Total Hip Replacement - Surgery, Benefits & Recovery Time

Total Hip Replacement

Treatment Duration

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1 Hours

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2 Hours

Treatment Cost

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80,000

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2,00,000

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Total Hip Replacement

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According to a study by A Singh et al., around 62.35 million individuals were diagnosed with osteoarthritis in 2019. This condition often requires hip replacement to restore mobility and alleviate pain. The procedure is crucial for patients with severe hip joint damage due to arthritis or injury. 

Hip replacement surgery provides lasting relief and enables patients to gradually return to their daily activities. Want to know more about the procedure? Continue reading to learn about the technique, benefits, risks, and recovery.  

Procedure Name 

Total Hip Replacement 

Alternative Name 

Total hip arthroplasty, hip replacement surgery 

Conditions Treated 

Osteoarthritis, rheumatoid arthritis, osteonecrosis 

Benefits of the Procedure 

Decreases symptoms, improves mobility, high success rate  

Treated By 

Orthopaedic surgeon 

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What is a total hip replacement?

A total hip replacement (THR), also called total hip arthroplasty, is a surgical procedure where a damaged hip joint is replaced with an artificial joint or prosthesis. The artificial hip joint used in the replacement consists of the following: 

  1. A ball made of ceramic or metal, which replaces the natural femoral head

  2. A socket that replaces the damaged acetabulum in the pelvis 

This surgery effectively reduces pain and enhances hip function and mobility.

Anatomy and Physiology of the Hip Joint

The hip joint is a ball-and-socket joint that provides a wide range of motion while bearing substantial weight. The anatomy of the hip joint is as follows: 

  1. It is made up of a hip bone (pelvis) and a thigh bone (femur). 

  2. The thigh bone has a rounded end (femur head) that rests inside a cup-like socket called the acetabulum in the pelvis. 

  3. The ball and socket surfaces of the hip joint are lined with articular cartilage. It is a smooth tissue that cushions the bones and facilitates easy movement.

  4. The synovial membrane (a thin tissue layer) surrounds the hip joint. In a healthy hip, this membrane produces a slight amount of fluid that lubricates the cartilage, significantly reducing friction during movement.

  5. Tissue bands, known as ligaments, connect the ball to the socket, ensuring stability and support for the joint.

Types of Hip Replacement

There are multiple types of hip replacement surgeries based on the socket implant attachment used and the material in the prosthetic component. These include: 

Socket Implant Attachment

  1. Cemented Prosthesis: This type uses special bone cement to secure the implant components to the bone.

  2. Uncemented Prosthesis: In uncemented total hip replacement, the prostheses attach with a porous surface to promote bone growth. 

Prosthetic Materials

  1. Metal-on-Polyethylene: A metal femoral head moves within a plastic (polyethylene) cup.

  2. Ceramic-on-Polyethylene: It refers to a ceramic femoral head with a plastic cup. 

  3. Ceramic-on-Ceramic: Both components of a ceramic hip replacement are made of ceramic. 

  4. Ceramic-on-Metal: It is a ceramic ball with a metal socket. 

Note: The treatment approach is based on the patient’s condition and the doctor’s opinion.

Who needs total hip replacement?

Hip joint replacement is mostly performed in people aged 60 and above. The doctor may recommend this procedure for those who experience hip pain that:

  1. Makes it difficult to sleep at night 

  2. Does not improve with other treatments like medication and physical therapy 

  3. Interferes with daily activities like bathing, walking, or doing household chores 

  4. Causes issues with walking, needing the use of a cane or walker 

  5. Impairs the ability to climb up and down the stairs 

  6. Makes it challenging to rise from a seated position 

Conditions Treated With Total Hip Replacement

Total hip replacement surgery is primarily used to treat a range of conditions that cause significant hip pain and mobility issues. The following are the common conditions that can be effectively managed or resolved through this procedure:

  1. Osteoarthritis: Also called wear and tear arthritis, this is the most common reason for hip replacement. It damages the cartilage that covers the ends of the bones, leading to pain and stiffness.

  2. Rheumatoid Arthritis: This autoimmune condition causes inflammation of the joint lining and cartilage, resulting in pain, swelling, and deformity.

  3. Osteonecrosis (avascular necrosis): It occurs when there is inadequate blood flow to the ball portion of the hip joint. This causes the bone to collapse and become deformed.

  4. Hip Fractures: In older adults, severe hip injuries like fractures may be treated with a hip replacement if the bones are unlikely to heal well with other treatments.

  5. Bone Tumours: Cancerous growths can impair the functionality of the hip and may necessitate a hip replacement.

Benefits of Total Hip Replacement

Hip replacement is a highly effective procedure for those whose lives are significantly impacted by hip joint problems. It offers the following benefits: 

  1. Decrease in Symptoms: One of the most immediate benefits post-surgery is significant relief from pain and stiffness.

  2. Improved Mobility: It results in enhanced mobility and increased range of motion. Patients typically find it easier to perform everyday activities such as walking, climbing stairs, and standing from a seated position.  

  3. High Success Rate and Durability: Hip replacements are known for their high success rate. According to a study by Ahmed M Negm et al., 2022, the survival rate of THR implants at 5 and 20 years is 90-100% and 60.4-77.7%, respectively.

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Orthopaedics and Joint Replacement

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Before and On the Day of the Total Hip Replacement

Patients receive comprehensive instructions from their orthopaedic surgeon to prepare for total hip replacement surgery. It is crucial to follow these guidelines before and on the day of the surgery to ensure the procedure goes smoothly.

Before Total Hip Replacement 

Before undergoing a THR, patients undergo thorough preparations to ensure optimal outcomes. They must clear away in advance any loose rugs, electrical cords, and other items that they can trip over at home. Other preparations and guidelines are as follows: 

Parameters 

Prerequisites 

Pre-op Assessments 

  1. Physical exam 

  2. Blood tests and urinalysis 

  3. X-ray 

Risk Evaluation 

  1. Allergies 

  2. Benefits vs risks 

Restrictions

Smoking, blood-thinning medications a week before surgery 

Anaesthesia Selection 

General or regional 

Fasting 

6 to 12 hours before the procedure 

On the Day of the Total Hip Replacement 

Patients arrive at the hospital early on the day of hip replacement to undergo final health checks. After being admitted, they are prepared for surgery, which includes the following: 

Parameters 

Prerequisites 

Consent 

Mandatory 

Surgical Preparation 

Changing into a hospital gown 

Physical Evaluation 

Vitals check-up (blood pressure, heart rate, breathing, etc.)

IV Line 

Yes, for medicines and fluids 

Patient Position 

Supine (lying on the back with face up) or lateral decubitus (lying on the side)

Total Hip Replacement Procedure

A total hip arthroplasty is performed in a hospital and takes two hours to complete. While the exact procedure can differ depending on the technique chosen, the general steps are as follows:

  1. Anaesthesia: The surgery is initiated by administering general or regional (spinal or epidural) anaesthesia. This ensures the patient feels no pain during the operation.

  2. Incision: The surgeon makes an incision over the hip to expose the joint. The location of the cut will depend on the approach (back, front, or side) of the procedure. 

  3. Removing Damaged Cartilage and Bone: The surgeon removes the damaged femoral head and cleans the acetabulum. They remove damaged cartilage and prepare the bones to fit the new prosthetic components.

  4. Implanting the Prosthesis: The femoral stem is inserted into the hollow centre of the femur with or without cement. Next, the femoral head component is placed on the stem. The acetabular component (artificial socket) is implanted into the pelvic bone.

  5. Reattaching Muscles: After the new joint components are in place, the surgeon reattaches the surrounding muscles and tissue with dissolvable stitches. 

After Total Hip Replacement and Recovery

Full recovery after hip replacement can vary from one person to another. However, patients can expect improvements in three months after the procedure. Recovery after the surgery begins immediately in the hospital and continues at home. The following is a general guideline: 

Recovery in Hospital

Depending on their condition and individual needs, many patients can return home on the same day of the procedure. Others may need to stay in the hospital for 1-3 days. Here’s what one can expect before discharge: 

  1. The patient will be moved to a recovery room until the effect of anaesthesia wears off. 

  2. The nurse will check their vitals like blood pressure, heart rate, and breathing. They will also monitor them for complications. 

  3. Once the individual’s condition stabilises, they will be moved to a hospital room or discharged to home. 

  4. They will be encouraged to walk within a day of surgery with a walker or crutches to promote blood circulation and prevent blood clots. 

At-Home Recovery 

It may take 6-12 weeks before patients can use their hips without restrictions. During this time, the doctor may provide the following instructions to ensure a smooth recovery: 

  1. Get a raised toilet seat and shower chair to help with sitting and standing.

  2. Keep the surgical area clean and dry. 

  3. Take pain medication as prescribed by the medical specialist to manage postoperative pain and inflammation.

  4. Attend physical therapy exercises aimed at strengthening the hip and improving flexibility. 

  5. Regularly apply ice packs to the hip area to help reduce swelling. 

  6. Avoid crossing the legs, bending the hips more than a right angle, and turning the affected leg inward. 

  7. Refrain from driving for 3-4 weeks after surgery or until the doctor approves. 

First Follow-Up Appointment 

The first follow-up appointment after a total hip replacement typically occurs 10-14 days after surgery. This initial check-up is important for the following reasons: 

  1. The surgeon examines the incision site for proper healing and checks for signs of infection or complications. 

  2. They assess the patient’s mobility, pain levels, and overall hip joint functionality. This includes observing how well the person can walk, bend, and carry out daily activities.

Risks and Complications of Total Hip Replacement

Complications after total hip replacement are rare. However, like any surgical procedure, it may have some risks. These include: 

  1. Infections

  2. Bleeding 

  3. Blood clots in the legs or lungs 

  4. Hip dislocation 

  5. Loosening or wear and tear of the prosthetic hip joints 

  6. Change in leg length 

  7. Fracture 

  8. Nerve damage 

When to consult a doctor? 

After total hip replacement surgery, it is important to monitor recovery and be aware of signs that need a consultation with a doctor. The following are some instances when patients should seek medical advice:

  1. A fever higher than 100.4°F

  2. Redness, swelling, bleeding, or discharge from the incision site 

  3. Increased discomfort around the surgical incision 

  4. Pain and swelling in the lower leg 

  5. Chest pain or shortness of breath 

Risks of Delaying Total Hip Replacement

Delaying hip replacement surgery when recommended by a healthcare provider can lead to several risks and complications. This is particularly true for individuals with severe hip conditions such as osteoarthritis. Here are some potential risks associated with postponing the surgery:

  1. As the hip joint continues to deteriorate, pain can become more severe and persistent, significantly impacting daily activities and quality of life.

  2. Delaying surgery leads to further joint damage and degeneration, resulting in decreased range of motion and increased stiffness.

  3. The procedure might be more complex when surgery is eventually performed, and recovery could take longer.

Cost of Total Hip Replacement

The total hip replacement cost in India can vary widely depending on several factors. Generally, it starts at ₹ 80,000 and can go up to ₹ 2,00,000. The average price of the procedure is ₹ 1,20,000. 

Procedure Name 

Estimated Cost Range 

Total Hip Replacement 

₹ 80,000 to ₹ 2,00,000

Note: These prices are approximate. Individuals considering the surgery should talk to HexaHealth consultants for updated cost information. 

Factors that can affect the expenses of total hip replacement include: 

  1. Hospital Facility: The cost can vary depending on whether the procedure is performed in a public hospital, private hospital, or specialised orthopaedic facility. Private and speciality hospitals generally have higher fees. 

  2. Location: Hospitals in metropolitan cities often charge more than those in smaller regions due to higher overhead expenses.

  3. Surgeon’s Experience: Medical specialists with extensive experience and a higher success rate may charge more for their services. 

  4. Type of Implant: The choice of implant greatly influences the expenditure. More durable or specialised implants are costlier.

  5. Insurance: Whether or not a patient has insurance and the extent of coverage provided can influence out-of-pocket expenses.

Takeaway

Total hip replacement is a highly effective surgery to relieve chronic hip pain and significantly improve mobility. It helps patients enjoy an active lifestyle free from the harmful effects of hip degeneration. The procedure treats various conditions, such as osteoarthritis, rheumatoid arthritis, and hip fractures, with high success rates. 

HexaHealth can assist patients considering hip replacement surgery by providing access to experienced orthopaedic surgeons. Our experts provide personalised guidance that suits each patient’s specific needs. From initial consultation through recovery, we make the process as smooth and efficient as possible. 

Suggested Reads

Partial Hip Replacement
Revision Hip Replacement
Hip Arthroscopy
Open Reduction and Internal Fixation Hip

Frequently Asked Questions (FAQ)

Total hip replacement surgery involves replacing a diseased hip joint with an artificial implant. It is performed to relieve pain and improve mobility in patients with severe joint damage.

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The exact process of hip replacement surgery can differ depending on the technique used in the procedure. However, the general steps involved are as follows: 

  1. An incision is made over the hip 

  2. The damaged femoral head and acetabulum are removed 

  3. They are replaced with artificial components made of metal, ceramic, or plastic

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Various types of hip replacement implants are used in THR, each varying in durability and suitability based on the patient’s age, activity level, and bone quality. These include: 

  1. Metal-on-polyethylene

  2. Ceramic-on-polyethylene

  3. Ceramic-on-metal

  4. Ceramic-on-ceramic

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Total hip replacement offers various benefits to patients suffering from hip joint diseases. These advantages are as follows: 

  1. Significant pain relief 

  2. Improved mobility 

  3. High durability of the implant

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The recovery process after hip replacement surgery involves initial pain management and mobilisation with physical therapy to strengthen the hip. This is followed by a gradual return to normal activities, typically 6-12 weeks.

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Avascular necrosis (osteonecrosis) of the hip is a condition when the femoral head does not get enough blood. This leads to the death of bone tissue. Hip replacement is an effective solution to treat avascular necrosis in the advanced stage. It replaces the damaged bone and cartilage with artificial components, thereby relieving pain and restoring function.

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Though rare, like any other surgery, there are some risks associated with hip replacement surgery. These include:

  1.  Infection 

  2. Blood clots 

  3. Hip dislocation 

  4. Wear and tear of the implant 

  5. Differences in the leg length 

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Yes, total hip arthroplasty is the same as total hip replacement. Both terms refer to the procedure that replaces the diseased hip joint with an artificial implant to relieve pain and enhance mobility.

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Uncemented total hip replacement involves implants that use a porous surface to promote bone growth into the implant for stability. On the other hand, cemented replacements use special bone cement to secure the components immediately within the bone structure.

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The long-term outcomes of hip joint replacement include lasting pain relief, improved mobility, and a better quality of life. Most modern hip implants can last 20 years or more, although activities and lifestyle can affect longevity.

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Full recovery from total hip replacement can vary from one individual to another. However, it may take up to 3 months. It depends on the patient’s health, the extent of surgery, and their commitment to following a rehabilitation program with physical therapy.

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Ceramic hip replacements are often more durable than metal ones in terms of wear resistance. It is a tough material that increases the longevity of the implant for an artificial hip. Ceramics can be used for the ball and socket or only the ball. 

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After total hip arthroplasty, patients should avoid high-impact activities like running and jumping. They should also refrain from sports that require twisting movements or excessive force on the joint.

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The average total hip replacement cost is ₹ 1,20,000, depending on the geographic location, surgeon fee, and type of implant. However, this price is an estimate. Patients should consult HexaHealth experts for up-to-date information. 

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Yes, total hip replacement surgery is covered under most health insurance plans. However, coverage can vary significantly. Patients are advised to consult HexaHealth for specific policy details.

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Total hip replacement is highly successful. About 95% of patients experience significant pain relief, improved mobility, and enhanced quality of life.

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Yes, most patients can live normal lives after total hip replacement. Proper rehabilitation and ongoing care help many return to everyday activities and low-impact sports with greater functionality and less pain.

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The 90-degree rule with hip replacement advises patients to avoid bending their hip more than 90 degrees. This restriction helps prevent dislocation of the new hip joint during the early recovery. 

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Yes, patients can go upstairs after hip replacement. This may require assistance or a handrail, crutch, or crane. They must step up with their non-surgical leg first and then with the surgical leg. 

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Sitting Indian style (cross-legged) is not recommended after hip replacement. This position can place excessive strain on the hip joint and elevate the risk of dislocation.

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Hip replacement effectively relieves the symptoms of avascular necrosis and restores function by replacing the damaged joint. However, it does not cure the underlying disease process that caused the bone loss. 

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References

All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.


  1. Singh A, Das S, Chopra A, Danda D, Paul BJ, March L, et al. Burden of osteoarthritis in India and its states, 1990–2019: findings from the Global Burden of Disease Study 2019. Osteoarthritis and Cartilage. 2022 May;link
  2. orthoinfo. Total Hip Replacement - OrthoInfo - AAOS [Internet]. Aaos.org. 2020. link
  3. Total Hip Replacement [Internet]. Cleveland Clinic. link
  4. Hip joint replacement: MedlinePlus Medical Encyclopedia [Internet]. Medlineplus.gov. 2015. link
  5. John Hopkins Medicine. Hip Replacement Surgery [Internet]. Johns Hopkins Medicine. 2019. link
  6. Mayo Clinic. Hip replacement - Mayo Clinic [Internet]. Mayoclinic.org. 2022.link
  7. Papalia GF, Zampogna B, Albo E, Torre G, Villari E, Papalia R, et al. The role of patient surgical positioning on hip arthroplasty component placement and clinical outcomes: a systematic re-view and meta-analysis. Orthopedic Reviews. 2023 Apr 11;15.link
  8. WebMD. Arthritis and Hip Replacement Surgery [Internet]. WebMD. WebMD; 2003.link
  9. Post-Operative Total Hip Arthroplasty: St. Elizabeth’s Medical Center | Steward Family Hospital | Brighton MA [Internet]. www.semc.org. [cited 2024 Apr 19]. link
  10. Negm A, Beaupre LA, Goplen C, Weeks CA, Jones CR. A Scoping Review of Total Hip Arthroplasty Survival and Reoperation Rates in Patients of 55 Years or Younger: Health Services Implications for Revision Surgeries. 2022 Aug 1;16:247-258.e6.link
  11. What To Expect from a Ceramic Hip Replacement [Internet]. Healthline. 2021. link
  12. HSS. Hip Replacement Surgery: Procedure, Types and Risks | HSS [Internet]. Hospital for Special Surgery.link
  13. Dislocation risk and 90 degree rule [Internet]. Joint Replacement Patient Forum. link
Disclaimer: The information provided here is for educational and learning purposes only. It doesn't cover every medical condition and might not be relevant to your personal situation. This information isn't medical advice, isn't meant for diagnosing any condition, and shouldn't replace talking to a certified medical or healthcare professional.

Reviewer

Dr. Aman Priya Khanna

Dr. Aman Priya Khanna

MBBS, DNB General Surgery, Fellowship in Minimal Access Surgery, FIAGES

12 Years Experience

Dr Aman Priya Khanna is a well-known General Surgeon, Proctologist and Bariatric Surgeon currently associated with HealthFort Clinic, Health First Multispecialty Clinic in Delhi. He has 12 years of experience in General Surgery and worke...View More

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Kirti V

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