Hip replacement surgery

The hip joint is described as a ball-and-socket structure due to the joint’s appearance of a ball (femoral head) fitting nicely in a cup-like socket (acetabulum). The ball is located at the top of the thigh bone (femur), and the socket is part of the pelvis. The area where the bones meet is covered by tissue called cartilage, which allows the joint to move smoothly.  

In a healthy hip, smooth cartilage covers the ends of the thigh bone and pelvis. This allows the ball to glide easily in any direction inside the socket. In a hip requiring replacement surgery, the worn cartilage no longer serves as a cushion. As the bones rub together without cushioning, they become rough and cause pain. To reduce pain and improve function, an orthopaedic surgeon will remove the damaged components of the hip and insert an artificial joint, also referred to as an implant or prosthetic. Modern prosthetics are usually made of a superalloy (high-performance blend of metals), polymer (plastic), or ceramic, often in combination, for the most durable implant. 

Penn Medicine’s joint replacement surgeons perform hip replacements using advanced materials and techniques for accurate and precise results. Recognized leaders in joint replacement care, our expert surgeons perform a high volume of hip replacement surgeries each year, including robotic hip replacement.

Your Penn Medicine care team will work with you to determine which type of surgery and approach is most appropriate for you based on the extent of your hip joint damage, bone quality, lifestyle, and overall health. Your options may include conventional surgery, minimally invasive techniques, or robotic hip replacement. Minimally invasive techniques are recommended whenever possible because they involve smaller incisions and less tissue disruption, which can lead to shorter recovery times.

• Total hip replacement: During this procedure, the surgeon removes the damaged parts of the hip joint and replaces them with artificial ball and socket components. Also known as total hip arthroplasty, this is the most common type of hip joint replacement.
• Partial hip replacement: This surgery replaces the ball of the hip joint only, not the socket. Also known as hemiarthroplasty, your doctor might suggest a partial hip replacement if the damage is limited to the ball of your hip. It typically works best for nondegenerative arthritis injuries (not primarily caused by wear and tear on the joints) and is typically reserved for older patients who have had a hip fracture or other medical condition that makes total hip replacement riskier.
• Bilateral hip replacement: This surgery replaces both hips at the same time. It may be recommended for people with degenerative joint disease who are experiencing severe and limiting pain in both hips and do not want to undergo surgery and postoperative rehabilitation twice.
• Hip revision surgery: This procedure removes and replaces some or all components of a previous hip implant that have failed or worn out. The typical lifespan for an artificial hip joint is 20 years. Penn Medicine performs many revisions of hip replacements that patients received in other facilities that did not last as expected.

The Penn Hip Preservation Center also offers a variety of nonsurgical and surgical alternatives to hip replacement, when appropriate. For example, hip resurfacing is an alternative to total hip replacement that keeps more of your natural bone intact. Instead of removing the entire ball of your hip joint, the surgeon trims and caps the femoral head with a metal implant. This procedure is often recommended for younger, active patients because it allows more stress on the hip joint than traditional replacements. It may also enable more natural movement since more of your original anatomy is retained.

You may be a candidate for hip replacement if:  

• Nonsurgical measures like medications and walking aids fail, and pain persists, worsens with movement, or disrupts sleep.   
• Common activities become painful due to conditions like arthritis or fractures, causing stiffness, discomfort, and limitations in mobility.  
• Conditions that degrade or destroy hip bone tissue, such as osteonecrosis or tumors, significantly compromising the hip.  

Penn Medicine’s orthopaedic specialists will perform a comprehensive physical examination, take a complete medical history, and order diagnostic imaging tests to determine if you are a candidate for hip replacement. Hip replacements are most commonly performed in individuals between 50 and 70 years old. However, your doctor may recommend the surgery if it’s the best option to address your pain and disability, regardless of your age.  

At Penn Medicine, our orthopaedic hip surgeons use advanced techniques for precision and accuracy in every procedure. We perform a high number of hip replacement surgeries each year and participate in a wide range of joint replacement research, which enables us to bring you the latest evidence-based care. We focus on understanding your unique needs and goals as we develop a treatment plan tailored to you.  

We also offer: 

• Nurses and advanced practice providers to guide you throughout the process, from scheduling appointments to recovery, and answer any questions you may have along the way   
• Innovative pain management to alleviate pain without increasing the risk of opioid overuse and addiction 
• Same-day discharge option for motivated patients in good health with a strong recovery support system at home  
• Comprehensive post-surgical rehabilitation to maximize your physical function and quality of life 
• Convenient access to ongoing care, with multiple specialists often available within the same location