Hip replacement

A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant).

Adults of any age can be considered for a hip replacement, although most are done on people between the ages of 60 and 80.

A modern artificial hip joint is designed to last for at least 15 years. Most people have a significant reduction in pain and improvement in their range of movement.

When a hip replacement is needed

Hip replacement surgery is usually necessary when the hip joint is worn or damaged so that your mobility is reduced and you are in pain even while resting.

The most common reason for hip replacement surgery is osteoarthritis. Other conditions that can cause hip joint damage include:

Who is offered hip replacement surgery

A hip replacement is major surgery, so it is usually only recommended if other treatments, such as physiotherapy or steroid injections, have not helped 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 cannot work or have a social life

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

How hip replacement surgery is performed

A hip replacement can be done under a general anaesthetic (where you're asleep during the operation) or under a spinal anaesthetic (where you're awake but have no feeling from the waist down).

Sometimes you may have an epidural, which is similar to a spinal anaesthetic.

The surgeon makes a cut (incision) into the hip, removes the damaged hip joint and replaces it with an artificial joint or implant.

The surgery usually takes around 1 to 2 hours to complete.

Find out more about how a hip replacement is done.

Hip resurfacing

Hip resurfacing is an alternative type of operation. This involves removing the damaged surfaces of the bones inside the hip joint and replacing them with a metal surface.

This type of operation removes less bone. However, it is usually only done on men who are very active and have larger hips.

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

Preparing for hip replacement surgery

Before you go into hospital, find out as much as you can about what's involved in your operation. Your hospital should provide written information or videos.

Stay as active as you can. Strengthening the muscles around your hip will help your recovery. If you can, continue to do gentle exercise, such as walking and swimming, in the weeks and months before your operation.

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

Your hospital may offer an enhanced recovery programme. This rehabilitation programme aims to get you back to full health quickly after major surgery.

Find out more about preparing for surgery, including information on travel arrangements, what to bring with you and attending a pre-operative assessment.

Recovering from hip replacement surgery

You'll usually be in hospital for 3 to 5 days, but recovery time can vary.

Once you're ready to be discharged, your hospital will give you advice about looking after your hip at home. You'll need to use a frame or crutches at first and a physiotherapist will teach you exercises to help strengthen your hip muscles.

An occupational therapist will check if you need any equipment to help you manage at home.

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

It's usually possible to return to light activities or office-based work within around 6 weeks. However, everyone recovers differently and it's best to speak to your doctor or physiotherapist about when to return to normal activities.

Find out more about recovering from hip replacement surgery.

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
  • DVT (deep vein thrombosis)
  • a fracture in the bone around the hip replacement during or after the operation
  • differences in leg length

However, the risk of serious complications is low.

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 require revision surgery to repair or replace the joint.

Find out more about the risks of a hip replacement.

Metal-on-metal implants

There have been cases of some metal-on-metal (MoM) hip replacements wearing out sooner than expected, causing deterioration in the bone and tissue around the hip. There are also concerns that they could leak traces of metal into the blood.

The Medicines and Healthcare products Regulatory Agency (MHRA) has issued updated guidelines that certain types of MoM devices should be checked every year while the implant is in place. This is so any potential complications can be found early.

MoM hip replacements are rarely used now. But if you're concerned about your hip replacement, contact your 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.

Get more advice about a metal-on-metal implant.

The National Joint Registry

The National Joint Registry (NJR) collects details of hip replacements done in England, Wales, Northern Ireland and the Isle of Man. Although it's voluntary, it's worth registering. This enables the NJR to monitor hip replacements, so you can be identified if any problems emerge in the future.

The registry also gives you the chance to participate in a patient feedback survey.

It's confidential and you have a right under the Data Protection Act to see what details are kept about you.