Hip Replacement
Hip replacement is a proven and effective procedure for patients suffering from advanced osteoarthritis, fractures, or joint degeneration. The damaged hip joint is replaced with smooth, artificial components to relieve pain and restore mobility. This surgery is typically recommended when non-surgical treatments like physiotherapy and medications have failed. this surgery can offer real relief and help you move more comfortably again.
Patients considering this option may also want to learn about hip resurfacing, particularly if they are younger and looking to maintain a high level of activity.
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During the procedure, the damaged parts of your hip joint are replaced with smooth, artificial parts made from strong materials like metal, ceramic, and plastic. These new components are designed to move easily and last for many years, allowing you to return to daily activities with less pain and better mobility.
A Brief History
Hip replacement has been around since the 1960s, and techniques have come a long way. Thanks to modern advances in surgery and materials, today’s hip replacements are more durable and more effective than ever.
How the Implant Is Fixed in Place
One of the key steps in hip replacement is how the artificial joint is attached to your bone. In our practice—and across the UK, as shown by the National Joint Registry—the hybrid method is the most commonly used. Here’s a simple breakdown:
Hybrid Fixation (most common): The femoral (thigh bone) component is fixed in place using special surgical cement, while the acetabular (hip socket) component is left uncemented to allow natural bone growth into the implant. This provides strong initial fixation and long-term stability.
Cemented Fixation: Both parts are secured using bone cement. This method is often used in older patients or those with weaker bone, offering immediate support.
Uncemented Fixation: Both parts are press-fitted into the bone without cement. Over time, the bone grows into the surface of the implant. This is typically used in younger patients with strong, healthy bone.
The best method depends on your age, bone quality, lifestyle, and personal health. Your surgeon will recommend the option that’s safest and most effective for you.
Ready to take the next step?
If hip pain is limiting your life and conservative treatments haven’t worked, hip replacement could be a life-changing solution. Book a consultation to discuss your options and create a treatment plan tailored to your needs.
Hip Resurfacing
Hip resurfacing is a surgical treatment for hip pain that preserves more of your natural bone compared to a total hip replacement. It’s typically considered for younger, active patients, especially men, who want to maintain a high level of physical function and may benefit from the bone-conserving nature of the procedure.
Rather than removing the entire ball of the hip joint (as in a total hip replacement), hip resurfacing involves reshaping it and placing a smooth, metal cap over it. The socket (acetabulum) is also fitted with a metal cup. This creates a low-friction surface that allows for smooth movement of the joint.
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A Bit of History
The most widely known and studied form of hip resurfacing is the Birmingham Hip Resurfacing (BHR) system, developed in the UK in the 1990s. It was introduced as a bone-preserving alternative for younger patients, aiming to delay or avoid the need for a full hip replacement.
Initially, the procedure showed excellent early results, particularly in active male patients. However, over time, concerns arose around metal-on-metal implants, which can release microscopic metal particles (debris) into the surrounding tissue and bloodstream. In some cases, this led to inflammation, pain, and the need for further surgery.
These issues were linked to both the design of certain implants and variations in surgical technique. As a result, the use of hip resurfacing has become more selective and carefully regulated. Only certain implants remain approved for use, and it is now recommended primarily for larger-framed male patients, as outcomes in smaller hips (more common in female patients) have not been as reliable.
Benefits of Hip Resurfacing
- Preserves more of your natural bone
- May feel more like a “normal” hip
- Larger joint size may reduce risk of dislocation
- Easier revision surgery if a future total hip replacement is needed
- Suitable for active lifestyles and some sports
Limitations and Considerations
- Slightly shorter lifespan compared to total hip replacement
- Requires regular follow-up over the long term
- Currently only recommended for male patients due to implant size limitations and outcomes
- Risk of metal debris, which is closely monitored through follow-up and imaging
Looking Ahead: Innovations in Materials
There is exciting progress in the development of ceramic hip resurfacing implants, which aim to avoid the issues linked to traditional metal-on-metal designs. One such innovation is the ReCerf® ceramic resurfacing implant, developed by MatOrtho. This new approach could offer the same bone-preserving benefits, but with improved safety and potentially broader suitability—including for female patients in the future.
Learn more about ReCerf® here →
If this option becomes appropriate and available for your case, we’ll discuss it with you as part of your personalised treatment plan.
Is Hip Resurfacing Right for You?
Hip resurfacing is a highly specialised procedure offered only to carefully selected patients. If you’re young, active, and experiencing hip pain that hasn’t improved with non-surgical treatments, we’ll discuss whether this option might suit you—or whether a total hip replacement would be a better fit.
A thorough consultation and assessment will help us determine the best approach for your needs, lifestyle, and long-term health.
Considering Hip Resurfacing?
As one of the few specialists in the region offering hip resurfacing, I can help you explore this bone-preserving alternative to full hip replacement. If you’re young, active, and seeking long-lasting relief, book a consultation today to see if hip resurfacing is right for you.
Revision Hip Replacement
A revision hip replacement, often called a “re-do,” is a procedure performed to replace or repair a hip replacement that is no longer working as it should. While primary hip replacements are very successful and can last many years, they may eventually need to be revised for a number of reasons. Revision surgery is more complex than the first operation, but it can help restore function, reduce pain, and improve your quality of life.
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Why Might a Hip Replacement Need to Be Revised?
There are several possible reasons for a revision:
- Implant Wear and Tear: Over time, artificial joints can wear out—especially in younger or more active patients.
- Loosening or Movement of the Implant: The components can become loose or shift from their original position.
- Infection: Though rare, deep infection in the joint can require removal and replacement of the implant.
- Dislocation: If the hip keeps dislocating (popping out of place), a revision may be needed to improve stability.
- Fracture Around the Implant: A fall or trauma can cause a break in the bone near the implant.
- Reaction to Implant Materials: In some cases, the body may react to debris from metal or other materials, causing inflammation or bone loss.
What Makes Revision Surgery More Complex?
Revision surgery is more challenging than the original hip replacement for several reasons:
- Bone Loss: There may be less healthy bone to work with, which makes it harder to secure a new implant.
- Scar Tissue: Previous surgery can cause scarring and make the tissues harder to work around.
- Custom Implants or Special Techniques: Surgeons may need to use specially designed implants, bone grafts, or reinforcement devices to rebuild the joint.
- Longer Surgery and Recovery Time: Revision procedures often take longer in theatre and may require a longer hospital stay and rehabilitation period.
Despite the added complexity, revision surgery can still be very successful, especially when performed by an experienced surgical team with access to advanced implant systems and planning tools.
What to Expect
Before recommending revision surgery, we’ll carry out a full assessment using X-rays, blood tests, and possibly advanced imaging or scans. We’ll talk through the reason for revision, the expected outcome, and any risks specific to your case.
Your recovery may be slower than after your first hip replacement, but with careful follow-up and a tailored rehabilitation plan, many patients regain excellent mobility and comfort.
If you’ve had a hip replacement and are experiencing new pain, instability, or other concerns, don’t hesitate to get in touch. Early assessment can help prevent more serious problems and guide you toward the best next steps—whether that’s further monitoring or revision surgery.
Patient Reviews
Book A Consultation
If you are experiencing ongoing hip pain, I can assess your condition and recommend the most effective treatment for you. To book an appointment, please contact my secretary at:
When to See a Specialist
If hip pain is affecting your daily activities or does not improve with self-care, you can book a consultation by filling in your details on my contact page or by contacting my secretary:
Trochanteric Injections
Trochanteric bursitis refers to inflammation of the bursa located on the side of the hip. It can cause pain, particularly when sitting, lying on the affected side, or during certain movements. Corticosteroid injections, often combined with local anaesthetic, can provide significant pain relief by reducing inflammation. In most cases, this treatment is combined with physical therapy to help prevent recurrence and restore function.
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What the injection involves:
A quick procedure using a small injection of local anaesthetic and steroid
Often done in clinic, sometimes with ultrasound guidance for accuracy
Aims to relieve pain so you can move more comfortably and return to activity
Aftercare:
- Rest for 1–2 days after the injection
- You may feel improvement within a few days
- Follow-up physiotherapy helps prevent symptoms from coming back
Injections are generally safe and effective when used alongside other treatments.
Sacroiliac Injections
The sacroiliac (SI) joints connect the lower spine to the pelvis and help absorb shock during movement. When irritated by arthritis, injury, or strain, they can cause pain — typically on one side of the lower back, sometimes radiating to the buttock or hip. This discomfort is often mistaken for general back or hip problems.
SI joint injections are a targeted treatment to reduce inflammation and ease pain. They usually contain a local anaesthetic for immediate relief and a corticosteroid for longer-term benefit. The procedure is carried out under X-ray or ultrasound guidance for accuracy.
Most patients feel improvement within a few days, making it easier to return to normal activities or begin physiotherapy. Injections can also help confirm the SI joint as the pain source and guide further treatment.
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What to Expect on the Day
Sacroiliac joint injections are typically carried out as a day case procedure and take only a few minutes to perform. You’ll lie on your front, and the area will be cleaned and numbed with a local anaesthetic. Using X-ray (fluoroscopy) or ultrasound guidance, the specialist will insert a fine needle into the SI joint and deliver the injection precisely.
You may feel some pressure or mild discomfort during the injection, but most patients tolerate it well without sedation.
Aftercare and Recovery
- You’ll be monitored briefly after the procedure and can usually go home the same day.
- Rest is advised for the first 24 hours.
- The local anaesthetic may provide immediate relief, but this may wear off before the steroid begins to work—typically within 2–5 days.
- You may gradually return to your normal activities as comfort improves.
Some soreness at the injection site is normal and usually settles within a day or two.