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

Overview

Who is a hip replacement for?

There is no age or X-ray cutoff. Surgeons usually suggest a hip replacement when arthritis pain and stiffness keep limiting daily life even after non-surgical treatment, and when X-rays show the joint is badly worn.46,47

Common signs that it may be time to talk about surgery:

  • Hip or groin pain that limits walking, stairs, getting in and out of a car, or putting on socks and shoes
  • Pain at rest or pain that wakes you at night
  • Stiffness that limits how far you can move or lift the leg
  • Not enough relief from activity changes, weight loss if needed, physical therapy, pain medicine, injections or a cane46

What to expect

Most people get large, lasting pain relief and better function.1 It still helps to go in with realistic expectations: in a systematic review of studies in unselected patients, between 7% and 23% of people reported long-term pain after hip replacement.5 Talking openly with your surgeon about what the new hip will and won't do is part of good preparation.

Health factors that raise risk

Smoking, diabetes and obesity are each linked to more complications, especially infection. They don't automatically rule out surgery, but your team may ask you to work on them first. Stopping tobacco before surgery appears to lower the risk.9

Clinical detail
  • Tobacco use was associated with higher odds of periprosthetic joint infection (OR 2.02) and wound complications (OR 1.78) in a meta-analysis of hip and knee arthroplasty. Former users had lower risk than current users.9
  • Lifetime revision risk was about 5% for patients over 70, rising to about 35% for men in their early 50s (hip and knee pooled).7

Sources for this page

  1. Ferguson RJ, et al. Hip replacement. Lancet. 2018;392(10158):1662-1671. doi:10.1016/S0140-6736(18)31777-X
  2. 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
  3. 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
  4. 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
  5. American Academy of Orthopaedic Surgeons, OrthoInfo. Total hip replacement. orthoinfo.org/bodypart/hip-thigh/total-hip-replacement
  6. Mayo Clinic. Hip replacement. mayoclinic.org/tests-procedures/hip-replacement

All references