic surgeon at the Hospital for Special Surgery in New York. “Right now, there are no long-term studies to support that idea.”

Osteotomy

What is it? The procedure involves cutting bone, and rotating and screwing the pelvis in place, often to correct hip misalignment (dysplasia) that occurs early in life.

Best candidates: Patients in their 30s and younger or who are too young for total joint replacement

Pros: Can halt damage and delay the need for a hip replacement.

Cons: Robert L. Barrack, MD, chief of staff for orthopaedic surgery at Barnes-Jewish Hospital in St. Louis, warns that osteotomies are not simple. “Because the surgery is so complex and highly specialized, only a small percentage of surgeons are best suited to perform it.”

Total hip replacement (THR)

What is it? The damaged hip – ball and socket – is replaced with an implant made from combinations of metal, plastic and/or ceramic components.

Best candidates: People with severe hip pain who haven’t been helped by other treatments. Improvement in implant durability means that hip replacement is more common in younger people than in the past.

Pros: Strong, proven track record for safety and success; less pain and better mobility, daily functioning and quality of life.

Cons: Any kind of artificial hip can wear out, which may require hip-revision surgery. Implants made entirely of metal (called metal-on-metal) can release metal ions that may damage bone and cause other health problems. Ask before surgery about an implant’s track record. THR is not recommended for people who have weak bones or who are obese.