Hip replacement surgery is an operation to remove damaged parts of your hip joint and replace them with artificial ones. It’s a major surgery, but the improvements to hip problems – including hip pain and stiffness – it gives can really improve your quality of life.
Hip replacement operations can reduce hip pain and improve movement
You may need hip replacement surgery if you have severe pain or restricted movement in your hip, most commonly due to osteoarthritis. Your doctor may also recommend hip replacement surgery if you have a damaged hip joint due to other reasons. These might include rheumatoid arthritis, injury or hip dysplasia (when there are problems with how your hip develops).
Your doctor will only recommend hip replacement surgery when your symptoms are really interfering with your quality of life and other measures, such as exercise, physiotherapy and painkillers, aren’t giving you enough pain relief.
How do I get hip replacement surgery?
You can have private hip replacement surgery from a variety of providers in different private hospitals or have your hip replacement operation on the NHS. Either way, you will need to see a consultant orthopaedic surgeon to discuss whether surgery is suitable for you. Usually your own doctor will refer you.
Waiting times for hip replacements in the NHS will vary depending on where you live. But it can often take several months, especially with current delays due to COVID. The surgery is the same, whether it’s in the NHS or the private sector. But you may well have surgery sooner if you opt to have it done in a private hospital.
How do I prepare for hip replacement surgery?
Your consultant orthopaedic surgeon will discuss the surgery with you and go through the benefits and risks, as well as any potential alternatives. If you decide to go ahead, you’ll need an examination and several tests to check you’re well enough for hip replacement.
Your surgeon will advise you on things you should do before hip replacement surgery to make sure you’re in the best possible health beforehand. These may include:
- exercises to keep you moving and strengthen muscles around your hip
- stopping smoking
- losing weight if you need to
- getting any other health problems under control – like diabetes or high blood pressure
You’ll usually have hip replacement surgery under spinal or epidural anaesthesia, which means you’ll be numb from the waist down. You’ll be offered a sedative too, so you won’t be aware of the surgery being performed. Sometimes you may have a general anaesthetic. You might only need to stay in hospital for a day or two, but it can be longer.
What happens during total hip replacement surgery?
Total hip replacement surgery (arthroplasty) involves making an incision around your hip bone and removing the damaged parts of your hip. This includes the top of your thigh bone (femur) and the damaged cartilage in the hip socket in your pelvis. Your surgeon then inserts an implant into your thigh bone, and an artificial socket (prosthesis) into your pelvis. The artificial hip joint has a ball on the top, that fits into the socket, allowing the ball and socket joint to move. The implant and socket can be made of different materials, including plastic, metal and ceramic. In some cases, hip resurfacing may be an option. This type of procedure removes less of the bone than a total hip replacement operation.
What are the other types of hip replacement?
You can also have a partial or half hip replacement (hemiarthroplasty). This is when just the top of your thigh bone is replaced, without the ‘socket’ in your pelvis. It’s usually done for a hip fracture, after an injury or fall.
Recovery and follow-up after hip replacement surgery
The exact recovery time after hip replacement surgery will depend on the type of procedure you’ve had. Your healthcare providers will encourage you to become mobile again as soon as possible after you get your new hip joint, but a full recovery can take several weeks. They may also want to assess and monitor your new hip using x-rays.
You’re likely to have some hip pain and discomfort during this time – you’ll be given pain medication to help manage this. Some people also have swelling in their leg. It’s good to keep moving regularly, and to avoid sitting still for too long. Your stitches or staples will normally be removed within a week or two. You’ll have a single scar on your hip from the surgery, which should get paler with time.
As part of your aftercare, you’ll see a physiotherapist after your operation, who can help to get you moving and start building up the strength in your muscles. They’ll show you exercises to help with this. It’s important to build up your normal activities gradually after surgery, beginning with getting back to walking normally without pain. You’ll need crutches and walking sticks to help you walk at first. It can take around six to eight weeks to get back to walking unaided and other light activities like swimming and cycling. But you’ll need to avoid more strenuous activities and heavy lifting for longer.
You won’t be able to drive for a few weeks after a hip replacement, so you’ll need to make arrangements for getting home.
What are the potential complications of hip replacement surgery?
All surgical procedures carry a risk of complications. Your risks can increase the older you are, particularly if you have other health problems. Your surgeon will discuss any specific concerns with you before your procedure.
Some of the more common complications of a hip replacement operation include:
- Infection. Your wound may become red, very painful or swollen, and you may notice some discharge or develop a fever.
- Blood clots developing in your legs. This can cause pain and swelling.
- Nerve injury. This can affect the strength of the muscles in your leg and make your leg feel numb.
- Dislocation. This is when the ball of your implant moves out of the socket.
You should also be aware that there is no guarantee that you will not suffer from continued pain, although the majority of patients can expect it to be greatly reduced or eradicated entirely.
Hip replacements are expected to last for many years. But the new hip joint can wear or loosen over time. You may then need hip revision surgery.
What costs and fees are involved in private hip replacement surgery?
Hip replacement surgery is often available through health insurance. Check with your private medical insurer whether they will cover it.
You can also self-fund private hip replacement surgery. Typically, an initial private consultation with the surgeon will cost between £180 and £250. The cost of the procedure itself will vary depending on the exact surgery you need. Hip replacement surgery costs in the UK also vary depending on where you live. If you move forwards with the procedure, you’ll be offered one of the following.
- An all-inclusive ‘package price’, where you know the full costs before undergoing treatment. Not all consultants and hospitals offer this.
- A ‘fee-per-service’ deal, where you pay for each part of your treatment and the services you use separately. You often won’t know the full costs until you receive invoices.
For more information, you can read our guide on self-pay.
Helpful websites
References
- Hip replacement surgery. Versus Arthritis. versusarthritis.org (accessed 15 July 2021).
- Varacallo M, Luo D, Johanson NA. Total hip arthroplasty techniques. StatPearls. ncbi.nlm.nih.gov, last update 8 July 2020.
- Osteoarthritis: care and management. National Institute for Health and Care Excellence (NICE), nice.org.uk, last updated 11 December 2020..
- Rheumatoid arthritis in adults: management. National Institute for Health and Care Excellence (NICE), nice.org.uk, last updated 12 October 2020.
- Joint replacement (primary): hip, knee and shoulder. National Institute for Health and Care Excellence (NICE), nice.org.uk, published 4 June 2020.
- BOA statement on waiting times data release from January 2021. British Orthopaedic Association. boa.ac.uk, 11 March 2021.
- Preparing for surgery. Fitter better sooner. Royal College of Anaesthetists. rcoa.ac.uk, published 2018.
- Get well soon. Helping you to make a speedy recovery after total hip replacement. Royal College of Surgeons of England. rcseng.ac.uk (accessed 15 July 2021).
- Total hip replacement. OrthoInfo. American Academy of Orthopaedic Surgeons. orthoinfo.aaos.org, last reviewed June 2020.
- Roland J. What to expect from hemiarthroplasty. Healthline. healthline.com, last reviewed 28 November 2017.
- Kazley J, Bagchi K. Femoral neck fractures. StatPearls. ncbi.nlm.nih.gov, last update 19 May 2021.
