Total Hip Replacement 

Total hip replacement, also called total hip arthroplasty, is a surgical procedure in which damaged parts of the hip joint are replaced with artificial components.

The hip is a ball-and-socket joint. The rounded head of the thigh bone (femur) fits into a socket in the pelvis. Damage to the cartilage and underlying bone can cause pain, stiffness and reduced movement.

During total hip replacement:

• The damaged femoral head is removed.
• An artificial socket component is placed in the pelvis.
• An artificial ball and stem are used to replace the damaged part of the femur.
• The components are selected and positioned according to the patient's anatomy, bone condition and surgical plan.

The aim is to reduce pain and improve joint function. The degree of improvement and the time needed to recover vary from person to person.

An orthopaedic surgeon may discuss total hip replacement when hip joint damage causes persistent symptoms and non-surgical treatment has not provided sufficient relief.

Possible reasons include:

• Osteoarthritis: Wear and damage to the joint cartilage.
• Inflammatory arthritis: Conditions that can cause inflammation and progressive joint damage.
• Avascular necrosis: Reduced blood supply to the femoral head, which may lead to bone damage.
• Certain hip fractures: Injuries for which joint replacement may be an appropriate treatment.
• Other forms of joint damage: Conditions that significantly affect hip function and are assessed individually.

Symptoms that may warrant an assessment include ongoing hip or groin pain, stiffness, difficulty walking, reduced movement, or discomfort that affects sleep and daily activities. These symptoms do not automatically mean surgery is required.

Before recommending surgery, the orthopaedic team reviews the patient's medical history, symptoms, physical function and previous treatments. Imaging, such as X-rays, may be used to assess the condition of the joint. Additional tests may be required depending on the patient's health.

The preoperative assessment may include:

• Reviewing existing medical conditions and medications.
• Assessing bone and joint health.
• Evaluating risks related to anaesthesia and surgery.
• Discussing implant options and the planned surgical approach.
• Explaining expected benefits, limitations, possible complications and alternatives.
• Planning rehabilitation and support needed at home.

Patients should tell their treating team about all medicines and supplements they take. Medication should not be stopped or changed without medical advice.

Total hip replacement is carried out under an appropriate form of anaesthesia. The surgical approach and implant selection depend on the patient's condition and the surgeon's assessment.

The procedure generally involves preparing the damaged joint surfaces, placing the artificial components and checking the stability and movement of the reconstructed joint. The incision is then closed, and the patient is monitored during the initial recovery period.

The duration of surgery and hospital stay can vary according to the complexity of the procedure, the patient's general health and the hospital's clinical protocol.

For appropriately selected patients, total hip replacement may help:

• Reduce pain associated with significant joint damage.
• Improve the ability to walk and perform daily activities.
• Increase hip movement and function.
• Support greater independence after rehabilitation.

However, results cannot be guaranteed. Some patients continue to experience pain or movement limitations, and the artificial joint may wear or require further treatment over time. A consultation should include a discussion of both potential benefits and limitations.

Total hip replacement is a major operation. Potential risks include:

• Infection.
• Blood clots.
• Dislocation of the artificial joint.
• Differences in leg length.
• Fracture around an implant.
• Injury to nearby nerves or blood vessels.
• Implant wear, loosening or the need for revision surgery.
• Complications related to anaesthesia or existing medical conditions.

The likelihood of complications varies according to individual health factors and the procedure. Your treating team can explain the risks that are most relevant to you and how they may be reduced.

Recovery is gradual and varies between patients. Some people begin standing or walking with assistance soon after surgery when the clinical team considers it appropriate. Physiotherapy and a personalised rehabilitation plan help patients practise safe movement and gradually improve strength and balance.

Recovery commonly involves:

• Early recovery: Pain management, wound care and supervised movement.
• Initial rehabilitation: Walking with a suitable aid and practising recommended exercises.
• Progressive activity: Gradually increasing movement and daily activities according to clinical advice.
• Follow-up appointments: Monitoring healing, joint function and any concerns.

The time needed to resume work, driving, exercise or other activities depends on recovery progress and the type of activity. Follow the instructions provided by your surgeon and physiotherapist rather than relying on a fixed timeline.

Seek urgent medical assessment if you develop sudden shortness of breath, chest pain, or significant calf swelling or pain after surgery. Contact your healthcare team promptly for fever, increasing wound redness, drainage or worsening pain.

The cost of surgery can differ between patients and hospitals. Factors may include:

• The type and brand of implant used.
• The complexity of the procedure.
• Preoperative investigations and medical assessments.
• Anaesthesia, hospital stay and medicines.
• Physiotherapy and follow-up care.
• Treatment of any additional medical needs or complications.

Ask the hospital for an itemised estimate that explains what is included and whether any additional charges may apply. Insurance coverage depends on the individual policy and its terms.

People experiencing persistent hip pain or restricted movement can seek an orthopaedic assessment at MAHI Hospitals, located at No. 118, Poonamallee High Road, Vepery, Chennai – 600084.

An assessment can help clarify the cause of symptoms, whether non-surgical treatments remain suitable, and whether total hip replacement should be considered. Patients should have an opportunity to discuss the potential benefits, risks, alternatives and rehabilitation requirements before making a treatment decision.