​Total hip replacement is one of the major advances in modern orthopaedic surgery. First developed by Sir John Charnley, it involves replacing the damaged ball and socket of the hip with artificial components (a prosthesis) to restore movement and relieve pain. Thousands of these operations are successfully performed each year in New Zealand.

The procedure is most often performed to relieve pain and stiffness caused by severe arthritis.

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• Osteoarthritis wears away the smooth cartilage covering the joint.

• Rheumatoid arthritis causes inflammation that destroys cartilage and bone.

• Other causes include injury, infection, or avascular necrosis.

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As arthritis progresses, inflammation leads to swelling, stiffness, and weakness of surrounding muscles. When pain and disability persist despite non-surgical treatments, hip replacement can restore mobility and improve quality of life.

Diagnosis involves a full medical history, physical examination, and imaging — usually x-rays and sometimes an MRI scan — to assess the degree of joint damage.

​Surgery is considered only when non-surgical options such as exercise, physiotherapy, medication, or walking aids no longer provide relief. Your surgeon will discuss all available treatment options before recommending hip replacement.

Under anaesthetic, the surgeon removes the damaged bone and cartilage.

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• The femoral head (ball) is replaced with a metal or ceramic head on a stem that fits into the thigh bone.

• The socket in the pelvis is fitted with a ceramic or metal cup.

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These components are designed to move smoothly and mimic the natural function of the hip joint.

Recovery varies by individual. Most patients stand and walk (with help) on the same day as surgery. Crutches are used for several weeks. Physiotherapy helps strengthen muscles and restore movement. Most people notice steady improvement over the following months.

Recovery varies by individual. Most patients stand and walk (with help) on the same day as surgery. Crutches are used for several weeks. Physiotherapy helps strengthen muscles and restore movement. Most people notice steady improvement over the following months.

• Pain relief: Usually dramatic and long-lasting

• Improved mobility: Better movement and flexibility

• Strength restoration: Muscles regain power through exercise

• Daily function: Easier walking, climbing stairs, and returning to normal activities

Every operation carries some risk. Major complications are rare but can include:

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• Infection: Usually treated with antibiotics; deep infection may require further surgery.

• Loosening: The implant can loosen over time, occasionally requiring revision surgery.

• Dislocation: Rare, and most often occurs in the first few weeks.

• Wear and tear: Slow and gradual over many years.

• Nerve injury: Rare and often temporary.

• Breakage of components: Extremely uncommon.
   

Tell your surgeon about any medical conditions or medications that might affect your surgery, and inform your GP and anaesthetist before the operation.

Most hip replacements last 15–20 years or more. Older, less active patients often never need another operation. Younger, more active people may require a revision later in life. Improvements in materials and surgical technique continue to extend implant longevity.

Surgery takes about two hours. Hospital stay is usually two to four days, and most patients use crutches for four to six weeks.

It’s important to have a dental check-up within six months before surgery, and to avoid major dental work for six months after. Treat any infections (including dental, bladder, or skin) before surgery, as infections can delay or complicate recovery.

You may experience some numbness, tightness, or clicking around the incision or joint. These symptoms usually improve over time. The artificial joint may set off metal detectors at airports — simply inform security staff about your replacement.

Pain typically decreases over the first few weeks. Swelling can persist for several months and improves with regular movement and elevation. The hip continues to strengthen and remodel for up to two and a half years after surgery.

Regular gentle exercise is essential. Walking, physiotherapy, and low-impact activity promote recovery. Avoid overexertion — mild soreness is normal, but persistent pain means you’ve done too much.

Most people can resume driving after about six weeks, depending on individual progress and safety.

You’ll begin stair training with a physiotherapist before leaving hospital. Progress depends on individual strength and balance.

Avoid high heels for the first few months. Otherwise, wear comfortable, supportive shoes that minimise the risk of slipping.

Both can help ease discomfort. Apply ice or a heat pack for 20 minutes at a time, and never sleep with a heating pad to avoid burns.

• Blood thinners (Aspirin or Cartia): usually for 1 month after surgery.

• Pain medication: take regularly for the first 10 days, then as needed.

• Always follow your prescribed instructions and ask your care team if unsure.

Yes. Clicking is common in artificial joints and usually fades as muscles strengthen and the tissues heal.

Difficulty sleeping is common in the first 6–8 weeks. It improves as your body heals. Try taking prescribed pain relief before bed, use a heat pack, and stay active during the day to help restore normal sleep patterns.