Hip replacement overview

Overview

A hip replacement is a surgery where a damaged hip joint is removed and replaced with an artificial one. The artificial joint is made of metal, plastic, or ceramic parts that work like a normal hip. This surgery can help relieve pain and improve your ability to walk and move.

Yes, hip replacement is a common operation. In the UK, around 90,000 hip replacements are done each year. It is most often performed on people over 60, but younger people with severe hip damage may also benefit.

Hip replacement is most common in older adults with osteoarthritis. However, it can also be needed by younger adults who have had a hip injury, or people with other conditions like rheumatoid arthritis or avascular necrosis (when the bone tissue dies due to lack of blood supply).

Symptoms

Common symptoms

• Persistent hip pain that does not go away with rest or pain relievers
• Stiffness in the hip that makes it hard to put on shoes or socks
• Difficulty walking or climbing stairs
• Pain that wakes you up at night

Symptoms in children

• Hip replacement is rarely done in children. If a child has severe hip problems, symptoms may include limping, hip pain, or trouble keeping up with peers during physical activities.

Symptoms in older adults

• Older adults may have hip pain that gets worse with activity and improves with rest. They might also find it harder to get up from a chair or walk short distances without pain.

Causes

Main causes

• Osteoarthritis – the most common cause, where the protective cartilage in the hip joint wears down over time
• Rheumatoid arthritis – an autoimmune disease that causes joint inflammation and damage
• Post-traumatic arthritis – arthritis that develops after a hip fracture or other injury
• Avascular necrosis – loss of blood flow to the hip bone, causing the bone to collapse

Risk factors

• Age – risk increases as you get older
• Family history – some forms of arthritis run in families
• Previous hip injury or fracture
• Being overweight – extra weight puts more strain on the hip joint
• Certain medical conditions, such as rheumatoid arthritis or lupus

When to see a doctor

See a doctor urgently if:

• You have sudden severe hip pain and cannot put any weight on your leg.
• Your hip looks deformed or out of place after a fall.
• You have hip pain along with a fever, chills, or redness and swelling around the joint.

Book a routine appointment if:

• You have hip pain that has lasted more than a few weeks and does not improve with rest or over-the-counter pain relief (like paracetamol).
• Your hip stiffness or pain makes it hard to do everyday activities like walking, shopping, or housework.

Diagnosis

Your doctor will start by asking about your symptoms and medical history. They will also examine your hip, checking for pain, stiffness, and range of motion. If they suspect a problem with the joint, they will refer you for imaging tests.

Tests that may be done

• X-rays – to see the bones of the hip joint and check for arthritis or fractures
• MRI scan – gives a detailed picture of the soft tissues, such as cartilage and tendons
• Blood tests – to look for signs of infection or inflammatory conditions like rheumatoid arthritis

What to expect at your appointment

If you need a hip replacement, you will have a consultation with an orthopaedic surgeon (a bone and joint specialist). They will explain the procedure, risks, benefits, and recovery. You will also have a preoperative assessment, which may include blood tests, an ECG (heart test), and a check of your general health.

Treatment

Treatment for hip problems often starts with non-surgical options. Surgery is considered when these options no longer control pain or help you function. Hip replacement is a major operation, but it can greatly improve quality of life.

Self-care at home

• Gentle exercise such as swimming or walking to maintain joint mobility and strengthen muscles around the hip
• Using a cane or walking frame to reduce weight on the sore hip
• Applying heat or cold packs to ease pain and stiffness
• Losing weight if you are overweight to reduce pressure on the hip

Medical treatments

Your doctor may recommend pain relievers such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) to help manage pain and swelling. They may also suggest physiotherapy to improve strength and flexibility. In some cases, corticosteroid injections into the joint can provide short-term pain relief. Always discuss these options with your healthcare provider – do not take any new medication without talking to them first.

When is surgery considered?

Surgery is usually recommended when your hip pain severely limits your daily activities, such as walking, dressing, or sleeping, and other treatments have not helped. Your surgeon will also consider your age, overall health, and the severity of joint damage before deciding if a hip replacement is right for you.

Living with this condition

After a hip replacement, you will need to take it easy for a few weeks. You will likely use a walking frame or crutches at first. Most people can return to light daily activities within 4 to 6 weeks. Full recovery may take several months. You will need to avoid certain movements, like crossing your legs or bending your hip past 90 degrees, to reduce the risk of dislocation.

Lifestyle tips

• Follow your physiotherapist’s exercises to regain strength and movement
• Avoid high-impact activities like running or jumping; low-impact activities like walking, swimming, and cycling are encouraged
• Sleep with a pillow between your legs to keep your hip in a safe position
• Make your home safer – remove loose rugs, arrange furniture so you have clear pathways, and use a raised toilet seat if needed

Diet and exercise

Eating a balanced diet rich in calcium and vitamin D can help your bones heal. Protein-rich foods like eggs, fish, and beans support muscle recovery. Regular, gentle exercise as advised by your physiotherapist will help you regain mobility and strength without putting too much strain on the new joint.

Mental health and emotional wellbeing

Recovering from a hip replacement can be frustrating, especially if you are used to being active. You may feel sad or anxious about the slow progress. These feelings are normal. Talk to your healthcare team or a counsellor if you feel overwhelmed. Support from family and friends can also make a big difference.

Prevention

You cannot always prevent the arthritis or injury that leads to needing a hip replacement. However, maintaining a healthy weight, staying physically active, and protecting your joints from injury may lower your risk or delay the need for surgery.

Complications

If left untreated

• Chronic pain that limits your ability to walk or do daily tasks
• Worsening joint damage and stiffness
• Muscle weakness in the leg because you use it less due to pain
• Increased risk of falls due to poor mobility

Long-term outlook

Most people who have a hip replacement experience a dramatic improvement in pain, mobility, and quality of life. The surgery is very safe, and serious complications are rare. With proper recovery and lifestyle adjustments, you can expect to return to most of your usual activities and enjoy many years with your new hip.

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