A total hip replacement swaps the worn-out joint for an artificial one. Most patients get much less pain and move better afterwards.
Dr Imran Salim Malik, orthopedic and trauma surgeon, performs hip replacement at Omar Hospital & Cardiac Centre, Johar Town, Lahore.
What happens in a hip replacement?
Your hip is a ball-and-socket joint. The worn ball and socket are replaced with smooth new parts made of metal, ceramic or plastic. This stops the painful rubbing of bone on bone.
Some parts are fixed with bone cement; others let your bone grow into them. Dr Malik chooses the type that suits you.
Who needs a new hip?
A hip replacement is done when a damaged hip causes constant pain and makes moving hard. The most common cause is wear-and-tear arthritis (osteoarthritis). Others include rheumatoid arthritis, loss of blood supply to the bone and bad fractures. It may help if you have:
- Strong hip pain that makes walking, stairs, or standing hard
- Pain at rest or at night that affects sleep
- Stiffness that makes daily tasks hard
- Little relief from physiotherapy, medicines or a walking stick
If these apply and tests show advanced joint damage, a new hip can make a big difference. Age alone does not rule it out. Many patients are in their 60s, 70s or 80s.
Before surgery, your parent's heart, diabetes and blood pressure are checked, and Dr Malik explains the risks for them specifically. In younger, very active people a new hip may wear out sooner, so the timing needs careful thought.
Fall or suspected broken bone? Go to the nearest emergency department now, or call Rescue 1122, if the person cannot stand or put weight on the leg, a limb looks bent or a bone is showing, a hand or foot is cold, pale or numb, there is heavy bleeding, or they hit their head. An older person who cannot walk after a fall may have a broken hip and needs to go to hospital now. Do not move someone who may have hurt their neck or back.
Once the patient is safe, call +92 300 4890692 for fracture care with Dr Malik. Dr Malik can arrange care in the emergency department: WhatsApp the X-ray, the patient’s medical history and any medical conditions to the same number. If you cannot reach us, go to the nearest emergency department.
How to get ready for surgery
Before surgery, your doctor checks your health and medicines and orders tests such as X-rays. Do not stop any blood thinner or heart medicine on your own. Dr Malik and your heart doctor will tell you what to do before surgery.
Steps you can take:
- Get healthy: control diabetes and blood pressure, and lose weight if needed. Stop smoking and all tobacco, including naswar and chewing tobacco. It slows bone and wound healing.
- Exercise: strengthen your leg and hip muscles before surgery.
- Prepare your home: remove loose rugs. Get a high, firm chair, a raised toilet seat or commode chair, a shower chair and a walker.
- Plan for help: someone should stay with you for the first week or two. If your home has stairs, set up a bed downstairs.
What happens during the operation
The operation takes 1 to 2 hours. You have either a spinal anaesthetic (an injection in the back that numbs you from the waist down) or a general one (fully asleep).
Through a cut at the front or back of the hip, the worn parts are removed and the new ones fitted. The hip is checked for movement and leg length. Antibiotics and clean methods lower the risk of infection.
Smaller-cut (minimally invasive) surgery can mean less blood loss and getting up a little sooner; long-term results are similar. But the surgeon has a smaller view, which can raise the risk of nerve injury or a new part sitting at the wrong angle. It is not right for everyone, so Dr Malik chooses the approach for each patient.
Less pain, longer-lasting hips
Modern pain relief, such as spinal blocks, means less pain and sickness after surgery.
New hips also last a long time. In large national joint registries, about 9 in 10 total hip replacements are still working after 15 years, and nearly 6 in 10 after 25 years.
Recovery week by week
Every recovery is different, but this is a common pattern:
- Same day or next day: you walk with help from a physiotherapist.
- Days 2–3: pain is usually at its worst, then eases with medicines and ice.
- Weeks 1–3: you keep up the exercises at home, first with a walker or crutches. After 2 to 3 weeks, many switch to a walking stick.
- Weeks 4–6: most people walk without an aid, though the leg may still feel weak. You see Dr Malik at about 6 weeks. Driving is usually possible after about 8 weeks, and only when Dr Malik agrees. Desk work may restart around 6 weeks.
- Month 3: most people move well with much less pain. Physical jobs may need about 3 months.
- Up to 1 year: strength and balance keep improving.
Keeping your new hip safe: the first 6 weeks
Dr Malik will tell you which of these rules apply to you. They depend on how your operation was done. For the first 6 weeks, they help stop the new hip slipping out of place (dislocating):
- Don't bend your hip more than a right angle (90 degrees)
- Don’t cross your legs
- Don’t twist your operated leg
- Use your walker or walking stick as advised
- Avoid falls: wear firm shoes and hold the rail on stairs
- Don't sit on the floor, squat or sit cross-legged
- Avoid low seats, such as a low sofa or charpai
- Use a raised Western-style toilet or a commode chair, not a squat toilet
- Pray sitting on a chair at first. Dr Malik will tell you when it is safe to pray on the floor again
Is hip replacement safe? The risks
Like any operation, a hip replacement has risks, but serious problems are uncommon. They include:
- Blood clots: early walking, tight stockings (compression) and medicines help prevent them. You may be given blood-thinning medicine to take at home for some weeks. Take it exactly as prescribed.
- Infection: keep the wound clean and dry, and watch for fever or redness
- Dislocation (the hip slipping out): careful surgery and the precautions above lower this risk
- Leg length: a small difference can happen; a shoe insert can usually correct it
- Rare risks: a break in the bone near the new joint, nerve or blood vessel injury, anaesthetic problems
- Ongoing pain or stiffness: some people still have some pain or stiffness after recovery
- Further surgery: after many years a new hip can wear or loosen and may need another operation
When to get help after surgery
Go to the nearest emergency department now, or call Rescue 1122, if you have:
- Chest pain, sudden breathlessness or coughing up blood
- Sudden severe hip pain, a leg that looks shorter or turned, or you cannot stand on it. The hip may have dislocated.
Call or WhatsApp +92 300 4890692 the same day if you have:
- A wound that is red, hot, swollen or leaking, or a fever
- Pain or swelling in the calf (a possible blood clot)
If you cannot reach the clinic, go to the nearest emergency department.
Worried about the risks for your parent? WhatsApp the hip X-ray to +92 300 4890692 to book a consultation. Dr Malik will need to examine them before advising on surgery.
What life is like with a new hip
Most people get a lot of pain relief, move much better and are happy with the result.
Once healed, gentle activities like walking to the market or mosque, swimming and light cycling are usually fine. High-impact sport is usually avoided to protect the joint.
About Dr Imran Salim Malik
Orthopedic and trauma surgeon with more than 20 years of experience in orthopedic surgery. Trained at Sheikh Zayed Hospital, Lahore. If you need a hip replacement, Dr Malik performs it himself.
Questions families often ask
Sources
- Evans JT, et al. The Lancet, 2019 (how long hip replacements last, from national joint registries).
- Smith TO, et al. International Orthopaedics, 2011 (smaller-cut versus standard hip replacement).
Questions families ask
When can my parent start walking?
Often on the same day or the next, with help.
How long is the hospital stay?
It varies from patient to patient. Dr Malik will tell you how long you are likely to stay.
When can I drive?
Usually after about 8 weeks, and only when Dr Malik agrees. You should feel steady and be off strong painkillers.
How long does recovery take?
Most people are back to normal daily life by about 3 months. Full recovery can take up to a year.
When can I stop the hip precautions?
Usually after 6 weeks. Dr Malik may advise up to 12 weeks for some patients.
How much does a hip replacement cost?
The consultation fee depends on the hospital you visit. We tell you the exact fee on WhatsApp before you book, so there are no surprises. A follow-up visit within 5 days of your first consultation is free to go through your reports and scans.
The cost of surgery depends on the operation, the implant, the room and the nights in hospital. It is explained to you before you decide.
From the clinics of Dr Imran Salim Malik, orthopaedic and trauma surgeon. MBBS (Allama Iqbal Medical College) · MS (Trauma & Orthopaedics) · PMDC Reg. 39646-P. Every patient is different: Dr Malik will tell you what applies to you.
