A hip replacement 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 in hip pain and stiffness it gives can really improve your quality of life.

Why do I need a hip replacement?
How to get a hip replacement
Preparing for hip replacement
What happens during hip replacement surgery?
Recovery and what to expect after hip replacement
Complications of hip replacement
Hip replacement costs and fees
Helpful websites
References

Why do I need a hip replacement?

You may need a hip replacement 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 your hip has been damaged 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 to get a hip replacement

You can have a hip replacement privately or on the NHS. Either way, you will need to see an orthopaedic surgeon to discuss whether surgery is suitable for you. Usually your own doctor will refer you. Waiting times for hip replacement 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 privately.

Preparing for hip replacement

Your 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 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 a hip replacement 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 hip replacement surgery?

A total hip replacement involves making an incision around your hip and removing the damaged parts of your hip. This includes the top of your thigh bone 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 into your pelvis. The implant has a ball on the top, that fits into the socket, allowing the joint to move. The implant and socket can be made of different materials, including plastic, metal and ceramic.

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 what to expect after hip replacement

The exact recovery time after a hip replacement will depend on the type of surgery you’ve had. Your healthcare team will encourage you to become mobile again as soon as possible after surgery, but a full recovery can take several weeks. You’re likely to have some 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.

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 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.

Complications of hip replacement

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 hip replacement include the following.

  • 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.

Hip replacements are expected to last for many years. But the new joint can wear or loosen over time. You may then need further surgery.

Hip replacement costs and fees

Hip replacement is often available through private medical insurance. Check with your insurer whether they will cover it.

You can also self-fund a private hip replacement. Typically, an initial 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 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.

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