Hip Replacement Surgery
This is one of the most successful operations in Orthopaedics, with a 98% satisfaction rate regarding improvement in quality of life and pain relief.
The hip is a ball-and-socket joint. In a damaged hip, the smooth cartilage that allows the ball to glide within the socket has worn away, causing the bones to rub painfully against each other. Hip replacement surgery involves removing the damaged surfaces of the hip joint and replacing them with carefully engineered artificial components that recreate the smooth, comfortable movement of a healthy hip.
Surgery is usually recommended when the pain and stiffness are significantly affecting daily life and when other treatments such as physiotherapy, anti-inflammatory medication, or steroid injections are no longer providing enough relief.
Common Causes
Osteoarthritis. The most common reason for hip replacement. Over time, the protective cartilage inside the hip joint wears away, leaving the bones to grind against each other. The result is deep, persistent pain, stiffness, and reduced mobility.
Rheumatoid arthritis. A condition in which the body's immune system attacks the lining of its own joints. In the hip, this chronic inflammation progressively destroys the cartilage and bone, causing pain and deformity that worsens over time.
A hip fracture. A serious break, particularly of the femoral neck (the top of the thigh bone), can damage the hip joint beyond the point where it can heal on its own.
Avascular necrosis. When the blood supply to the head of the thigh bone is disrupted (through injury, prolonged steroid use, or certain medical conditions) the bone tissue begins to break down. This leads to the collapse of the joint surface and, eventually, severe arthritis.
Benefits
Pain relief. The most significant outcome for most patients. The deep aching pain that has built up over months or years is relieved almost entirely once the joint has healed.
Improved mobility. Activities that had become difficult or impossible: walking, getting in and out of a car, climbing stairs, or standing up without help, become manageable again.
Better sleep. Hip pain is often worse at night. Once this pain has been eliminated, patients typically notice a meaningful improvement in the quality of their sleep.
Lifestyle benefits. Improved quality of life, improved physical health, better independence and return to certain sports that were stopped due to pain.
Common Hip Replacement Procedures
Total Hip Replacement
The damaged ball (the head of the thigh bone) and the worn socket (the acetabulum) are both removed and replaced with prosthetic components. The socket is replaced with a cup that is fixed into the pelvis, and a metal or ceramic ball is attached to a stem inserted into the thigh bone. Together, they recreate the smooth, stable movement of a healthy hip joint.
Revision Hip Replacement
Revision surgery is required when a previous hip replacement has worn out, become loose, or failed for another reason. It is a more complex procedure than the original replacement, and Dr. Barrett ensures the patient is fully informed about both the need for the operation and what to expect during recovery.
What to Expect Prior to Surgery
1. A pre-operative assessment. Dr. Barrett will review the patient's hip through examination to confirm the diagnosis and plan the surgery. General health is also assessed to make sure the patient is fit for the operation and anaesthetic.
2. A medication review. Patients may be asked to stop certain medicines (such as blood thinners or anti-inflammatory drugs) in the days before surgery.
3. Final surgery preparation. The patient may be asked not to eat or drink for several hours before the operation. It is also worth preparing the home environment before surgery, such as a raised toilet seat and everyday items within easy reach all make the early days of recovery more comfortable.
What to Expect During Surgery
Hip replacement surgery is carried out under either general anaesthetic (the patient is fully asleep) or spinal anaesthetic (the patient is awake but numb from the waist down). Dr. Barrett assesses this on a case-by-case basis. The operation typically takes between 1 and 2 hours.
1. An incision is made over the hip to access the joint. The size of the cut will depend on the technique used.
2. The damaged ball and socket surfaces are carefully removed.
3. The prosthetic components are positioned and fixed securely in place.
4. Before closing, Dr. Barrett checks the movement, stability, and alignment of the new joint.
What to Expect During Recovery
Recovery is gradual and varies between patients. The following is a general guide:
Days 1 – 3
The patient will be admitted to hospital after surgery. Movement begins early, usually the day of or the day after the operation, with the support of a physiotherapist. Getting up and bearing weight on the new hip as soon as it is safe to do so is an important part of recovery.
Weeks 1 – 6
A walking aid will be needed initially. Swelling and discomfort are normal and ease progressively. A gentle physiotherapy programme is essential during these early weeks.
Weeks 6 – 12
Most patients are walking unaided and returning to light everyday activities by this stage. Driving is typically possible again around 6 to 8 weeks after surgery, depending on Dr. Barrett's guidance.
Months 3 – 12
The hip continues to settle and strengthen. Most patients reach the full benefit of their surgery between 6 and 12 months after the operation.
This is calculated on a case-by-case basis. We use Medical Aid billing tariffs, and are affiliated with almost all Medical Aid providers to use their billing schedule.
Hip replacement is typically considered when the pain is significantly affecting daily life and when other treatments have stopped working. Dr. Barrett will assess the severity of the damage, alongside a full picture of how the hip is impacting the patient's quality of life.
Modern hip implants are highly durable. Around 80 to 90% of replacements are still functioning well at 20 years. Avoiding high-impact activities and maintaining a healthy weight can help extend the life of the implant. If the patient is younger, Dr. Barrett will discuss the realistic possibility of eventually needing revision surgery as part of making a fully informed decision.
Hip replacement is a safe and well-established operation, but as with any surgery, there are some risks. These include infection, blood clots, dislocation of the new joint, and, very rarely, injury to surrounding nerves or blood vessels. Dr. Barrett discusses all relevant risks with each patient during the pre-op consultation.
Most patients are walking independently within 4 to 6 weeks, and back to light daily activities shortly after. Low-impact activities such as swimming, cycling, and walking are actively encouraged. High-impact activities such as running are generally not recommended.
Support is most important in the first 6 weeks. The patient will not be able to drive, and help may be needed with cooking, shopping, and getting around the house. Arranging this support in advance makes a significant difference to the early recovery.
Other Services
Dedicated Orthopaedic surgeries focused on improved mobility and exceptional recovery.
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Shoulder Replacement Surgery
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Arthroscopic Surgery
Precise keyhole surgery for knee and shoulder injuries, with minimal disruption and a fast return to normal life.
Muscle & Tendon Repair
Getting patients back to full strength by repairing torn or ruptured muscles and tendons.
Ligament Surgery
Rebuilding the ligaments that keep a joint stable, so the giving-way feeling becomes a thing of the past.
Trauma
Expert doctor care for broken bones and serious injuries.
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