Everything You Need to Know About Hip Replacement Surgery

Hip replacement surgery is a procedure carried out to replace damaged parts of the hip joint. It’s a common and highly successful surgery, with thousands undergoing it in the UK every year.

Speak to our Orthopaedics team to discuss hip replacement surgery.

What is hip replacement surgery?

Also known as total hip replacement, hip replacement surgery involves replacing damaged elements of a hip bone with metal, plastic, or ceramic parts. While a total hip replacement is most common, people may also receive a partial hip replacement.

Why might you need hip replacement surgery?

High levels of hip pain or stiffness are the main reasons people have hip replacement surgery. The procedure is usually recommended if this pain is having a major impact on your life and alternative solutions have not worked.

In a functioning hip joint, the hip moves smoothly because cartilage covers both ends of the bones to protect them. When cartilage is worn away, the bones rub against each other and cause pain, resulting in a need for total hip replacement surgery.

People may experience hip pain and stiffness due to osteoarthritis, a prime cause of painful and stiff joints. Other conditions that can be treated by hip replacement surgery include rheumatoid arthritis and hip pain caused by an injury or accident.

Types of hip replacement surgery

Hip replacement surgery is most commonly carried out as a total hip replacement, but in some cases, surgeons will choose to do a partial hip replacement. The type of surgery you have will depend on the cause and severity of your hip pain and your unique needs.

Total hip replacement

During a total hip replacement, both the ball and socket of the hip joint are replaced by artificial parts. This surgery is mostly needed by people suffering from joint conditions such as osteoarthritis and arthritis, typically those in later life.

A surgeon will make an incision in the back or side of your hip before taking apart the damaged hip joint. Then, the top end of the thigh bone is removed, and a new ball is fitted to the end of the thigh bone. Finally, the hip socket is drilled out and replaced with a new one before the new hip is put back together and the cuts are closed.

Partial hip replacement

With a partial hip replacement, only the ball of the hip joint is replaced, following the same process as this part of a total hip replacement. This procedure is usually carried out due to an accident or fall, particularly in elderly patients, where bones and joints become weaker with age.

Hip resurfacing

A less common procedure, hip resurfacing can be used to reshape the hip joint. Surgeons do this by replacing the hip socket and then reshaping the top of the thigh bone to fit into the new artificial socket. This procedure is most common among patients under 60, who are otherwise fit and healthy.

Preparing for hip replacement surgery

Before undergoing hip replacement surgery, there are several things you should do to prepare. These will be discussed with you by your doctor in advance of your procedure.

Most commonly, you will be asked to:

Follow a healthy diet
Carry out muscle-strengthening exercises
Stop smoking
Maintain a healthy weight, or lose weight if necessary

Your doctor will also ask you to attend a pre-clinic assessment before your hip replacement to make sure you are well enough. This often includes blood tests, urine samples, blood pressure checks and sometimes, an ECG or x-ray.

While it may feel a long way off, you should also start to prepare for your recovery. Consider asking people to help you when you arrive home, batch cooking your favourite meals, arranging transport for a few weeks after surgery, and ensuring your most-used items are within easy reach.

Proper preparation for hip replacement surgery will help you recover faster and may also lessen the risk of complications both during and after your surgery.

What happens during hip replacement surgery?

Most hip replacement patients arrive at the hospital on the day of the surgery, before meeting with surgeons to discuss the operation. Next, you will be prepared for surgery and given anaesthetic, which is either local or general.

With local anaesthetic, you will be awake for the procedure but will have no feeling from the waist down, as the anaesthetic is injected into your spine. You may also be offered a sedative to help you feel more relaxed. General anaesthesia will mean you are asleep for the duration of your surgery.

How long does hip replacement surgery take?

It typically takes surgeons between one and two hours to complete a hip replacement. The type of surgery you have and how long it takes will be influenced by the extent of the damage to your hip, what caused the damage, and your overall health.

Recovering from hip replacement surgery

After hip replacement surgery, you often need to spend a couple of days in the hospital to recover. This is to ensure the procedure went well and you can get around safely and effectively. You will be given pain relief medication and support from nurses and physiotherapists to help you walk and get used to your new hip.

Upon returning home, hip replacement recovery can last for several months. You will usually need a walking frame or crutches to get around in the first few days and weeks after surgery. Most patients also continue using pain relief until any swelling or pain subsides.

During your recovery, you should carry out the exercises provided by your doctor as early as you feel able to. This will ensure long-term strength and mobility in the hip joints and make healing faster.

Around 10 days after your surgery, you will need to go back to the hospital to have any stitches or clips removed. After this, your doctor will arrange regular follow-up appointments to check on your progress.

Top tips for hip replacement recovery

After a hip replacement, you will be given plenty of information about how to recover well and speed up the healing process. Guidance often includes:

Completing physiotherapy exercises
Drinking plenty of water
Taking pain relief when needed
Maintaining a healthy diet and weight
Walking as far as is comfortable, every day
Using a walking frame or crutches if needed
Sitting in a reclined position, but not for prolonged periods
Avoiding bending down or bending the hip more than 90 degrees
Avoiding sitting down in low chairs
Waiting at least six weeks before driving
Avoiding exercises with a high risk of falling

Potential complications of hip replacement surgery

Like any type of surgery, there are risks and potential complications to be aware of, despite hip replacement surgery being a common and safe procedure. These will be explained to you by your doctor, but the key complications to keep an eye out for are:

Blood clots or deep vein thrombosis (DVT)
Damage to tissue or nerves
Infection around the wound
A difference in leg length
Hip dislocation or wear

Many hip replacement complications and risks are minor and can be treated or managed. However, if you experience throbbing or cramping in the hip or leg, a high temperature, wound oozing, chills, or pain that does not improve, you should contact your doctor immediately.

Is it common to need a second hip replacement?

Although modern artificial hip replacement joints are designed to last, they can still wear over time. Most parts are built to last for at least 15 years, but depending on your age at the time of surgery and how much you use your hips, they may get over-worn and cause pain and swelling.

If your new hip dislocates or wears too much, a second hip replacement may be required to fix it. This is not always a complete replacement, as sometimes surgeons can revise the original procedure to make your hip more comfortable.

What are the alternatives to hip replacement surgery?

In most cases, a hip replacement procedure is recommended because other changes or solutions have not been successful. Before hip replacement surgery is discussed with you, you may be advised to try: