Will a Hip Replacement Cure Bursitis? Inside vs Outside the Hip Joint
Dr. Rob Letizia PT, DPTShare
Medically reviewed by Dr. Rob Letizia, PT, DPT · Doctor of Physical Therapy, 25+ years treating spine & orthopedic conditions · Last reviewed 2026-10-20
The side of your hip hurts. Maybe you have been told you have arthritis, maybe you have been told it is bursitis, and maybe a surgeon has mentioned a hip replacement. The question people type next is a fair one: will a hip replacement cure the bursitis too? Or you have already had the replacement, the groin ache is gone, and the outside of the hip still hurts when you lie on it.
The short answer is no, not on its own, and the reason is anatomy. This guide explains where each problem lives, how to tell which one is driving your pain, and what actually treats the one a hip replacement leaves behind. Every clinical line carries its source.
Will a hip replacement cure bursitis?
Not by itself. A total hip replacement removes the damaged femoral head, the ball, and the damaged cartilage surface of the socket, and replaces both (AAOS OrthoInfo: total hip replacement). That is the inside of the joint, which is where arthritis lives.
Trochanteric bursitis lives somewhere else: over the bony point on the outside of the hip, the greater trochanter. What used to be called trochanteric bursitis is now more often called greater trochanteric pain syndrome (GTPS), because the pain is frequently a gluteal tendon problem rather than pure bursa inflammation (Furia, Rompe & Maffulli, American Journal of Sports Medicine, 2009). A hip replacement does not remove that bursa or those tendons. If the side-of-hip pain was coming from them, it can still be there after surgery.
Will a hip replacement help bursitis?
It helps the part of the pain that came from the arthritic joint. Plenty of people have both problems at once, and that is where the confusion starts: once the arthritis pain is gone, the side-of-hip pain stands out, and it can feel as if the operation did not work. It did. It fixed the joint. The bursitis is a separate problem with a separate treatment, and that treatment is usually non-surgical: avoiding the activities that aggravate it, physical therapy, anti-inflammatory medication and, if needed, a limited number of corticosteroid injections (AAOS OrthoInfo: hip bursitis).
Do I need a hip replacement, or is it bursitis?
This is the question to settle before a surgical decision, because the two can feel similar and often sit side by side. The pattern of the pain is the first clue:
- Arthritis pattern: pain worse when walking and stiffness after moving, usually in people over 45 (NHS: hip pain).
- Bursitis pattern: pain at the point of the hip that can spread down the outer thigh, worse at night when lying on that hip, and when getting up from a chair after sitting; long walks, stairs and squatting can aggravate it (AAOS OrthoInfo: hip bursitis; NHS: hip pain).
A pattern is not a diagnosis. An examination, with imaging where it is needed, is what tells you whether the pain is coming from the joint, the tendons, or both, and a focused hip exam is part of how a physical therapist separates them.
Can you get bursitis after a hip replacement?
Yes. The American Academy of Orthopaedic Surgeons lists surgery around the hip and hip implants among the things that can irritate the bursa and cause bursitis (AAOS OrthoInfo: hip bursitis). In one series of 200 consecutive total hip replacements by a single surgeon, 14 of 200 (7%) needed a corticosteroid injection for symptomatic trochanteric bursitis afterwards (Berney et al., Acta Orthopaedica Belgica, 2020).
There is a second link worth knowing. A limp that is still there around three months after a hip replacement, once pain has settled, is usually hip-abductor weakness, and it does not resolve by waiting (our hip replacement recovery timeline covers this). Weak hip abductors are also one of the drivers of trochanteric pain. That is why the strengthening work after a hip replacement and the treatment for side-of-hip pain overlap so much.
The 3-Question Inside-or-Outside Check
Whether you are deciding about surgery or recovering from it, three questions sort most side-of-hip pain into the right box. No single answer settles it; the pattern does.
- Where exactly does it hurt? Pain at the bony point on the outside of the hip, spreading down the outer thigh, points outside the joint. Pain with walking and stiffness after moving points to the joint itself (NHS: hip pain).
- Can you lie on that side? Pain that is worse at night lying on the affected hip is typical of trochanteric bursitis (AAOS OrthoInfo: hip bursitis).
- Is the bony point tender to press? Tenderness right over the greater trochanter points to the bursa and gluteal tendons, not the ball and socket.
The 2-Location Hip Pain Rule
A hip replacement treats the inside of the joint. Bursitis lives on the outside. If your answers point outside, the pain needs its own treatment plan, whether or not you have had, or need, a replacement. If they point inside, the joint is the conversation to have with your surgeon.
Hip Arthritis vs Trochanteric Bursitis: The Side-by-Side Table
| Hip arthritis (inside the joint) | Trochanteric bursitis / GTPS (outside the joint) | |
|---|---|---|
| Where it lives | The ball (femoral head) and socket (acetabulum) cartilage | The bursa and gluteal tendons over the bony point on the outside of the hip, the greater trochanter |
| How it typically feels | Pain worse when walking, stiffness after moving, usually over 45 | Pain at the point of the hip that can spread down the outer thigh; worse lying on that side, getting up from a chair, stairs |
| Pressing on the bony point | Not the main source of pain | Tender to press on |
| Does a hip replacement remove it? | Yes: the damaged ball and socket surfaces are replaced | No: the bursa and tendons sit outside the joint and stay |
| What treats it | Total hip replacement when pain and function justify surgery | Usually non-surgical first: activity changes, physical therapy, medication, injections |
Sources: AAOS OrthoInfo: total hip replacement; AAOS OrthoInfo: hip bursitis; NHS: hip pain; Furia, Rompe & Maffulli, American Journal of Sports Medicine, 2009.
What helps bursitis that is still there after a hip replacement?
The same things that help it without surgery (AAOS OrthoInfo: hip bursitis):
- Change what aggravates it for now: long walks, stairs, squatting, and lying on that side.
- Physical therapy. Because the pain is frequently a gluteal tendon problem (Furia, Rompe & Maffulli, American Journal of Sports Medicine, 2009), resting the hip until it stops hurting does not fix anything; progressive loading of the gluteal muscles does. Our bursitis guide covers how long it takes and why it lingers.
- Medication and walking aids in the short term, as your doctor advises.
- Corticosteroid injections, limited in number. After a hip replacement, your surgeon should be the one to decide on any injection near the implant.
Red flags: side-of-hip pain after a hip replacement that is not bursitis
These are carried from our hip replacement recovery guide, and they come before anything else on this page:
- Sudden severe pain and you cannot bear weight, especially if the leg looks shorter or turned in or out: possible dislocation. Go to the emergency department; do not try to walk it off.
- Calf pain or tenderness, or sudden swelling clearly worse in one leg, hot skin, or red or purplish discolouration: possible blood clot. With shortness of breath or chest pain, call emergency services.
- Fever or shivering, or a wound that is increasingly red, hot or swollen, leaking fluid or pus: possible infection, same-day call to your surgeon.
- Groin pain that persists or is getting worse: needs assessment, not more strengthening.
- New pain after a period of doing well, particularly after a dental or other procedure: late infections happen and are easy to dismiss.
- A fall onto the new hip, even if you feel able to walk afterwards.
Started with an AI assistant? Bring the plan in.
ChatGPT, Gemini and Claude will usually tell you, correctly, that a hip replacement treats arthritis and that bursitis is a different problem. What none of them can do is press on the bony point of your hip, watch you walk, or test the strength of your hip abductors. If an assistant has given you a plan, bring it in with your answers to the three questions above, and, if you have had surgery, the approach your surgeon used. We will check it against what we find on examination.
Frequently asked questions: hip replacement and bursitis
Will a hip replacement cure bursitis?
Not on its own. A total hip replacement replaces the damaged ball and socket inside the hip joint (AAOS). Trochanteric bursitis, now usually called greater trochanteric pain syndrome, sits outside the joint, over the bony point on the side of the hip, and is frequently a gluteal tendon problem rather than pure bursa inflammation (Furia, Rompe & Maffulli, 2009). The surgery does not remove that tissue, so if the side-of-hip pain was bursitis rather than arthritis, it can still be there afterwards.
Will a hip replacement help bursitis?
It helps the pain that came from the arthritic joint. It does not treat the bursa or gluteal tendons. Many people have both at once, and when the arthritis pain goes, the side-of-hip pain is easier to notice. That remaining pain is treated the way bursitis is treated without surgery: activity changes, physical therapy, medication and, if needed, injections (AAOS).
Do I need a hip replacement or is it bursitis?
The location and behaviour of the pain are the first clue. Arthritis pain is typically worse when walking with stiffness after moving; bursitis pain sits at the point of the hip, can spread down the outer thigh, and is worse lying on that side (NHS; AAOS). A point on the outside of the hip that is tender to press on points to bursitis. Only an examination, and imaging if needed, can tell you which you have or whether you have both, and that is the question to settle before a surgical decision.
Can you get bursitis after a hip replacement?
Yes. AAOS lists surgery around the hip and hip implants among the things that can irritate the bursa and cause bursitis. In one series of 200 consecutive hip replacements by a single surgeon, 14 patients (7%) needed a corticosteroid injection for trochanteric bursitis afterwards (Berney et al., 2020).
Is pain on the side of my hip normal after a hip replacement?
Side-of-hip soreness can come from muscles and tendons recovering after surgery, and trochanteric bursitis is a recognised cause of it. It is not the pain to ignore if it comes with a fever, a wound that is red, hot or leaking, sudden severe pain with the leg looking shorter or turned, or calf pain and swelling. Groin pain that persists or worsens also needs assessment rather than more strengthening.
How is bursitis treated after a hip replacement?
The same way it is treated without surgery: activity changes, physical therapy, anti-inflammatory medication and, if needed, a limited number of corticosteroid injections (AAOS). Because the pain is often a gluteal tendon problem, progressive loading of the hip abductor muscles is the core of physical therapy for it. Your surgeon should be the one to clear any injection near a new implant.
Hip bursitis and hip replacement physical therapy in Wayne and Northern New Jersey
Spectrum Therapeutics of NJ is a one-on-one physical therapy clinic in Wayne, serving Passaic County and Northern New Jersey, led by Dr. Rob Letizia, PT, DPT. We see side-of-hip pain both before a surgical decision and after a hip replacement; see our hip rehabilitation page for how we assess it. New Jersey allows direct access to physical therapy, and if you have any Medicare plan, including Medicare Advantage and Medigap, a doctor's prescription is required.
