Hip replacement, also hip arthroplasty, is a surgical procedure in which the hip joint is replaced by a prosthetic implant. Such joint replacement orthopaedic surgery generally is conducted to relieve arthritis pain or fix severe physical joint damage as part of the hip fracture treatment.
The modern artificial joint owes much to the work of John Charnley at Wrightington Hospital; his work in the field of tribology resulted in a design that almost completely replaced the other designs by the 1970s. Charnley's design consisted of three parts—
- a metal (originally stainless steel) femoral component,
- a teflon acetabular component, the wear debris of which resulted in a condition called Osteolysis, and so it was replaced by Ultra High Molecular Weight Polyethylene or UHMWPE in 1962, both of which were fixed to the bone using
- PMMA (acrylic) bone cement, and/or screws.
The replacement joint, which was known as the Low Friction Arthroplasty, was lubricated with synovial fluid. The small femoral head (7/8" (22.2 mm)) was chosen for its decreased wear rate; however, this has relatively poor stability (the larger the head of a replacement the less likely it is to dislocate, but the more wear debris produced due to the increased surface area). For over two decades, the Charnley Low Friction Arthroplasty, and subsequent similar designs were the most used systems in the world, far surpassing the other available options (like McKee and Ring). Recently the use of a polished tapered cemented hip replacement (like Exeter) and uncemented hip replacements have become more popular. Cemented stems are commonly used in older patients due to their lower cost, including the Austin Moore proximal femoral replacement for Medicaid patients, while more modern and longer lasting 'cementless' stems, often coated in Hydroxy-Apatite Ceramic, are used in 'younger' and more physically active patients. Once an uncommon operation, hip replacement is now common, even among active athletes including racecar drivers Bobby Labonte and Dale Jarrett.
In a paper published August 14, 2007 in The Japan Times, signed by K. Rogoff, it is mentioned that 250,000 hip replacements are performed in the U.S. each year, for an average cost of $6,000. This cost cited is likely that for the implant devices only. However, the total cost including the implants, the hospital charges and the surgeon's fee is probably what CNN-TV reported on Dec. 5, 2000, stating that the average cost of hip replacement surgery is $25,000.
In 2008, a source quoted US$7–9,000 in India at an internationally accredited hospital; in a county in Florida, USA, from $41,597-$56,258 , most likely the total costs for cementless devices, was quoted.
Surgery costs vary from country to country, with the US typically being among the highest-priced markets, and countries like Thailand, Cuba and Argentina, among the lowest.