Overview - Hip replacement

A hip replacement is a common type of surgery. A damaged hip joint is replaced with an artificial one. This is known as a prosthesis.

Adults of any age can be considered for a hip replacement. Most are carried out on people between the ages of 60 and 80.

Artificial hip joints are designed to last for at least 15 years. Most people experience a significant reduction in pain. They get some improvement in their range of movement.

When a hip replacement is needed

Hip replacement surgery is usually needed when the hip joint is worn or damaged. Your mobility is reduced and you experience pain even while resting.

The most common reason for hip replacement surgery is osteoarthritis.

Other conditions that can cause hip joint damage include:

• rheumatoid arthritis
• a hip fracture
• septic arthritis
• ankylosing spondylitis
• disorders that cause unusual bone growth (bone dysplasias)

Who is offered hip replacement surgery

A hip replacement is major surgery. Your GP will usually recommend it if other treatments haven't helped to reduce pain or improve mobility.

You may be offered hip replacement surgery if:

• you have severe pain, swelling and stiffness in your hip joint and your mobility is reduced
• your hip pain is so severe that it interferes with your quality of life and sleep
• everyday tasks, such as shopping or getting out of the bath, are difficult or impossible
• you're feeling depressed because of the pain and lack of mobility
• you can't work or have a normal social life

You'll also need to be well enough to cope with a major operation and the rehabilitation.

How hip replacement surgery is performed

A hip replacement can be carried out under a general anaesthetic or an epidural.

A general anaesthetic is where you're asleep during the procedure. An epidural is where the lower body is numbed.

The surgeon makes an incision into the hip and removes the damaged hip joint. They replace it with an artificial joint made of a metal alloy or, in some cases, ceramic.

The surgery usually takes around 60-90 minutes to complete.

Read about how a hip replacement is performed.

Alternative surgery

There is an alternative type of surgery to hip replacement, known as hip resurfacing. This involves removing the damaged surfaces of the bones inside the hip joint. They are replaced with a metal surface. An advantage of this is that it removes less bone.

This surgery may not be suitable for:

• Adults over the age of 65 years – bones tend to weaken as a person becomes older
• women who've been through the menopause – bones can become weakened and brittle (osteoporosis)

Resurfacing is much less popular now. This is due to concerns about the metal surface causing damage to soft tissues around the hip.

Your surgeon should be able to tell you if you could be a suitable candidate for hip resurfacing.

Preparing for hip replacement surgery

Before you go into hospital, find out as much as you can about what's involved in your operation.

Stay as active as you can. Strengthening the muscles around your hip will aid your recovery. Continue to take gentle exercise in the weeks and months before your operation. Walking and swimming are good options.

You may be referred to a physiotherapist, who will give you helpful exercises.

Recovering from hip replacement surgery

The rehabilitation process after surgery can be a demanding time.

For the first 4 to 6 weeks after the operation you'll need a walking aid, such as crutches, to help support you.

You may also be enrolled on an exercise programme. It's designed to help you regain and improve the use of your new hip joint.

Most people are able to resume normal activities within 2 to 3 months. It can take up to a year before you experience the full benefits of your new hip.

Risks of hip replacement surgery

Complications of a hip replacement can include:

• hip dislocation
• infection at the site of the surgery
• injuries to the blood vessels or nerves
• a fracture
• differences in leg length

The risk of serious complications is low – estimated to be less than 1 in a 100. There's also the risk that an artificial hip joint can wear out earlier than expected or go wrong in some way.

Some people may need revision surgery to repair or replace the joint.

Read more about risks of hip replacement

Metal-on-metal implants

Some metal-on-metal (MoM) hip replacements wear out sooner than expected. This can cause deterioration in the bone and tissue around the hip. There are also concerns that they could leak traces of metal into the bloodstream.

If you're concerned about your hip replacement, contact your GP or orthopaedic surgeon. They can give you a record of the type of hip replacement you have and tell you if any follow-up is required.

You should also see your doctor if you have:

• pain in the groin, hip or leg
• swelling at or near the hip joint
• a limp, or problems walking
• grinding or clunking from the hip

These symptoms don't necessarily mean your device is failing. But they do need investigating.

Any changes in your general health should also be reported, including:

• chest pain or shortness of breath
• numbness, weakness, change in vision or hearing
• fatigue, feeling cold, weight gain
• change in urination habits