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Total hip replacement

If you are considering having total hip replacement surgery, or have a total hip replacement operation planned, it is important to know all you can about it. This includes:


  • why you need total hip replacement surgery

  • what it will be like

  • how it will affect you

  • what risks are involved in total hip replacement surgery

  • any alternatives.


The information here is a guide to common medical practice. Each hospital and doctor will have slightly different ways of doing things, so you should follow their guidance where it is different from the information given here. Because all patients, conditions and treatments vary it cannot cover everything. Use this information when making your choice of total hip replacement surgery with your doctors. You should mention any worries you have. Remember that you can ask for more information at any time.



What is the problem?

You have arthritis of your hip joint. This is causing pain and, possibly, reduced movement of the joint.


What is the hip joint?

The hip is a ball and socket joint. The socket part of the joint is a cup in the pelvis, called the acetabulum. The ball at the top of the thighbone is called the head of femur. Between the shaft and the head is called the neck of femur. Normally, the surfaces of each bone are covered with a layer of cartilage. This allows the bones to move smoothly on each other.

Total hip


What has gone wrong?

The cartilage in your hip joint has worn away due to the arthritis. The bones are now rubbing against each other. This is why your hip is stiff and painful.


The aim

We replace both the ball and socket of your hip with an artificial joint, called a prosthesis. This operation is called a total hip replacement or THR for short.


The benefits

The range of movement in your hip may not improve very much, but the pain in your hip should go. As a result you will be able to walk further and climb stairs more easily.

Total hip 2

Are there any alternatives?

Painkillers and anti-inflammatory tablets may control the pain. Exercise may improve the movement of your hip. Physiotherapy can help reduce the pain if your arthritis is not too advanced.


A new operation to renew the socket and just put a new cap on the head of femur is still experimental. It is only suitable for relatively young patients if the arthritis is not too advanced. 


An operation to cut the neck of the femur and fix it at a different angle, called an osteotomy, is sometimes done in very young patients.


A new operation, called a minimally invasive hip replacement, but not all patients are suitable for the minimally invasive approach. There is a higher complication rate following minimally invasive hip replacement that has to be balanced against the advantages.


What if you do nothing?  

Arthritis is not dangerous in itself. But without an operation your hip will become more painful and your mobility will be reduced.


Who should have it done?

You should have your hip replaced if all the following apply to you:


  • The pain in your hip interferes with your life.
  • Tablets do not make the pain bearable.
  • X-rays show that your joint is damaged by arthritis.


Who should not have it done?

You should not have a hip replacement operation if any of the following apply to you:


  • You have angina or shortness of breath that limits your walking more than your hip pain.
  • You have a urinary infection, called a UTI. This may result in infection of your new hip. We will test your urine. If it is infected, we will give you antibiotics before your operation.
  • You are a man with prostate problems. If you have poor urinary flow it is better to have this investigated and treated before we replace your hip.


Author: Mr Boyd Goldie MBBS FRCS BSC DHMSA. Consultant in orthopaedics & trauma.

© Dumas Ltd 2006

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