Artificial hips

Why are they necessary?

The most common reason for replacing the hip joint is because of damage caused by osteoarthritis. Other reasons include infection or a fractured hip, which commonly occurs in older women as a complication of osteoporosis or a fall.

How much do they cost?

Total hip replacements are available on the NHS, but there may be a long waiting list, so some people choose to have it done privately.

The cost of artificial joints ranges from hundreds to thousands of pounds, depending on how sophisticated the joint is.

The overall cost of an NHS operation including all the hospital stay and doctors fees is estimated to range from £4,000 to £7,000. Prices in the private system will be competitive.

If you choose to go private, check what's offered in the package. Make sure it covers the management of complications, including the possible need to revise the hip if there are initial problems. Replacement of the hip if it wears out is unlikely to be covered.

What are the risks?

There are possible complications, such as infection, after the operation or loosening of the artificial joint later on. But most people enjoy a new lease of active life with their artificial hip.

What does the operation involve?

The new joint is put in during an operation known as a total hip replacement (THR). About 50,000 THRs are carried out each year in England and Wales on the NHS, and a considerable number more in private hospitals.

In general the joint consists of three parts:

• A metal ball (usually cobalt or titanium-based alloys) replaces the top of the femur or leg bone
• A metal stem joined to the ball, which is inserted down into the centre or marrow space of the femur using cement or other gripping devices
• A spherical plastic cup, which is inserted separately in the bone of the pelvis

The metal ball is pushed into the plastic cup, joining the leg and the pelvis. The ball can move around in the cup, so the joint can bend and move.

After the operation it's essential to get you and your new hip moving, initially with help from a physiotherapist and occupational therapist.

When you get home you should take things carefully for the first six to 12 weeks, following the advice of your medical team. For example, crossing your legs could lead to dislocation of the hip until the muscles have strengthened around it.

Regular exercise is important, but avoid high-impact sports.

How long will the new hip last?

There are more than 60 different types of hip available. The National Institute for Health and Clinical Excellence (NICE) has reviewed different types of artificial hip joint and recommended surgeons only use types that have been shown to last at least ten years.

In general, unless you're unlucky enough to have problems early on, your hip should last at least ten years, possibly longer.

Hips are more likely to fail in younger active people who want to get back to all their previous activities or sport.