Because a total hip replacement is an elective surgery, there are no serious or life-threatening consequences associated with not having it. However, it is important to understand what may result from this decision.
Currently no medicine has been developed that can reverse the process of a joint wearing out. There are medicines and treatments that slow the process. However, the hip joint does not spontaneously heal when arthritis is present. With this in mind, patients with hip arthritis and pain generally do not get better with time, and often experience these symptoms getting worse. In the end, it is your choice whether disability caused by the arthritis is bothersome enough to have this surgery.
The final decision to have or not have surgery rests with you, but all concerns relating to this decision should be discussed with your doctor at length. Then you and your doctor can come up with a treatment method that is comfortable for you.