What is total hip replacement?
Total hip replacement—also called total hip arthroplasty—replaces both sides of the ball-and-socket joint. The damaged femoral head is removed and replaced by a ball on a stem inside the thigh bone. The worn socket is prepared for a cup and liner. The components may be metal, ceramic and highly durable plastic in different combinations.
The main aim is to reduce pain and improve ordinary function when the natural joint is badly damaged. It does not create a normal young hip, and the implant still needs long-term protection and follow-up.
An X-ray can show arthritis, deformity or collapse, but surgery is normally considered only when the findings fit the pain, stiffness and loss of function and reasonable non-surgical options are no longer adequate.
Who may be considered?
A hip surgeon may discuss replacement for severe osteoarthritis, inflammatory arthritis, post-traumatic damage, osteonecrosis or selected fractures and childhood hip disorders that have led to joint destruction. Common features include:.
- Groin, thigh or buttock pain that substantially limits walking, sleep or daily activities.
- Stiffness that makes dressing, stairs, transfers or getting into a vehicle difficult.
- Imaging that shows advanced damage matching the symptoms.
- Insufficient relief from medication, activity changes, walking aids, injections or physiotherapy where appropriate.
- Medical fitness for anaesthesia, clot prevention and rehabilitation.
What the hospital usually reviews
Recent standing pelvis and hip X-rays are the usual starting point. CT or MRI may be requested for complex anatomy, bone loss, previous surgery, suspected osteonecrosis or another diagnosis. The team also reviews heart and lung health, diabetes control, medication, skin and dental infections, anaesthetic history and the support available after discharge.
Key points for this treatment
How the operation works
Under spinal or general anaesthesia, the surgeon reaches the joint through an anterior, lateral or posterior route. Damaged bone and cartilage are removed, the socket is prepared for a cup and liner, and a stem with a new ball is placed in the femur. Trial components help the surgeon check stability, movement and leg length before the final implants are secured and the wound is closed.
Cemented or press-fit fixation
A stem or cup may be fixed with bone cement or designed for bone to grow onto a porous surface. Bone quality, age, anatomy and surgeon judgement guide the choice. A hybrid combination may also be used. The best option is the one appropriate to the individual—not automatically the newest or most expensive implant.
Surgical approach and technology
The approach describes the route through the soft tissues; it is not a different replacement. Some hospitals also use navigation or robotic assistance for planning and component positioning. These tools do not replace the surgeon, and their availability alone should not determine where or whether to have surgery.
Hospital stay and recovery
Pain control, wound care, clot prevention and mobilisation begin in hospital. Many patients start walking with a frame or crutches soon after surgery. NHS guidance gives a general discharge range of about one to three days for a straightforward replacement, but age, medical conditions, home support and complications can change this.
Precautions for bending, sleeping and sitting vary with the approach and patient. Long-haul flying adds immobility and clot considerations, so international travel should be cleared by the surgeon before tickets are booked. Confirm who will remove sutures, manage medication and provide follow-up after returning home.
Risks and later considerations
Important risks include infection, blood clots, bleeding, anaesthetic or medical complications, dislocation, fracture, nerve or blood-vessel injury, leg-length difference, persistent pain, implant wear and loosening. A fall in the early recovery period can damage the new joint.
Modern hip replacements can function for many years, but no implant lasts forever. High-impact activity, infection, fracture or wear can lead to later revision. Regular low-impact exercise and follow-up should be discussed with the treating team.
Sudden chest pain or breathlessness, increasing calf swelling, fever, wound drainage, rapidly worsening hip pain or inability to bear weight requires urgent assessment.