Independent, sourced patient educationInformedSurgery
Hip Replacement Explained
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All topics
  1. What it is
  2. Who it helps
  3. Timing
  4. The procedure
  5. What a hemiarthroplasty is
  6. Hemi vs total hip
  7. Recovery after hip fracture
  8. Patient journey
  9. Recovery supplies
  10. Finding a surgeon
  11. Insurance and costs
  12. Questions to ask
  13. Implant designs
  14. Side-by-side
  15. Robotics and navigation
  16. US manufacturers
  17. What the evidence says
  18. Value analysis
  19. Resources
  20. Glossary
  21. References

Summary

Side by side

A simplified view of the main choices. Each row is a general finding, not a guarantee for any individual patient.

Scroll sideways to see every column.

ChoiceOptionsWhat the evidence shows
ApproachAnterior vs posterior or lateralSimilar dislocation and revision; anterior has faster early recovery but longer surgery and more nerve injury14,15,16
PrecautionsMovement restrictions vs noneNo clear difference in dislocation; recent reviews don't support routine precautions18,19
BearingFixed vs dual mobilityLower dislocation with dual mobility in complex cases; long-term data limited20
TechnologyRobotic vs conventionalFewer cup outliers and early dislocations in one meta-analysis; long-term benefit unproven21
Fracture: extentHemiarthroplasty vs total hipSimilar reoperation; total hip slightly better function but more dislocation24,26
Fracture: fixationCemented vs uncemented hemiCement: better quality of life, fewer periprosthetic fractures25,26
SettingSame-day vs inpatientSimilar complications and readmissions in selected patients31
Clot preventionAspirin vs injectable heparinFewer symptomatic clots with enoxaparin in a large hip-and-knee trial12

Sources for this page

  1. Sidhu VS, et al. Effect of aspirin vs enoxaparin on symptomatic venous thromboembolism in patients undergoing hip or knee arthroplasty: the CRISTAL randomized trial. JAMA. 2022;328(8):719-727. doi:10.1001/jama.2022.13416
  2. Ang JJM, et al. Comparing direct anterior approach versus posterior approach or lateral approach in total hip arthroplasty: a systematic review and meta-analysis. Eur J Orthop Surg Traumatol. 2023;33(7):2773-2792. doi:10.1007/s00590-023-03528-8
  3. Liu R, et al. Comparative efficacy of direct anterior approach versus conventional surgical approaches in total hip arthroplasty: a systematic review and meta-analysis of randomized clinical trials. J Orthop Surg Res. 2025;20(1):837. doi:10.1186/s13018-025-06227-8
  4. Ghandour M, et al. Direct anterior approach versus posterior approach in total hip arthroplasty: a systematic review and meta-analysis. J Orthop. 2025;65:233-250. doi:10.1016/j.jor.2025.06.007
  5. Korfitsen CB, et al. Hip precautions after posterior-approach total hip arthroplasty among patients with primary hip osteoarthritis do not influence early recovery: a systematic review and meta-analysis of randomized and non-randomized studies with 8,835 patients. Acta Orthop. 2023;94:141-151. doi:10.2340/17453674.2023.11958
  6. Guo J, et al. No need for hip precautions after total hip arthroplasty with posterior approach: a systematic review and meta-analysis. Medicine (Baltimore). 2024;103(50):e40348. doi:10.1097/MD.0000000000040348
  7. Manohar M, et al. Dual mobility versus fixed bearings in complex primary total hip arthroplasty: a systematic review and meta-analysis. J Clin Orthop Trauma. 2026;80:103538. doi:10.1016/j.jcot.2026.103538
  8. Arun Kumar G, et al. Robotic-assisted versus conventional manual total hip arthroplasty: a systematic review and meta-analysis of component position accuracy, Lewinnek zone outliers, and early dislocation rates. J Robot Surg. 2026;20(1). doi:10.1007/s11701-026-03678-x
  9. HEALTH Investigators; Bhandari M, et al. Total hip arthroplasty or hemiarthroplasty for hip fracture. N Engl J Med. 2019;381(23):2199-2208. doi:10.1056/NEJMoa1906190
  10. Fernandez MA, et al. Cemented or uncemented hemiarthroplasty for intracapsular hip fracture (WHiTE 5). N Engl J Med. 2022;386(6):521-530. doi:10.1056/NEJMoa2108337
  11. Lewis SR, et al. Arthroplasties for hip fracture in adults. Cochrane Database Syst Rev. 2022;2(2):CD013410. doi:10.1002/14651858.CD013410.pub2
  12. Bemelmans YFL, et al. Safety and efficacy of outpatient hip and knee arthroplasty: a systematic review with meta-analysis. Arch Orthop Trauma Surg. 2022;142(8):1775-1791. doi:10.1007/s00402-021-03811-5

All references