Hip Replacement Surgery

Hip replacement surgery is a common and highly effective procedure used to relieve chronic hip pain and improve mobility in people with severe hip joint damage. Also known as total hip arthroplasty, this surgery involves replacing the damaged hip joint with an artificial implant made from metal, ceramic, or plastic materials.

This procedure is often recommended for individuals with severe arthritis, hip fractures, or other degenerative joint conditions that limit daily activities and do not improve with non-surgical treatments. Thanks to advancements in surgical techniques and implant technology, modern hip replacements are long-lasting and offer excellent pain relief, allowing patients to return to an active lifestyle.

In this guide, we’ll cover how hip replacement surgery works, why it’s performed, what to expect during recovery, and potential risks.

Hip Joint Anatomy

The hip is a ball-and-socket joint, one of the body’s largest and most important weight-bearing joints. It allows for smooth movement and stability during activities like walking, running, and sitting.

• The socket (acetabulum) is part of the pelvis and forms the cup-shaped structure.
• The ball (femoral head) is the upper part of the femur (thighbone) that fits into the socket.
• Articular cartilage covers the surfaces of the ball and socket, acting as a cushion to reduce friction and allow smooth movement.
• The synovial membrane produces fluid that lubricates the joint and prevents stiffness.
• Ligaments (hip capsule) connect the ball to the socket, keeping the joint stable while allowing flexibility.

When the hip joint becomes damaged due to arthritis, injury, or wear and tear, the smooth surfaces break down, causing pain and stiffness—often leading to the need for hip replacement surgery.

Why is Hip Replacement Surgery Performed?

Hip replacement surgery is recommended for individuals with severe hip pain and mobility issues that interfere with daily activities. It is often performed when non-surgical treatments, such as medication, physical therapy, or assistive devices, no longer provide relief.

Common Conditions Leading to Hip Replacement

• Osteoarthritis: The most common reason for hip replacement, osteoarthritis causes the protective cartilage in the hip joint to wear down, leading to pain and stiffness.
• Rheumatoid arthritis: An autoimmune condition that causes inflammation in the joints, leading to pain, swelling, and joint damage.
• Hip fractures: Severe fractures, often due to falls or osteoporosis, may require a hip replacement if the bone cannot heal properly.
• Avascular necrosis: A condition where reduced blood supply to the hip joint causes bone tissue to die, leading to joint collapse.
• Developmental hip disorders: Conditions such as hip dysplasia can cause joint damage over time, requiring a replacement.

Who is Hip Replacement Surgery Suitable For?

This procedure is typically recommended for individuals who:

• Experience chronic hip pain that limits walking, standing, or daily activities.
• Have stiffness and reduced range of motion in the hip.
• Find pain relief methods, such as medications or physical therapy, ineffective.
• Have hip joint damage visible on X-rays or other imaging tests.

What Happens if Hip Pain is Left Untreated?

Without treatment, severe hip conditions can worsen over time, leading to:

• Increased pain and stiffness, making walking or movement difficult.
• Joint deformity, which may affect posture and mobility.
• Loss of independence, as simple tasks like dressing, climbing stairs, or getting in and out of a chair become challenging.

Hip replacement surgery can provide long-lasting pain relief and restore mobility, improving overall quality of life.

How is Hip Replacement Surgery Performed?

Hip replacement surgery is a well-established procedure that typically takes one to two hours and is performed under general or spinal anaesthesia. The goal is to remove the damaged joint and replace it with a prosthetic implant that restores normal movement.

1. Pre-Surgery Preparation

Before the procedure, patients may need:

• A medical evaluation, including blood tests and imaging (X-rays or MRI) to assess hip damage.
• Temporary adjustments to medications, especially blood thinners, to reduce bleeding risk.
• Preoperative physical therapy to strengthen muscles around the hip.
• Fasting for several hours before surgery, as advised by the medical team.

2. During the Procedure

Hip replacement surgery can be performed using different techniques, including:

Traditional Hip Replacement

• A larger incision is made on the side or back of the hip.
• The damaged bone and cartilage are removed.
• The hip socket is reshaped, and the artificial components (metal, plastic, or ceramic) are implanted.

Minimally Invasive Hip Replacement

• Uses smaller incisions, leading to less muscle disruption and quicker recovery.
• Not suitable for all patients – your surgeon will determine the best approach.

The prosthetic hip consists of:

• A metal or ceramic ball, which replaces the femoral head.
• A plastic, metal, or ceramic socket, which replaces the hip joint.

3. Post-Procedure Care

• A drain or catheter may be placed to remove excess fluid from the surgical site.
• Patients are moved to a recovery area for monitoring as the anaesthesia wears off.
• Physical therapy begins within 24 hours to encourage movement and prevent stiffness.

Most patients stay in the hospital for one to three days, depending on their progress.

Recovery & Rehabilitation from Hip Replacement Surgery

Recovery from hip replacement surgery varies by individual, but most patients experience significant pain relief and improved mobility within a few weeks. A structured rehabilitation plan is key to ensuring a smooth recovery.

1. Immediate Post-Surgery Recovery

• Most patients stay in the hospital for one to three days for monitoring.
• Pain and swelling are managed with medications and ice therapy.
• Walking begins within 24 hours with the help of a physiotherapist and mobility aids (walker or crutches).
• A urinary catheter may be used temporarily, especially after spinal anaesthesia.

2. At-Home Recovery

• Mobility aids (walker, cane, or crutches) may be needed for the first few weeks.
• Physical therapy exercises help restore strength and flexibility.
• Daily activities like sitting, standing, and climbing stairs should be done with care to avoid straining the new joint.
• Patients are advised to sleep on their back with a pillow between their legs to prevent dislocation.

3. Long-Term Recovery Timeline

• 6 to 12 weeks – Most patients can resume normal daily activities with minimal discomfort.
• 3 to 6 months – The majority regain full mobility and strength.
• 12 months and beyond – The hip continues to heal, and function improves further.

4. Returning to Normal Activities

• Driving – Usually possible within 4 to 6 weeks, depending on mobility and pain levels.
• Work – Sedentary jobs may be resumed in 4 to 6 weeks, while physically demanding jobs may require 3 months or more.
• Exercise – Low-impact activities like walking, swimming, and cycling are encouraged, but high-impact sports should be avoided.

A successful recovery depends on following post-operative guidelines, staying active, and attending follow-up appointments with the surgeon.

Risks & Potential Complications

Hip replacement surgery is a highly successful procedure, but like any surgery, it carries some risks. Advances in surgical techniques and implant materials have reduced complications, but it’s important to be aware of potential issues.

1. Common Side Effects

These are typically mild and improve as recovery progresses:

• Pain and swelling around the surgical site, managed with medication and ice therapy.
• Temporary stiffness in the hip, improving with physical therapy.
• Leg length discrepancy, which may require physical therapy or shoe inserts for balance.

2. Less Common but Possible Complications

While rare, some patients may experience:

• Blood clots (Deep Vein Thrombosis – DVT) – Blood thinners and early movement help reduce this risk.
• Infection – Symptoms include redness, swelling, and fever; severe cases may require antibiotics or implant revision.
• Hip dislocation – Avoiding certain movements (e.g., crossing legs, bending past 90 degrees) helps prevent this.
• Nerve or blood vessel injury – Rare but possible, leading to numbness or weakness.
• Implant loosening or wear – Over time, the implant may wear down, potentially requiring revision surgery.

3. How Risks Are Managed

• Blood clot prevention – Patients are encouraged to move early, take blood-thinning medication, and wear compression stockings.
• Infection control – Surgeons use sterile techniques, and antibiotics are given before and after surgery.
• Follow-up care – Regular check-ups monitor healing and ensure the implant remains in good condition.

Most complications are preventable and treatable, and the majority of hip replacements last 15-20 years or longer with proper care.