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Your Hip ReplacementA guide for patients aged 65 and over

Section 7

Questions to ask, and where this comes from

Take this list with you to your appointments — and see the evidence this package is based on.

It is easy to forget your questions in a clinic room. Write your answers straight onto a printed copy of this page, or hand it to whoever is coming with you.

Ask your surgeon

  • Which approach will you use, and which movements should I avoid afterwards?
  • Will my implant be cemented, uncemented or hybrid — and why is that right for me?
  • How many of these operations do you do each year, and what are your results?
  • How long should I expect this hip to last, given my age?
  • Will I be able to put my full weight on the leg straight away?
  • How much pain is normal in the first two weeks?
  • What follow-up will I have, and who do I contact if something worries me?

Ask your anaesthetist

  • Do you recommend a spinal or a general anaesthetic for me, and why?
  • If I have a spinal, will I be sedated as well?
  • Will I have a nerve block, and will it make my leg weak?
  • Which of my medicines do I take on the morning of surgery?
  • I was confused after a previous operation — what can be done to prevent that?
  • How likely am I to need a blood transfusion?

Ask your nurse, physiotherapist or occupational therapist

  • How long am I likely to stay in hospital?
  • What equipment will I need at home, and who provides it?
  • How will I manage stairs, and washing and dressing?
  • How often should I do my exercises, and how much aching is acceptable?
  • When will my stitches or clips come out, and who does that?
  • Can I have this in large print, or can my daughter be on the phone for this conversation?

You are allowed to ask again

If an answer is too fast, too technical, or you simply cannot take it in on the day, ask for it to be repeated, written down, or explained to a family member. Every member of the team would far rather explain twice than have you go home unsure.

Plain-English glossary

Acetabulum
The socket part of your hip, formed by the pelvis.
Arthroplasty
The medical name for a joint replacement operation.
Femoral head
The ball at the top of the thigh bone.
Prosthesis / implant
The artificial parts that replace your joint.
Cemented fixation
Holding the implant in place with fast-setting bone cement.
DVT
Deep vein thrombosis — a blood clot in a deep vein, usually in the leg.
ODP
Operating department practitioner — a registered practitioner specialising in theatre care.
Revision surgery
A second operation to replace or adjust an existing joint replacement.
Tranexamic acid
A drug given during surgery to reduce bleeding.
Delirium
Sudden, temporary confusion, common in older people after illness or surgery.
PROMs
Patient-reported outcome measures — questionnaires such as the Oxford Hip Score.

Where to find more trustworthy information

  • NHS website — hip replacement pages, including videos on exercises and recovery.
  • Versus Arthritis — patient-focused information and local support groups.
  • Royal College of Anaesthetists — clear leaflets on spinal anaesthesia, general anaesthesia and nerve blocks.
  • National Joint Registry — information about implants and hospital results.
  • Age UK — practical help with equipment, home adaptations and care at home.

Be cautious with social media groups and personal videos. People's experiences are real but not always typical, and the most alarming stories travel furthest.

About this information package

This package was produced as an educational resource on total hip replacement for patients aged 65 and over and their carers, drawing on national guidance from NICE, Getting It Right First Time (GIRFT), the National Joint Registry and NHS outcome data, together with the peer- reviewed literature listed below. Figures given as approximate risks are national averages for planned surgery and are not a substitute for the individual estimate your own surgeon and anaesthetist will give you.

References

  1. Aalders, M.B., Ligthart, M.J.P., Temmerman, O.P.P., Benner, J.L., van der List, J.P., Kerkhoffs, G.M.M.J. and Keijser, L.C.M. (2025) 'Anxiety and depression symptoms are associated with inferior outcomes in patients undergoing total hip arthroplasty: a prospective cohort study', The Journal of Arthroplasty. https://pubmed.ncbi.nlm.nih.gov/40499743/
  2. Ackerman, I.N., Cashman, K., Lorimer, M., Heath, E. and Harris, I.A. (2024) 'Hip-specific and generic patient-reported outcome measure scores after primary hip replacement are associated with early revision surgery: a national registry study', Journal of Patient-Reported Outcomes, 8(1). https://pmc.ncbi.nlm.nih.gov/articles/PMC10957851/
  3. Barney, J., Piuzzi, N.S. and Akhondi, H. (2019) Femoral head avascular necrosis. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK546658/
  4. Best Practice for Hip Arthroplasty Surgery Documentation, working in partnership with NHS Resolution (2019). Getting It Right First Time. https://gettingitrightfirsttime.co.uk/wp-content/uploads/2017/07/1a.-GIRFT-BHS-and-BOA-Best-Practice-hip-arthroplasty-documentation.pdf
  5. Bischoff, P., Kubilay, N.Z., Allegranzi, B., Egger, M. and Gastmeier, P. (2017) 'Effect of laminar airflow ventilation on surgical site infections: a systematic review and meta-analysis', The Lancet Infectious Diseases, 17(5), pp. 553–561. https://pubmed.ncbi.nlm.nih.gov/28216243/
  6. Briggs, T. (2015) A national review of adult elective orthopaedic services in England: Getting It Right First Time. https://gettingitrightfirsttime.co.uk/wp-content/uploads/2018/07/GIRFT-National-Report-Mar15-Web.pdf
  7. Britto, E.J., Nezwek, T.A. and Robins, M. (2024) Wound dressings. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470199/
  8. Carter, M. (2023) Guidance for hip and knee surgery outlines measures to support a significant reduction in length of stay. Getting It Right First Time. https://gettingitrightfirsttime.co.uk/guidance-for-hip-and-knee-surgery-outlines-measures-to-support-a-significant-reduction-in-length-of-stay/
  9. Sarier, C., Walsh, S., Bowers, S., O'Connor, M., Mohamed, A., Keller, H., Ford, K.L., Galvin, R. and Griffin, A. (2025) 'Effectiveness of interventions to improve malnutrition among older adults living with frailty who are discharged from the acute setting: a systematic review', Nutrients, 17(19), p. 3181. https://pubmed.ncbi.nlm.nih.gov/41097258/
  10. Chen, X., Xiong, J., Wang, P., Zhu, S., Qi, W., Peng, H., Yu, L. and Qian, W. (2018) 'Robotic-assisted compared with conventional total hip arthroplasty: systematic review and meta-analysis', Postgraduate Medical Journal, 94(1112), pp. 335–341. https://pmc.ncbi.nlm.nih.gov/articles/PMC5992373/
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  14. Getting It Right First Time (2026) Elective primary total hip replacement pathway, January 2026. https://gettingitrightfirsttime.co.uk/wp-content/uploads/2026/01/Elective-Primary-Total-Hip-Replacement-Pathway-Jan-2026.drawio-1.pdf
  15. Getting It Right First Time (2020) Elective surgery pathways LCAG v1 [PowerPoint presentation]. https://www.gettingitrightfirsttime.co.uk/wp-content/uploads/2020/11/Ortho4.pdf
  16. Gandbhir, V.N. and Rayi, A. (2020) Trendelenburg gait. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK541094/
  17. Günther, K.-P., Deckert, S., Lützner, C., Lange, T., Schmitt, J. and Postler, A. (2021) 'Total hip replacement for osteoarthritis — evidence-based and patient-oriented indications', Deutsches Ärzteblatt International, 118(43), pp. 730–736. https://doi.org/10.3238/arztebl.m2021.0323
  18. Healio (2019) Posterior approach for THA may have higher dislocation risk. https://www.healio.com/news/orthopedics/20191118/posterior-approach-for-tha-may-have-higher-dislocation-risk
  19. Jones, O. (2022) The hip joint. TeachMeAnatomy. https://teachmeanatomy.info/lower-limb/joints/hip-joint/
  20. Lan, P.-W., Chen, X., Fang, Z., Zhang, J., Liu, S. and Liu, Y. (2022) 'Effects of comorbidities on pain and function after total hip arthroplasty', Frontiers in Surgery, 9. https://pmc.ncbi.nlm.nih.gov/articles/PMC9130629/
  21. Matar, H.E., Platt, S.R., Board, T.N. and Porter, M.L. (2020) 'Overview of randomized controlled trials in primary total hip arthroplasty (34,020 patients): what have we learnt?', JAAOS: Global Research and Reviews, 4(8), p. e20.00120. https://pmc.ncbi.nlm.nih.gov/articles/PMC7417146/
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  42. Zheng, H., Barnett, A.G., Merollini, K., Sutton, A., Cooper, N., Berendt, T., Wilson, J. and Graves, N. (2014) 'Control strategies to prevent total hip replacement-related infections: a systematic review and mixed treatment comparison', BMJ Open, 4(3), p. e003978. https://doi.org/10.1136/bmjopen-2013-003978