Surgery can improve function for one or more decades for patients with osteoarthritis of the hip, even though the operations may not be very invasive. The indications must be made by surgeons in collaboration with rheumatologists. There is no patent recipe, no 'common' intervention which gives a reliable result in all cases. The patient must be studied in all stages of development of his disease: his joint structure in the radiogram, the morphology of the bones, the functional requirements and his general state of health influence the decision regarding the possibility and modality of a surgical intervention. The patient's return to an active life which would not have been possible for him under medicinal treatment supports the importance of surgical treatment.