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

Sources

References

Sources 1 to 45 are peer-reviewed articles retrieved from PubMed, each linked to its DOI. Sources 46 to 70 are patient-education and official pages from professional societies, hospitals and the US government. Manufacturer sources are linked on each manufacturer card. Studies with an industry co-author are marked.

  1. Ferguson RJ, et al. Hip replacement. Lancet. 2018;392(10158):1662-1671. doi:10.1016/S0140-6736(18)31777-X
  2. Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet. 2007;370(9597):1508-1519. doi:10.1016/S0140-6736(07)60457-7
  3. Shichman I, et al. Projections and epidemiology of primary hip and knee arthroplasty in Medicare patients to 2040-2060. JB JS Open Access. 2023;8(1):e22.00112. doi:10.2106/JBJS.OA.22.00112
  4. Shichman I, et al. Projections and epidemiology of revision hip and knee arthroplasty in the United States to 2040-2060. Arthroplast Today. 2023;21:101152. doi:10.1016/j.artd.2023.101152
  5. Beswick AD, et al. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open. 2012;2(1):e000435. doi:10.1136/bmjopen-2011-000435
  6. Evans JT, et al. How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet. 2019;393(10172):647-654. doi:10.1016/S0140-6736(18)31665-9
  7. Bayliss LE, et al. The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study. Lancet. 2017;389(10077):1424-1430. doi:10.1016/S0140-6736(17)30059-4
  8. Ong KL, et al. Prosthetic joint infection risk after total hip arthroplasty in the Medicare population. J Arthroplasty. 2009;24(6 Suppl):105-109. doi:10.1016/j.arth.2009.04.027
  9. Bedard NA, et al. Tobacco use and risk of wound complications and periprosthetic joint infection: a systematic review and meta-analysis of primary total joint arthroplasty procedures. J Arthroplasty. 2019;34(2):385-396.e4. doi:10.1016/j.arth.2018.09.089
  10. Premkumar A, et al. Projected economic burden of periprosthetic joint infection of the hip and knee in the United States. J Arthroplasty. 2021;36(5):1484-1489.e3. doi:10.1016/j.arth.2020.12.005
  11. Januel JM, et al. Symptomatic in-hospital deep vein thrombosis and pulmonary embolism following hip and knee arthroplasty among patients receiving recommended prophylaxis: a systematic review. JAMA. 2012;307(3):294-303. doi:10.1001/jama.2011.2029
  12. 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
  13. Salazar CA, et al. Direct factor Xa inhibitors versus low molecular weight heparins or vitamin K antagonists for prevention of venous thromboembolism in elective primary hip or knee replacement or hip fracture repair. Cochrane Database Syst Rev. 2025;1(1):CD011762. doi:10.1002/14651858.CD011762.pub2
  14. 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
  15. 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
  16. 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
  17. Smith TO, et al. Assistive devices, hip precautions, environmental modifications and training to prevent dislocation and improve function after hip arthroplasty. Cochrane Database Syst Rev. 2016;7(7):CD010815. doi:10.1002/14651858.CD010815.pub2
  18. 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
  19. 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
  20. 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
  21. 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
  22. Jha G, et al. Beyond robotics: a systematic review of technology integration in direct anterior approach total hip arthroplasty. J Robot Surg. 2026;20(1). doi:10.1007/s11701-026-03485-4
  23. Sarrel K, et al. Understanding economic analysis and cost-effectiveness of CT scan-guided, 3-dimensional, robotic-arm assisted lower extremity arthroplasty: a systematic review. J Comp Eff Res. 2024;13(4):e230040. Industry co-authors. doi:10.57264/cer-2023-0040
  24. 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
  25. 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
  26. Lewis SR, et al. Arthroplasties for hip fracture in adults. Cochrane Database Syst Rev. 2022;2(2):CD013410. doi:10.1002/14651858.CD013410.pub2
  27. Morrell AT, et al. Surgical approaches for inserting hemiarthroplasty of the hip in people with hip fractures. Cochrane Database Syst Rev. 2025;6(6):CD016031. doi:10.1002/14651858.CD016031
  28. Núñez JH, et al. Hip fractures in Spain. How are we? Systematic review and meta-analysis of the published registries. Rev Esp Cir Ortop Traumatol. 2025;69(3):303-317. doi:10.1016/j.recot.2024.09.010
  29. Patel PV, et al. Doctor when can I drive? A systematic review and meta-analysis of return to driving after total hip arthroplasty. Hip Int. 2023;33(1):17-27. doi:10.1177/1120700021998028
  30. DiSilvestro KJ, et al. When can I drive after orthopaedic surgery? A systematic review. Clin Orthop Relat Res. 2016;474(12):2557-2570. doi:10.1007/s11999-016-5007-9
  31. 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
  32. Finkelstein A, et al. Mandatory Medicare bundled payment program for lower extremity joint replacement and discharge to institutional postacute care: interim analysis of the first year of a 5-year randomized trial. JAMA. 2018;320(9):892-900. doi:10.1001/jama.2018.12346
  33. Haas DA, et al. Evaluation of economic and clinical outcomes under Centers for Medicare & Medicaid Services mandatory bundled payments for joint replacements. JAMA Intern Med. 2019;179(7):924-931. doi:10.1001/jamainternmed.2019.0480
  34. Navathe AS, et al. Cost of joint replacement using bundled payment models. JAMA Intern Med. 2017;177(2):214-222. doi:10.1001/jamainternmed.2016.8263
  35. Peng L, et al. Effect of neuromuscular electrical stimulation after total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials. Front Med (Lausanne). 2021;8:779019. doi:10.3389/fmed.2021.779019
  36. van der Vorst MAT, et al. Effectiveness of prehabilitation modalities before total hip arthroplasty: a systematic review and network meta-analysis. Ann Phys Rehabil Med. 2026;69(4):102114. doi:10.1016/j.rehab.2026.102114
  37. Aggarwal A, et al. Cryotherapy following total knee replacement. Cochrane Database Syst Rev. 2025;10(10):CD007911. doi:10.1002/14651858.CD007911.pub4
  38. Song M, et al. Compressive cryotherapy versus cryotherapy alone in patients undergoing knee surgery: a meta-analysis. Springerplus. 2016;5(1):1074. doi:10.1186/s40064-016-2690-7
  39. Eladl HM, et al. Systematic review on the effectiveness of photobiomodulation therapy on enhancing musculoskeletal rehabilitation outcomes after total knee and hip arthroplasty. Photobiomodul Photomed Laser Surg. 2026;44(10):597-605. doi:10.1177/25785478261475529
  40. Kemker BP, et al. Hip and knee bracing: categorization, treatment algorithm, and systematic review. J Am Acad Orthop Surg Glob Res Rev. 2021;5(6):e20.00181. doi:10.5435/JAAOSGlobal-D-20-00181
  41. Meissner N, et al. The effect of surgeon volume on outcomes after total hip arthroplasty: a systematic review and meta-analysis. Arch Orthop Trauma Surg. 2026;146(1). doi:10.1007/s00402-026-06434-w
  42. Wiegers EJA, et al. The volume-outcome relationship for hip fractures: a systematic review and meta-analysis of 2,023,469 patients. Acta Orthop. 2019;90(1):26-32. doi:10.1080/17453674.2018.1545383
  43. Ekhtiari S, et al. Evidence versus frenzy in robotic total knee arthroplasty: a systematic review comparing news media claims to randomized controlled trial evidence. J Bone Joint Surg Am. 2024;106(24):2384-2392. doi:10.2106/JBJS.24.00264
  44. Okike K, et al. Association between physician online rating and quality of care. J Med Internet Res. 2016;18(12):e324. doi:10.2196/jmir.6612
  45. Murasko MJ, et al. Patient satisfaction scores are a poor metric of orthopedic care. Orthopedics. 2022;45(3):e127-e133. doi:10.3928/01477447-20220217-06
  46. American Academy of Orthopaedic Surgeons, OrthoInfo. Total hip replacement. orthoinfo.org/bodypart/hip-thigh/total-hip-replacement
  47. Mayo Clinic. Hip replacement. mayoclinic.org/tests-procedures/hip-replacement
  48. MedlinePlus (US National Library of Medicine). Hip joint replacement. medlineplus.gov/ency/article/002975.htm
  49. American Academy of Orthopaedic Surgeons. Management of hip fractures in older adults: evidence-based clinical practice guideline (December 3, 2021). aaos.org/hipfxcpg
  50. US Food and Drug Administration. Metal-on-metal hip implants. fda.gov/medical-devices/implants-and-prosthetics/metal-metal-hip-implants
  51. Centers for Medicare & Medicaid Services. Transforming Episode Accountability Model (TEAM). cms.gov/priorities/innovation/innovation-models/team-model
  52. American Board of Orthopaedic Surgery. Verify certification. abos.org/verify-certification
  53. American Association of Hip and Knee Surgeons. What it means to be a member of AAHKS. hipknee.aahks.org
  54. Federation of State Medical Boards. DocInfo physician search. docinfo.org
  55. Centers for Medicare & Medicaid Services. Open Payments data overview. cms.gov/openpayments/data
  56. Medicare.gov. Second surgical opinions. medicare.gov/coverage/second-surgical-opinions
  57. HealthCare.gov. Out-of-pocket maximum/limit. healthcare.gov
  58. Centers for Medicare & Medicaid Services. Your rights when you have insurance (No Surprises Act). cms.gov
  59. Centers for Medicare & Medicaid Services. Your rights without insurance: Good Faith Estimates. cms.gov
  60. Centers for Medicare & Medicaid Services. Dispute a bill that's higher than your Good Faith Estimate. cms.gov
  61. Medicare.gov. Inpatient or outpatient hospital status. medicare.gov
  62. Medicare.gov. Skilled nursing facility care. medicare.gov
  63. Internal Revenue Service. Financial assistance policies (FAPs) for charitable hospitals. irs.gov
  64. Centers for Medicare & Medicaid Services. Billing and Coding: Total Joint Arthroplasty (A59811). cms.gov
  65. Centers for Medicare & Medicaid Services. Local Coverage Determination: Total Joint Arthroplasty (L39911). cms.gov
  66. Aetna. Clinical Policy Bulletin 0287: Hip arthroplasty. aetna.com
  67. Andrew Wickline, MD. Self-pay joint replacement (published example). andrewwicklinemd.com
  68. Surgery Center of Oklahoma. Hip arthroplasty pricing (published example). surgerycenterok.com
  69. American Academy of Orthopaedic Surgeons, OrthoInfo. Revision total hip replacement. orthoinfo.org
  70. American Association of Hip and Knee Surgeons. Total hip replacement. hipkneeinfo.org