What is Total Hip Replacement Surgery?

Hip replacement surgery (either total or partial), refers to the surgical procedure in which the damaged hip is replaced with a prosthetic implant. It is typically performed when the hip is severely damaged either by an injury (e.g. car accident) or degenerative conditions such as osteoarthritis.

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damaged hip


When Do I Need Hip Replacement Surgery?

Most hip replacement surgeries are performed due to the cartilage and bone in the hip joint wearing away due to arthritis. As arthritis is an age-related condition, people aged between 50 and 80 are the most common demographic to undergo hip replacement surgery. For some people, suffering from a childhood hip disease makes them more at risk of developing arthritis later in life and needing a hip replacement surgery.


Suffering from a hip fracture may also result in hip replacement surgery. In such cases, patients typically go for surgery if they are experiencing the following symptoms:


  • Progressively intense hip pain that interferes with daily activities
  • Pain or inflammation that does not go away even after taking anti-inflammatory/pain medications
  • Abnormal walking pattern


Nevertheless, surgery is a big procedure and should be thoroughly discussed with your orthopaedic doctor before deciding on it. Your doctor will go through your medical history, conduct a physical examination to assess your hip’s mobility and strength, and run diagnostic tests such as X-rays and MRI to gauge the extent of the damage.


How Does Hip Replacement Surgery Help Me?

The goal of performing hip replacement surgery is to remove the damaged parts of the hip, restore mobility, and relieve pain symptoms.


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What are the approaches and benefits of a hip replacement surgery?

The common approaches to a hip replacement are the posterior approach and lateral Hardinge approach. In the last decade, direct anterior approach, a muscle sparing approach, has become increasingly popular.


Each approach has its benefits.  Benefits of the direct anterior approach include faster recovery, and reduced risks of dislocation. However it does have a slightly increased rate of fracture and lateral thigh numbness.


Consult your doctor and have a good discussion regarding the approaches to a total hip replacement.


The benefits of hip replacement is reliable pain relief, and restoration of leg length. With less pain, patients may be able to return to the activities that they enjoy.



What Should I Expect Before A Hip Replacement Surgery?

If you have decided to have a hip replacement surgery, you may undergo a series of tests to assess whether you have any other medical conditions that need to be treated beforehand. Other things to expect are:


  • Stopping blood-thinning medications and TCM herbs 2 weeks before surgery
  • Stopping smoking as soon as possible
  • No eating or drinking 6 hours before surgery


What Happens During A Hip Replacement Surgery?

The patient is first given anesthesia (either general or spinal). After the anesthesia has taken effect, incisions are made at the hip area and the damaged cartilage and bone are removed. They will then be replaced by prosthetic implants. A hip replacement surgery will go through the following steps:


  • The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place.
  • The damaged femoral head (upper end of the thigh bone) is removed and replaced with a metal stem that is placed into the hollow center of the femur. The femoral stem may be either cemented or “press-fit” into the bone.
  • A metal or ceramic ball is placed on the upper part of the stem. This ball replaces the damaged femoral head that was removed.
  • A plastic, ceramic, or metal spacer is inserted between the new ball and socket to allow for a smooth gliding surface.


You can also refer to the video above for a more detailed overview of the surgery.


How Long Can I Expect To Recover From Surgery?

You should expect the recovery period to span several weeks. That’s why many patients start physical therapy the day after surgery, or in the same afternoon if surgery was done in the morning. This usually takes the form of doing simple exercises while sitting on a chair. A physiotherapist will also help you get used to using supporting devices such as a walker or crutches.


As with any joint replacement surgery, physical therapy is highly recommended as it helps with the recovery process.

hip replacement surgery procedure

After a hip replacement surgery, your movements may be limited for a while. Reaching for high objects, bending down, and twisting are just a few of the things that you may have difficulty doing in the first few weeks following surgery. However, with consistent physical therapy, your muscles will strengthen and mobility will be restored.


You may also work with an occupational therapist so that they can advise you on how to go about doing your daily activities while minimising aggravation to the hip. This includes learning specific body posturing techniques, how to use the bathroom, and reaching for objects.


While the success rate for hip replacement surgery is high, you should still follow up with an orthopaedic clinic regularly so that your progress can be monitored and any complications can be dealt with swiftly.


What Are the Potential Complications of Hip Replacement Surgery?

Total hip replacement is generally a safe procedure. The risk of major complication after total hip replacement is <1%.  However, chronic illnesses may increase the potential for complications. Although uncommon, when these complications occur they can prolong or limit full recovery. Common complications of hip replacement surgery include:


  • Infection around the surgery wound
  • Blood clots forming in the veins of the legs or pelvis
  • Unequal leg-length as one leg may be slightly shorter or longer than the other
  • Dislocation
  • Loosening of the implant


Your surgeon will discuss the risks with you in detail and will go over the necessary precautions that they will take to minimise the chances of complications occurring.


Our Doctors

Dr Tan Sok Chuen

Orthopaedic Surgery Specialist

Dr Tan Sok Chuen is an orthopaedic surgery specialist with subspecialty training in hip and knee surgery – making her the first female hip and knee replacement surgeon in Singapore. She has trained and educated junior doctors through various teaching programmes and courses. Dr Tan has also made many contributions to the scientific literature on hip and knee arthroplasty and her publications on trunnionosis in hip replacements are frequently quoted in indexed journals.

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Dr Adrian Lau

Orthopaedic Surgery Specialist

Dr Adrian Lau is a specialist orthopaedic surgeon trained in primary and complex hip and knee arthroplasty. His clinical practice comprises mainly of total knee replacements, total hip replacements, complex hip and knee replacements, revision surgeries, prosthetic joint infections, and periprosthetic fractures. Dr Lau also plays an active role in the education and training of junior doctors and is a recipient of numerous awards, one of them being the Ministry of Health Training Award in 2014.

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Dr Tan Sok Chuen and Dr Adrian Lau

Medisave & Integrated Shield Plans Approved

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Certain Orthopaedic procedures done at our Clinic is claimable under Medisave and Integrated Shield Plans.

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Evidence-Based Treatments Centred Around Your Needs

Our doctors are trained and highly experienced in diagnosing and treating orthopaedic conditions of the hip. We aim to provide you with quality care by thoroughly assessing your condition and personalising your treatments to your needs and goals.

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