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Introduction

Hip care · Hip replacement

Hip replacement (total hip arthroplasty)

Specialist orthopaedic surgeon · hip problems

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    Dr Sean LeoOrthopaedic Surgeon, Singapore

    Clinic enquiries · Not an emergency service

    Illustrative image

    A hip replacement replaces a worn hip joint with an artificial one.

    A hip replacement replaces a worn hip joint with an artificial one.

    A hip replacement replaces a worn hip joint with an artificial one.

    • Hip replacement (total hip arthroplasty), sometimes called total hip replacement, is surgery that replaces the damaged parts of the hip joint with metal, plastic or ceramic parts.[1]
    • It is a considered step, not the first one. It may be recommended when hip pain and stiffness are having a big effect on your life and other treatments have not worked.[2]
    • A hip replacement is not always the end of the story. Modern hip replacements are designed to last many years, and if one wears out, a further operation called a revision may be needed.[4]
    • OrthoKinetics is Dr Sean Leo’s professional brand. Clinical care is provided through OrthoSports Orthopaedic & Sports Surgery. Dr Sean Leo is a specialist orthopaedic surgeon who cares for hip problems.
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    What’s covered on this webpage

    Follow the route in order, or jump to the stop you need. Stops you have read are marked.

    The hip is a ball-and-socket joint.

    The hip is a ball-and-socket joint.

    The hip is a ball-and-socket joint.

    The hip is one of the body’s largest joints.[5] It is a ball-and-socket joint: the ball is the femoral head, and the socket is the acetabulum.[1][5]

    Arthritis is the most common cause of a painful, stiff hip.

    Arthritis is the most common cause of a painful, stiff hip.

    Arthritis is the most common cause of a painful, stiff hip.

    The most common cause of chronic hip pain and disability is arthritis.[5] Osteoarthritis, rheumatoid arthritis and posttraumatic arthritis are the most common forms.[5]

    Osteoarthritis is the most common reason a hip replacement is done. It is a condition that causes joints to become painful and stiff.[2]

    If you are wondering whether your own hip pain is arthritis, the hip osteoarthritis page explains how that question is approached.

    When should a hip problem be assessed

    When should a hip problem be assessed

    When should a hip problem be assessed?

    Hip pain or stiffness that is having a big effect on your life is a reasonable reason to be assessed.[2]

    A hip problem that comes on after a fall or injury is a different situation. Severe hip pain after a fall or injury, or being unable to walk or put weight on your leg, needs urgent attention, because a broken hip needs treatment in hospital straight away.[8][9] That is covered on the hip fracture page.

    Safety note: This webpage is not an emergency service. If you have severe hip pain after a fall or injury, or you cannot put weight on your leg, seek urgent medical care.[9]

    Other treatments come first.

    Other treatments come first.

    Other treatments come first.

    A hip replacement is not where hip arthritis treatment begins. If medications, changes in your everyday activities and the use of walking supports do not adequately help your symptoms, you may consider hip replacement surgery.[5]

    When is a hip replacement considered

    When is a hip replacement considered

    When is a hip replacement considered?

    A hip replacement may be recommended if hip pain and stiffness are having a big effect on your life and other treatments have not worked.[2] Osteoarthritis is the most common reason.[2]

    Whether that describes you is a decision made with your clinician, based on your own situation.

    A man presses a lump of clay with both hands at a work table in a bright pottery studio.

    Structure / Patient / Goal

    Structure / Patient / Goal

    Deciding together

    Structure / Patient / Goal

    S

    Structure: what is affected?

    Structure is the hip joint itself: the ball and socket, how worn or painful they are, and how the surrounding hip is involved. It also includes what the assessment shows.

    P

    Patient: how does it affect you?

    Patient means you as a whole person. Your symptoms, how active you are, your general health, your preferences and your circumstances all shape which options are reasonable.

    G

    Goal: what are you hoping to return to?

    Goal is what matters to you, whether that is walking comfortably, getting on with daily life, or returning to sport or work. A useful plan starts from a clear purpose.

    Your plan

    No single factor decides the plan alone, and one scan or one symptom does not determine it.

    The worn ball and socket are replaced, and there is more than one way to reach the joint.

    The worn ball and socket are replaced, and there is more than one way to reach the joint.

    The worn ball and socket are replaced, and there is more than one way to reach the joint.

    In a hip replacement, the damaged bone and cartilage are removed and replaced with artificial parts.[5] These parts are made of metal, plastic or ceramic.[1]

    The surgeon can reach the hip through a traditional incision, which is relatively long, or through a minimally invasive approach, which uses one or more shorter incisions or changes where the incision is placed.[6] Which one is used is something your surgeon discusses with you.[6]

    What “minimally invasive” means

    The goal of using shorter incisions, or changing the location of the incision, is to reduce pain and speed recovery.[6] Minimally invasive techniques may not be suitable for every patient, and both traditional and minimally invasive hip replacement are technically demanding operations.[6]

    Recovery is gradual and measured in months.

    Recovery is gradual and measured in months.

    Recovery

    Recovery is gradual and measured in months.

    It may take several months to recover from a hip replacement.[3] How long it takes can vary depending on your age and general health.[3]

    A woman reaches up to place a glass jar on a wooden shelf in a traditional provision shop.

    Risks and complications

    Risks and complications

    Risks and complications

    A hip replacement is a common and generally safe procedure. However, as with any type of surgery, there are risks, and your doctor will explain these to you.[4]

    Risks include:

    • Blood clots (deep vein thrombosis, or DVT), which are possible after a hip replacement.[4]
    • Wound infection. There is a small chance that the hip wound could get infected after surgery.[4]
    • A difference in leg length.[4]
    • Dislocation. Sometimes a hip replacement can dislocate. This is not common.[4]
    • Wear of the new joint over time, which is covered in the sections below.[4][5]

    A hip replacement can last many years, but not necessarily forever.

    A hip replacement can last many years, but not necessarily forever.

    A hip replacement can last many years, but not necessarily forever.

    Modern hip replacements are designed to last for at least 15 years, according to the NHS.[4] They can also wear over time, causing pain or swelling.[4]

    With normal use and activity, the material between the ball and the socket of every hip replacement begins to wear. This is a normal process. Excessive activity or being overweight may speed up this normal wear and cause the replacement to loosen and become painful.[5] With appropriate activity modification, hip replacements can last for many years.[5]

    A man walks through a bright tropical hotel lobby while wheeling a dark carry-on suitcase.

    What if a hip replacement needs replacing

    What if a hip replacement needs replacing

    What if a hip replacement needs replacing?

    If a replacement hip dislocates or wears out, you may need another operation to fix it.[4] An operation that replaces an earlier hip replacement is called a revision hip replacement.

    OrthoKinetics Recovery Reflection

    Recovery reflection

    What does it mean to live with a joint that was built rather than born?

    A hip replacement is less an event than a long relationship. The operation is where it begins. A new joint is made to serve for many years, and like most things a person relies on for a long time, it asks for sensible use and a little ordinary attention: neither treated as too fragile to use, nor forgotten about.

    How do you make peace with something that is not promised to be forever?

    Very little that a person depends on comes with a guarantee of forever. What anyone can do is understand what they have, use it well, and check in with the people who look after it. Held that way, the question shifts from how long it will last to how well it is being lived with, year by year.

    A long partnership is measured in years of ordinary use, not in any single day.

    Illustrative image

    With you through the seasons

    Meet Dr Sean Leo

    Meet Dr Sean Leo

    A consultant orthopaedic surgeon whose clinical focus is the knee, sports injuries and the lower limb.

    • Dr Sean Leo is a consultant orthopaedic surgeon. OrthoKinetics is his professional brand; clinical services are provided through OrthoSports Orthopaedic & Sports Surgery at Mount Elizabeth Novena Specialist Centre and Connexion, Farrer Park Hospital.
    • His clinical interests include sports injuries, including those in adolescent athletes; ligament reconstruction; realignment surgery; cartilage repair and joint-preservation approaches; knee replacement; and technology-assisted hip and knee surgery.
    • The consistent aim is to return people to meaningful function and activity while avoiding unnecessary downtime.
    • Qualifications: MBBS, MRCS (Ed), MMed (Ortho), FRCSEd (Ortho).
    More detail: Meet Dr Sean Leo
    • Training and career: Dr Leo trained in medicine at the National University of Singapore and served in the Singapore Armed Forces Medical Corps from 2000 to 2012, where his work included the care of soldiers in physically demanding roles. He completed postgraduate orthopaedic training in 2009 and a one-year clinical fellowship at Royal North Shore Hospital in Sydney, Australia, before joining Changi General Hospital as an orthopaedic consultant in 2012, where he later held the positions of Senior Consultant and Director of the Hip and Knee Service. With seniority, his educational contribution has evolved towards mentorship and support for junior doctors.
    About Dr Sean Leo
    Dr Sean Leo standing in clinical scrubs against a plain wall
    Dr Sean LeoOrthopaedic Surgeon · consultations through OrthoSports

    Questions people often ask

    Common hip replacement questions

    Common hip replacement questions

    What is a hip replacement, and what is total hip arthroplasty?

    They are the same operation. Hip replacement (total hip arthroplasty) involves replacing damaged parts of your hip joint with metal, plastic or ceramic parts. It is sometimes called total hip replacement.[1]

    When is a hip replacement actually needed?

    A hip replacement may be recommended if hip pain and stiffness are having a big effect on your life and other treatments have not worked. The most common reason is osteoarthritis, a condition that causes joints to become painful and stiff.[2]

    How long does a hip replacement last?

    Modern hip replacements are designed to last for at least 15 years, according to the NHS, but they can wear over time. With appropriate activity modification, hip replacements can last for many years. If one wears out, another operation may be needed.[4][5]

    Is hip replacement major surgery?

    A hip replacement is a common and generally safe procedure. As with any type of surgery, there are risks, including blood clots, wound infection, a difference in leg length and dislocation. Your doctor will explain these to you.[4]

    Is one way of doing a hip replacement better than another?

    A hip replacement can be done through a traditional, relatively long incision or through a minimally invasive approach with shorter incisions or a changed incision location. Minimally invasive techniques may not suit everyone. Your surgeon will discuss the options with you.[6]

    What is a revision hip replacement, and when is it needed?

    A revision hip replacement is an operation that replaces an earlier hip replacement. If a replacement hip dislocates or wears out, you may need another operation to fix it.[4]

    How long does it take to recover from a hip replacement?

    It may take several months to recover from a hip replacement. This can vary depending on your age and general health.[3]

    Can I avoid a hip replacement?

    Other treatments come first. If medications, changes in your everyday activities and walking supports do not adequately help your symptoms, you may consider a hip replacement. It is recommended when pain and stiffness have a big effect on your life and other treatments have not worked.[2][5]

    What are the risks of a hip replacement?

    A hip replacement is common and generally safe, but as with any surgery there are risks. They include blood clots (deep vein thrombosis), wound infection, a difference in leg length and dislocation. Your doctor will explain these to you.[4]

    Am I too young or too old for a hip replacement?

    A hip replacement may be recommended if hip pain and stiffness are having a big effect on your life and other treatments have not worked.[2] Whether it is right for you is a decision made with your clinician, based on your own situation.

    What is the difference between a hip replacement and hip resurfacing?

    In hip resurfacing the femoral head is not removed but is trimmed and capped with a smooth metal covering, and it is now performed less frequently than in the past; it is not covered on this page.[7]

    Costs and insurance

    Costs and insurance

    Practicalities

    Cost, Medisave and insurance

    Logos of Great Eastern, HSBC Life, Prudential, Singlife, Alliance Medinet and iXchange, the insurers and corporate health plan administrators on whose panels Dr Sean Leo is listed

    Ask the clinic team for current information about fees, panel status, pre-authorisation and expected payment arrangements. Insurance coverage and out-of-pocket costs depend on the individual policy and the insurer’s decision; no coverage is guaranteed.

    A cost estimate for surgery can be given only after a consultation and assessment, once a surgical plan has been developed. Each individual condition is unique — implants used, time taken, and other factors contribute to the overall estimate. The estimate will be provided to you by the clinic should you decide on surgical management, and will also be used to assist in obtaining pre-authorisation from insurance where applicable.

    Insurance panels. Dr Sean Leo, Orthopaedic Surgeon, is on the specialist panels of Great Eastern (GE Panel), HSBC Life (HSBC Life Shield) and Singlife (Singlife Shield), and on the Prudential Panel. AXA Insurance Singapore became part of HSBC Life in 2023, and former AXA Shield plans are now HSBC Life Shield plans.

    Corporate health plans. Dr Leo is on the panels of both Alliance Medinet and iXchange, which administer medical benefits for many company health plans. If your company plan uses either panel, you can see Dr Leo as a panel doctor.

    If your company uses a different panel. Some company plans still let you see a doctor of your choice outside their panel, then claim reimbursement. This varies from plan to plan, as may the co-payment, so please check your benefits with your company’s HR department.

    Panel arrangements change from time to time, so please confirm with your insurer or your company’s plan administrator before your appointment.

    Dr Leo is on the panels shown. If your insurer is not listed, you may ask whether co-management with an Orthosports surgeon partner on that panel is clinically and administratively appropriate. Orthosports surgeon partners are collectively on the panels of all Shield plans.

    Specific benefits, pre-authorisation, reimbursement and cashless treatment depend on the individual policy and insurer approval and are not guaranteed.

    Arrange a consultation: the appointment section is further down this page.

    Sources

    References

    References

    1. NHS. What is a hip replacement? Available at: https://www.nhs.uk/tests-and-treatments/hip-replacement/what-is-a-hip-replacement/ (last reviewed 6 March 2024)
    2. NHS. Why a hip replacement is done. Available at: https://www.nhs.uk/tests-and-treatments/hip-replacement/why-a-hip-replacement-is-done/
    3. NHS. Recovering from a hip replacement. Available at: https://www.nhs.uk/tests-and-treatments/hip-replacement/recovering-from-a-hip-replacement/
    4. NHS. Complications of a hip replacement. Available at: https://www.nhs.uk/tests-and-treatments/hip-replacement/complications-of-a-hip-replacement/
    5. American Academy of Orthopaedic Surgeons (AAOS). Total Hip Replacement. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/treatment/total-hip-replacement
    6. American Academy of Orthopaedic Surgeons (AAOS). Minimally Invasive Total Hip Replacement. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/treatment/minimally-invasive-total-hip-replacement
    7. American Academy of Orthopaedic Surgeons (AAOS). Hip Resurfacing. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/treatment/hip-resurfacing
    8. NHS. Broken hip. Available at: https://www.nhs.uk/conditions/broken-hip/
    9. NHS. Hip pain in adults. Available at: https://www.nhs.uk/symptoms/hip-pain/

    Final next step

    Final next step

    Next step

    Final next step

    Reading about a problem is a starting point. An assessment brings together the history, an examination where needed and any useful tests, and helps you and your clinician decide what to do next. How much physical examination is needed is a matter of clinical judgement. It may be limited when pain makes an examination unreliable, or when imaging clearly shows a problem that matches the symptoms, such as a fracture seen on an X-ray or an MRI scan that clearly shows an injury consistent with the symptoms. The Singapore Medical Council and the UK General Medical Council both allow remote medical consultations, where a physical examination is not possible, with safeguards: the doctor must be clear about the limits of an opinion formed without an examination, and whether an in-person examination is needed, or referral to other services, is left to the clinical judgement of the attending doctor.

    If a hip problem may need urgent attention, such as after a fall or if you cannot bear weight, seek urgent medical care.[9]

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    Read about the hip and its conditions

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