Total Hip Replacement Surgery in Birmingham
Total hip replacement is one of the most successful operations in modern surgery. It removes the worn hip joint and replaces it with precision-engineered components, restoring pain-free movement and an active life. Mr Shakir Hussain, one of the UK's highest-volume hip surgeons, performs total hip replacement at the Royal Orthopaedic Hospital, Priory Hospital Edgbaston, and Harborne Hospital, with day-case options available for suitable patients.
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ENDO-Klinik Hamburg
The Procedure Explained
What Is Total Hip Replacement Surgery?
Total hip replacement, also known as total hip arthroplasty (THA), is a surgical procedure in which both surfaces of a damaged or arthritic hip joint are removed and replaced with artificial components. The hip is a ball-and-socket joint: the femoral head (the ball at the top of the thigh bone) sits inside the acetabulum (the socket in the pelvis). When the cartilage lining these surfaces wears away, bone rubs on bone, causing persistent pain, stiffness, and loss of mobility.
During the operation, the femoral head is removed and a metal stem is inserted into the femoral canal. A ball component is attached to the top of the stem. The acetabulum is prepared and a cup is pressed or cemented into the socket. A liner sits inside the cup to provide a smooth bearing surface. The ball and liner move against each other, recreating the natural gliding motion of the hip.
Total hip replacement is one of the most studied and successful operations in all of surgery. National Joint Registry data consistently shows high patient satisfaction, low revision rates, and excellent long-term implant survival.
Who Should Consider Surgery
When Is Total Hip Replacement the Right Choice?
The decision to proceed with total hip replacement is made jointly between you and Mr Hussain after a thorough assessment of your symptoms, X-rays, and how your hip is affecting your life. Surgery is generally considered when non-surgical measures have been exhausted and pain is significantly limiting your daily activities.
Persistent Hip Pain
Pain that is present at rest, at night, or during low-impact activities such as walking short distances, and that has not responded adequately to analgesia, anti-inflammatory medication, physiotherapy, or injections.
Severely Reduced Mobility
Inability to walk more than a short distance, difficulty getting up from chairs or climbing stairs, and progressive loss of independence due to hip pain and stiffness.
Advanced Arthritis on X-ray
Significant joint space narrowing, bone-on-bone contact, osteophyte formation, or subchondral cyst formation seen on weight-bearing X-rays, consistent with symptoms that warrant surgical intervention.
Failed Non-Surgical Treatment
A reasonable trial of physiotherapy, weight management, activity modification, walking aids, and pain management has not provided sufficient relief or has ceased to be effective.
Avascular Necrosis
Collapse of the femoral head due to loss of blood supply, at a stage where the joint cannot be preserved, requires total hip replacement to restore a functional, pain-free joint.
Inflammatory Arthritis
Rheumatoid arthritis, ankylosing spondylitis, and other inflammatory conditions can destroy the hip joint. Total hip replacement gives excellent results when medical management is optimised alongside surgery.
Implant Options
Bearing Surfaces: Which Materials Are Used?
The bearing surface is the interface between the ball and the liner inside the cup. The choice of bearing material affects wear rate, longevity, and suitability for different patient groups. Mr Hussain will discuss the most appropriate bearing surface for your age, activity level, and anatomy at your consultation.
Ceramic-on-Ceramic
The hardest and most scratch-resistant bearing combination. Exceptionally low wear rate, making it the preferred choice for younger, more active patients. Ceramic-on-ceramic bearings produce minimal wear debris, reducing the risk of long-term implant loosening due to particle-induced bone loss.
Ceramic-on-Polyethylene
A ceramic ball articulating against a highly cross-linked polyethylene liner. Cross-linked polyethylene has dramatically lower wear than older conventional polyethylene. A reliable and versatile option suitable for most patients, combining durability with a forgiving liner that reduces the consequences of minor impingement.
Metal-on-Polyethylene
A cobalt-chrome ball against a cross-linked polyethylene liner. A well-established combination with a long track record. Still used in some patients, particularly where ceramic ball size is limited or a specific implant system requires it. Metal-on-metal bearings are no longer routinely used due to concerns about metal ion release.
Hip resurfacing, which preserves more of the femoral head using a metal cap rather than a stem, remains an option for selected younger patients with good bone quality. Learn more about hip resurfacing surgery and how it compares to total hip replacement.
Fixation Methods
Cemented or Cementless: How Is the Implant Fixed?
The implant components can be fixed to the bone in two ways: using bone cement (acrylic polymer), or by press-fitting the components so that bone grows into the implant surface over time. Both methods have decades of excellent outcome data.
Cementless (uncemented) fixation
The components are shaped to fit tightly against the prepared bone surfaces. The implant surface is porous or coated with hydroxyapatite to encourage bone to grow into the component, creating a durable biological bond over several weeks. Cementless fixation is generally preferred in patients under 70 with good bone quality and higher activity levels, as it avoids any long-term issues with cement fatigue or interface breakdown.
Most total hip replacements performed in the UK today use cementless acetabular cups combined with either a cemented or cementless femoral stem.
Cemented fixation
Bone cement is mixed and applied to the prepared bone cavity before the implant is inserted. The cement hardens rapidly, providing immediate and secure fixation. Cemented fixation is well suited to patients with osteoporosis or poorer bone quality, where bone ingrowth may be less reliable, and to older patients where an immediately stable construct is advantageous.
The Exeter cemented femoral stem, developed in the UK, has some of the best long-term survival data of any hip implant in the National Joint Registry.
For a detailed comparison of the two fixation methods, including which is recommended for different patient profiles, see the dedicated cemented vs uncemented hip replacement page.
Your Road to Recovery
What to Expect After Total Hip Replacement
Recovery after total hip replacement follows a broadly predictable course, though individual timelines vary based on age, general health, fitness, and the nature of the surgery. The following milestones are typical for a straightforward total hip replacement performed as part of an enhanced recovery programme.
Standing and first steps
Most patients stand with physiotherapy support on the day of surgery or the following morning. A physiotherapist will guide you through safe movement, getting in and out of bed, and using a walking frame or crutches.
Discharge home
Most patients are discharged 1 to 3 days after surgery. Discharge is planned once you can mobilise safely, manage stairs if needed, and your pain is controlled with oral medication. You will leave with crutches, a physiotherapy programme, and a follow-up appointment.
Wound check and early recovery
The wound is reviewed at around two weeks. Most patients progress from two crutches to one, and then to a walking stick, during this period. Hip precautions (where applicable) are followed. Gentle walking, stairs, and home physiotherapy exercises are the priority.
First post-operative review
X-rays are taken to confirm implant position. Driving is usually permitted from this point if you can perform an emergency stop and have been cleared by Mr Hussain. Return to desk-based work is typically possible around this time.
Returning to most activities
The majority of patients have recovered most of their function by three months. Low-impact activities such as swimming, cycling, and walking are usually well established. Outpatient physiotherapy continues where needed.
Maximum recovery
Full strength, endurance, and confidence on the hip develops over 6 to 12 months as the surrounding muscles strengthen and adapt. Long-term activity goals, including return to sport, are reviewed at the 12-month appointment.
Hip Replacement in Birmingham
Why Choose Mr Hussain for Total Hip Replacement?
Mr Hussain's practice is focused on hip and knee arthroplasty. With over 5,000+ procedures performed, subspecialty training at ENDO-Klinik Hamburg, 33 peer-reviewed publications, and a Doctify rating of 4.98 from 498 verified reviews, he brings both the depth of experience and the personal commitment to outcomes that patients need from a hip replacement surgeon.
Your Questions Answered
Frequently Asked Questions
Ready to Discuss Your Hip Replacement?
Book a private consultation with Mr Hussain at the Royal Orthopaedic Hospital, Priory Hospital Edgbaston, or Harborne Hospital.