When Is Hip Replacement Indicated?
Total hip replacement (arthroplasty) is considered when hip joint disease causes persistent pain and functional limitation that is not adequately managed by non-surgical treatment. It is not primarily an age-related decision — suitability depends on symptoms, functional impairment, and overall health.
- Osteoarthritis — the most common indication; progressive loss of articular cartilage causing bone-on-bone contact
- Inflammatory arthritis — including rheumatoid arthritis and other systemic inflammatory conditions
- Avascular necrosis — collapse of the femoral head due to loss of blood supply
- Fractures — displaced femoral neck fractures in older patients
- Post-traumatic arthritis — arthritis developing after a hip fracture or dislocation
- Failed previous procedures — where prior hip surgery has not produced satisfactory outcomes
The Procedure
The operation involves removing the diseased femoral head and resurfacing the acetabulum, replacing both with prosthetic components that recreate the smooth, pain-free mechanics of a healthy hip joint. The procedure is performed under general or spinal anaesthesia.
Femoral Component
A stem inserted into the femoral canal, topped with a precisely sized femoral head of ceramic or metal.
Acetabular Component
A cup pressed or cemented into the prepared acetabulum, lined with highly cross-linked polyethylene or ceramic.
Fixation
Components may be cemented (bone cement) or uncemented (relying on bone ingrowth), chosen based on bone quality and patient age.
Multiple surgical approaches exist — posterior, lateral, and anterior — each with specific advantages. The approach is selected based on anatomy, patient factors, and surgical preference.
Recovery & Outcomes
Most patients are mobilised with the assistance of a physiotherapist on the day of surgery or the day after. Hospital stay is typically three to five days. Recovery progresses through several stages.
Weeks 1–6
Walking with a frame progressing to a stick, physiotherapy, wound care, and hip precautions. Driving typically avoided for six weeks.
Weeks 6–12
Walking aid is usually no longer required. Return to light activities, low-impact exercise, and most daily tasks.
3–6 Months
Continued strengthening and conditioning. Most patients report significant improvement in pain and function. Return to recreational activities including golf, cycling, and swimming.
Modern hip implants are highly durable. Studies show that approximately 95% of hip replacements are still functioning well at 15 years, and the majority exceed 20 years of service. High-impact activities such as running are generally not recommended after total hip replacement.
Discuss Hip Replacement
For a personalised assessment and treatment plan, contact Dr. Pirpiris’s rooms at Cabrini Medical Centre, Malvern.
📞 Call 03 9508 9600