Over 80,000 hip replacement operations are carried out each year in England, Wales and Northern Ireland. [HS1]Hip replacement operations have a high success rate in the UK, with just 1.3% of patients requiring further surgery. (National Joint Registry 2013).

A complete hip replacement operation usually takes around two hours, followed by a stay in hospital of around five days and recovery at home of around six weeks. 

Preparing for a hip replacement operation

As with all major surgery, it is a good idea to do some preparation in advance for your hip replacement operation: 

• Stop smoking. If you smoke, you will be asked to stop to reduce your risk of chest and wound infections.
• Lose weight if you need to. You may also be asked to lose weight as excess weight not only makes hip replacement surgery more difficult, it can also place unnecessary strain on your new hip joint.
• Have an MRSA test. Whether you have your hip replacement operation in an NHS or a private hospital, it is now usual to have a test to see if you are a carrier of MRSA. This methicillin-resistant form of the bacterium Staphylococcus aureus is found on some people’s skin; if you have it you will be given antibiotics to make sure you don’t bring it into the hospital and to prevent a serious wound infection once you have had surgery. 

After you are admitted, your surgeon and anaesthetist will still visit you in hospital before the hip replacement operation to answer any final questions you may have. 

During hip replacement surgery

Your hip replacement operation will usually be done under general anaesthetic and consists of several stages: 

• First, your surgeon will make a cut of around 20-30cm in your hip.
• The top of the femur (thigh bone) is then separated from the hip joint.
• This is removed and a shaft drilled to take the long tip of the replacement femur head.
• The new femur head is put in place and secured.
• The hip socket is then hollowed out and re-lined with an artificial socket.

The hip replacement operation concludes when the ball and socket joint is matched up and the wound is stitched or clipped. 

A hip prosthesis may be cemented into place using a special bone adhesive. Alternatively, a replacement joint made from specially coated material, or from rough, porous material, may be used to encourage bone growth around the artificial hip joint to anchor it in naturally. 

After a hip replacement operation 

As you come round you may not be able to move very much due to the effects of the anaesthetic and because your legs are held in a set position by pillows to immobilise your hip to prevent dislocation. You will need painkillers for the first few days, and drugs to prevent deep vein thrombosis while you are immobile. Don’t expect to be in bed long though; most people are encouraged to take a few steps on the second day after surgery, if not the first. 

Your physiotherapist will visit you several times a day following your hip replacement operation to give you a series of special exercises to get you moving again. You will need to practice walking using a walker and then crutches. Once you have mastered going up and down stairs with your crutches, but otherwise unaided, you will be ready to go home. 

Most patients are in hospital for around a week following their hip replacement operation, although this increases with age. You will then require around six weeks to recover at home before you are able to return to work, or to your normal activities such as driving.