A hip replacement replaces the worn parts of the hip joint with artificial components. The NHS describes it as a common and safe procedure, recommended when hip pain and stiffness are having a big effect on your life and other treatments have not worked. The most common reason is osteoarthritis; others include rheumatoid arthritis and damage after an injury.
What the operation involves
In a total hip replacement — the most common type — the “ball” at the top of the thigh bone and the “socket” in the pelvis are replaced with metal, ceramic or plastic parts. The NHS notes that the operation usually takes about 1 to 2 hours, under either a spinal anaesthetic (you are awake but numb from the waist down) or a general anaesthetic. NICE recommends that people are offered a choice between these, combined with local pain relief at the wound.
A partial hip replacement, which replaces only the ball, is mainly used after a hip fracture or for people who are frail. Hip resurfacing is used in small numbers and only for selected patients.
Who it is for
There is no single X-ray grade, score or age at which a hip replacement becomes “due”. NICE advises that referral decisions should be based on clinical assessment rather than numerical scoring systems, and that age or body weight should not, on their own, exclude someone. For more on timing, see when is the right time for a hip replacement?
Implants and registry evidence
After surgery you will be asked whether you consent to your operation being recorded in the National Joint Registry (NJR), which monitors joint replacements to improve safety and outcomes. NICE recommends hip implants with revision rates of 5% or less at 10 years. The NJR’s 2026 annual report notes that, with metal-on-metal hips excluded, ten-year revision rates have improved from 3.4% to 2.5% over the last decade. I favour implants with long registry follow-up rather than new designs because they are new.
Recovery
- NICE recommends that physiotherapy starts on the day of surgery if possible, and within 24 hours
- Many people go home around 1 to 3 days after the operation
- Stitches or clips are usually removed after about 10 days
- The NHS advises waiting at least 6 weeks before driving, and many people return to work at around 6 weeks, depending on the job
- Full recovery takes several months
Risks
Most people do well, but every operation carries risk. The NHS lists blood clots, wound or deeper joint infection, a difference in leg length, damage to nerves or blood vessels, dislocation, and wear of the joint over time. Modern hip replacements are designed to last at least 15 years. I discuss these risks openly so you can weigh them against your current quality of life.
After surgery, seek urgent advice (your GP or NHS 111) for throbbing or cramping leg pain, a high temperature, oozing from the wound, or worsening redness, swelling or pain. Call 999 for breathlessness or chest pain.
Questions worth asking
- Have we tried reasonable non-operative options?
- Which implant would you use for me, and what does its registry record show?
- Which anaesthetic and surgical approach do you suggest, and why?
- What will recovery look like for my work and activities?
The right choice depends on your history, examination and imaging. If you would like a clear assessment, you can arrange a private consultation or discuss a referral with your GP.
Frequently asked questions
How long does a hip replacement operation take?
The NHS notes that the operation usually takes about 1 to 2 hours.
How long will I be in hospital?
If you are generally fit and the surgery goes well, the NHS notes that you can usually go home around 1 to 3 days after the operation.
When can I drive after a hip replacement?
The NHS advises waiting at least 6 weeks and checking with your doctor that you are fit to drive.
How long does a hip replacement last?
The NHS notes that modern hip replacements are designed to last at least 15 years, and National Joint Registry data show revision rates have improved over time.
References
- NHS. Why a hip replacement is done. https://www.nhs.uk/tests-and-treatments/hip-replacement/why-a-hip-replacement-is-done/
- NHS. How a hip replacement is done. https://www.nhs.uk/tests-and-treatments/hip-replacement/how-a-hip-replacement-is-done/
- NHS. Recovering from a hip replacement. https://www.nhs.uk/tests-and-treatments/hip-replacement/recovering-from-a-hip-replacement/
- NHS. Complications of a hip replacement. https://www.nhs.uk/tests-and-treatments/hip-replacement/complications-of-a-hip-replacement/
- NICE. Joint replacement (primary): hip, knee and shoulder (NG157), recommendations. National Institute for Health and Care Excellence, 2020. https://www.nice.org.uk/guidance/ng157/chapter/Recommendations
- NICE. Osteoarthritis in over 16s: diagnosis and management (NG226), recommendations. National Institute for Health and Care Excellence, 2022. https://www.nice.org.uk/guidance/ng226/chapter/Recommendations
- National Joint Registry. 23rd Annual Report (2026): Executive Summary. https://reports.njrcentre.org.uk/AR-Executive-Summary