How A Hip Replacement Is Done

Overview

A hip replacement is an operation to replace a worn or damaged hip joint with an artificial joint, called an implant or prosthesis. The hip is a ball-and-socket joint: the top of the thigh bone (femur) is the ball, and it sits in a socket in your pelvis. When the surfaces of this joint are damaged, moving can become very painful and stiff. During the operation, the surgeon removes the damaged parts and fits new ones made from materials such as metal, ceramic, or strong plastic.

Yes. Hip replacement is one of the most common operations worldwide, and hundreds of thousands are done each year.

It is most often done for people in their 60s to 80s whose hip joint has worn away, usually from osteoarthritis. Younger adults sometimes need it too, for example after a hip injury or because of conditions such as hip dysplasia or inflammatory arthritis.

Symptoms

Common symptoms

• Hip pain that is worse with walking, standing, or going up stairs
• Stiffness that makes it hard to put on socks or shoes, or to get in and out of a car
• Pain that carries on at rest or at night
• A limp or a feeling that the hip cannot take your weight
• Less ability to walk distances or do everyday activities

Causes

Main causes

• Osteoarthritis — the smooth cartilage that lines the joint wears away over time.
• Rheumatoid arthritis and other inflammatory joint diseases.
• A hip fracture, especially in older adults with thin bones.
• Avascular necrosis — when the blood supply to the ball of the hip is damaged and the bone dies.
• Hip dysplasia — when the hip socket is too shallow and the joint wears out early.
• Damage from a previous injury or from conditions such as childhood hip disease.

Risk factors

• Older age
• Being overweight, which puts extra load on the hip
• A family history of hip problems
• Previous hip injury or surgery
• Jobs or sports that involve heavy loading or repeated impact on the hip
• Conditions such as inflammatory arthritis or weak bones
• Some rare conditions that affect bone growth or blood supply to the hip

When to see a doctor

See a doctor urgently if:

• Fever, chills, or a wound that is hot, red, swollen, or leaking pus after surgery
• Calf pain, swelling, or redness that is getting worse
• A hip that suddenly gives way, or a leg that looks twisted or shorter
• Chest pain or sudden shortness of breath — call your local emergency number

Book a routine appointment if:

• Hip pain or stiffness that is limiting your walking, sleep, work, or daily activities
• A limp or pain that does not improve with rest and simple pain relief
• You want to discuss whether surgery is an option for you
• You are finding it harder to manage at home because of hip pain

Diagnosis

Your doctor will ask about your pain, how it affects your walking and daily life, and your medical history. They will examine your hip and watch you walk. Imaging tests show how much the joint has worn and help decide whether surgery is likely to help.

Tests that may be done

• X-rays of the hip
• Blood tests to check for inflammation or infection
• MRI or CT scans in some cases
• A review of your general health before surgery, such as heart and lung checks

What to expect at your appointment

You may be referred to an orthopaedic surgeon, a doctor who specialises in bones and joints. They will explain the benefits and risks and what recovery involves. You may also have a pre-operative assessment to make sure you are fit for surgery.

Treatment

Treatment starts with simpler options such as activity changes, physiotherapy, walking aids, and pain relief. If these no longer control pain and daily life is badly affected, hip replacement may be considered. The operation is usually done under spinal or general anaesthetic, and you will be given medicine to keep you comfortable.

Self-care at home

• Stay active with gentle exercise such as walking, swimming, or cycling
• Keep to a healthy weight
• Use a stick or cane if it helps
• Do strength and stretching exercises for the hip and thigh muscles
• Make your home safer to reduce falls
• Pace activities and use aids for dressing and household tasks

Medical treatments

Doctors may suggest pain-relieving medicines and anti-inflammatory medicines, given by mouth, as a cream or gel, or occasionally as an injection into the joint. These can ease pain but do not repair the joint. Physiotherapy can strengthen muscles and improve movement. Walking aids and shoe inserts can help. Your doctor will discuss which options suit you, and you should not start or stop medicines without advice.

When is surgery considered?

Surgery may be offered when hip pain and stiffness seriously affect your sleep, walking, work, or daily life, and other treatments have not helped enough. Your surgeon will consider your general health, your weight, whether you smoke, and other conditions. There is no single right time; it is a shared decision.

Living with this condition

You will usually be in hospital for a few days. You will be encouraged to get up and walk with help soon after the operation. You will be given exercises and advice on how to move safely, such as avoiding deep bending or twisting for a few weeks. Most people use a frame, crutches, or sticks for a while. Recovery takes time; many people feel a big difference by 3 to 6 months, and the joint can keep improving for up to a year.

Lifestyle tips

• Follow your physiotherapy plan
• Build activity gradually
• Avoid heavy lifting and twisting early on
• Keep your wound clean and dry as advised
• Attend follow-up appointments
• Stop smoking if you smoke — it helps healing
• Plan for help at home for the first weeks

Diet and exercise

Eat a balanced diet with enough protein, calcium, and vitamin D to help healing and bone strength. Gentle exercise and walking are encouraged; your physiotherapist will guide you on what is safe and when. Avoid high-impact activities in the early months.

Mental health and emotional wellbeing

It is common to feel anxious before surgery or frustrated during recovery. Sleep problems, pain, and relying on others can affect mood. Talk to your doctor or nurse if you feel low, worried, or overwhelmed. If you ever have thoughts of harming yourself, contact your local emergency number or a crisis helpline straight away.

Prevention

Not all hip damage can be prevented, but you can lower your risk. Keep active, stay at a healthy weight, strengthen your hip and leg muscles, and reduce the chance of falls and injuries. If you have hip pain, getting advice early can help you manage it.

Vaccines

There is no vaccine for hip arthritis. Before surgery, your team may check that your routine vaccinations are up to date and talk to you about any vaccines that are recommended for you.

Screening programmes

There is no routine screening test for hip arthritis. If you have ongoing hip pain or stiffness, see your doctor.

Complications

If left untreated

• Pain and stiffness that get worse over time
• Losing the ability to walk longer distances or manage stairs
• More risk of falls and injuries
• Strain on other joints, such as the knee or lower back
• Low mood, poor sleep, and less social contact because of pain

Long-term outlook

Hip replacement is a very common and generally successful operation. Most people get much less pain and can walk and do daily activities more easily. Recovery takes weeks to months, and some people need help and patience along the way. Your healthcare team will support you through it.

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