Total Hip Replacement
Overview
Total hip replacement removes the damaged ball and socket surfaces and replaces them with artificial components. Its main aim is to reduce pain and improve mobility when hip disease continues to cause major limitations despite appropriate non-surgical treatment. It is a major operation and cannot treat every cause of pain around the hip. Expected benefits, limitations, alternatives, recovery and individual risks should all be discussed before surgery.
Who may be suitable?
Hip replacement is most often performed for osteoarthritis. It may also be considered for some inflammatory conditions, avascular necrosis, post-traumatic arthritis or selected fractures. Typical reasons to consider surgery include persistent pain, disturbed sleep, reduced walking and difficulty with work, self-care or valued activities.
The decision is based on symptoms, function, expected benefit and individual risk rather than age or imaging alone. Medical conditions, infection risk, bone quality, smoking or nicotine use, support at home and ability to participate in rehabilitation are also considered.
A hip replacement is most likely to help when the arthritic hip joint is the main source of pain. Pain from the lower back, nerves or soft tissues may not improve after the joint is replaced.
Alternatives to surgery
- Tailored exercise and physiotherapy.
- Activity modification and pacing.
- Weight management where relevant.
- Walking aids and practical home modifications.
- Pain-relieving medicines or, in selected cases, an image-guided injection after review of likely benefit and risk.
- Continuing non-surgical care when symptoms remain acceptable or surgical risk outweighs likely benefit.
What happens during surgery?
The damaged femoral head is removed and the socket is prepared. A socket shell and liner, a stem within the thigh bone and a new ball are inserted. Components may be fixed with bone cement, by bone growing onto their surface, or by a combination. Implant and fixation choices depend on anatomy, bone quality, health, activity and the surgeon’s assessment.
The operation is performed under spinal or general anaesthesia, often with additional local anaesthetic and several forms of pain relief. The surgical approach is selected according to your anatomy, health and the surgeon’s experience. No single approach is best for every person.
Hospital care and early recovery
- Mobilisation usually starts on the day of surgery or the following morning with physiotherapy supervision.
- Walking aids are used until gait is safe and comfortable.
- Blood-clot prevention is individualised and may include early mobilisation, compression and medication.
- Discharge may be the same day or after one or more nights, depending on medical needs, mobility and home support.
- Wound care, exercises, medicines and follow-up instructions are provided before discharge.
Recovery and expectations
Pain and mobility usually improve over the first weeks and months. Swelling, fatigue, muscle weakness and an altered gait are common early. Many routine activities return before strength and endurance are fully restored, and improvement can continue for up to a year. Recovery varies with preoperative function, health, complications and rehabilitation.
Driving depends on the operated side, vehicle, reaction time, medicines and your ability to perform an emergency stop. Do not drive until you can control the vehicle safely and have followed advice from your surgeon, licensing authority and insurer. High-impact activity may increase implant load or injury risk; suitable activities are discussed individually.
Risks and possible complications
- Infection, bleeding, wound problems or the need for further surgery.
- Blood clots in the leg or lungs.
- Dislocation or instability.
- Fracture, nerve or blood vessel injury.
- Difference in leg length or persistent limp.
- Ongoing pain, stiffness, weakness or dissatisfaction despite a technically satisfactory replacement.
- Wear, loosening or other implant problems that may require revision surgery in the future.
- Heart, lung, stroke, anaesthetic or other medical complications, including rare life-threatening events.
Preparing for surgery
- Optimise medical conditions, nutrition, anaemia, dental problems and any broken or infected skin before surgery.
- Stop smoking and all nicotine use as early as possible; nicotine increases wound and healing risks.
- Review medicines, including blood thinners, diabetes medicines and supplements.
- Plan transport, home support and equipment before admission.
- Report any infection, wound or new illness before surgery.
Seek urgent medical review after surgery
Contact the treating team or seek urgent care for increasing wound redness or drainage, fever, severe or worsening pain, new calf swelling, chest pain, shortness of breath, sudden inability to bear weight, a fall with new pain, or a hip that feels displaced.
Frequently asked questions
Does hip replacement guarantee a pain-free hip?
No. Many people have substantial pain relief and improved function, but some pain, weakness, stiffness or altered sensation may remain. Outcomes depend on the diagnosis, health, rehabilitation and any complications.
How long does a hip replacement last?
Modern hip replacements commonly function for many years, but no implant lasts forever. Longevity varies with implant, fixation, age, activity, weight, anatomy and other factors.
Will I need antibiotics before dental work?
Tell your dentist that you have a joint replacement. Routine preventive antibiotics are not recommended automatically for every dental procedure; advice depends on the dental treatment and your individual infection risk. Your dentist and treating doctors can guide this.
When can I return to work?
This depends on the physical demands of the role, travel, pain control and progress with walking. Desk-based work may be possible earlier than heavy or safety-critical work.
General information
This page provides general information only. It cannot diagnose your condition or replace advice from a clinician who has assessed you. Your treatment and recovery plan may differ from the examples described here. Follow the instructions from your treating team. In an emergency, call 000 or attend the nearest emergency department.