Total Hip Replacement.

Procedure overview

The damaged joint surfaces are removed and replaced with a precision prosthesis. Most procedures take around 90 minutes; either spinal or general anaesthesia is used, often with a regional nerve block to assist post-operative pain control.

You will typically stand the same day as surgery. Hospital stay is two to three nights for a traditional approach and one to two nights for an anterior approach. Crutches are needed for two to four weeks, with most patients fully recovered by six weeks.

Conditions treated

• Hip arthritis — osteoarthritis, inflammatory arthritis, post-traumatic arthritis
• Advanced avascular necrosis with bone collapse
• Selected hip fractures of the femoral head/neck
• Complex hip dysplasia in adulthood

Surgical approaches

Three approaches are used in modern hip replacement, each chosen for specific patient anatomy and clinical considerations:

Posterior

The classical approach. Highly reliable; suits most patients and most anatomies.

Direct superior

A muscle-sparing modification of the posterior approach with a smaller incision.

Anterior

Through the front of the thigh, passing between muscles without cutting tendons — see Anterior Approach Hip Replacement.

Implant types

Modern hip implants consist of a femoral stem, an acetabular cup, a socket liner (highly cross-linked polyethylene or ceramic), and a femoral head (ceramic or metal). Fixation can be cemented or cementless depending on bone quality.

Implant longevity

Independent registry data: more than 90% of modern hip replacements last at least 10 years, and more than 70% last at least 20 years.

Pre-surgery preparation

Optimising your health in the weeks before surgery measurably improves your recovery and reduces complication rates:

• Smoking — stop at least 8 weeks before surgery if possible
• Diabetes control — HbA1c ideally below 7.5%
• Weight — even modest weight loss reduces implant stress and infection risk
• Dental hygiene — resolve any active dental infection prior to surgery

You will receive a pre-admission pack to complete at least a week before surgery, plus an anaesthetic questionnaire. See the Planning For Surgery page.

Recovery timeline

• Day 0 — out of bed, standing same day
• Day 1–3 — discharge from hospital
• Week 2 — wound check, stitches reviewed
• Week 2–4 — crutches gradually reduced
• Week 6 — return to driving (for most patients)
• Month 3–6 — full functional recovery

Surgical risks

Hip replacement is one of the most successful operations in modern surgery, but no procedure is without risk. The principal risks include:

• Infection (low single-digit percent)
• Dislocation (1% in posterior approach, 0.2–0.5% in anterior approach)
• Deep vein thrombosis / pulmonary embolism — preventive measures reduce risk substantially
• Leg length discrepancy
• Periprosthetic fracture
• Nerve injury
• Cardiac and anaesthetic events

Activity guidance

Driving returns at around six weeks. Office work can resume from four to six weeks; manual work takes longer. Air travel should be deferred for six weeks (DVT risk). Modern implants can trigger airport metal detectors — carry a notification card.