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Orthopedics & Joint Replacement

Total Hip Replacement Surgery

Swaps a hip damaged by arthritis, AVN or a fracture for an artificial ball and socket, so groin pain stops limiting how far you can walk.

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Total Hip Replacement Surgery at Prakash Hospital, Orthopedics & Joint Replacement
Surgery duration
1.5 to 2 hours
Anaesthesia
Spinal or general
Hospital stay
2 to 4 days
Recovery
4 to 6 weeks for daily activities
On this page

Overview

Hip pain rarely stays in the hip. Most people feel it in the groin, often spreading down the thigh to the knee, and some spend months treating the wrong joint. Putting on socks, climbing out of an autorickshaw and sitting on the floor get hard long before walking does.

A total hip replacement (total hip arthroplasty) replaces both halves of this ball-and-socket joint. Your surgeon removes the damaged ball at the top of the thigh bone (the femoral head) and fits a metal stem into the hollow centre of the bone, topped with a new metal or ceramic ball. The worn socket in the pelvis (the acetabulum) gets a metal cup with a smooth plastic or ceramic liner for the new ball to move in.

It's one of the most dependable operations in orthopaedics. The arthritis pain usually goes within weeks, though the hip muscles take months to get their strength back and a slight limp can last until they do.

Our orthopaedics and trauma team performs total hip replacements, choosing cemented or uncemented fixation based on your bone quality and age. Our physiotherapists usually have you standing within 24 hours of surgery.

Why it's done

Surgery is considered when the joint is badly damaged and pain keeps coming back despite medicines, physiotherapy and a walking stick. In India, many younger adults need a new hip because of avascular necrosis rather than wear and tear.

  • Osteoarthritis, where the cartilage lining the ball and socket has worn away
  • Avascular necrosis (AVN), where the ball loses its blood supply and collapses, often linked to steroid medicines or heavy drinking
  • Rheumatoid arthritis or ankylosing spondylitis affecting the hip
  • A displaced fracture of the hip neck in an older person, where screws are unlikely to hold
  • Groin or thigh pain at night, or pain that limits walking to short distances
  • Stiffness that makes it hard to cut your toenails, wear shoes or sit on the floor

Is it right for you?

Usually a good fit

  • X-rays or MRI show the hip joint itself is badly damaged
  • Other treatment hasn't helped, or the ball has already collapsed
  • Diabetes, blood pressure and heart conditions are under control, and you can do daily exercises for about three months

May not be suitable

  • An infection anywhere in the body, until it has been treated
  • Pain that actually comes from a trapped nerve in the lower back
  • Early AVN where the ball hasn't collapsed, which may respond to joint-saving treatment first
  • Severe anaemia, poorly controlled diabetes, or a heart attack or stroke in the past few months, until treated

Types and techniques

Cemented or uncemented parts

Bone cement grips the stem straight away and suits softer bone, which is common in older women. Uncemented parts have a rough coating that your bone grows onto over the following weeks, and are often used in younger people with strong bone. Some hips use one of each.

Total or half hip after a fracture

After a break in the neck of the thigh bone, an older person sometimes needs only the ball replaced (a hemiarthroplasty, or half hip). A total hip is preferred if you walked independently before the fall and are otherwise fit, or if the socket already has arthritis. Surgery is usually within a day or two, because long spells in bed bring chest infections, clots and bed sores. Breaks that can be saved are fixed with screws or a nail instead.

Preparing for surgery

  • Blood tests including HbA1c, an ECG, and hip and pelvis X-rays, which also help plan implant sizes
  • Bring a list of your medicines. Blood thinners such as warfarin, apixaban or clopidogrel may need pausing, but only when your doctor says so
  • If you take steroid tablets, tell us and don't stop them suddenly. The anaesthetist may adjust the dose around surgery
  • Get any tooth abscess, urine infection or sore on the legs treated first
  • Raise your seating: a firm, high chair with arms and a raised toilet seat or commode chair
  • Keep a long-handled shoe horn and a grabber ready so you don't have to bend down
  • Arrange for a family member to stay and help for the first two weeks

The procedure, step by step

  1. 01

    Anaesthesia and positioning

    You'll have a spinal or general anaesthetic, sometimes with a nerve block, and are placed on your side or back depending on the approach.

  2. 02

    Reaching the joint

    A cut of about 10 to 20 cm is made over the hip. The muscles are eased aside or partly released, and the ball is lifted out of the socket.

  3. 03

    Removing the ball and preparing the socket

    The damaged femoral head is cut away. The socket is reamed down to healthy bone and the new cup is pressed or cemented in, angled to keep the hip stable.

  4. 04

    Stem, ball and leg length

    The thigh bone is shaped to take the stem and trial balls are fitted. With the hip back in place, your surgeon tests its stability and compares the length of both legs before fitting the final parts.

  5. 05

    Repair and closure

    Muscles and tendons that were moved are stitched back and the skin is closed with stitches or clips. Most operations take 1.5 to 2 hours.

Benefits and risks

Benefits

  • The grinding arthritis pain gone for most people within a few weeks
  • Easier walking and stairs, and getting in and out of cars
  • Better sleep once the night pain has gone
  • Implants that usually last 15 to 20 years, and often longer

Possible risks

  • Dislocation of the ball out of the socket, in roughly 1 to 2 in 100 people, mostly in the first few months. It can usually be put back without another operation
  • Infection in the new joint, at roughly 1 in 100, which usually means further surgery
  • Blood clots in the leg or lungs, reduced with blood-thinning medicine, stockings and early walking
  • A small difference in leg length, which a shoe insert can even out if it's noticeable
  • Rarely, a crack in the thigh bone around the stem, or nerve injury causing foot weakness
  • The implant wearing or working loose over the decades, sometimes needing a second operation

Recovery timeline

For six weeks the aim is to protect the hip while the tissues around it heal. After that, strengthening the buttock muscles on the outer side of the hip is what gets rid of the limp.

  1. 01

    Days 0 to 4, in hospital

    You stand with a walker, usually within 24 hours, then walk the corridor, try a few steps and practise with a raised toilet seat. Most people go home once they manage these safely.

  2. 02

    Weeks 2 to 6

    Clips come out at about two weeks, and you move to a stick held in the hand opposite the new hip. Don't cross your legs, avoid low seats and don't bend forward past a right angle.

  3. 03

    Weeks 6 to 12

    By now the stick is usually gone, and most people are back at desk work and driving. Your surgeon will tell you when the precautions can be relaxed.

  4. 04

    3 months to 1 year

    The hip muscles go on getting stronger for up to a year. Walking, swimming and cycling suit a new hip well, and follow-up X-rays check the implant.

When to call your doctor

  • Sudden severe hip pain with the leg looking shorter or turned, and you can't stand on it. This may be a dislocation
  • A temperature of 38°C (100.4°F) or higher, or pus or spreading redness at the wound
  • Pain, swelling or tenderness in the calf or thigh
  • Breathlessness or chest pain that comes on suddenly. Call an ambulance
  • New numbness or weakness in the foot
  • A fall onto the operated hip

Call us on +91-8826000033 or come straight to our 24/7 emergency department.

Alternatives to surgery

Medicines, weight and a walking stick

Painkillers, hip-strengthening physiotherapy and losing extra weight all help earlier arthritis, and a stick in the opposite hand takes a large share of the load off the hip. Our BMI calculator shows whether your weight is adding to the load.

Steroid injection

An injection into the hip, given under imaging guidance, can settle pain for weeks to months. It doesn't slow the arthritis, and one given in the months before a replacement may raise the infection risk.

Joint-saving treatment for early AVN

If AVN is found before the ball collapses, core decompression (drilling small channels to relieve pressure inside the bone) may delay a replacement for some people.

Talk to our Orthopedics & Joint Replacement team

Ask about your options, the cost and your insurance before you decide. See the insurance and TPA panels we work with.

Book an Appointment+91-8826000033

This page explains Total Hip Replacement Surgery in general terms. Your own plan depends on your health, your test results and your doctor's advice. Please read our medical disclaimer.

Your care team

Total Hip Replacement Surgery is led by our Orthopedics & Joint Replacement team, with other departments stepping in at each stage of your care.

Orthopedics and Traumatology Department
Leads your treatment

Orthopedics and Traumatology Department

At Prakash Hospital, our Orthopedics and Traumatology Department offers expert diagnosis, surgical and non-surgical treatments, and rehabilitation for bone, joint, and musculoskeletal injuries.

What the department treats

Total Knee Replacement

Total Hip Replacement

Arthroscopic Surgery

Spine Surgery

Trauma and Fracture Care

Sports Medicine

Visit the Orthopedics & Joint Replacement department

Other departments involved

Physiotherapy

Gets you standing within about 24 hours, teaches hip precautions and runs the strengthening programme that fixes the limp.

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General Medicine

Brings blood sugar, blood pressure and heart problems under control before surgery and manages them on the ward.

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Blood Bank

Cross-matches blood in advance, since hip replacement occasionally needs a transfusion.

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Meet the specialists

Related procedures

Procedures often considered alongside Total Hip Replacement Surgery, or that treat related conditions.

Total Knee Replacement

Replaces a knee worn out by arthritis with a metal and plastic joint to relieve pain and get you walking again.

Fracture Fixation Surgery

Realigns broken bones and holds them with plates, screws, rods or frames so they heal in the right position.

Joint Reconstruction

Realigns and rebuilds a joint damaged by injury, deformity or earlier surgery, keeping your own joint.

Spine Surgery (Discectomy)

Frees a trapped spinal nerve by removing slipped disc or bone, easing sciatica and leg pain.

More in Orthopedics & Joint Replacement

Other procedures our Orthopedics & Joint Replacement team performs.

View the department

Shoulder Replacement

Replaces a damaged shoulder ball and socket to relieve arthritis pain and help you use your arm again.

Arthroscopy (Knee/Shoulder)

Keyhole surgery using a thin camera to diagnose and repair problems inside the knee or shoulder.

ACL Reconstruction

Rebuilds a torn ACL with a tendon graft through keyhole surgery to stop the knee giving way.

Ligament Repair Surgery

Reattaches or rebuilds torn ligaments in the knee, ankle, elbow or thumb to steady an unstable joint.

Revision Knee Replacement

Replaces a failed knee implant that is loose, worn, infected or unstable with new revision parts.

Partial Knee Replacement

Replaces only the worn part of an arthritic knee, keeping the healthy cartilage and ligaments.

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Frequently Asked Questions

Answers to common questions about Total Hip Replacement Surgery at Prakash Hospital, Noida.

How long does a hip replacement last?

In large registry studies, about 9 in 10 hip replacements are still working at 15 years, and more than half at 25 years. Low-impact exercise and a steady weight slow the wear.

Can I sit on the floor, squat or use an Indian toilet afterwards?

Not for at least three months. Deep squatting and cross-legged sitting put the hip in the positions most likely to dislocate it, and many surgeons advise avoiding them for good. Use a Western-style toilet or a commode chair at home.

I'm in my forties with AVN. Am I too young for a new hip?

Age alone doesn't decide it. If the ball has collapsed and the pain stops you working, a replacement is often the right choice even in your thirties or forties, though a hip put in at 40 will probably need replacing again at some point.

When can I drive or ride a two-wheeler again?

A car at around 6 weeks, once you can sit comfortably and brake firmly. A scooter or motorcycle means getting a leg over and holding the bike up at every stop, so most surgeons suggest waiting at least 3 months.

When can I sleep on my side?

Most people sleep on their back with a pillow between the knees for six weeks, then move to the unoperated side, keeping the pillow a little longer.

Does insurance cover hip replacement?

Most policies do, but many have a waiting period of a few years for joint replacement or for arthritis you had before buying the policy. Hip fracture surgery after a fall usually counts as an accident. See our empanelled insurers and TPAs and ask for pre-authorisation early.

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