Hip replacement surgery

Hip replacement is a highly successful operation that can help relieve pain, restore mobility and function in the hip, and improve quality of life for people with severe hip pain and stiffness.

Your hip is a ball and socket joint made of the top of your thigh-bone (also called a femur) and a cavity in your pelvis that makes up the socket (also called the acetabulum).

In a healthy hip, the bone surfaces are lined with cartilage that enables them to glide smoothly together. But, in conditions that affect the hip, such as osteoarthritis, this cartilage is damaged and the bones rub against one another. This harms the hip bones and leads to pain and stiffness.

During hip replacement surgery, your surgeon will remove the damaged parts of the bone and/or cartilage in your hip joint, and replace them with artificial parts. These artificial parts, also called prostheses, are made of metal, and the surface that lines them can be ceramic, plastic, or metal.

Mount Alvernia Hospital offers fixed price packages that include the cost of your initial consultation, diagnostic tests, your surgery, and post-surgery aftercare.

You can pay for your treatment with various payment options, from self-pay to using your private health insurance.

Circle Health Group also offers the opportunity to pay in instalments for your care using flexible finance. 

Hip replacement may be necessary if you have significant damage and/or pain that did not respond to other treatments. This may be due to one of the following conditions:

• Osteoarthritis – this is the most common cause of hip replacement
• Rheumatoid arthritis
• Osteonecrosis, also called avascular necrosis – this occurs when the blood supply to the bone is cut off and parts of the bone die as a result
• Hip fracture
• Tumour in the hip joint

If you have any of these conditions, and your quality of life is severely impacted by your hip pain and stiffness, it may be time for a hip replacement.

What are the signs you need a hip replacement?

Signs that you may need a hip replacement include:

• Your hip is stopping you from enjoying the activities that you used to enjoy
• It is very difficult to perform simple tasks such as climbing stairs or getting in and out of chairs
• Your pain is keeping you up at night
• You have tried other treatments for hip pain, such as medication, walking aids, injections, and physiotherapy, and they didn’t work

If you are experiencing any of the above signs, speak to your consultant. They will be able to tell you more about hip replacement surgery and help you with your decision. The decision to have a hip replacement will vary from person to person.

There are different types of hip replacements. Hip replacements are classified according to how much of the hip is being replaced, the angle from which the surgeon approaches the surgery, and the material that makes up the artificial hip.

Hip replacements can be:

• Total
• Partial

In total or full hip replacement, the hip socket is replaced as well as the top of the thigh-bone (or femoral head).

In a partial hip replacement or hemiarthroplasty, only the femoral head is replaced.

What are hip replacements made of?

In terms of the materials used, hip replacements can be:

• Cemented – these use a special, mortar-like glue to stick the prostheses to the healthy bone
• Uncemented, or cementless hip replacements – these artificial parts have either a textured surface that the bone can grow on, or a porous surface that the bone can grow into
• Hybrid hip replacements – these combine a cemented part of the thigh-bone with an uncemented part of the hip bone

Depending on the angle from which the surgeon approaches the procedure, the three most common types of hip replacement are:

• Posterior hip replacement, where the surgeon makes an incision behind the hip
• Direct lateral hip replacement, where the surgeon makes the incision on the side of the hip
• Direct anterior hip replacement, where the surgeon approaches the hip from the front

Each approach has its own advantages and disadvantages, but they are all effective and safe.

Your surgeon may choose which approach to use depending on what they are most used to and experienced with.

Hip replacement is a highly successful surgery that is in high demand and done very frequently.

However, it is still major surgery, and as with any major surgery, it comes with risks. Complications are rare, but the risk of them occurring increases with age. Such complications include:

• Pulmonary embolism (a blood clot that forms in another part of the body but then travels to a lung artery and blocks it)
• Blood clots
• Bone forming in soft tissue (heterotopic ossification) – this can be quite common, but it is not serious and does not interfere with a person’s full recovery and ability to exercise after hip replacement
• Thromboembolism – this occurs when a blood clot blocks a major artery
• Nerve damage affecting the thigh-bone nerve, the sciatic nerve, or the nerves on your buttocks
• Fractures
• Dislocation of the hip
• Infection
• Failure of the prosthesis
• Squeaking noise from the hip

There are several things you can do in the weeks or months leading up to your hip replacement to make sure you minimise the risk of complications and speed up recovery.

• If you are overweight, try to lose weight
• If you smoke, cut back or try to quit
• Stay active and keep your muscles strong

There are also things you can do to make your recovery as smooth and comfortable as possible.

• You should arrange for transportation to and from your hip replacement surgery; the hospital staff will also be happy to call a taxi for you after the surgery
• Prepare your meals in advance, or ask someone to help cook your meals for a while
• Prepare to use crutches to or have a walker ready to help you move around
• Arrange for transportation for follow-up and aftercare visits

At home

Adjustments to your home and lifestyle can also help you recover:

• Prepare an area in your home where you plan on doing most of your recovery
• Keep your TV/tech devices nearby for entertainment, mobile phone, medication
• You may wish to arrange for a raised toilet seat and a shower chair to use when showering after surgery
• Taking a shower will be preferable to taking a bath after hip replacement surgery

Making these preparations will make life during recovery easier and more comfortable.

You will receive either general anaesthesia or spinal anaesthesia. In general anaesthesia, you will be asleep for the whole operation. In spinal anaesthesia, you will receive an injection in your spine that will numb you from the waist down.

The surgeon will make an incision over the hip or on the side of the hip. They will then remove the damaged parts of the bone and cartilage from your hip joint and replace them with artificial parts.

In partial hip replacement, the surgeon will only replace the femoral head. In full hip replacement, they will replace the femoral head and your hip socket.

They will then stitch the incision back together with stitches that dissolve.

Immediately after the surgery, you will be taken to the recovery room and then to your private en-suite room.

How long does hip replacement surgery last?

The entire procedure may last anywhere between 45 minutes and two hours. A partial hip replacement may take less time, and a total hip replacement can take longer.

Complications may extend the procedure.

Recovery time varies from person to person. Several factors, such as age and overall health and fitness, can influence your recovery.

Your recovery timeline

Generally speaking, most patients will be able to walk one to two days after the operation, using a walker or crutches. Usually, people can leave the hospital two to three days after surgery and continue to use a walking aid.

You will meet with your physiotherapist as soon as possible after your hip replacement surgery to discuss a recovery plan that will be personalised to your needs.

2–6 weeks: returning to work, exercise

Between two and six weeks, you can start gentle exercise recommended by your physiotherapist.

Walking slowly for long periods of time is helpful for regaining fitness. You may also be able to return to work at this stage, depending on the type of work that you do.

Bending down to do things like tying your shoes is not recommended during this period.

You can usually exercise by week 6, although lower-impact forms of exercise may be possible sooner. Swimming may also be fine at the 6-week mark if the incision has fully healed.

6–12 weeks: walking unaided, driving, tying your shoes

Between six and 12 weeks of hip replacement surgery, you should be able to resume your day-to-day activities.

Most people no longer need a walking aid at eight weeks after hip replacement. They also tend to feel like their lives are mostly back to normal between 10 and 12 weeks post-surgery.

Driving may be possible at week 8, although that depends on a few factors, such as the progress of your recovery or whether you had your left hip or your right hip replaced. 

Most people can comfortably bend down to tie their shoelaces at three months after surgery.

3–6 months: greatest improvements in pain, mental health

By three to six months after the surgery, you should see the greatest improvement in pain, hip function, and stiffness.

The positive mental health effects of hip replacement surgery tend to show at six months after the procedure — health-related quality of life improves, and feelings of anxiety and depression drop significantly by the six-month threshold.

A full recovery from hip replacement surgery may take between six and 12 months, but it’s important to remember everyone is different and many people take much less than that.

At Mount Alvernia Hospital, hip replacement treatment packages[1]  include a comprehensive aftercare plan. You will be supported in your journey by the same compassionate clinical team from beginning to end.

Pain after surgery – what is ‘normal’?

Some swelling and pain around the hip are normal after hip replacement.

To help relieve pain, you can:

• Take painkillers and anti-inflammatory medication, as prescribed by your doctor
• Do exercises prescribed by your physiotherapist, which can reduce pain
• Apply ice to the incision
• Talk to your consultant about when and how to apply heat therapy

Paying attention to your pain levels is important throughout recovery, as more serious pain can be a sign of a hip replacement complication.

How long do hip replacements last?

According to recent international research, about 85% of hip replacements last for 15 years. Over half of them (58%) last for 25 years.

This is good news, because it means that you are unlikely to need a second hip replacement further down the line. 

The Mount Alvernia Hospital in Guildford, Surrey, is a top choice for anyone seeking private healthcare and private hip replacement.

The hospital is a leading provider of independent healthcare, with excellent patient satisfaction surveys and good ratings on all accounts awarded by the Care Quality Commission (CQC).

Our hip replacement specialists are internationally trained, they have experience with complex sports injuries, or have published their own research in reputable academic journals.