Hip replacement surgery is a common procedure in the UK, with thousands of people undergoing this operation every year. It is well established as a highly successful treatment for severe hip pain and disability due to conditions such as osteoarthritis, rheumatoid arthritis, hip fractures and other hip conditions, and has a high rate of success.

However, like any surgical procedure, hip surgery is not without risk. Before they undergo treatment, hip replacement patients need to be aware of what can potentially go wrong, and make sure they know what options will be available to them in case this happens.

In this blog post, we will explore hip replacement success rates in the UK, and examine the potential risks and complications associated with this common type of surgery.

How successful is hip replacement surgery on average?

The most important fact to bear in mind when undergoing hip replacement surgery is that it is a procedure with a very strong track record of success. According to the latest figures from the National Joint Registry, there were 84,998 primary hip replacements in England, Wales, Northern Ireland, the Isle of Man and Guernsey in 2021.

A total hip replacement can sound daunting, but for most patients, this will be a smooth process that delivers long-lasting positive outcomes. The following official stats from the NHS for April 2020 to March 2021 demonstrate this:

• 97% of patients receiving hip replacements reported improvements in their Oxford Hip Score, a patient-reported scale designed to assess pain and functionality in patients undergoing hip replacement surgery
• 95% of hip replacement patients said they felt better after the operation
• 93% of patients thought the results of their operation were excellent, very good or good

The success of a hip replacement surgery is measured by the reduction in pain and improvement in function that the patient experiences after the operation. Most patients report a significant improvement in their quality of life following the surgery. They can move more freely, participate in activities they enjoy, and live without the constant pain that was previously a part of their daily lives.

Additionally, according to patient information from the Hull University Teaching Hospitals NHS Trust, at least 85% of hip replacements will continue to work well up to 20 years after they are inserted, showing that this procedure delivers lasting benefits for most patients who opt to undergo it.

Take a look at our blog post to learn more about how many hip replacements are performed in the UK in previous years, or you can get the latest up-to-date stats and insights from the National Joint Registry.

When are total hip replacements needed?

Part of the reason why joint replacement surgery is usually successful is that it is only recommended for patients who have been unable to achieve relief from pain and disability using non-surgical treatments, such as medication, physiotherapy, weight loss and the use of walking aids. As such, for these patients, a total hip replacement is often the endpoint of a long therapeutic journey.

The most common reasons for getting a hip replacement include:

• Osteoarthritis, a degenerative joint disease that causes the cartilage in the hip joint to wear away over time. As the cartilage wears away, the bones of the hip joint rub together, causing pain and stiffness.
• Rheumatoid arthritis, a chronic inflammatory disorder that can affect the lining of the joints. In severe cases, rheumatoid arthritis can destroy the cartilage and bone within the joint, leading to pain and deformity.
• Hip fractures, particularly in older adults. The elderly are more prone to hip fractures due to conditions like osteoporosis, which weakens the bones and makes them more susceptible to fractures. In these cases, repairing the fracture might not be enough to restore mobility and function, and a total hip replacement may be necessary.
• Certain hip diseases, such as hip dysplasia or avascular necrosis. Hip dysplasia is a condition where the hip joint is not properly formed, leading to instability and premature wear-and-tear. Avascular necrosis is a condition where the blood supply to the hip bone is disrupted, leading to the death of bone tissue and eventual collapse of the hip joint.

A total hip replacement involves removing the damaged hip joint and replacing it with an artificial joint made from metal and plastic components. This artificial hip joint is designed to mimic the function of a natural hip joint, allowing the patient to move their hip normally and without pain.

It is important to note that the decision to have a hip replacement should be made in consultation with your doctor, taking into consideration your overall health, the extent of your hip damage, and your personal needs and lifestyle.

What causes unsuccessful outcomes for hip replacement surgery?

Although hip replacement surgery is largely very successful, there are a number of circumstances in which patients may not experience an optimal outcome. According to statistics from Hull University Teaching Hospitals NHS Trust, around 5% of patients will have lingering symptoms following their joint replacement surgery, or will otherwise be unhappy with the outcome.

This is because there are several potential risks and complications that may arise from hip replacement surgery:

• Blood clots can form in the leg veins as a result of decreased mobility following surgery. These clots, known as deep vein thrombosis (DVT), can be life-threatening if they travel to the lungs, causing a pulmonary embolism. Clots in legs can travel to the lungs in 1-2% of cases, while around 5% may experience pain and swelling in the legs.
• Infections can occur in the wound or deep around the artificial joint. In hip replacements, this can cause the new joint to loosen and may require further surgery to remove and replace the joint. There is roughly a 2% risk of a superficial infection, or a six in 1,000 chance of a deeper and more serious infection.
• Dislocation of the artificial ball of the hip joint from the socket is a risk, particularly in the first few months after surgery, when the soft tissues surrounding the joint are healing.
• Loosening or wearing of the joint over time can cause severe pain and potentially require revision surgery, especially among patients who are very active or overweight, or those who undergo hip replacement surgery at a young age.
• Nerve damage in the hip joint is a rare occurrence, but this can happen during surgery, leading to weakness, numbness, or a tingling sensation in the leg.
• Differences in leg length may emerge after hip replacement surgery, due to changes in the muscles and ligaments around the new hip joint. This can affect the way a person walks and may require the use of a shoe insert to even out the leg lengths.
• Strokes, heart attack or heart failure may also occur as a consequence of stress associated with surgery.

A 2022 study of data from the National Joint Registry also noted that younger patients are at an elevated risk of requiring multiple revisions, and that patients who undergo hip revision surgery tend to have a progressively increased risk of needing further revision procedures, with each subsequent revision lasting for less time than the previous one.

All of these factors should be taken into account by both the patient and the doctor when considering the best course of treatment.

What Can I Do if Something Goes Wrong with My Hip Replacement Surgery?

If you experience complications or are unsatisfied with the outcome of your hip replacement surgery, it is important to know that you have options and resources available to you.

The first step is to seek immediate medical attention, especially if you are experiencing severe pain, signs of infection, or any other potentially concerning symptoms. If you are not satisfied with the information or treatment plan provided by your current healthcare provider, consider seeking a second opinion. If your symptoms persist or worsen, you may also consider consulting with a specialist, such as an orthopaedic surgeon who specialises in hip replacements.

Throughout this process, keep a detailed record of your symptoms, treatments and interactions with healthcare providers. This can be helpful in tracking your progress and can provide valuable evidence if you decide to pursue a legal claim.

If you believe that your complications are the result of medical negligence, it may be beneficial to seek legal advice. Medical negligence occurs when a healthcare provider fails to provide the standard of care that a reasonable professional would have provided under the same circumstances, leading to harm or injury.

In the context of hip replacement surgery, negligence could involve:

• Surgical errors, such as damaging a nerve or blood vessel during the operation
• Implanting the wrong size or type of artificial joint
• Failing to adequately inform you of the risks associated with the surgery
• Failing to diagnose or treat post-operative complications in a timely manner

The process of making a medical negligence claim can be complex and time-consuming, so it is advisable to seek legal advice in these cases. A solicitor experienced in medical negligence claims can guide you through the process, gather the necessary evidence, and represent your interests in negotiations or court proceedings.

At JMW, our team of expert medical negligence solicitors have extensive experience in handling these kinds of claims. Find out more about our hip surgery negligence claims service.