Hip replacement surgery in London

Hip replacement surgery replaces your natural hip joint with an artificial one known as a prosthesis or implant.

A hip replacement is usually suggested when your natural hip has been damaged to such an extent that other treatments are no longer able to relieve the symptoms of severe pain and stiffness. The most common cause of this is wear and tear over time (osteoarthritis), though your hip might also be damaged by injury.

The new artificial hip restores movement and function in your joint - relieving pain and improving mobility.

Hip replacement surgery in London: in the words of a consultant

We asked one of our consultant orthopaedic surgeons, Mr Kostas Tsitskaris, to describe the difference he's seen hip replacement surgery make in people's lives. Here's what he told us:

"Large joint osteoarthritis, and in particular osteoarthritis of the hip, can have a severe impact on individuals - an impact that ranges from limitation of activity levels to the side-effects of analgesic chronic opiate use and mental health issues, such as depression. Different patients can be affected to a different degree, and one often sees a wide spectrum of symptoms and their effects.

"Hip replacement - for the vast majority of patients - brings about reliable, long-term pain relief, with secondary functional gains. Patients have been shown to be healthier and happier following hip replacement, with some studies also reporting a positive impact on life expectancy."

The hip is often described as being a 'ball and socket' joint. It is formed by the upper part of your femur (thigh bone) and the acetabulum (part of your pelvis). The femoral head is the 'ball' while the acetabulum is the 'socket'.

Both parts of your hip joint have a smooth covering of cartilage known as articular cartilage, which helps the bones to move over one another without any friction. If you have osteoarthritis in your hip, it means that the articular cartilage starts to become worn and damaged, leading to increased friction as the joint is used. This causes pain and stiffness.

As the osteoarthritis progresses and causes ever more damage to the articular cartilage, the femoral head and acetabulum may start rubbing directly against one another. As they grate together, pain and stiffness are severe and often reduce mobility significantly.

Before hip replacement surgery is ever considered, non-operative treatments will usually be used, as these can often successfully manage and relieve the symptoms caused by early-stage osteoarthritis.

Mr Tsitskaris describes the common reasons people book to see him at The London Independent Hospital for a private consultation:

"When somebody comes to see me, the most common reason is that they have been troubled by gradually deteriorating, persistent pain in their groin. They're often quite surprised when I tell them that this is probably caused by a problem with their hip, as they think - as many people do - that their hip is on the outside of their leg. However, your hip joint is actually in the groin area.

"On occasions, people will have already tried non-operative treatments before they come to see me. For example, they may have tried pain relief medication or to lose weight, physiotherapy or other conditioning exercises.

"These will often have helped them a bit, but then gradually they get more persistent and deteriorating pain, even at rest."

The National Joint Registry suggests that most people with hip pain will be in an older age group, around 70-80 years old, but Mr Tsitskaris' experience is of seeing people younger than this UK average. He believes this is probably due to the younger population being more prevalent in London. And as he points out, arthritis can occur in younger people too.

If you are concerned about a problem with your hip that is not settling or easing over time, or that is causing you significant problems with your daily activities, it is best to see a doctor for assessment and advice at an earlier stage.

It may be found that no treatment is needed, and this can be reassuring to know. If it is found that treatment would be appropriate, this can be arranged for you without delay so that you can get back to better, easier movement sooner.

When you first visit your consultant at The London Independent Hospital, they will go through a detailed history with you, talking about your symptoms and your medical history.

They will often arrange some imaging, which may be standard X-rays of your hip or pelvis or more advanced scans like CT or MRI. These are all available on-site so can be easily arranged for you.

Once the results of any tests are back, your consultant will discuss the diagnosis with you and talk through treatment options.

Depending on your diagnosis, treatment may be non-operative or operative. Your consultant will ensure that treatment is always tailored to your specific requirements.

Alternative treatments available in London for hip pain

Not everyone with pain and stiffness in their hip will need a hip replacement by any means. Your initial treatment will often be non-operative.

Typically, non-operative treatments for stiffness and pain in the hip include:

• Pain relief medication
• Physiotherapy
• Gentle exercise like swimming
• Joint injections

In the earlier stages of osteoarthritis, these treatments can be very effective at relieving and managing symptoms. Your consultant will ensure you receive the treatment(s) that are the most suitable for your specific needs. Regular monitoring means these treatments can be adjusted as needed to ensure your symptoms continue to be managed as well as possible.

While these non-operative treatments can be extremely useful, as the hip joint becomes more damaged by osteoarthritis, they will often become less effective. Eventually, hip replacement surgery may be the only option left to treat the cause of your pain and stiffness adequately.

Many people find that by the time hip replacement surgery becomes an option, they have already decided to have it because their symptoms are having such a limiting, debilitating impact on their daily life.

When surgery does become an option, your consultant will discuss the operation fully with you, including:

• How the surgery will be done
• The benefits you should realistically expect to see from it
• What to expect your recovery to be like
• Any risks or possible complications you need to be aware of

Your consultant will be happy to give you their expert opinion, but the final choice as to whether to have hip replacement surgery or not is always yours. There is never any pressure put on you and your consultant will be very happy to talk through any questions or concerns you may have.

People in London who come to us for their hip replacement surgery find this collaborative approach between them and their consultant to be incredibly reassuring.

Waiting lists for surgery continue to increase in many hospitals. This means that many thousands of people living in London will end up struggling with hip pain and stiffness for many weeks and months before they are eventually able to have their surgery.

With the population in London expected to continue to grow, this will inevitably have a knock-on effect on these waiting times.

Faced with such long waiting times for hip replacement surgery in London, many people are choosing treatment here at The London Independent Hospital so that they can get back to a better quality of life much more quickly.

Before you have your hip replacement surgery, you will have had a number of appointments at The London Independent Hospital, either with your consultant or other members of our healthcare team.

A pre-operative assessment will be done, and you will be given more information about the procedure and what to expect from your recovery.

When you come in for your operation, you will be taken to your ward where you will meet the nursing staff on the ward. They will guide you through the process of getting ready for the surgery. You will also see the anaesthetist as well as your consultant, who will visit you to talk through things once more and to get your consent for the operation.

Before your surgery, your consultant will use special templating software and current X-rays or scans (MRI or CT) to plan the operation.

The surgery may be carried out using a general anaesthetic (so you are fully asleep) or using a spinal anaesthetic (where your legs and pelvis are numb) and sedation. You will be able to discuss the different options with your anaesthetist beforehand.

Once the surgery begins, a cut is made in the skin above the hip to allow access to the joint. Your surgeon will then carefully remove any remaining articular cartilage from the acetabulum and the head of the femur (the 'ball' of the joint) will be fully removed.

An artificial socket is then positioned in the acetabulum. A spike is moved into the femur and a ball placed on top of it to act as the new 'ball' of the joint.

Your consultant will then carry out a few specific tests to make sure the new hip is working properly. If any adjustments are needed, these are made and then the skin is closed with sutures and covered with a sterile dressing.

How long does hip replacement surgery take?

Hip replacement surgery will normally take around an hour and half, but exact timings depend on a range of factors.

"The vast majority of people who have been correctly selected for the surgery will experience a dramatic improvement in terms of their symptoms and their ability to mobilise," explains Mr Tsitskaris.

"When I see people for their follow-up appointment a few weeks after their operation, they are almost universally thankful and very happy with the results. It is just such a dramatic improvement for them, one that can be felt even in the first few weeks."

Mr Tsitskaris tells his patients that even though they can already feel improvements in the first few weeks, they should expect to have further improvement as time goes on.

Most people will continue to improve and feel the benefits over a number of months, often with dramatic improvement in their pain and also changes in their gait pattern. Because they are able to walk more easily, and faster, they often have better overall health.

Hip replacement surgery recovery time itself varies from person to person. Various factors - including age, overall health and fitness - can affect your recovery.

Find out more about recovering from hip replacement surgery.

While some people will only need one of their hips replaced, others may have osteoarthritis in both hips. Usually, one hip is more damaged than the other and so hip replacement surgery is separated by a number of years.

In other cases, people may benefit from having both hips replaced, with the operations separated only by a few weeks. This is known as bilateral hip replacement.

Mr Tsitskaris sees two different trends with this:

"The first is that very quickly after the first replacement, the person realises that they want to have the other hip done because of the improvement they have seen.

"The other trend tends to be that after somebody has had a hip replacement on one side, they experience improvement in some of the symptoms on the other side, because the new artificial hip is able to take over a lot of the function and offloads pressure from the other hip.

"So, some people will choose to have their second hip replacement quite close to their first, while other people will choose to delay their second surgery for a number of years. Neither is right or wrong, it is just what is right for that patient.

"This makes the follow-up appointment very important, as it can identify people who would benefit from having their second hip replacement sooner and those who would be right to delay until later."

The cost of hip replacement surgery in London starts from around £11,995*

This will differ from person to person and is affected by various factors, from the complexity of the surgery you need, to the surgeon you choose to have treatment with. You will always receive written confirmation of the fixed-price fee after your consultation and once any diagnostic tests have been carried out.

We offer fixed-price payment packages and our self-paying patients can take advantage of our flexible payment options, allowing you to spread the cost of treatment over a period of up to five years.

If you have private health insurance, hip replacement surgery will usually be covered by your policy. Speak to your provider directly to find out.

*This is just a guide price for patients paying for their own treatment.

If you live in London, we believe you will find no better place to come for hip replacement surgery than The London Independent Hospital.

Here are just some of the many reasons people choose to have their private hip replacement surgery with us:

Rapid access

We can arrange a consultation for you with a leading hip surgeon at a time that is convenient for you. Waiting times for hip replacement surgery do vary, but on most occasions, you should expect between two to six weeks from appointment to surgery.

Depth of experience

We carry out many hip replacements and our consultants are highly experienced. With easy access to a multidisciplinary team, including physiotherapists, anaesthetists, nurses and pharmacists, our experienced staff will ensure you receive the help you need throughout your time with us.

Safety

The London Independent Hospital has the advantage of offering a well-run high dependency unit. This means we can cater for people with complex medical comorbidity.

Managed recovery

When you are discharged from the ward, you will be given a number to call if you have any concerns at any time. Our physiotherapy team will help you throughout your recovery and follow-up appointments with your consultant to review your recovery and give you peace of mind.

If you would like to discuss hip surgery with one of our dedicated consultants, you can book a private consultation at a time that is convenient to you or call us to speak with a friendly member of our advisory team.

Content reviewed by Circle in-house team in November 2022. Next review due November 2025.

1. https://worldpopulationreview.com/world-cities/london-population