A hip replacement that is working well should feel comfortable and steady. The main warning signs are:
- new pain in the groin, buttock or thigh
- pain when you first stand up
- new clicking or clunking
- the hip giving way
- a new limp
- swelling, warmth or a leaking scar
- sudden pain after a fall
- any new symptom, if you have a metal-on-metal hip
Most of these are not emergencies, but they should be checked.[7] An X-ray is usually the first step.
When to Get Urgent Help
Call 999 or go to A&E if:
- you have sudden, severe hip pain and cannot put weight on your leg
- your leg suddenly looks shorter or is turned to one side
- you have pain and swelling in your hip or leg, with chest pain or trouble breathing
- you have signs of infection and are confused, breathing fast, or have blotchy or very pale skin
Ask for an urgent GP appointment or call NHS 111 if:
- your hip or scar is hot, red or newly swollen
- you have a high temperature, or feel hot and shivery
- fluid or pus is leaking from your scar
- you have throbbing pain, swelling or redness in one calf or leg
The other signs in this guide are less urgent. Still, ask to be seen within a week or two. Problems found early are often simpler to treat.[5]
1. Pain That Comes Back in the Groin, Buttock or Thigh
A good hip replacement should be comfortable in daily life. Pain that returns after months or years of comfort is the most common warning sign.
What it feels like. A deep ache in the groin or buttock. Sometimes it runs down the front of the thigh. It is often worse when you walk and better when you rest.
What it can mean. The implant may have come loose from the bone. Surgeons call this aseptic loosening, which means loosening without infection. It is the most common reason hip replacements are redone in the UK.[1] Less often, the cause is a slow infection. Pain that has never settled since your operation also needs checking. You can read more about a loose hip implant.
2. Pain When You First Stand Up or Start Walking
Some people feel a sharp pain with the first few steps. It then eases as they get going. Doctors call this start-up pain.
What it can mean. Start-up pain is a classic sign of a loose stem. The stem is the part that sits inside your thigh bone. If it moves a little each time you put weight on it, the first steps hurt most.
Tell your surgeon exactly when the pain comes on. That detail helps.
3. Clicking, Clunking, Grinding or Squeaking
Many hip replacements click now and then. A noise with no pain is often harmless. This does not apply to metal-on-metal hips (see sign 8).
See someone if the noise is new, is getting worse, or comes with pain.
What it can mean. A clunk can mean the ball is slipping slightly in the socket. Grinding can mean the lining of the socket is wearing thin. Squeaking can happen with some ceramic hips. Rarely, a ceramic part can crack. Sudden grinding or crunching in a ceramic hip needs an urgent check. You can read more about hip implant wear.
4. The Hip Gives Way, or Has Come Out of Joint
Your hip may feel as if it is about to give way. It may catch when you turn, or when you get up from a low chair. This is called instability.
A hip that comes fully out of the socket has dislocated. This causes sudden, severe pain and you will not be able to walk. Call 999. Do not eat or drink while you wait. You may need sedation to put it back.
One dislocation makes another more likely. If it has happened to you, ask for a review, even if the hip is back in place. You can read more about hip replacement dislocation.
5. A New Limp, or One Leg Feeling Shorter
You may find you are limping again. Family often spot it first. Your leg may feel shorter, or one shoe may wear down faster.
What it can mean. The implant may have sunk a little into the bone. The lining of the socket may have worn. Tiny particles from wear can also slowly eat away the bone around the implant.
All of this can happen with very little pain. A new limp deserves an X-ray.
6. Swelling, Warmth, Redness or a Leaking Scar
These can be signs of infection around the implant. Infection can start soon after surgery. It can also start years later, when germs travel in the blood from another part of the body. A bad tooth, a skin ulcer or a urine infection can be the source.
What it feels like. The hip aches at rest and at night. It may be warm or swollen. The scar may turn red or start to leak. You may feel unwell or feverish.
Some slow infections cause only pain, with no fever and no redness. Tell any doctor you see that you have a hip replacement. Ask if samples are needed before antibiotics start.
Infection needs prompt care. Use the urgent advice above if you have a temperature or a leaking scar. You can read more about hip replacement infection.
7. Sudden Pain After a Fall
A fall or a hard twist can crack the bone around the implant. Surgeons call this a periprosthetic fracture. It becomes more likely as bones get thinner with age.
What it feels like. Sudden pain in the hip or thigh, and you cannot stand on the leg. Sometimes the pain is milder and you can still walk a little.
Go to A&E if you cannot put weight on your leg. If you can walk but the hip has hurt since a fall, get an X-ray that day or the next. Call NHS 111, or go to an urgent treatment centre. Use a stick or frame, and keep weight off the leg until then. You can read more about a break around a hip replacement.
8. Any New Symptom if You Have a Metal-on-Metal Hip
Some hip replacements have a metal ball that moves against a metal socket. Many were fitted in the 2000s. Metal hip resurfacings work the same way.
Most people with these hips have no problems. But tiny metal particles can sometimes damage the muscle and bone around the joint. Finding this early makes treatment simpler.
What to look for. New pain, a lump or swelling in the groin, or a new clicking sound.
People with these hips should have regular checks, even if they feel fine.[6] The checks include a blood test and sometimes a scan. Not sure what type of hip you have? The hospital that did your operation can tell you. You can read more about reactions to metal hips.
Some Problems Give No Warning
Wear and bone loss can build up silently. This is why checks matter for older hips.
UK research suggests an X-ray and a review about 10 years after a standard hip replacement.[4] This applies even if the hip feels fine. Metal-on-metal hips and redone hips need checks sooner and more often. If your hip is more than 10 years old and has not been checked, ask your GP.
Not Every Pain Means the Hip Is Failing
Pain near a hip replacement often comes from something else. Common causes are:
- a sore tendon at the front of the hip
- a sore, inflamed spot over the outer hip bone (bursitis)
- a trapped nerve or arthritis in the lower back
- a strained muscle
These are usually treated without another operation. A specialist can usually tell the difference with an examination, an X-ray and blood tests.
Why Do Hip Replacements Wear Out or Fail?
There are five main reasons:[2]
- the implant comes loose from the bone
- the hip keeps dislocating
- the bone around the implant breaks
- infection sets in
- the body reacts to tiny particles worn from the joint
Loosening is still the most common. It becomes more likely once a hip is more than five years old. Infection now accounts for a growing share of repeat operations.[1]
Each cause is treated in a different way. Our guide to revision hip and knee surgery explains how.
How Long Does a Hip Replacement Last?
Longer than most people expect. In the UK, only about 2 or 3 in every 100 modern hip replacements need redoing within 10 years.[1] This figure leaves out metal-on-metal hips, which have needed redoing more often.
You may have read that only 58 in 100 hips last 25 years.[3] That figure comes from older designs fitted in other countries. Modern implants are doing better so far. We do not yet have 25-year results for them.
Age matters too. Younger, more active people put more years of use on a hip. They are more likely to need a second operation in their lifetime. Our main guide covers hip replacement surgery in Birmingham.
How Is a Painful Hip Replacement Checked?
- Your story. When the pain started, where it is, and what brings it on.
- An examination. How you walk, how the hip moves, and whether your legs are the same length.
- X-rays. New pictures are compared with your old ones. Small changes over time are the best clue to loosening.
- Blood tests. These look for signs of infection, and for metal levels if you have a metal hip.
- Further tests if needed. A CT or MRI scan, or a sample of fluid taken from the hip with a fine needle.
Bring any old X-rays, operation notes and implant details you have. If you do not have them, they can usually be traced.
What Can Be Done?
It depends on the cause. Not every failing hip needs a big operation.
- Some problems are watched with regular X-rays.
- Some need one part changed, such as the ball or the socket lining.
- Some need the whole implant replaced. This is called revision hip replacement.
- A deep infection usually needs surgery as well as antibiotics. Antibiotics alone rarely cure it.
Revision surgery is more complex than a first hip replacement. In England, NHS hospitals now work in regional revision networks. Complex cases are discussed by a specialist team.[8]
Mr Shakir Hussain specialises in revision hip surgery at the Royal Orthopaedic Hospital in Birmingham. The hospital takes complex cases from other hospitals. You can read about revision hip replacement in Birmingham. You can also read about Mr Hussain's work as a specialist in revision hip and knee surgery.
If your hip has changed, the next step is to have it checked. You can arrange a private hip consultation in Birmingham.
Frequently Asked Questions
What are the first signs of a hip replacement failing?
The first sign is usually pain that returns in the groin, buttock or thigh after a long spell of comfort. Other early signs are pain on first standing, new noises, and the hip giving way.
Can a hip replacement fail without pain?
Yes. Wear and bone loss can build up with no pain at all. This is why UK research suggests an X-ray check about 10 years after surgery.
Is it normal for a hip replacement to hurt after 10 years?
No. A hip replacement that is working well should stay comfortable. New pain after 10 years should be checked with an X-ray. The cause is often something simple, but loosening becomes more common as a hip gets older.
How long does a hip replacement last in the UK?
Most last well beyond 10 years. National figures show that only about 2 or 3 in every 100 modern hip replacements need redoing within 10 years. This figure leaves out metal-on-metal hips, which have needed redoing more often.
Who should I see if I think my hip replacement is failing?
Start with your GP or the hospital that did your operation. National guidance covers new or worsening pain, a limp, or loss of function after a joint replacement. It says your GP should refer you to an orthopaedic surgeon. You can also see a revision hip specialist privately. If you are insured, check whether your insurer needs a GP referral.
References
- National Joint Registry (NJR). 23rd Annual Report 2026: hip revision rates and reasons for revision.
- National Joint Registry (NJR). 22nd Annual Report 2025: indications for first revision of a hip replacement.
- Evans JT, Evans JP, Walker RW, et al. How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet. 2019;393(10172):647-654. NIHR Evidence summary
- Kingsbury SR, et al. Safety of disinvestment in mid- to late-term follow-up post primary hip and knee replacement: the UK SAFE evidence synthesis and recommendations. Health Soc Care Deliv Res. 2022;10(16). NIHR Evidence summary
- NHS. Complications of a hip replacement. nhs.uk.
- Medicines and Healthcare products Regulatory Agency. All metal-on-metal (MoM) hip replacements: updated advice for follow-up of patients. Medical Device Alert MDA/2017/018.
- National Institute for Health and Care Excellence. Joint replacement (primary): hip, knee and shoulder. NICE guideline NG157, 2020.
- Wilson M, Gambhir A, Board T, Whitehouse M. Revision hip networks. Journal of Trauma and Orthopaedics (British Orthopaedic Association), Vol 13, Issue 2, June 2025. boa.ac.uk (PDF)
This page is for general information and is not a substitute for a consultation. Whether your hip replacement needs treatment is assessed individually.
Mr Shakir Hussain
Consultant Hip and Knee Surgeon at the Royal Orthopaedic Hospital Birmingham, with over 5,000 procedures and fellowship training in revision hip surgery at the ENDO-Klinik Hamburg.