Hip arthroplasty

During hip arthroplasty, the surgeon removes the diseased femoral head and the damaged acetabular cartilage and bone, then implants a stem inside the femur with a prosthetic head and a cup in the acetabulum, often lined with a durable plastic (polyethylene) or ceramic insert. Depending on factors such as age and bone quality, components may be fixed using bone cement or press-fit (cementless) designs that allow bone to grow onto their surface. The aim is to restore joint alignment and leg length as much as possible, reduce pain and provide smoother, more predictable motion than a severely arthritic hip. A range of surgical approaches exists, including traditional and minimally invasive techniques, selected according to the surgeon’s expertise and each patient’s characteristics.

The decision to proceed with THA is usually made when hip pain is severe, interferes with sleep and daily function and no longer responds adequately to non-surgical options. Before surgery, a thorough history, physical examination and imaging are performed to assess joint status and to review expected benefits, potential risks and the recovery pathway. After the operation, most patients begin standing and walking short distances with assistance while still in hospital, with gradual increases in walking distance and independence over the following days and weeks, guided by the surgical and rehabilitation team.

After hip arthroplasty, rehabilitation is a key part of treatment and usually begins within the first day or two after surgery. While in hospital, your physiotherapist will help you get out of bed safely, take your first steps with a walker or crutches, practise getting in and out of a chair and, when relevant, learn how to manage stairs. Some patients are advised to follow specific “hip precautions” for a period of time – guidance on which movements and positions to avoid so the new joint stays in a safe position as tissues heal – and these depend on the surgical approach used.

Over the following weeks, physiotherapy usually focuses on restoring hip range of motion, strengthening the gluteal and surrounding muscles, improving balance and gradually increasing walking or other low-impact activities. Home-exercise programmes are often performed several times per day early on, at a comfortable intensity, to help control swelling, regain movement and build confidence in using the new hip. As recovery progresses, the plan is adapted: assistive devices are reduced, walking distances increase and, once the surgical team is satisfied with healing and strength, more demanding activities such as driving, work tasks and selected sports are reintroduced step by step.