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The hip replacement process

The hip replacement surgery process

Hip replacement surgery is one of the most common types of surgery in the UK with the majority of procedures being undertaken by older patients aged between 60 and 80.


Before undergoing hip replacement surgery, you may be given options for the type of anaesthetic you're given. Your Consultant and Anaesthetist will help with this decision.

There are two options - a general anaesthetic or spinal anaesthesia. Under general anaesthetic, you're asleep during the operation. Spinal anaesthesia is administered as an injection into the patient's spine which numbs the lower half of your body. This method is likely to be in combination with sedatives that make you drowsy and unaware of your surroundings. This is typically used for very stressed and worried patients. Read on to discover how Jean’s anxieties were eased before her hip replacement.

Mr Alex Chipperfield, Consultant Orthopaedic Surgeon, explains, "The surgery will often be performed under what's called a spinal anaesthetic, which is when you have an injection into the lower part of your back that makes your legs go to sleep, so you can't feel the surgery. On top of that, you do have the option to have sedation as well, where a medicine is injected into your veins which means that you won't be aware of what's going on. You won't hear, feel, see, or smell anything.

"A lot of people worry that having a spinal anaesthetic means they will be completely awake, aware, and able to hear all the, hammering, and sawing going on. The only time that would be the case is if that's what you want, and if you want to be completely awake. Most will have some form of sedation so that they don't know what's going on".

The operation 

To improve your current condition, the removal of your existing hip joint is required. Once pain relief has been administered, the surgeon removes the existing hip joint completely. Additionally, the upper part of the femur is removed, and the natural socket is hollowed out.

“The surgery itself takes around an hour. The time taken to do the surgery is however long it takes to do things properly. We recreate the ball and socket that's worn out in your hip with a combination of a shell and a stem. We cut away the top of the thigh bone, we hollow out the socket in the pelvis, and we can implant the new hip back into those, put them all back together, and sew you up again. So, all very straightforward.” says Mr Chipperfield.

A socket is fitted into the hollow in the pelvis and a metal stem with a smooth and rounded ball on its upper end is placed into the hollow. This process is also carried out for metal-on-metal hip resurfacing with less of the bone being removed from the femur. Only the joint surfaces are replaced with metal inserts.

In more recent years, some surgeons have been using a minimally-invasive technique in which the surgeon makes one to two cuts between two to five inches long instead of the traditional eight to 10 inches. The same procedure is then performed through these smaller incisions. This technique is believed to stem blood loss, ease pain post-surgery, reduce hospital stays and ultimately recovery time, as well as reduce the appearance of scars.

What to do post-operation?

Mr Chipperfield advises that “ideally, our Physiotherapists get you up and walking as quickly as possible. It's perfectly safe to bear all your weight through your new hip on the day of the operation. If you have surgery in the morning, you'll be walking in the afternoon. If you have surgery later that day, it may well be that the effects of the anaesthetic don't wear off in time for you to walk that day, so we give you the night to rest.

"Your hip can be a bit tight, stiff, and sore following the operation. Most people tend to find the grinding pain from their hip has gone straight away. The pain that you have after surgery is different, people often describe it more as discomfort or tightness around the hip, and that pain will fade and settle as you heal."

Even after your hip joint has healed, certain sports or heavy activity should be avoided at all costs. The replacement joint is designed for usual day-to-day activity and not extreme pressures and strain.

"You may find that you're back to driving within the first six weeks. So, I tell most people to not make any big plans for the first three months following an operation, so that includes long-distance travel, getting back to high-demand work activities, and exercising. You know, it's a gradual process that will take as long as it takes for you to get back to life after a hip replacement" says Mr Chipperfield.

To make it easier for your recovery process, there are several simple measures to make life easier when you return home:

  • Keep stair climbing to a minimum. There are programmes and help available including fitting stair lifts, if necessary. If you do have to go up or down stairs, keep it to a minimum
  • Maintain a straight back in a firm chair
  • Fit additional rails where appropriate to help avoid falls and remove all clutter from the floor including mats
  • Consider using an elevated toilet seat to reduce bending too far at the hips

Mr Chipperfield adds, "The whole point of this operation is to allow you to get rid of the shackles that are holding you down, get rid of the pain that's holding you back, and return to living your life in a much less restricted, pain-free way.

"There are some activities that common sense would say you shouldn't do, like high-impact sports. Hip replacement surgery is not carte blanche to start running marathons again, but within reason, most people are able to get back to doing most things."

Hip replacement surgery at Benenden Hospital

At Benenden Hospital, we pride ourselves on our quality of service and ensuring that each and every patient leaves us feeling happy.

"We're a leading provider of private hip and knee treatments in Kent. Everyone is very experienced and caring, and more importantly they have the time to take to go through things with you. We get very high patient satisfaction rates and very good reviews and feedback. We also have a rapid recovery programme that means that fortunately your stay in hospital is pretty brief these days when it comes to this kind of surgery” explains Mr Chipperfield.

If you have any questions regarding hip replacement surgery and the options available, complete our online enquiry form or get in touch with our Private Patient Team using our Livechat or by calling 01580 363158.

Published on 15 May 2024