In the most recent National Joint Register (NJR) it was estimated that 65,000 total hip replacements are performed in the United Kingdom each year.  The average age of patients undergoing hip replacement is 66.  While only 12 per cent of patients are under 54 in the National Register, younger patients are not uncommon within my practice.  In fact the youngest patient in whom I have had to carry out joint replacement surgery was only 13.

Total hip replacement involves dividing the neck of the femur to remove the very proximal part of the bone (the femur) including the damaged femoral head.  This allows the surgeon to implant a metal stem into the femur.

Subsequently the damaged articular cartilage in the socket (the acetabulum) is removed, allowing a new socket to be implanted.  Thus a new artificial bearing surface is created.

Cemented total hip replacement

There are various options from the point of view of implant fixation and bearing surface that can be used in a hip replacement.  This gives the surgeon a variety of options that can be used according to the patient’s age, bone quality and required activity levels at work, rest and indeed at ‘play’.   There might also be underlying medical issues which can influence the surgeon’s choice of fixation technique and bearing surface options in an attempt to reduce the associated risks.

Uncemented hip replacement
 All options should be considered to ensure that the best and most reliable technique is used to provide a joint replacement that is essentially tailored to the individual patient’s circumstance and desired level of activity post-reconstruction.

These options should be discussed around the time that a decision is taken to proceed with joint replacement surgery, in advance of the surgery itself.


The results of hip replacement surgery are extremely reliable. Patients are expected to return to a very good level of function with good range of movement and excellent pain relief following the procedure.


© Andrew R J Manktelow – September 2011