NHS Hip Replacement Surgery: Complete Patient Guide

Hip replacement (total hip arthroplasty) is one of the most common and successful operations performed by the NHS, with over 100,000 procedures carried out each year. This guide explains everything you need to know — from initial referral through to full recovery.

⚡ Key Facts

Duration: 1–2 hours under general or spinal anaesthetic
Hospital stay: Typically 3–5 days
Full recovery: 6–12 months for most patients
NHS waiting time: Variable; typically 6–18 months from referral
Success rate: Over 90% of patients report significant pain relief
Implant lifespan: 15–20+ years for most modern implants

What is Hip Replacement Surgery?

Hip replacement surgery involves removing a damaged hip joint and replacing it with an artificial implant (prosthesis) made from metal, ceramic, and plastic components. The goal is to relieve chronic pain and restore movement in patients whose hip joint has been severely damaged — most commonly by osteoarthritis.

The NHS performs over 100,000 hip replacements every year, making it one of the most routinely performed orthopaedic operations in the United Kingdom. The procedure has a very high success rate — the vast majority of patients experience a dramatic reduction in pain and a significant improvement in quality of life.

Who Needs a Hip Replacement?

Your GP or orthopaedic consultant may recommend hip replacement surgery if you have:

Severe, persistent hip pain that interferes with daily life or sleep
Hip pain that persists at rest or at night
Stiffness that makes it hard to walk, get dressed, or move normally
Significant reduction in quality of life despite non-surgical treatment
X-rays or MRI confirming substantial damage to the hip joint

The most common reason for needing a hip replacement is osteoarthritis (wear and tear arthritis). Other causes include rheumatoid arthritis, hip fractures, avascular necrosis (bone death due to poor blood supply), and hip dysplasia.

💡 Non-Surgical Options First

Surgery is usually only considered after non-surgical options have been tried, including: physiotherapy, weight management, walking aids, pain relief medication (paracetamol, NSAIDs), steroid injections, and activity modification. Your consultant will discuss whether surgery is appropriate for your individual situation.

Getting a Hip Replacement on the NHS

The pathway to an NHS hip replacement typically follows these steps:

GP consultation: Discuss your symptoms with your GP. They will assess your joint and may arrange X-rays.
Referral to orthopaedics: If your GP believes surgery may help, they will refer you to an orthopaedic consultant via the NHS e-Referral Service.
Outpatient appointment: The consultant will review your case, examine your joint, and discuss treatment options with you.
Pre-operative assessment: Before surgery, you will have tests (blood tests, ECG, medical review) to ensure you are fit for the operation.
Surgery: You will be added to the waiting list and called in when a theatre slot becomes available.

The NHS target is to treat patients within 18 weeks of GP referral. However, waiting times for hip replacements vary significantly across NHS trusts — some patients wait considerably longer in areas with high demand.

What Happens During the Operation

The operation typically takes 1 to 2 hours. You will be given either a general anaesthetic (you will be asleep throughout) or a spinal anaesthetic (you are awake but the lower half of your body is numb).

During surgery, the surgeon makes an incision over the hip, removes the damaged ball-and-socket joint, and replaces it with the prosthetic components. The artificial joint consists of a metal stem inserted into the femur (thigh bone), a metal or ceramic ball, a metal cup fitted into the pelvis socket, and a plastic liner between the ball and cup to allow smooth movement.

Recovery and Rehabilitation

Days 1–3: Physiotherapists will help you stand and walk (with crutches or a walking frame) the day after surgery.
Week 1–2: Most patients are discharged home with exercises, pain medication, and blood-thinning medication to prevent clots.
Weeks 2–6: Gradual increase in mobility. Crutches typically needed for 4–6 weeks. Driving is usually possible after 6 weeks (check with your consultant).
Months 3–6: Most daily activities resume. Continue prescribed physiotherapy exercises.
Month 12: Most patients achieve full recovery and return to normal activities.

Risks and Complications

Important: All surgical procedures carry risks. Your consultant will discuss these with you in detail before you consent to the operation. The risks should always be weighed against the benefits of the procedure for your specific situation.

Common risks associated with hip replacement include:

Blood clots (DVT/PE): Risk minimised with blood-thinning medication and compression stockings
Infection: Around 1 in 100 patients (treated with antibiotics or, rarely, further surgery)
Hip dislocation: Most common in the first few weeks; following post-operative instructions minimises risk
Leg length difference: Small discrepancy possible; usually correctable with a shoe insert
Nerve or blood vessel damage: Rare but possible
Implant loosening: May require revision surgery after 15–20 years

Frequently Asked Questions

How long will I be on the waiting list for an NHS hip replacement?

Waiting times vary significantly by NHS trust and region. The official NHS target is 18 weeks from GP referral to treatment. However, many patients wait longer — sometimes 12–18 months or more in high-demand areas. You can ask your GP about waiting times at different hospitals and use the NHS e-Referral Service to choose a provider.

Can I have a hip replacement privately to avoid the NHS waiting list?

Yes. Private hip replacement surgery in the UK typically costs between £10,000 and £16,000 depending on the hospital and surgeon. You may be able to use private health insurance if you have a policy. Private surgery can usually be arranged within weeks rather than months.

How long do hip replacements last?

Modern hip implants are designed to last 15–20 years or more. According to the National Joint Registry, about 95% of hip replacements are still functioning well 10 years after surgery. A revision (replacement of the implant) may be needed if the components loosen or wear over time.