Complex Hip Replacement Surgery in Birmingham
Specialist complex and difficult primary hip replacement in Birmingham and the West Midlands with Mr Shakir Hussain, a consultant hip surgeon at the Royal Orthopaedic Hospital. For hips affected by dysplasia, bone loss, deformity, or previous metalwork, he plans each reconstruction in detail to restore a stable, pain-free joint.
Medically reviewed by Mr Shakir Hussain, MBBS MRCS FRCSEd (Tr & Orth), Consultant Orthopaedic Surgeon · Last reviewed: June 2026 · Next review due: June 2029
In Short
Complex hip replacement is a first-time (primary) hip replacement made technically demanding by abnormal anatomy, significant bone loss, deformity, or metalwork left from earlier surgery. It relies on detailed CT-based planning, a wider range of standard and custom implants, and a surgeon who manages difficult hips every week. The operation typically takes 1.5 to 3 hours, most patients stay 1 to 3 nights, and all-inclusive self-pay packages start from £17,850, with the final price confirmed after consultation and templating. Mr Shakir Hussain performs complex hip replacement at the Royal Orthopaedic Hospital, Birmingham.
Also known as: complex primary total hip arthroplasty, difficult primary hip replacement. This page covers first-time replacement of a complex hip; if a previous hip replacement has failed and needs redoing, see hip revision surgery.
On This Page
What Is Complex Hip Replacement Surgery?
Complex hip replacement is a primary hip replacement made technically demanding by abnormal anatomy, significant bone loss, deformity, or metalwork left from earlier surgery. It calls for detailed planning, a wider range of implants, and a surgeon who regularly manages difficult cases.
Most hip replacements are straightforward. A smaller group are not, because the shape of the hip has been changed by a developmental condition, a previous injury, or earlier surgery. These hips often cannot be reconstructed with a standard implant alone.
Mr Hussain performs these reconstructions at the Royal Orthopaedic Hospital, drawing on advanced fellowship training and a high-volume practice of over 5,000 procedures. Where a worn or failed implant needs renewing rather than a first-time reconstruction, hip revision surgery is the related pathway.
- Abnormal anatomy - dysplasia or a shallow, poorly formed socket
- Bone loss - cysts, collapse, or protrusio reducing bone stock
- Deformity - from previous fracture, malunion, or childhood conditions
- Retained metalwork - nails, plates, or screws needing removal
- Altered mechanics - after spinal fusion, affecting hip stability
Any one of these can turn a routine hip replacement into a complex reconstruction that benefits from specialist planning.
What Makes a Hip Replacement Complex?
A hip replacement becomes complex when the standard approach is not enough. You may need specialist input if any of the following apply to you:
Hip Dysplasia
Hip dysplasia leaves a shallow or poorly formed socket that needs specialised reconstruction and careful implant choice.
Avascular Necrosis
Avascular necrosis causes loss of blood supply and collapse of the femoral head, often in younger patients.
Previous Fracture or Malunion
An old hip or thigh fracture that healed in an abnormal position, or post-traumatic arthritis, alters the normal anatomy.
Retained Metalwork
Nails, plates, or dynamic hip screws from earlier surgery often need removing at the same time as the hip replacement.
Severe Protrusio & Bone Loss
A socket pushed inward, or significant loss of bone stock, may need bone grafting, augments, or specialised fixation.
Spinal Fusion & Metabolic Bone Disease
Previous spinal fusion changes pelvic mechanics, while Paget's disease and other conditions weaken or distort bone.
How Complex Hip Replacement Is Performed
Complex reconstruction depends on detailed planning, the right implant for the anatomy, and the support of a specialist centre.
Every complex case starts with detailed pre-operative planning. Mr Hussain reviews x-rays and, where needed, CT or MRI scans to template the reconstruction and anticipate problems before surgery.
In theatre, the plan may involve removing existing metalwork, reconstructing bone defects with grafts or augments, and selecting standard or custom implants that achieve a stable, well-aligned joint. Higher-risk patients are planned through a multidisciplinary team and recovered with high-dependency care where appropriate.
- Detailed templating and cross-sectional imaging before surgery
- Removal of retained nails, plates, or screws in the same operation
- Bone grafting, augments, and acetabular reconstruction for bone loss
- Standard or custom implants matched to individual anatomy
- Implant positioning tailored to altered spinopelvic mechanics
Specialist Tertiary Centre
The Royal Orthopaedic Hospital is a national tertiary referral centre and one of the UK's largest specialist orthopaedic hospitals, so complex and referred hip cases are managed here every week.
Multidisciplinary Approach
Complex cases are planned in MDT meetings bringing together orthopaedic, anaesthetic, medical, and specialist nursing expertise.
High-Dependency Care
Harborne Hospital and Priory Hospital Edgbaston both have HDU facilities for cases needing closer post-operative monitoring.
Advanced Implant Options
Access to the full range of solutions including custom-made prostheses, augments, and specialised fixation for challenging anatomy.
Complex Hip Replacement Case Examples
Real, anonymised x-rays from Mr Hussain's practice showing complex hips reconstructed with a stable, well-aligned replacement. Each case pairs the pre-operative x-ray with the result.
What Is Recovery Like After a Complex Hip Replacement?
Recovery after a complex hip replacement follows the same pattern as a standard hip replacement, though some patients take a little longer depending on what the reconstruction involved. Most patients are up and walking with the physiotherapy team on the day of surgery or the following morning, and go home once they are safe on crutches, usually within 1 to 3 nights.
Where bone grafting or augments were used to rebuild the socket, Mr Hussain may advise a period of protected weight-bearing to let the graft incorporate, and your physiotherapy plan is adjusted accordingly. If metalwork was removed at the same operation, the old screw holes temporarily weaken the bone, so high-impact activity is reintroduced more gradually.
Most patients walk unaided by 6 weeks, return to driving at around 6 weeks, and feel the full benefit between 3 and 6 months. The choice between a spinal or general anaesthetic is made with your anaesthetist, and higher-risk patients are recovered with high-dependency monitoring where appropriate. You will have a wound review at two weeks and structured follow-up with interval x-rays to confirm the implant position and healing.
How Much Does Complex Hip Replacement Cost in Birmingham?
Mr Hussain's all-inclusive complex hip replacement package at the Royal Orthopaedic Hospital starts from £17,850. Because complex cases vary in what they need, from metalwork removal to bone grafting, augments, or a custom implant, the final package price is confirmed individually after your consultation, imaging review, and templating.
The package covers the surgeon's fee, the anaesthetist, the implant, and your hospital stay. Complex hip replacement is covered by all major private medical insurers, including Bupa, AXA Health, Vitality, WPA, and Aviva. If you are insured, our guide to insurance pre-authorisation for hip and knee surgery explains how to get your treatment approved. Full details for self-pay and insured patients are on the fees and insurance page.
Why Choose Mr Hussain for a Complex Hip Replacement?
Complex hips reward experience. Mr Hussain is a Consultant Orthopaedic Surgeon at the Royal Orthopaedic Hospital with a high-volume hip practice and advanced fellowship training, including a British Hip Society Travelling Fellowship at the ENDO-Klinik in Hamburg, a world-leading centre for complex hip and revision surgery. Because the Royal Orthopaedic Hospital is a tertiary referral centre for complex orthopaedics, he operates on a steady stream of difficult and referred hip cases, building an exceptional depth of experience that routine practice rarely offers.
His results are tracked against National Joint Registry benchmarks. You can review his published hip replacement outcomes, and read about fees and insurance for self-pay and insured patients.
- 5,000+ surgical procedures performed
- 33 peer-reviewed publications
- ENDO-Klinik Hamburg fellowship training
- Royal Orthopaedic Hospital specialist centre
- Doctify Outstanding Patient Experience
Key Takeaways
Complex Hip Replacement at a Glance
- Complex hip replacement is a first-time hip replacement made demanding by dysplasia, bone loss, deformity, retained metalwork, or altered spinopelvic mechanics after spinal fusion.
- Every case is planned in detail before surgery with templating and, where needed, CT or MRI, so problems are anticipated rather than discovered in theatre.
- Retained nails, plates, and screws are removed and the hip replaced in a single operation wherever possible.
- Bone grafting, augments, and standard or custom implants rebuild a stable, well-aligned joint even where bone stock is poor.
- Recovery mirrors a standard hip replacement for most patients: home in 1 to 3 nights, walking unaided by around 6 weeks, full benefit by 3 to 6 months.
- All-inclusive self-pay packages start from £17,850, confirmed after consultation and templating; all major private medical insurers are accepted.
Frequently Asked Questions
References and further reading
- NHS. Hip replacement. nhs.uk/conditions/hip-replacement
- National Joint Registry (NJR). Annual reports and implant performance data. njrcentre.org.uk
- National Institute for Health and Care Excellence (NICE). Joint replacement (primary): hip, knee and shoulder, NG157. nice.org.uk/guidance/ng157
- Evans JT, Evans JP, Walker RW, Blom AW, Whitehouse MR, Sayers A. How long does a hip replacement last? The Lancet, 2019. thelancet.com
Medically reviewed by Mr Shakir Hussain, Consultant Orthopaedic Surgeon. Last reviewed: June 2026. Next review due: June 2029.
Ready to Discuss Your Complex Hip Replacement?
If your hip has been called difficult or complex, Mr Hussain can review your x-rays and explain your options. Book a specialist consultation today.