Hip Replacement

A hip replacement rebuilds a ball-and-socket joint. Your surgeon removes the worn ball at the top of the thigh bone, hollows out the shaft and fits a metal stem carrying a new ball, then prepares the socket in the pelvis and fits a cup with a smooth liner inside it. The two new surfaces articulate against one another.

The bearing surfaces vary. A ceramic or metal head running against a hard-wearing plastic liner is the most widely used combination, and ceramic against ceramic is chosen in some younger patients. The implants are fixed either with cement or with a surface that bone grows into over the following weeks, and your surgeon chooses based on your age and the quality of your bone.

The joint can be approached from behind, from the side or from the front, and each route has its own trade-offs in muscle handling, in how quickly you move freely afterwards, and in the precautions you are asked to follow. Your surgeon uses the approach they get the most reliable results with, and the differences between them matter less over the long run than the position the implants end up in.

A spinal anaesthetic is standard, so you are numb from the waist down and awake, with sedation if you prefer. You will feel movement and pressure without pain, and there is less sickness and blood loss with a spinal than with a general anaesthetic.

The incision runs over the hip and is usually ten to fifteen centimetres. Your surgeon dislocates the old joint, cuts and removes the worn head, prepares the socket and the shaft, trials the components to check leg length, stability and range, and then implants the final ones. Allow around sixty to ninety minutes for the operation itself, with anaesthetic and positioning either side.

You stay in hospital. Admission is the morning of surgery or the night before, and the stay is usually two to four nights. A physiotherapist gets you standing and walking with a frame the same evening or the following morning, teaches you stairs before you leave, and shows you how to get in and out of bed, a chair and a car. Expect to go home on blood-thinning treatment, with a raised toilet seat and any other equipment you have been advised to arrange in advance.

Most people walk with a frame or crutches for two to four weeks, move to a stick, and are walking unaided somewhere between four and six weeks. Pain from the joint itself is often better immediately; what you feel in the first fortnight is the surgery.

Desk work is realistic at four to six weeks and manual work at around three months. Driving is usually possible at around six weeks once you can get in and out without twisting and can brake sharply, and your surgeon confirms it. Swimming is generally allowed once the wound is fully healed, at around six weeks.

Your surgeon will give you precautions on how far to bend the hip, whether to cross your legs, and how to sit and sleep, and these apply most strictly for the first six to twelve weeks while the soft tissues heal around the new joint. In Indian homes that usually means avoiding sitting cross-legged on the floor, squatting and floor-level toilets during that period, and your surgeon will tell you what is permitted after it. Most of the recovery is complete by three months, with continued strengthening for a year.