Hip Replacement

The hip is a ball-and-socket joint where the rounded head of the thigh bone sits in a cup in the pelvis, cushioned by smooth cartilage. When that cartilage wears away, the bones grind together, causing pain, stiffness and loss of movement. Total hip arthroplasty, commonly called total hip replacement, removes the damaged ball and resurfaces the worn socket, then fits an artificial joint that recreates the natural shape and glide of a healthy hip. The implant has a stem that anchors into the thigh bone and a cup that seats into the pelvis, made from durable, body-compatible metals such as titanium, while the bearing surfaces that move against each other are made of hard-wearing ceramic, polyethylene or metal. The result is a smooth, stable, pain-free joint built to last for many years.

Hip replacement is recommended when a damaged hip causes pain and disability that no longer respond to non-surgical care such as medication, weight management, physiotherapy, a cane or joint injections. The most common reason is osteoarthritis, the age-related wearing of the joint, but it is also used for rheumatoid and other inflammatory arthritis, for avascular necrosis where the bone of the femoral head loses its blood supply and collapses, for developmental hip dysplasia, for the after-effects of childhood hip conditions, for some hip fractures and for damage left by tumours. There is no fixed upper age limit, and what matters is the severity of the symptoms and the overall health of the patient. In conditions such as dysplasia or avascular necrosis it can give a definitive, pain-relieving result even in younger adults.

The operation is performed under general anaesthesia or with the patient awake under spinal anaesthesia, and the choice is made with the anaesthetist after a pre-operative review. Through an incision over the hip, the surgeon removes the worn ball of the thigh bone and prepares the socket, then fixes the new cup into the pelvis and the stem into the thigh bone, either press-fitted so bone grows onto it or secured with bone cement. A new ball is placed on the stem and set into the cup, the hip is tested for smooth, stable movement, and the muscle, soft tissue and skin are closed in layers. The operation usually takes about 1 to 2 hours. Before surgery, blood tests and an anaesthetic assessment confirm fitness, any active infection elsewhere in the body is treated first, and conditions such as diabetes and high blood pressure are brought under good control.

A good candidate has a hip damaged enough to limit daily life despite non-surgical treatment, and is in a general state of health that allows safe anaesthesia and recovery. Preparation includes blood tests, imaging of the hip, an electrocardiogram where appropriate and a review of all regular medicines, with blood thinners adjusted on medical advice. Diabetes and blood pressure are optimised, and stopping smoking is strongly encouraged because it raises the risk of wound and implant infection. The procedure is generally not advisable while there is an active infection in the hip, and it is approached with extra care in people with severe circulation problems or muscle weakness around the hip from neurological disease. For international patients, much of the assessment can begin with reports reviewed before travel, with the final examination and planning completed in person on arrival.

Recovery is active and begins quickly. Patients are usually helped to stand and take their first assisted steps within a day of surgery, using a walker or crutches, and a physiotherapist guides safe movement, gentle exercises and the precautions that protect the new joint. Most people stay in hospital about 3 to 5 nights, then continue rehabilitation as the wound heals and walking improves. When planning a trip abroad, it is sensible to allow about 10 to 14 days in the destination city so the wound can be checked, stitches or clips removed, walking confidently established and a clear home exercise plan provided before flying. Because long flights and immobility raise the risk of blood clots, the team advises on timing, blood-thinning measures, compression stockings and moving regularly in the cabin. After returning home, follow-up continues remotely by message or video, with interpreters and coordinators on hand, and routine wound care can be done by a clinician near home.

Performed by an experienced surgeon in a well-equipped centre, hip replacement is a safe and highly reliable operation with excellent long-term results, though like any major surgery it carries some risk. Expected early effects such as pain, swelling and bruising settle steadily with medication and rehabilitation. Less common risks include infection, blood clots in the leg or lung, dislocation of the new joint, a small difference in leg length, loosening or wear of the implant over many years, or injury to nearby nerves or blood vessels; careful surgery, early movement and clot-prevention measures keep these uncommon. Modern implants are designed to last for many years, and most patients enjoy lasting relief from pain, a corrected limp and a return to comfortable walking and daily activity. Choosing a qualified surgeon, a properly equipped centre and quality implants, and following the rehabilitation plan closely, are the keys to a safe experience and a durable result.