Hip replacement - Why it is necessary 

When a hip replacement is necessary 

Waiting times

Under current waiting time targets, people in England should not have to wait longer than 18 weeks for hip replacement surgery once it has been recommended.

These targets are not always met. Read more about waiting times in the NHS.

A hip replacement will usually be recommended if one or both of your hip joints is damaged to such an extent that:

  • you are experiencing persistent hip pain that is not responding to other treatments
  • the range of movement in the joint is so restricted that day-to-day tasks such as walking are very difficult or, in some cases, impossible

Common causes of hip damage

Some of the most common causes of hip damage are described below.


Osteoarthritis is the most common type of arthritis. It occurs when the joints become damaged over time and causes the surrounding cartilage to wear away. This causes the bones of the joint to rub together leading to hip pain, stiffness and loss of movement. Osteoarthritis affects around 1 million people in England and Wales.

Rheumatoid arthritis

In cases of rheumatoid arthritis, the immune system – which usually fights infection – attacks the cells that line the joints, making them swollen, stiff and painful. Over time, this can damage the joint itself, the cartilage and nearby bone.

Hip fractures

Hip fractures are one of the most common causes of bone injury in older people, with an estimated 70-75,000 occurring each year in the UK. Most cases of hip fracture occur as a result of a fall.

It is possible to repair a fractured hip, but in some circumstances a hip replacement is recommended.

Less common causes of hip damage

Less common causes of hip damage include:

  • septic arthritis – this form of arthritis occurs when the joint becomes infected
  • crumbling of the bone (avascular necrosis) – due to alcohol misuse
  • Paget's disease of bone – this affects bone growth and can make bones weak and deformed
  • bone tumours – abnormal cancerous growths that develop inside the bone
  • hip dysplasia – which is where a baby is born with incorrectly formed bones in the hips. Over time this misalignment can become worse, which sometimes means that it becomes necessary to replace the affected joint 

Page last reviewed: 23/01/2012

Next review due: 23/01/2014


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The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Hollybob said on 03 February 2014

Avascular necrosis is not just caused by alcohol abuse and its unhelpful to suggest otherwise. Corticosteroid use, Gaucher's disease, sickle cell disease for example can all cause AVN. Some cases, like my own, are medically unexplained

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Who can have one

Most people are suitable candidates, except those who have a serious health condition, such as poorly controlled heart disease or kidney disease that could be made worse by surgery or those who would be unable to follow the physical rehabilitation programmes required after surgery. This could be because they have a condition, such as dementia, that means they are unable to understand and follow instructions or they may be too frail or have other disabilities.