What is a hip replacement?

A hip replacement is a type of surgery to replace damaged parts of the hip with man-made parts. The operation can relieve hip pain and improve movement. It is commonly recommended if you have severe hip damage that interferes with your life, when other treatments have not helped.

During hip replacement surgery, damaged bone and cartilage (tissue at the end of the bone that cushions the joint) are removed from the hip joint. These are replaced with metal or plastic parts.

Hip replacement surgery usually takes 1 to 2 hours. You will be given a general anaesthetic, which makes you fully unconscious, or a spinal anaesthetic, which numbs the lower half of your body.

A hip replacement is also known as hip arthroplasty or a total hip replacement.

During hip replacement surgery, the damaged bone and cartilage are removed from the hip joint. These are replaced with metal or plastic parts.

There are different types of hip replacement — partial and total.

A partial hip replacement only replaces the ball on the end of the thigh bone. A ceramic or metal ball attached to a stem is attached to the bone.

Total hip replacement means the ball of the hip and the socket of the hip joint are both replaced. Sometimes just the surface of head of the hip is replaced, rather than the whole ball.

When is a hip replacement recommended?

Your doctor may recommend a hip replacement if you have:

• osteoarthritis
• rheumatoid arthritis
• arthritis or pain following a hip injury
• an injury that affects blood supply to the hip
• hip disease from birth
• hip pain that has lasted a long time and that makes moving difficult, has not improved with medicines, physical therapy or walking support and that makes it difficult for you to look after yourself and is affecting your daily activities

A hip replacement can reduce pain, improve mobility and improve quality of life.

There might be alternatives, such as continuing with physical therapy, adding new methods of pain relief or trying hip resurfacing therapy.

What are the risks and complications of hip replacement surgery?

Hip replacement surgery is considered safe and effective. However, very rarely, complications can include:

• infections
• blood clots (deep vein thrombosis, or DVT)
• hip dislocation, especially in the first few months after surgery
• one leg feels shorter than the other
• nerve and blood vessel injury
• swelling and stiffness
• continued pain

Should I have a hip replacement?

To help you decide, here are some questions you might want to ask your surgeon:

• What are the alternatives to surgery?
• What are the different surgical options? For instance, is ‘minimally invasive’ hip replacement suitable? This technique reduces cutting of the tissue around the hip.
• What are the possible complications and how likely are they?
• What can I expect during recovery?
• How much improvement can I realistically expect?
• Will the new hip last all my life?

What should I expect after hip replacement surgery?

You will probably spend a few days in hospital after the surgery. Most people will be encouraged to walk with the help of a walking support soon after surgery. You will be advised on how to take care of your new hip and how to avoid hip dislocation. For example, you should avoid sitting in low chairs and running, squatting and jumping for the first 3 months.

Recovery can be slow and you will need to do rehabilitation, including physiotherapy and occupational therapy, to strengthen the new joint and improve flexibility. After about 3 months you should be able to get back to most of your normal activities, and in fact these might be easier because your hip pain will be reduced. For some people, it takes 6 to 12 months to feel the full benefits of the hip replacement.

Your surgeon will let you know what activities you can do after the operation, but you will likely need to avoid high impact sports.

How long does a hip replacement last?

All joint replacements eventually need to be replaced (called revision surgery). Hip replacements last at least 15 years for more than 9 in 10 people who have a hip replacement. The younger you are, the more likely you are to need revision surgery.

Doing all your exercises as instructed and keeping to a healthy weight will help your recovery and increase the lifespan of the new hip.