Hip replacement surgery is now a routine procedure. According to the National Joint Registry, 105,306 hip replacement procedures were carried out in 2017 in the UK, up from 101,651 in 2016. The average age for surgery in men is 67.5. In women it is 69.9.

The vast majority of hip replacement surgery (90%) is for osteoarthritis, also called wear and tear arthritis. Osteoarthritis is caused by the protective cartilage that cushions your bones starting to wear away. This can cause the bones to rub, causing pain, swelling and stiffness in the joint. Bony spurs can start to develop in the affected area, which may exacerbate the problem and cause the joint to lock.


Symptoms of hip osteoarthritis

Symptoms can range from mild to severe. They include pain and stiffness in your hip, as well as swelling and tenderness. You may experience a grating sensation or hear a crackling noise when you move. As the condition worsens, your mobility may become increasingly limited. Severe osteoarthritis can make it difficult to carry out simple everyday activities and your quality of life may be significantly reduced.


Causes of hip osteoarthritis

There can be a number of different reasons why people develop osteoarthritis. Cartilage starts to wear away naturally as we age and if there is a family history of osteoarthritis you may be more at risk of developing the condition yourself. Injuring your hip can also increase the chances of developing the disease, particularly if you overuse the joint following an injury or operation.

Being overweight or obese puts additional strain on weight-bearing joints such as hips and knees, which can lead to arthritis. If your hip joint has been damaged by rheumatoid arthritis, which is an autoimmune condition, you may also have a greater risk of developing osteoarthritis.

You may also need hip replacement surgery following a hip fracture.


Things to consider

If you have severe osteoarthritis of the hip, you may be offered hip replacement surgery. There are a number of questions you may need to consider, including:

Should I have a total or a partial hip replacement?

A partial hip replacement (hemiarthroplasty) involves replacing just the femoral head, which is the ball at the top of the femur, with an artificial implant. Total hip replacement involves replacing the femoral head and implanting a prosthetic shell inside the natural hip socket. Partial hip replacements are generally offered to patients who fracture the neck of their femur rather than people with arthritis.

Am I ready for a hip replacement?

Hip replacement surgery is only offered to people who are experiencing severe hip pain and whose symptoms can no longer be managed non-surgically. Your doctor will discuss the procedure and whether it is appropriate for you. One factor to consider is your age as, if you are young, you may need hip revision surgery at a later date, which means replacing a worn out implant.

Are there any alternatives to surgery?

If the symptoms are not severe, you may be able to manage your symptoms with lifestyle changes and / or medication. Certain exercises and a good diet can help to reduce inflammation in the joint and keep your mind positive.

What is hip resurfacing surgery?

This is similar to a standard hip replacement but more of the normal bone is preserved. It has become a far less common procedure in recent years due to concerns about metal-on-metal implants which have had well-documented problems.

What are the risks of hip replacement surgery?

Although hip replacement is now a routine surgical procedure it remains a major operation with all of the associated risks. These might include: blood clots, infection, blood loss, dislocation of the hip, or the hip implant loosening and requiring revision surgery.

How can I support my recovery?

You will be given full details on the best way to support your recovery after surgery. You will need to take painkillers regularly in the first 48 to 72 hours and a physiotherapist will recommend exercises to improve your flexibility and mobility. You will normally be able to drive after six weeks, subject to advice from your surgeon and may be able to return to work within six to 12 weeks.

Joseph Queally is an experienced hip surgeon who can diagnose and recommend the right time for hip replacement surgery.

Whereas in the past, patients having a hip replacement might need to spend three weeks in hospital, now some patients can go home the same day or the following day.

This means you can get back to full function more quickly and limit the risks of an extended hospital stay.