Hip Replacement in the UK: Everything You Need to Know Before Surgery

When Is It Time for a Hip Replacement?

Hip replacement is one of the most successful operations in medicine \u2014 but it's still major surgery, so timing matters. The main reason people have a hip replacement is osteoarthritis that's causing pain and limiting daily life. If your hip pain stops you sleeping, walking, or doing the things you enjoy \u2014 and you've tried painkillers, physiotherapy, and weight loss without enough improvement \u2014 it's probably time to have the conversation. There's no benefit to waiting until you can barely walk. In fact, people who have the operation while they're still reasonably fit tend to recover faster and have better outcomes.

How to Choose Your Surgeon

For hip replacements, surgical volume matters enormously. A surgeon who does 100+ hip replacements a year will typically have lower complication rates than one who does 20. In England, you can check consultant-level outcome data through the National Joint Registry (njrcentre.org.uk), which publishes revision rates (how often the replacement needs redoing) by surgeon. Your GP should give you a choice of where to be treated. Use this. Ask the surgeon: How many hip replacements do you do per year? What's your revision rate? Which implant do you use and why? What approach do you use (anterior, posterior, lateral) and what are the pros and cons?

NHS vs Private: What's the Difference?

On the NHS, a hip replacement typically involves a wait of 3-12 months from GP referral to surgery. You may have less choice over your surgeon, and the hospital experience is functional rather than luxurious \u2014 but the clinical quality is often excellent, especially at high-volume centres. Privately, you can usually have the operation within 2-4 weeks. Costs range from \u00a311,000-16,000 for a fixed-price package including the implant, surgeon's fee, anaesthetist, and hospital stay. Many surgeons work in both sectors, so you may see the same person either way. The key advantage of private is speed and choice.

What to Expect: The Operation and Hospital Stay

The operation takes 60-90 minutes under general or spinal anaesthetic. Most people stay in hospital for 1-3 days \u2014 the trend is towards faster discharge. You'll be encouraged to stand and walk (with support) within hours of the operation. This feels daunting but it's important for recovery. You'll go home with blood-thinning medication (to prevent blood clots), painkillers, and instructions for exercises. The hospital should arrange follow-up physiotherapy. If they don't, ask for it \u2014 structured rehabilitation makes a significant difference to how well and how quickly you recover.

Recovery: What Nobody Tells You

Weeks 1-2 are the hardest. You'll need help at home \u2014 getting dressed, cooking, getting in and out of bed. Plan this in advance. Most people can walk short distances with a stick by week 3-4, drive again by week 6 (check with your surgeon and insurer), and return to office work by week 6-8. Full recovery takes 3-6 months. Some things that catch people off guard: sleeping is uncomfortable for weeks, the other hip often starts hurting more once the new one feels better (it was compensating), and there's usually a period of frustration around weeks 3-6 when progress feels slow. This is normal. Keep doing the exercises.

Risks and Complications: What to Watch For

Hip replacement is safe \u2014 serious complications are rare but real. The main risks are: infection (about 1 in 100 \u2014 antibiotics during surgery reduce this significantly), blood clots in the legs or lungs (you'll take blood-thinning medication to prevent this), dislocation (about 1-2 in 100 \u2014 following the movement restrictions your surgeon gives you reduces this risk), and the implant eventually wearing out (modern implants typically last 15-25 years). After surgery, contact your surgical team urgently if you develop: a high temperature, increasing redness or oozing from the wound, sudden leg swelling, chest pain, or breathlessness. These could indicate infection or a blood clot and need prompt treatment.