Hip replacement surgery is commonly used to overcome and remedy severe damage and pain caused by arthritis of the hip. Arthritis is a disease in which cartilage (the cushion between bones that helps bones to easily move against each other) breaks down. With damaged cartilage, the bones rub against each other and become worn.
Your hip joint is made up of a ball and socket. The ball is the top of the thighbone (femoral head). The socket area (acetabulum) is inside the pelvis. The surfaces of the ball and socket are covered with cartilage that enables them to move easily.
In hip replacement surgery, an artificial, synthetic prosthesis which naturally mimics the hip joint, is used to replace the joint or part of it.
But what types of hip replacement surgery are available and what do they involve?
Types of Hip Replacement Surgery
Total Hip Replacement: What does it involve?
A total hip replacement removes both the ball and socket from the damaged joint and replaces it with a prosthesis which is an artificial part. This is done via an anterior (front), posterior (back) or lateral (side) approach. The anterior approach is more technically challenging whereas the posterior and lateral approaches provide the surgeon with a better view of the hip joint.
The surgery usually takes around two hours.
Partial Hip Replacement: What does it involve?
In partial hip replacement surgery, your surgeon replaces the femoral head (ball) and not the socket. This type of surgery is used to treat certain femoral head fractures or to treat local cartilage defects of the femoral head in order to postpone the need for total hip replacement surgery. The surgery will typically take one to two hours.
Hip Resurfacing: What does it involve?
In hip resurfacing, the femoral head and neck are not removed. Instead the femoral head is trimmed and capped with a smooth metal covering. The damaged bone and cartilage within the socket are replaced with a metal shell, just as in total hip replacement. The surgery can usually last from 1-1/2 to 3 hours.
Hip implants are medical devices intended to replace the defected hip joint. These are made up of metal, plastic, titanium, stainless steel, cobalt-chromium, polyethylene, ceramic materials or a combination of these materials.
These are the components of hip implants:
Implant designs have unique features such as shape, size, material and dimensions that closely mimic the motion of the normal hip joint. Each design has benefits and risks. The surgeons may have a preference for a particular implant, depending on your hip anatomy. Several companies produce high-quality hip implants but the most popular of them are Stryker, Smith+Nephew, Zimmer, and DePuy.
Latest Developments in Hip Replacement Surgery
Stryker Mako® Robotic-Arm Assisted Technology
Mako robotic-arm assisted surgery is performed with the assistance of a robotic arm for greater precision, better results and short recovery time. In traditional hip arthroplasty, information from static imaging such as X-rays, CT scans, or an MRI taken before surgery, allows your surgeon to plan the overall procedure. With Mako robotic-arm assisted surgery, the surgeon takes a CT scan and uploads it to Mako software to develop a 3D virtual model of your hip joint.
|1||Customized Patient’s Surgical Plan||The first step is patient-personalized surgical planning. Before the Mako-assisted surgery, a 3D virtual model is developed by taking a specialized CT scan of your hip joint to evaluate your: • Bone structure • Alignment of the hip joint • Surrounding tissues This information helps your surgeon determine the desired implant size, orientation, placement, and accurate positioning of the implant based on your unique anatomy.|
|2||Continued assessment||Mako provides real-time data to your surgeon throughout the procedure. This allows your surgeon to continually assess the joint movements and tension in order to adjust the surgical plan if desired.|
|3||Preparing the Bone||Your surgeon follows the personalized surgical plan while preparing the bone for the implant. The surgeon uses tracking pins along the hip that help the robot "see" your anatomy. After that, Mako's arm positions itself according to those measurements to create a virtual boundary so that your surgeon can guide Mako’s robotic arm to remove the arthritic bone and cartilage. A virtual boundary helps your surgeon to stay within the boundary as defined in your surgical plan.|
|4||Positioning the Implant||The Mako robotic arm guides the implant at the desired angle defined in the surgical plan. This ensures the alignment and placement of the implant with high precision (as defined in the surgical plan).|
Mako Robotic Assisted Hip Surgery In The UK
|The Princess Grace Hospital (6)||London||£12,363 excluding indicative consultant fee (7)|
|Sulis Hospital Bath (8)||Bath||£13,910|
|Nuffield Hospital Cambridge (9)||Cambridge||£16,210 (10)|
|Spire Cambridge Lea Hospital (11)||Histon and Impington||£14,330 (12)|
|Spire Manchester Hospital (13)||Manchester||
|Manchester Hip Clinic (15)||Manchester||----- (16)|
|Fortius Clinic (17)||London||£1250 (excluding hospital fees)|
|London Hip Practice (18)||London||£2600 – £4100 (19) (excluding hospital fees)|
|The Beardwood Hospital (20)||Blackburn||£15,000|
|The Albyn Hospital (21)||Aberdeen||£16,710 (22)|
|The Alexandra Hospital (23)||Cheadle||£15,200 (24)|
|The Princess Margaret Hospital (25)||Windsor||£14,425|
|Woodlands Hospital (26)||Darlington||£13,000 (27)|
|The BMI Winterbourne Hospital |
The BMI Harbour Hospital
The Nuffield Hospital
|£10,500 - £13,000 (28)|
|Spire Little Aston Hospital (29)||Birmingham||£13,569|
Smith+Nephew CORI Surgical System
|1||Hip Navigation (Pre-operative Planning)||Before surgery, the surgeon will create a 3D representation of the unique shape and profile of your hip joint without the need for a pre-operative CT scan or MRI. This 3D representation helps your surgeon finalise and verify the right size implant for you. This will enable them to create a detailed surgical plan for how your replacement will be placed to optimize movement and function.|
|2||Advanced image-free Smart mapping|| CORI technology uses RI. HIP NAVIGATION that enables:
CORI technology also uses RI. HIP MODELER that helps:
|3||Preparing the Bone||After collecting patient-specific data, the CORI sends precise information about your hip joint to the robotic-assisted hand piece more than 300 times per second. This allows your surgeon to remove damaged surfaces, balance your joint and position the implant with accuracy.|
|4||Positioning the Implant||After preparing the site for the prosthesis, the surgeon will precisely position the implant.|
OrthAlign® Surgical System
HipAlign helps determine the orientation of an acetabular cup and assess changes in leg length for total hip replacements. It also displays the abduction and anteversion angles (range of motion angles) during acetabulum cup placement and assesses changes in leg length while trialing and during final implantation.
For a comprehensive guide to the cost of hip replacement surgery in every hospital in your area, follow this link to our recent article:
Hip replacement is a surgery focused on reducing pain and getting you back to normal activities. Modern advancements in hip replacement technology and the types of hip replacement surgery are having a big effect on the success rate of the surgery.
However, deciding to undertake a hip replacement is a decision that should not be taken lightly. There are possible risks and complications that you should be aware of, and a full recovery can take months. But if other treatment options have failed to provide adequate pain relief, it may be a decision well worth making in the long term.