Hip Replacement Surgery

Hip replacement surgery, also called hip arthroplasty, is a procedure in which damaged parts of the hip joint are replaced with artificial components. The hip is a ball-and-socket joint that supports body weight and allows movement during walking, sitting, and other daily activities.

When the cartilage and underlying bone become significantly damaged, movement may become painful and restricted. Depending on the condition, the surgeon may recommend replacing the femoral head and the socket or performing a partial replacement in selected cases.

The type of operation depends on the underlying diagnosis, the extent of joint damage, bone quality, age, activity level, and other individual factors.

Hip replacement may be discussed when symptoms significantly affect daily activities and appropriate non-surgical treatment has not provided adequate relief.

Reasons for assessment may include:

• Persistent hip or groin pain that interferes with walking or routine activities.
• Stiffness and reduced movement in the hip joint.
• Difficulty standing, climbing stairs, or putting on footwear.
• Pain that disturbs sleep or occurs during rest.
• Advanced joint damage associated with osteoarthritis or inflammatory arthritis.
• Avascular necrosis, in which the blood supply to part of the bone is reduced.
• Certain fractures or other conditions that cause substantial joint damage.

These symptoms do not automatically mean surgery is necessary. An orthopaedic specialist evaluates the cause of pain and considers appropriate treatment options before recommending an operation.

Assessment usually begins with a discussion of symptoms, their duration, previous treatments, medical history, and the effect of hip pain on daily life.

The examination may include an assessment of walking, joint movement, muscle strength, and pain. X-rays are commonly used to evaluate joint-space narrowing, bone changes, and the extent of damage. Additional investigations may be recommended when the diagnosis is unclear or another condition is suspected.

The decision to proceed with surgery is based on the combined clinical findings rather than an imaging result alone.

The appropriate procedure depends on the condition affecting the joint.

Total Hip Replacement

Total hip replacement involves replacing the damaged femoral head and the socket with artificial components. It may be considered when both parts of the joint are significantly affected.

Partial Hip Replacement

Partial hip replacement replaces the femoral head while retaining the natural socket. It may be suitable for selected patients, particularly in certain types of hip fracture.

Implant and Surgical Approach Selection

Implant materials, fixation methods, and surgical approaches vary according to the patient's anatomy, bone quality, diagnosis, and the surgeon's assessment. No single technique is appropriate for every patient.

The expected benefits, limitations, and risks of the recommended procedure should be discussed before treatment.

Before surgery, the medical team assesses the patient's general health, medications, anaesthesia requirements, and readiness for the procedure. The surgical plan is based on the clinical assessment and imaging.

During the operation, the damaged joint surfaces are prepared and the selected artificial components are positioned. The procedure may be performed under spinal or general anaesthesia, depending on the patient's condition and the anaesthesia team's recommendation.

After surgery, the team monitors pain, wound healing, circulation, and mobility. The timing of standing and walking depends on the procedure, the patient's condition, and the treating team's instructions.

Hip replacement is a major operation and carries risks. Potential complications include infection, blood clots, bleeding, dislocation, fracture, nerve or blood vessel injury, differences in leg length, implant loosening, and persistent pain.

Some patients may require further treatment or another operation if complications develop. Individual risks depend on factors such as general health, bone condition, the reason for surgery, and the type of procedure.

A preoperative consultation provides an opportunity to discuss personal risk factors, preventive measures, and alternative treatment options.

Not everyone with hip pain requires joint replacement. Depending on the diagnosis and severity, treatment may include activity modification, suitable pain-relief medication, physiotherapy, walking aids, and management of underlying medical conditions.

These measures may help manage symptoms, although they cannot reverse all forms of advanced joint damage. The choice of treatment should be based on an individual assessment and discussion of expected benefits and limitations.

People experiencing persistent hip pain can seek an orthopaedic evaluation to understand the cause of their symptoms and discuss suitable treatment options. At MAHI Hospitals, the assessment should consider the patient's medical history, physical examination, imaging findings, functional limitations, and overall health.

Where hip replacement is being considered, the treating orthopaedic team can explain the proposed procedure, alternative treatments, potential complications, and rehabilitation requirements. The decision to undergo surgery should be made after an appropriate clinical assessment and an informed discussion with the treating specialist.