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How it is performed

You'll usually be admitted to hospital on the day of your operation. The surgeon and anaesthetist will see you to discuss what will happen and answer any questions you have.

Most people would have seen their surgeon at a pre-assessment clinic and had the chance to talk about the operation.

A senior-level surgeon, consultant or registrar will do the operation. They may be helped by junior doctors. You should be told at your pre-operative assessment who will be doing the operation. Ask if you're not told.

How the operation is done

Hip replacement surgery is usually done either under general anaesthetic (you're asleep throughout the procedure) or under spinal anaesthetic (you're awake but have no feeling from the waist down).

Sometimes you may have an epidural, which is similar to a spinal anaesthetic.

Once you've been anaesthetised, the surgeon makes a cut (incision) of up to 30cm over the side of your hip.

The upper part of your thigh bone (femur) is removed and the natural socket for the head of your femur is hollowed out.

A socket is fitted into the hollow in your pelvis. A short, angled metal shaft (the stem) with a smooth ball on its upper end (to fit into the socket) is placed into the hollow of your femur. The cup and the stem may be pressed into place or fixed with bone "cement".

The operation takes up to 2 hours.

Minimally invasive surgery

Some surgeons use minimally invasive techniques that help to avoid damage to the muscles and tendons around the hip joint.

1 or 2 small cuts (less than 10cm) are made and special instruments are used to remove and replace the hip joint.

Minimally invasive hip replacement appears to be as safe and effective as conventional surgery. It also causes less pain after the operation.

The National Institute for Health and Care Excellence (NICE) has more information on minimally invasive total hip replacement.

The hip replacement operation has become a routine procedure. However, as with all surgery, it carries a degree of risk. Find out about the risks of hip replacement surgery.

Metal-on-metal hip resurfacing is done in a similar way, however this is rarely done now because of possible complications and a higher "failure rate". This means that the hip joint must be replaced rather than resurfaced again.

The main difference with this procedure is that less of the bone is removed from the femur, as only the joint surfaces are replaced with metal inserts.

Choosing your implant

There are several types of implant made of plastic, metal or ceramic, or a combination of these.

The different parts of the implant can be cemented or uncemented:

  • cemented parts are secured to healthy bone using bone "cement"
  • uncemented parts are made from material that has a rough surface; this allows the bone to grow on to it, holding it in place

Metal-on-metal (MoM) hip implants are rarely used now as they can cause complications. Find advice about metal-on-metal implants.

NICE only recommends implants known to have a 95% chance of lasting at least 10 years.

Your surgeon should discuss any concerns you have about the choice of implant.

TheĀ National Joint Registry (NJR), which collects details on total hip replacement operations from hospitals in England, Wales, Northern Ireland and the Isle of Man, can help you to identify the best performing implants and the most effective type of surgery.