Hip Replacement Surgery
Hip Replacement Surgery (Total Hip Replacement)
A total hip replacement (THR) is a common operation performed to relieve pain and improve mobility when the hip joint has become severely damaged.
For many people, hip replacement surgery significantly improves quality of life by reducing pain and allowing them to return to everyday activities.
What is a Total Hip Replacement?
A total hip replacement involves replacing the damaged hip joint with artificial components.
During the operation:
- The damaged femoral head (ball) is removed and replaced with an artificial ball.
- A new cup is inserted into the hip socket (acetabulum).
- Together these create a new smooth, weight-bearing joint surface.
Several different implant materials and fixation methods are available. Your orthopaedic surgeon will recommend the most appropriate option based on factors such as:
- Your age
- General health
- Activity level
- Severity of arthritis or joint damage
- Bone quality
Why Might I Need a Hip Replacement?
Hip replacement surgery is most commonly recommended when the hip becomes too painful or stiff to function normally.
Common reasons include:
- Osteoarthritis
- Rheumatoid arthritis
- Other inflammatory arthritis
- Hip fractures
- Severe joint damage
Typical symptoms include:
- Persistent hip pain
- Difficulty walking
- Reduced mobility
- Pain affecting sleep
- Difficulty with everyday activities such as climbing stairs or putting on shoes
Diagnosis is usually confirmed through:
- Clinical examination
- X-ray imaging
Occasionally, further scans may be required.
Do I Need Surgery?
Not everyone with arthritis requires a hip replacement.
Many people successfully manage their symptoms with conservative treatments, including:
- Physiotherapy
- Pain relief medication
- Activity modification
- Regular exercise
- Walking aids where appropriate
Some people may also benefit from a corticosteroid injection into the hip joint.
Your clinician will discuss all available treatment options and help you decide whether surgery is appropriate for you.
What Are the Risks?
Like all operations, hip replacement surgery carries some risks.
Serious complications are uncommon and occur in less than 1% of patients.
These include:
- Blood clots
- Infection
- Stroke
- Death (very rare)
More common complications include:
- Persistent pain following surgery
- Hip stiffness
- Dislocation
- Differences in leg length
- Loosening of the implant over time
Your surgeon will explain these risks fully before your operation to help you make an informed decision.
Where Will My Surgery Be Performed?
Hip replacements are performed at several hospitals across the region.
You may:
- Choose your preferred hospital through the NHS e-Referral Service.
- Request a particular consultant if you wish.
Your clinician can explain the referral process but cannot recommend a specific hospital or surgeon.
What Type of Anaesthetic Will I Have?
Many hip replacements are performed using a spinal (epidural) anaesthetic.
This numbs the body from the waist down while allowing you to remain awake.
A sedative is often given to help you relax during the procedure.
Benefits may include:
- Faster recovery
- Earlier mobilisation
- Reduced risks compared with a general anaesthetic
In some situations, a general anaesthetic may be recommended.
The most suitable option will be discussed between you, your surgeon and your anaesthetist.
How Long Will I Stay in Hospital?
Most people stay in hospital for 2–4 days.
Before going home you will usually need to:
- Walk safely with appropriate walking aids.
- Complete basic daily activities safely.
- Be medically fit for discharge.
- Receive advice from the physiotherapy and occupational therapy teams.
Recovery After Surgery
Recovering from a hip replacement takes time.
Although movement may be uncomfortable initially, early mobilisation is one of the most important parts of recovery.
Most people:
- Walk with assistance within the first day after surgery.
- Return to their pre-operative walking ability by approximately 6 weeks.
- Continue improving for up to 12 months.
Recovery varies between individuals, so always follow the advice of your surgical team.
Aftercare
During your hospital stay you will:
- Learn exercises to complete at home.
- Practise walking with mobility aids.
- Receive advice on safely returning to everyday activities.
Most patients do not require outpatient physiotherapy after discharge.
A follow-up appointment is usually arranged around 6 weeks after surgery.
Further physiotherapy can be organised if required.
Preparing for Your Operation
Keeping your muscles as strong as possible before surgery can make recovery easier.
Good activities include:
- Short walks
- Swimming
- Exercise bike
- Gentle strengthening exercises
Some discomfort during exercise is normal, but exercises should not cause severe pain.
Key Pre-Operative Exercises
Complete each exercise slowly and within a comfortable range.
Exercise 1 – Knee Extension
Sit comfortably in a chair.
Slowly straighten your knee before lowering it back down.
Repeat: 10 repetitions
Exercise 2 – Ankle Pumps
Sit comfortably in a chair.
Slowly bend and straighten your ankle.
Repeat: 10 repetitions
Exercise 3 – Side Leg Raise
Stand holding a stable surface for support.
Slowly lift one leg out to the side before returning to the starting position.
Repeat: 10 repetitions
Exercise 4 – Hip Extension
Stand holding a stable surface.
Slowly lift one leg backwards without leaning forwards.
Return slowly.
Repeat: 10 repetitions
Exercise 5 – Knee Raise
Stand holding a stable surface.
Lift one knee towards your chest before lowering it.
Repeat: 10 repetitions
Exercise 6 – Mini Squat
Stand holding onto a stable surface.
Slowly bend both knees into a comfortable squat before returning to standing.
Repeat: 10 repetitions
When Should You Seek Medical Advice?
Speak to your healthcare professional if you experience:
- Increasing hip pain while waiting for surgery.
- Difficulty walking safely.
- Sudden swelling in the leg.
- Fever or signs of infection.
- Any concerns about your planned surgery.
Key Points
- Hip replacement surgery replaces the damaged ball-and-socket joint with artificial components.
- Conservative treatments should usually be considered before surgery.
- Most people stay in hospital for 2–4 days.
- Walking begins soon after surgery and recovery continues for up to 12 months.
- Strengthening your muscles before surgery can help improve your recovery afterwards.
