# Hip Replacement (Total Hip Arthroplasty)

> Citation bundle for Hip Replacement (Total Hip Arthroplasty) on The Treatment Registry.
> URL: https://thetreatmentregistry.com/procedures/hip-replacement
> Bundle URL: https://thetreatmentregistry.com/api/citations/procedures/hip-replacement

- Category: orthopaedic
- Average recovery: 42 days
- Typical sessions: 1
- Price range (USD international): $8,000–$25,000

## Description

Total hip replacement (arthroplasty) replaces the damaged femoral head and acetabulum with prosthetic components, typically used for end-stage osteoarthritis, post-traumatic arthritis, avascular necrosis, or hip fracture in older patients. Modern implants combine a femoral stem (cemented or uncemented), a femoral head (metal or ceramic), and an acetabular cup with a polyethylene, ceramic, or metal liner. Per UK NJR data, modern implant survivorship at 15 years exceeds 90% for the most-used implant combinations.

## Overview

Hip arthroplasty is one of the highest-volume major elective procedures performed worldwide and one of the most cost-effective surgeries by quality-adjusted life-year. Surgical approach (posterior, lateral, anterior) and implant choice (cemented vs uncemented, head size, bearing surface) materially affect dislocation risk, longevity, and revision rate. Patient selection and pre-operative optimisation (weight, glycaemic control, smoking cessation) drive outcomes alongside surgical technique.

## Peer-reviewed outcome rates

- **Complication rate:** 5.00% (range 3.00–8.00%) — from 2 cited sources
- **Revision rate:** 5.00% (range 3.00–10.00%) — from 1 cited source
- **Mortality rate:** 0.50% (range 0.20–1.00%) — from 1 cited source

## Common risks

- Periprosthetic infection
- Dislocation
- Deep vein thrombosis / pulmonary embolism
- Implant loosening (long-term)
- Leg-length discrepancy
- Nerve injury (sciatic, femoral)

## FAQs

### How long will my hip replacement last?

Per UK National Joint Registry data, modern implant survivorship at 15 years exceeds 90% for the most-used implant combinations. Factors affecting longevity include patient age and activity level, body weight, implant choice (bearing surface and fixation type), and surgical technique.

### What surgical approach is best?

Posterior, lateral, and anterior approaches all have advocates. Posterior is the most commonly used worldwide and has excellent visualisation; anterior may allow faster return to function and lower dislocation rates but has a steeper learning curve. Surgeon experience with their chosen approach matters more than the approach itself for most patients.

### How long until I can walk normally?

Most patients walk with a frame or crutches from day 1, transition to crutches by week 2, and are off crutches by week 4-6. Independent walking without aids typically by week 6-8. Some return to near-normal gait by month 3; complete elimination of any limp may take 6-12 months.

### When can I fly home after hip replacement?

Most surgeons recommend at least 14-21 days in-country before flying long-haul, with continued DVT prophylaxis (LMWH, DOAC, or aspirin per protocol). Short-haul flights may be permitted earlier. Cabin DVT risk is elevated for several weeks post-op.

### Will I set off airport security scanners?

Modern hip implants typically contain metallic components and may trigger metal detectors. Patients receive an implant passport documenting the implant; some carry a 'medical alert' card. Body scanners are usually less affected.

### What is the difference between cemented and uncemented hip replacement?

Cemented hips use polymethylmethacrylate cement to fix the implant to bone; uncemented hips rely on bone in-growth into a porous-coated implant surface. Cemented is generally preferred for older patients and lower bone density; uncemented is generally preferred for younger, more active patients. Hybrid approaches (uncemented cup, cemented stem) are common.

### Can I have hip replacement if I'm under 60?

Yes — younger patients are increasingly common candidates as implants have improved. Trade-off: younger patients place more demand on the implant over a longer remaining lifespan, so revision in later decades is more likely. Modern uncemented implants with advanced polyethylene or ceramic bearings are typically chosen for younger patients.

### What complications should I look for after returning home?

Sudden severe pain, inability to bear weight, leg shortening, or external rotation may indicate dislocation — immediate medical attention. Wound discharge, fever, or increasing pain suggests possible infection. Calf swelling or shortness of breath may indicate DVT/PE. Any of these warrants emergency assessment.

## Alternative treatments

- **Hip resurfacing** — Bone-conserving alternative for younger active male patients; concerns over metal-on-metal wear in some implants.
- **Periacetabular osteotomy** — Joint-preserving option for dysplastic young hips before arthritis is established.
- **Intra-articular injection** — Symptom relief while planning surgery; limited durability.

## Sources

- [National Joint Registry for England, Wales, Northern Ireland and the Isle of Man — Annual Report](https://www.njrcentre.org.uk/njrcentre/Reports-Publications-and-Minutes/Annual-reports) — National Joint Registry (accessed 2026-05-09)
- [AAOS — Surgical Management of Osteoarthritis of the Knee Clinical Practice Guideline](https://www.aaos.org/quality/quality-programs/lower-extremity-programs/surgical-management-of-osteoarthritis-of-the-knee/) — American Academy of Orthopaedic Surgeons (accessed 2026-05-09)
- [RCoA — Guidelines for the Provision of Anaesthetic Services (GPAS)](https://www.rcoa.ac.uk/standards-of-clinical-practice) — Royal College of Anaesthetists (accessed 2026-05-09)
- [NICE NG89 — Venous thromboembolism in over 16s: reducing the risk of hospital-acquired DVT and PE](https://www.nice.org.uk/guidance/ng89) — National Institute for Health and Care Excellence (accessed 2026-05-09)