How a hip replacement is done with Hugh Apthorp

What is the technique used for replacing a worn out hip joint?

Hugh: A hip replacement is a technique where we replace the worn out joint with an artificial one. The hip is a ball that has a covering, which is cartilage, which sits in a socket. As the cartilage wears away, the bones rub together, so we have to replace the ball and the socket because they're both worn.

How do you replace the hip (socket)?

Hugh: When we replace the hip, what we do is we go down to the hip joint, moving the muscles aside. I then remove the ball, in the space that's created in the socket. I can then remove the cartilage and replace it with a metal shell which is made of titanium. It has a coating on it, on which bone will grow. I’ve prepared the socket so that the bone is perfectly shaped to take the (artificial) socket and within here is a special bearing which is made of a certain type of plastic. This plastic will last twenty five years, when it's used with a ceramic ball.

How do you replace the ball in a hip replacement?

Hugh: On the femoral side (the femur: thigh bone), we’ve removed the ball. When we've removed the ball - and bones are hollow, they’re full of marrow - we can move the marrow aside and place a stem down inside the bone. That stem has a coating on it which bone will grow onto. It becomes a part of you and permanently fixed to you. Onto the end of the end of the stem will go a ball which is made of ceramic, and that’s an incredibly strong, long-lasting material.

There are different sizes and shapes of stem, and different balls, which will fit in different positions to enable me to exactly correct your anatomy - so your hip will then feel perfect.

This ball bears against the socket, and because of the shape of it, and the way it all works together, you get a fantastic range of movement without the ball coming out of the joint. And this combination should last the vast majority of patients for the rest of their lives with high levels of activity.

And this combination should last the vast majority of patients for the rest of their lives - with high levels of activity.

Mr Hugh Apthorp specialises in hip replacment and operates exclusively on the hip at London Bridge Hospital. His hip replacment volumes and success rates are amongst the highest in the country. Given his reputation, built over more than two decades, patients come for treatment from all over the UK.