A total hip replacement (total hip arthroplasty) is an operation to replace the worn ball-and-socket joint of the hip with artificial components. It is one of the most reliable and effective operations in modern medicine, performed on tens of thousands of patients in the UK each year.
The surgeon makes an incision over the side or front of the hip. The damaged ball (femoral head) is removed and the socket (acetabulum) is prepared. An artificial socket made of metal and a plastic or ceramic liner is fixed into the pelvis, and a new ball on a metal stem is inserted into the thighbone (femur). These components may be cemented, uncemented (press-fit), or a combination of both. The operation usually takes between one and two hours.
Hip replacement is recommended when hip arthritis or a hip fracture causes significant pain, stiffness, and limitation of daily activities. It is considered when non-operative treatments have not provided sufficient relief.
Physiotherapy and structured exercise, weight loss if appropriate, oral pain medication, walking aids, activity modification, and hip injections. These can be effective for many patients and are worth discussing fully with your clinician.
A pre-operative assessment includes blood tests, heart tracing, and medication review. If you take blood-thinning medication, you may need to stop this before surgery. Maintaining a healthy weight, staying active, and optimising medical conditions before the operation supports a smoother recovery.
The aim is to relieve hip pain, restore mobility, and allow a return to normal daily activities. The vast majority of patients experience dramatic improvement in pain and quality of life. Modern hip replacements typically last 20 years or more.
A slight difference in leg lengths after surgery is relatively common, though usually minor.
Expected around the wound in the early weeks.
Occurs in a small percentage of cases, usually manageable with antibiotics.
Possible despite preventive measures including medication and stockings.
The ball coming out of the socket. Occurs in roughly 1–2% of patients, more likely in the first few weeks.
Approximately 1 in 100. May require further surgery or prolonged antibiotics.
Rare but can cause weakness or numbness.
Fracture of the femur during or after surgery.
Unwanted bone formation around the joint.
A blood clot travelling to the lungs. Rare but serious.
Commonly performed under spinal anaesthesia with sedation, or under general anaesthesia. Your anaesthetist will discuss the best approach. Regional nerve blocks may assist with pain management.
Most patients are mobilised on the day of surgery. Hospital stays are typically one to three days. Crutches or a walking stick are used for several weeks. Driving is usually possible at around six weeks. Many patients return to low-impact activities within three to six months. Full recovery may take up to a year.
Typically reviewed at two weeks, six weeks, three months, and one year. X-rays are taken to monitor the implant.
Modern hip replacements are expected to last 20 years or more for most patients.
Your surgeon may advise specific precautions depending on the surgical approach. These are usually relaxed after six to twelve weeks.
Low-impact activities such as swimming, cycling, and golf are generally encouraged. High-impact sports are usually discouraged.
Not necessarily. If both hips are affected, the second replacement is usually planned after recovery from the first.