Persistent hip or knee pain rarely affects just one part of life. It can make stairs feel daunting, shorten walks, disrupt sleep and leave you thinking twice before playing with grandchildren, exercising or travelling. An orthopaedic surgeon specialising in hips and knees can identify what is causing that limitation and provide clear, evidence-based advice on the most appropriate way forward.
The right treatment is not always an operation. For many people, the most valuable first step is an accurate diagnosis, a realistic conversation about their goals and a plan that addresses pain while protecting long-term joint function.
When to see an orthopaedic surgeon
A referral or private consultation may be helpful when hip or knee symptoms persist despite sensible measures such as activity modification, physiotherapy and simple pain relief. This is particularly relevant if pain is affecting sleep, walking distance, work or independence, or if the joint feels unstable, locks, catches or repeatedly swells.
Some problems develop gradually. Osteoarthritis, for example, may begin as stiffness after sitting or discomfort following longer walks, before progressing to more constant pain and restricted movement. Others begin suddenly, perhaps after a sporting injury, fall or twisting movement that damages the meniscus, ligaments or joint surface.
Previous surgery is another reason to seek specialist input. A hip or knee replacement that remains painful, becomes unstable or shows signs of wear needs careful assessment. Revision joint replacement is more complex than a first operation, and it benefits from a surgeon with focused experience in identifying why the original joint replacement is not performing as intended.
What happens during a hip and knee assessment
A good consultation should not feel rushed. Your surgeon will ask about the pattern of pain, how it has changed, which activities matter most to you and what treatments you have already tried. Pain in the groin, for instance, can point towards the hip, while pain around the knee may arise from arthritis, a meniscal tear, kneecap problems or referred pain from another area.
The physical examination assesses movement, strength, joint stability, gait and areas of tenderness. Imaging may include X-rays, which are particularly useful for showing arthritis, joint alignment and existing implants. An MRI or CT scan may be appropriate where there is a suspected soft-tissue injury, complex bone anatomy or a need for detailed surgical planning.
The purpose is not simply to name a condition. It is to understand how the condition is affecting you and whether the findings on a scan genuinely explain your symptoms. Scans can show age-related changes in people with little pain, so treatment decisions should always combine imaging with your clinical history and examination.
Treatment should match the problem and the person
Hip and knee surgery can be life-changing for the right patient, but it is not automatically the best first answer. The appropriate option depends on the diagnosis, the severity of symptoms, the condition of the joint and your priorities.
Non-operative and regenerative options
For early arthritis, inflammation or selected tendon and soft-tissue problems, non-operative treatment may reduce symptoms sufficiently to keep you active. This might include a targeted exercise programme, physiotherapy, weight management where appropriate, medication or image-guided injections.
Steroid injections can offer short-term relief from inflammation, although the duration and degree of benefit vary. Hyaluronic acid injections may be considered in selected cases, while platelet-rich plasma, known as PRP, uses a concentration of your own platelets in an effort to support the body’s healing response. Arthrosamid is a newer injectable hydrogel treatment that may be suitable for some people with knee osteoarthritis.
These treatments are not cures for advanced arthritis, and no responsible surgeon should present them that way. Their role is to reduce pain, improve function or create time before surgery where that is safe and sensible. A specialist should be open about the likely benefit, limitations and cost of each option.
Arthroscopy and reconstructive surgery
Knee arthroscopy uses small incisions and a camera to inspect and treat certain problems inside the knee. It can be effective for specific mechanical symptoms, such as a treatable meniscal injury in an otherwise healthy joint. It is generally less helpful for pain caused primarily by established osteoarthritis, where the underlying issue is loss of joint cartilage rather than a single repairable tear.
Complex trauma or instability may require reconstructive treatment. Here, detailed planning matters: restoring alignment, stability and the joint surface can have a substantial effect on comfort and future function.
Joint replacement surgery
When arthritis has caused severe pain and significantly reduced quality of life, joint replacement may offer dependable pain relief and improved mobility. Total hip replacement replaces the ball-and-socket surfaces of the hip. Total knee replacement resurfaces the damaged parts of the knee, while partial knee replacement may be an option if arthritis is limited to one compartment and the remaining joint structures are healthy.
The best operation is not necessarily the most extensive one. A partial knee replacement can preserve more of the natural knee in a carefully selected patient, but it is not suitable when arthritis affects multiple areas of the joint. Similarly, implant choice and surgical technique should be based on your anatomy, bone quality, activity level and clinical needs, rather than a one-size-fits-all approach.
Custom hip replacement planning may be considered where individual anatomy or complexity calls for a more personalised approach. Precision-led planning helps the surgeon prepare for component positioning, leg length, joint stability and the practical challenges that may arise during surgery.
Why specialist experience matters in revision surgery
A revision hip or knee replacement is performed when an existing implant has failed or is no longer functioning well. Reasons can include loosening, wear, infection, fracture around the implant, instability or unexplained persistent pain.
These operations require more than replacing one component with another. The surgeon must establish the cause of the problem, assess bone loss and soft tissues, review previous records and plan for the possibility that the final procedure may be more involved than imaging initially suggests. It is an area where concentrated hip-and-knee expertise, careful preparation and honest communication are particularly valuable.
A fellowship-trained specialist can explain whether revision surgery is likely to improve your symptoms, what level of recovery to expect and what risks need to be weighed. In some cases, further surgery is not the right answer, and that advice is just as important.
Questions worth asking your orthopaedic surgeon
Choosing whether to have treatment, particularly surgery, is a significant decision. You should feel able to ask about the diagnosis, alternatives, expected benefits and the risks most relevant to your circumstances. It is also reasonable to ask how often the surgeon performs the proposed procedure, whether they manage complex or revision cases and what support is available during recovery.
Ask what the first few weeks will involve in practical terms. You may need help at home, modifications to your routine or time away from work. Recovery is not identical for everyone. Fitness before surgery, the complexity of the procedure, other health conditions and commitment to rehabilitation all influence the pace of progress.
Clear answers build confidence, but they should not promise perfection. The aim is meaningful improvement in pain, mobility and quality of life, with a plan that recognises both the potential benefits and the unavoidable risks of treatment.
Recovery is part of the treatment, not an afterthought
Successful hip and knee care extends beyond the operating theatre. Rehabilitation begins with preparation before surgery and continues through early mobilisation, physiotherapy, wound care and follow-up. Most patients make steady gains, but recovery has good and less comfortable days, particularly in the early stages.
Your care team should explain when to seek advice about increasing pain, swelling, wound changes, calf pain, breathlessness or fever. Attending follow-up appointments also allows progress to be reviewed and any concerns addressed promptly.
For patients in London, Kent and the wider South East, specialist private care can provide an efficient route to assessment, treatment and continuity of follow-up. What matters most, however, is having a clinician who listens carefully, explains the options plainly and recommends the treatment that best supports the life you want to return to.
If hip or knee pain is beginning to dictate your choices, seeking specialist advice can replace uncertainty with a practical plan – whether that plan involves rehabilitation, injections, surgery or the reassurance that an operation is not needed at this stage.