A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as a prosthesis). Adults of any age can be considered for a hip replacement, although most are carried out on people between the ages of 60 and 80.A modern artificial hip joint is designed to last for at least 15 years. Most people experience a significant reduction in pain and some improvement in their range of movement.
When a hip replacement is needed
Hip replacement surgery is usually necessary when the hip joint is worn or damaged to the extent that your mobility is reduced and you experience pain even while resting.
The most common reason for hip replacement surgery is osteoarthritis. Other conditions that can cause hip joint damage include:
- rheumatoid arthritis
- a hip fracture
- septic arthritis
- ankylosing spondylitis
- disorders that cause unusual bone growth (bone dysplasias)
Who is offered hip replacement surgery
A hip replacement is major surgery, so is normally only recommended if other treatments, such as physiotherapy or steroid injections, haven’t helped reduce pain or improve mobility.
You may be offered hip replacement surgery if:
- you have severe pain, swelling and stiffness in your hip joint and your mobility is reduced
- your hip pain is so severe that it interferes with your quality of life and sleep
- everyday tasks, such as shopping or getting out of the bath, are difficult or impossible
- you’re feeling depressed because of the pain and lack of mobility
- you can’t work or have a normal social life
You’ll also need to be well enough to cope with both a major operation and the rehabilitation afterwards.
How hip replacement surgery is performed
A hip replacement can be carried out under a general anaesthetic (where you’re asleep during the procedure) or an epidural (where the lower body is numbed).
The surgeon makes an incision into the hip, removes the damaged hip joint and replaces it with an artificial joint made of a metal alloy or, in some cases, ceramic.
The surgery usually takes around 60-90 minutes to complete.
There is an alternative type of surgery to hip replacement, known as hip resurfacing. This involves removing the damaged surfaces of the bones inside the hip joint and replacing them with a metal surface.
An advantage to this approach is that it removes less bone. However, it may not be suitable for:
- adults over the age of 65 years – bones tend to weaken as a person becomes older
- women who have gone through the menopause – one of the side effects of the menopause is that the bones can become weakened and brittle (osteoporosis)
Resurfacing is much less popular now due to concerns about the metal surface causing damage to soft tissues around the hip.
Your surgeon should be able to tell you if you could be a suitable candidate for hip resurfacing.
Preparing for hip replacement surgery
Before you go into hospital, find out as much as you can about what’s involved in your operation. Your hospital should provide written information or videos.
Stay as active as you can. Strengthening the muscles around your hip will aid your recovery. If you can, continue to take gentle exercise, such as walking and swimming, in the weeks and months before your operation.
You may be referred to a physiotherapist, who will give you helpful exercises.
Read about preparing for surgery, including information on travel arrangements, what to bring with you and attending a pre-operative assessment.
Recovering from hip replacement surgery
The rehabilitation process after surgery can be a demanding time and requires commitment.
For the first four to six weeks after the operation you’ll need a walking aid, such as crutches, to help support you.
You may also be enrolled on an exercise programme that’s designed to help you regain and then improve the use of your new hip joint.
Most people are able to resume normal activities within two to three months but it can take up to a year before you experience the full benefits of your new hip.