Hip Replacement
What is the most popular type of hip replacement in Australia?
In Australia in 2023, there were more than 58,500 hip joint replacements performed, and the procedure is enjoying the lowest revision rates on record. The cumulative revision rates for all existing hip joints dropped from 12.7% in 2011 to only 7.1% in 2023.
The most popular type of hip replacement is the total hip replacement for severe hip arthritis – and this replaces both the ball (femoral head) and the socket (acetabulum) with prosthetic components,” says Dr Philip Markham, Gosford Hip Replacement Surgeon.
“The old style trend for metal on metal hip resurfacing has really declined to less than 1% of all procedures, however new technologies for hip resurfacing are emerging. It is the total hip replacement that is by far the most common type of surgery (76%), while a partial hip replacement may suit older fracture patients.”
Dr Markham said hip replacement could safely be formed on increasingly older Australians.
He was the surgeon who operated on Australia’s oldest known hip replacement patient Daphne Keith in 2019 in Wollongong after she he a fall on her hip at age 107.
The results of the surgery were presented months later an an international conference after Daphne, a former ballroom dancer celebrated her 108th birthday.*
The surgical approach to hip surgery in recent years has also changed, with minimally-invasive procedures focused on minimising the impact on surrounding healthy tissues, like muscles and blood vessels.
One approach is the the Direct Anterior Approach (DAA) which is performed with an incision at the front of the thigh which involves minimal cutting through muscles and tendons.
“Unlike other approaches, which enter the hip from the side (lateral approach) or back (posterior approach), the DAA offers a different way of accessing the joint that appeals to many patients,” says Dr Markham.
He says DAA has become increasingly popular in younger, more active Australians, as it often results in less post-operative pain and a quick recovery time.
“There is also lower risk of post operative dislocation because the posterior capsule and muscles are left intact.”
He says the Posterior Approach on the other hand, may be better suited for more complex cases where patients have anatomical anomalies or previous hip conditions or for revision surgery.
“All these factors make the operation easier than via the DAA – simply because the posterior approach has superb visibility and in some circumstances is the best choice.”
He says the Posterior Approach is often the approach of choice, particularly for overweight patients or for elderly patient with significant osteoporosis.
“The downside of the Posterior Approach is a slightly increased risk of dislocation and you are cutting through major hip muscles, so there may be a slightly longer recovery time than the DAA.
“The lateral approach is used less commonly. The main reason we would use this is in patients where there is a massive gluteal tendon tear that requires repairing at the same time as the hip surgery.
Dr Markham performs all of these procedures and says factors such as your age, body weight, anatomy and overall health are important in together determining the most appropriate hip replacement approach for your needs.
“It really is horses for courses. There is no one-size-fits-all approach.”
Hip replacement is a surgical procedure designed to replace a damaged hip joint with an artificial implant.
This surgery is typically recommended to help relieve chronic hip pain and enhance mobility.
Hip replacement surgery usually takes between 1 and 2 hours, and can be performed under general anaesthetic and often with the addition of a spinal anaesthetic for pain relief.
In a total hip replacement, also known as a total hip arthroplasty, the surgeon will remove the damaged portions of your hip joint and replace them with components made of metal, ceramic, or high-density plastic. This prosthesis is intended to alleviate pain and restore hip function, improving your overall quality of life.
During this time, the medical team will closely monitor your observations such as your blood pressure, heart rate and oxygen saturation.
“Osteoarthritis is one of the leading causes of chronic pain and disability in Australia,” says Dr Markham.
“Hip surgery has become a choice for many Australians who are still active, wanting to maintain their mobility and enhance their quality of life.
Notable individuals who have undergone hip replacement include Olympic Swimmer Dawn Fraser who had hip surgery after a fall in December 2024.
Actor Anthony LaPaglia, a keen soccer player had two hip replacements after going back to sport too early the first time. Music man Billy Joel had a double hip-replacement at age 61, joking “he was twice as hip as he used to be.”
If you answer yes to one or more of these questions you should consult your GP or surgeon about your hip pain.
Are you experiencing persistent and severe groin or hip pain that cannot be managed with medication, interfering with your work, sleep, or daily activities?
Is the stiffness in your hip joint limiting your range of motion, making simple tasks like walking or putting on shoes and socks a struggle?
Do you find it difficult or even impossible to fully participate in the activities you enjoy?
Is hip pain making you feel like you’re losing control over your quality of life?
Would you like to regain pain-free movement and return to the daily activities you love?
Some patients may need to stay in the hospital for several days, typically between 2 to 3 days, though patients can often go home sooner.
Most individuals are encouraged to begin walking shortly after surgery with a walking support. You will receive guidance on how to care for your new hip, including tips on avoiding dislocation.
Recovery times vary from person to person.
Rehabilitation, including physiotherapy and occupational therapy, will be an essential part to strengthen the new joint and improve flexibility.
After your hip replacement surgery, you will be encouraged to get up and start walking as soon as possible.
Patients who have no additional health concerns are generally allowed to go home once they are able to walk, climb stairs, and get in and out of a car independently.
Avoid driving until you are off any pain medications.
Most patients are able to return to their regular activities around 6 weeks after surgery, can drive between 2-6 weeks with sign off from Dr Markham.
Showering is ok from day 1, and you can start lifting 6 weeks after surgery.
Most people experience full recovery between 3 to 4 months.
A new hip joint can often completely eliminate pain and greatly enhance mobility.
Many patients report feeling so comfortable that they eventually forget they even had a hip replacement after full recovery.
Hip replacement surgery is considered safe and effective with common side effects including pain for a few weeks.
Less common complications include
– Infection
– Blood clots (deep vein thrombosis, or DVT)
– Hip dislocation
– Leg Length discrepancy (feeling one leg is shorter than the other)
– Swelling and stiffness
– Persistent pain from trochanteric bursitis
– Very rarely, nerve or blood vessel damage
