Total Hip Replacement

What is Total Hip Replacement?

Total hip replacement involves surgically removing the damaged surfaces of the hip joint and replacing them with prosthetic components. The hip is a ball-and-socket joint — the ball is the rounded head of the femur (thigh bone), and the socket is the acetabulum, a cup-shaped cavity in the pelvis. In a worn or arthritic hip, the cartilage that cushions these surfaces breaks down, causing bone-on-bone contact, pain, stiffness, and progressive loss of function.

During the procedure, the damaged femoral head is removed and replaced with a metal stem inserted into the femur, topped with a ball component. The acetabulum is resurfaced with a metal cup and liner, which the new ball moves against. The choice of materials — metal, ceramic, and polyethylene in various combinations — is based on the patient’s anatomy, activity level, and the nature of their joint disease.

Who Needs a Total Hip Replacement?

The most common reason for total hip replacement is osteoarthritis, where progressive loss of hip cartilage leads to pain and stiffness that worsens over time. Hip replacement is also used to treat:

• Rheumatoid arthritis
• Avascular necrosis (disrupted blood supply to the femoral head, leading to bone death and joint collapse)
• Hip dysplasia
• Femoral neck fractures
• Post-traumatic arthritis

Surgery is generally recommended when hip pain is significantly affecting daily life and conservative measures — including physiotherapy, anti-inflammatory medications, activity modification, and walking aids — have failed to provide adequate relief. Hip replacement can be appropriate across a wide range of ages in skeletally mature patients. The decision is based on the severity of symptoms, the degree of joint damage on imaging, and the patient’s overall health and goals. In younger patients, joint preservation surgery is always carefully considered first, given the likelihood of needing revision surgery at some point over a longer lifetime. Dr Slattery has particular expertise in managing hip disorders in younger patients and will discuss all appropriate options at your consultation.

Surgical Approach

There are several surgical approaches to total hip replacement, and the choice depends on the patient. Dr Slattery most commonly uses the direct anterior approach, which accesses the hip joint from the front, working between the muscles rather than cutting through them. This muscle-sparing technique is associated with a lower risk of dislocation and a faster early recovery compared to traditional posterior approaches. In selected patients a posterior approach is more appropriate, and Dr Slattery will discuss the best option for you at your consultation. Regardless of approach, surgery is performed under spinal or general anaesthesia and typically takes one to two hours. Fluoroscopic or robotic guidance may be used to assist with precise implant positioning.

Implant Selection

Dr Slattery uses a range of implants and selects the most appropriate combination for each patient. Implants may be cemented, uncemented (where bone grows into a porous-coated surface over time), or a hybrid of both. Bearing surfaces — the materials that articulate against each other — include ceramic-on-ceramic, ceramic-on-polyethylene, and metal-on-polyethylene combinations, each with different wear characteristics and indications.

Recovery

Most patients are walking with crutches on the day of surgery or the morning after. Hospital stays are typically two to three days for uncomplicated cases, though this varies depending on individual health and recovery. A local anaesthetic is injected around the hip during surgery to help manage pain in the early postoperative period. Some discomfort in the first one to two weeks is normal as the tissues heal. Crutches are generally used for the first two weeks, after which most patients begin to transition off them. By six weeks, the majority of patients are walking independently and managing everyday activities comfortably. The following reflects Dr Slattery’s typical recovery guidance, though your treating team will tailor this to your individual progress:

• From ~2 weeks: exercise bike
• From ~4 weeks: hydrotherapy
• From ~8 weeks: walking for fitness
• Up to 12 months: strength, balance and endurance continue to improve

Return to office-based work is typically possible within two weeks. Physically demanding work may require four to six weeks away. Driving depends on which leg was operated on, vehicle type, and whether you have adequate strength and response time to do so safely — your surgeon will advise you on this specifically.

Risks and Complications

Total hip replacement is a safe and well-established procedure, but as with any major surgery it carries risks. These include:

• Infection
• Blood clots (deep vein thrombosis or pulmonary embolism)
• Bleeding
• Intraoperative fracture
• Dislocation of the prosthesis
• Leg length inequality
• Injury to adjacent nerves or blood vessels
• Implant loosening or wear over time
• Persistent pain

Some patients experience temporary numbness or tingling on the outer thigh due to stretching of small cutaneous nerves during surgery — this typically resolves over weeks to months and is not generally associated with any functional deficit. Dr Slattery takes a thorough approach to minimising risk, and all relevant risks will be discussed in detail at your consultation.

How Long Will a Hip Replacement Last?

Modern hip replacement implants are highly durable. Joint replacement registry data consistently shows that approximately 90% of total hip replacements are still functioning well at 20 years, though this varies depending on patient age, activity level, body weight, bone quality, underlying diagnosis, and implant type. Younger and more active patients have higher revision rates over time, which is one reason implant selection and surgical precision at the primary operation are so important. Revision surgery — replacing a worn or failing implant — is generally more complex than the original procedure.

Frequently Asked Questions

Am I too young for a hip replacement?

Hip replacement is performed in skeletally mature patients whose bones have finished growing. Beyond that, there is no arbitrary age cutoff. If your hip is severely damaged and other treatments have failed, a hip replacement may be the right option. In younger patients, Dr Slattery will always first consider whether joint preservation surgery is viable, given that younger patients are more likely to outlive their implant and require revision surgery at some point.

How long will my recovery take?

Most patients notice significant improvement within the first six weeks. Full recovery — including strength, walking endurance, and return to recreational activities — typically takes three to six months, with ongoing improvement possible for up to twelve months. Recovery varies between individuals depending on overall health, preoperative fitness, and commitment to rehabilitation.

Will I need rehabilitation after surgery?

Most patients recover at home with outpatient physiotherapy rather than inpatient rehabilitation. A structured programme focused on hip muscle strengthening and restoring normal movement is an important part of recovery. Dr Slattery’s team will arrange appropriate support based on your individual circumstances.

How much does a total hip replacement cost?

For patients with appropriate private health insurance, the majority of the cost is covered by the insurer. Out-of-pocket costs vary depending on your level of cover, implants used, and length of hospital stay. It is worth confirming your policy covers joint replacement surgery, as this is often excluded on lower levels of cover. Dr Slattery’s rooms can provide a detailed cost estimate prior to surgery. For eligible public patients, surgery is covered through Medicare.

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Medical Disclaimer The information on this page is intended as general patient education and does not constitute medical advice. Every patient is different, and treatment decisions should always be made in consultation with a qualified medical professional based on your individual circumstances, health history, and imaging. Outcomes from surgery vary between patients and cannot be guaranteed. If you have concerns about your hip health or are considering surgery, please contact Dr Slattery’s rooms to arrange a consultation.