Total Hip Replacement (THA) Surgery in Birmingham
Total hip replacement is one of the most successful operations in modern surgery, replacing the worn ball and socket of an arthritic hip with precision-engineered implants to restore pain-free movement and an active life. Mr Shakir Hussain, one of the UK's highest-volume hip surgeons, performs private total hip replacement in Birmingham and the West Midlands at the Royal Orthopaedic Hospital, Priory Hospital Edgbaston, and Harborne Hospital, with day-case options for suitable patients.
Total procedures
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ENDO-Klinik Hamburg
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
Total hip replacement replaces the worn ball and socket of an arthritic hip with precision-engineered implants to relieve pain and restore movement. The operation takes around 1 to 2 hours, most patients are walking the same day and home within 1 to 3 days, and a modern hip replacement typically lasts 15 to 20 years or more. Mr Shakir Hussain performs the procedure privately in Birmingham from £13,050 as an all-inclusive package, with day-case options for suitable patients.
Also known as: total hip arthroplasty (THA), THR. This page covers the standard procedure in detail; for an overview of every option, see the main hip replacement guide.
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. For a step-by-step walkthrough of each stage, read our guide on what happens during hip replacement surgery.
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.
Pre-operative x-ray showing severe arthritis of the right hip, and the same hip after total hip replacement by Mr Hussain.
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.
What about non-surgical treatment? Surgery is rarely the first step. Most patients try a period of conservative care first, and Mr Hussain will only recommend total hip replacement once these measures no longer control your symptoms. Non-surgical options include:
- Activity modification, weight management, and walking aids to reduce load on the joint
- Physiotherapy to strengthen the muscles that support the hip
- Pain relief and anti-inflammatory medication
- Corticosteroid injections, which can settle pain for weeks to months in selected patients
When these measures no longer provide meaningful relief, joint replacement offers the most reliable and long-lasting solution.
Before Your Surgery
Your Consultation, Assessment and Preparation
Your journey begins with a consultation with Mr Hussain. He will review your symptoms and medical history, examine your hip, and study your X-rays to confirm the diagnosis and judge whether a hip replacement is the right step. This is your opportunity to ask questions and understand exactly what surgery would involve. You can refer yourself privately or come through your insurer.
Once you decide to proceed, you will attend a pre-operative assessment shortly before surgery. This routine health check includes blood tests, baseline observations, and, where appropriate, a heart trace (ECG), to confirm you are well prepared and to plan your anaesthetic safely. Your hip is templated on X-ray so that the correct implant sizes are ready for the day of your operation.
In the weeks before surgery you can help your own recovery by staying as active as your hip allows, optimising your weight and general fitness, and stopping smoking if relevant. For a full step-by-step walkthrough, read our guide on what happens during hip replacement surgery.
How Surgery Is Performed
The Operation: Approach, Anaesthetic and Timing
A total hip replacement usually takes between one and two hours. It is most often performed under a spinal anaesthetic with light sedation, which is very safe and tends to give a smoother, more comfortable early recovery, though a general anaesthetic is also available. Your anaesthetist will discuss the best option for you at your pre-operative assessment.
Mr Hussain performs total hip replacement through a tissue-sparing posterolateral approach, reaching the hip from behind while preserving the surrounding muscles as far as possible and carefully repairing the soft tissues at the end of the operation. This reduces post-operative pain and blood loss and supports a rapid, reliable recovery.
The tissue-sparing posterolateral approach
The posterolateral approach is one of the most widely used and versatile techniques worldwide. It gives excellent access to the joint, is suitable for almost any hip anatomy, and has outstanding long-term results. Mr Hussain's tissue-sparing technique minimises soft-tissue disruption, and a meticulous capsular repair keeps the risk of dislocation low. Simple precautions in the early weeks protect the repair while it heals.
How other approaches compare
The hip can also be reached from the front (the anterior approach) or the side (the lateral approach). Each has strengths and trade-offs, and in experienced hands the long-term results of a well-performed hip replacement are excellent whichever approach is used. Read a full comparison on the anterior approach hip replacement page.
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.
| Cementless (uncemented) | Cemented | |
|---|---|---|
| How it is fixed | Press-fit; bone grows into the implant surface | Bone cement fixes the implant immediately |
| Best suited to | Younger, more active patients with good bone quality | Older patients or those with osteoporosis or softer bone |
| Initial stability | Stable, with full bond developing over several weeks | Immediately secure once the cement sets |
| Track record | Excellent long-term survival in registry data | Excellent long-term survival; the Exeter stem is among the best studied |
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.
Beyond these milestones, two questions come up most often: what you should avoid in the early weeks, and when you can return to the things you enjoy.
Hip precautions in the early weeks
Depending on the surgical approach, you may be asked to avoid certain movements while the soft tissues heal: typically not crossing your legs, not bending the hip much beyond 90 degrees, and not twisting on the operated leg. These precautions reduce the already small risk of dislocation and usually relax by around six weeks. Some approaches need very few restrictions.
Returning to everyday life
- Driving: usually from around 6 weeks, once you can perform an emergency stop
- Work: desk-based roles around 6 weeks; physically demanding jobs 10 to 12 weeks
- Sleeping: on your back early on, often with a pillow between the knees
- Flying: short flights from about 6 weeks; discuss long-haul travel with Mr Hussain
- Sport: walking, swimming, and cycling are encouraged; higher-impact activity is reviewed at 3 to 12 months
Cost and Payment
How Much Does Total Hip Replacement Cost?
Mr Hussain treats both self-pay and privately insured patients. Going private means fast access, usually within a few weeks rather than the long NHS waits, and the reassurance of being seen and operated on by Mr Hussain personally at every stage.
| Total hip replacement in Birmingham | Guide price |
|---|---|
| All-inclusive surgery package | From £13,050 |
| Initial consultation | £250 |
| What the package includes | Surgeon's fee, anaesthetist's fee, implant, hospital stay, routine post-operative follow-up |
| Insurance | Recognised by all major insurers, including Bupa, AXA Health, Vitality, WPA, and Aviva |
Paying for yourself
A private total hip replacement with Mr Hussain is an all-inclusive package from £13,050. The package covers the surgeon's fee, anaesthetist, implant, your hospital stay, and routine post-operative follow-up, so there are no unexpected extras. Interest-free and longer-term payment plans are available through the hospitals.
See the fees page for a full breakdown by procedure.
Using health insurance
Mr Hussain is recognised by all major UK private medical insurers, including Bupa, AXA Health, Vitality, WPA, and Aviva. Most policies cover total hip replacement in full. Contact your insurer for a pre-authorisation number before booking, and Wendy Richards, Mr Hussain's secretary, will help with the rest.
For a step-by-step guide, see the insurance pre-authorisation guide.
Hip Replacement in Birmingham
Why Choose Mr Hussain for Total Hip Replacement?
Mr Shakir Hussain is a Consultant Orthopaedic Surgeon at the Royal Orthopaedic Hospital and a high-volume hip replacement surgeon in Birmingham. His practice is built around specialist-centre care and surgery he delivers personally, from first consultation to final follow-up.
Royal Orthopaedic Hospital
Consultant at one of Europe's largest specialist orthopaedic hospitals, a tertiary referral centre with dedicated arthroplasty theatres, consultant-led anaesthetic teams, and specialist infection control.
ENDO-Klinik Fellowship
British Hip Society Travelling Fellowship at the ENDO-Klinik in Hamburg, an internationally recognised centre for hip and knee reconstruction, plus 33 peer-reviewed publications.
Personal Care at Every Stage
Mr Hussain sees and operates on every patient personally across the Royal Orthopaedic Hospital, Priory Hospital Edgbaston, and Harborne Hospital.
Audited Results
Total hip replacement outcomes audited against National Joint Registry benchmarks, with a Doctify rating of 4.98 out of 5 from verified patients.
Patients travel to him from across Birmingham and the West Midlands, including Solihull, Sutton Coldfield, Wolverhampton, Coventry, Staffordshire, Shropshire, Worcestershire, and Warwickshire.
Your Questions Answered
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 Hip Replacement?
Book a private consultation with Mr Hussain at the Royal Orthopaedic Hospital, Priory Hospital Edgbaston, or Harborne Hospital.