Does your mother or father need a new hip because of arthritis or a fall? There are two main operations: replacing the whole joint (total), or only the ball (partial). This guide explains the difference, so the family can decide together.
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.
By Dr Imran Salim Malik, orthopedic and trauma surgeon, Lahore.
What is a total hip replacement?
Both the ball (top of the thigh bone) and the socket (the cup in the pelvis) are replaced with new parts.
Who is it for?
- Severe arthritis of the hip (wear-and-tear or rheumatoid)
- Damage to both the ball and the socket
- People who want a long-lasting joint and to stay active
- Some fit, active older people with a broken hip, who walked on their own before the fall
Dr Malik does total hip replacement at Omar Hospital & Cardiac Centre, with an exercise plan and follow-up visits through recovery.
What the operation involves
- The worn bone and cartilage (smooth joint lining) are removed
- A new ball (metal or ceramic) and a new socket (a metal cup with a plastic or ceramic lining) are fitted
- The joint is lined up so it moves smoothly
Benefits
- Long-lasting pain relief for most patients
- Usually brings back good movement
- In large national joint registries, about 9 in 10 total hip replacements still work after 15 years, and nearly 6 in 10 after 25.
Downsides
- A longer operation than a partial replacement
- A higher risk of dislocation (the ball slipping out of the socket) than a partial replacement
- More physiotherapy (exercise treatment) is needed
What is a half (bipolar) hip replacement?
Only the ball is replaced. The patient keeps their own socket. Doctors call this a hemiarthroplasty.
Who is it for?
- A broken hip (hip fracture), especially in older people
- People whose own socket is still healthy
- People who may not cope with a longer operation or a lot of physiotherapy
It is mainly used for a broken hip, often in older or frail patients, when a shorter operation matters most.
Not every broken hip needs a new joint. Some breaks are fixed with screws, a plate or a rod. The X-ray decides which.
Procedure
- The broken or worn ball is removed
- A new artificial ball is fitted into the patient's own socket
- A shorter, smaller operation than a total replacement
Pros
- A shorter operation
- Lower risk of dislocation in some patients
- Suitable for older or frail patients
Cons
- May not work as well over many years as a total replacement
- May not ease pain if the socket is also worn
- A second operation may be needed later if the socket wears out
Total vs partial: the key differences
| Feature | Total hip replacement | Half (bipolar) hip replacement |
|---|---|---|
| What is replaced | Ball and socket | Only the ball |
| Usually for | Severe arthritis; some broken hips in fit, active older people | A broken hip in older or frail people |
| Recovery time | Daily activities: usually 6–12 weeks | Depends on general health; often slower after a broken hip |
| How it works long term | Better movement; lasts longer | May be limited; may need surgery later |
| Length of operation | Longer | Shorter |
| Risks | Higher risk of dislocation | Lower risk of dislocation; overall risk depends on general health |
| Physiotherapy | More intensive physiotherapy | Just as important; recovery after a broken hip is often slower, and frail patients may need extra help |
Partial replacement is mostly done after a fall, often in older or frail patients. Their recovery depends on their general health and can be slower than after a planned total replacement.
Not sure which operation your parent needs? WhatsApp their hip X-ray to +92 300 4890692 to book a consultation. Dr Malik will need to examine your parent before advising on surgery.
How long is recovery?
It depends on the operation and the patient's general health:
Total hip replacement
- Hospital stay: usually 2–4 days
- Walking: usually allowed straight away with a walker, as the surgeon advises
- Back to daily activities: usually 6–12 weeks
Half (bipolar) hip replacement
- Hospital stay: depends on general health; often longer after a broken hip
- Walking: usually allowed straight away with a walker and help, as the surgeon advises
- Back to daily activities: depends on how fit the patient was before the fall; often slower in frail patients
- Physiotherapy: exercises to strengthen the hip are important after both operations.
- Blood thinners: you may be given blood-thinning medicine to take at home for some weeks. Take it exactly as prescribed.
- Smoking: stop smoking and all tobacco, including naswar and chewing tobacco. It slows bone and wound healing.
- Lifestyle: a healthy weight and avoiding hard-impact sport (running, jumping) help the new joint last longer.
Warning signs after a hip operation
Call the clinic on +92 300 4890692 the same day if:
- the wound is red, hot, swollen or leaking, or there is a fever
- the calf is painful or swollen
If you cannot reach the clinic, go to the nearest emergency department.
Go to the nearest emergency department now or call Rescue 1122 if there is:
- chest pain or sudden breathlessness
- sudden severe hip pain, a leg that looks shorter or turned, or the patient cannot stand on it. The hip may have dislocated (come out of its socket).
What decides which operation is right?
The choice depends on:
- Age and overall health
- How badly the hip is damaged, and whether it is arthritis or a fracture
- How active the person is, and what they hope to do
- What the X-ray and examination show
At the first visit, after the X-ray and an examination, Dr Malik will explain which operation suits your parent and why.
Questions families ask
Which one is right for your parent?
Total replacement usually gives better movement and lasts longer. Partial replacement is mostly used for a broken hip, often in older or frail patients, when a shorter operation matters most.
After a hip fracture, a partial (half) hip replacement is common, but some fit, active older patients are offered a total hip replacement. Dr Malik will explain which suits your parent.
At the consultation you get a full check, a clear explanation of the risks and other options, and a plan for after the operation. No surgery is risk-free, so the risks are discussed before any decision. If your parent needs an operation, Dr Malik performs it himself.
Already been told you need an operation? A second opinion is your right. Bring your reports and Dr Malik will go through your options with you, including non-surgical ones for arthritis.
Questions families ask
Is it safe for someone over 75?
Many people who need a new hip are older. Before surgery, tests and the anaesthetist (plus a heart specialist, if needed) check that the patient is fit. For a frail parent with a broken hip, the shorter partial operation is often the choice. Some fit, active older patients are offered a total replacement instead.
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.
Every hip operation has risks. These include infection, blood clots, dislocation, nerve or blood-vessel injury, and sometimes needing another operation. Dr Malik will explain your parent's own risks.
How much does it 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.
Will my father walk again after a broken hip?
Many people walk again after a broken hip, often with a walker or a stick. Some need more help than before, especially if they were frail before the fall.
Surgery is done as soon as the patient is fit for it, because getting up and moving early helps recovery. Dr Malik will tell you what to expect for your parent.
Who helps at home after discharge?
Before your parent goes home, you are shown the exercises and how to help safely.
In the first weeks, a family member should help with walking, the toilet and bathing. Avoid low seats, squatting and sitting cross-legged on the floor. Use a raised toilet seat or commode, and pray seated on a chair at first. Dr Malik will tell you when it is safe to stop these precautions.
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.
