Hip Replacement Surgery Singapore: A Comprehensive Guide

What is hip replacement surgery?

Hip replacement surgery, or hip arthroplasty, is a medical procedure in which a damaged or worn-out hip joint is replaced with an artificial implant. If you have chronic hip pain and limited mobility, and all the conservative methods have failed, your next best option would most likely be going towards a surgical approach. This surgery is one of the most successful and commonly performed orthopaedic surgeries worldwide. It offers significant improvements in quality of life for patients suffering from constant hip pain due to various medical conditions.

Learn more about hip pain, it's alternative treatments and more here.

Types of hip replacement surgery

There are several types of hip replacement surgeries:

1. Total hip replacement

   • It involves replacement of the entire hip joint, including the femoral head and acetabulum (hip socket), is replaced.

2. Partial hip replacement

   • It involves replacing only the femoral head, typically used in cases of hip fractures. Also called Hemiarthroplasty.

3. Hip resurfacing

   • Instead of replacing the entire joint, hip resurfacing involves capping the damaged surface of the femoral head with a metal covering. This is more common in younger, active patients.

4. Minimally invasive hip replacement

   • As the name suggests, it is a minimally invasive surgery that involves the use of smaller incisions and less muscle disruption. Although it's relatively expensive, it potentially leads to faster recovery.

Indicators of hip replacement surgery

When other conservative management options such as medication, physical therapy, lifestyle modifications fail to relieve hip arthritis or improve mobility, you will typically be recommended to an orthopaedic surgeon who will assess your condition and recommend suitable treatment options. Conditions that may lead to the need for hip replacement surgery include:

1. Osteoarthritis

   • The most common reason for hip replacement especially in elderly patients is osteoarthritis. It leads to the wearing down of cartilage surface in the hip joint, causing pain and stiffness.

2. Rheumatoid arthritis

   • Rheumatoid arthritis is an autoimmune condition that causes inflammation of the joint lining, resulting in pain, swelling, and damage to the hip.

3. Hip fractures

   • Severe fractures or injuries that cause significant damage to the hip joint, especially in elderly patients.

4. Avascular necrosis

   • A condition where the blood supply to the hip bone is interrupted, leading to bone death and joint damage.

5. Developmental hip dysplasia

   • A congenital condition where the hip socket is abnormally shaped, leading to early joint damage.

Some common signs that indicate the need for hip replacement surgery include:

• Persistent hip pain: 

  • Severe pain that interferes with daily activities like walking, climbing stairs, or sitting down.

• Limited range of motion: 

  • Stiffness or difficulty moving the hip joint.

• Loss of mobility: 

  • Difficulty walking or the need for a cane or walker to get around.

• Discomfort while resting: 

  • Discomfort that persists even when lying down or sitting.

These symptoms can severely impact your daily living and quality of life. If conservative treatments are ineffective, your healthcare provider may recommend a hip replacement.

For personalised advice regarding your underlying disease, you may consult with a specialist from Thomson Medical. Request for an appointment with our specialists today.

Types of hip implants used in surgery

Hip replacement is a surgical approach that involves the removal of damaged bone and cartilage by an orthopaedic surgeon. The removed diseased hip joint is then replaced with an artificial joint. The implant is made up of several parts that mimic the natural hip joint. The artificial joint known as the acetabular cup replaces the hip joint. Similarly the femoral stem is inserted in the thigh bone (femur), while the femoral head fits into the socket and mimics the natural head of the femur. In partial surgeries only a certain part gets replaced while in total hip replacement surgery, all three components of implants may be used. 

These artificial joint implants are made of several types of materials. They include:

• Metal on polyethylene: 

  • A metal ball that fits into a plastic (polyethylene) cup. This is the most common type of implant.

• Ceramic on polyethylene:

  •  A ceramic ball with a plastic cup, which may produce less wear over time.

• Ceramic on ceramic: 

  • A ceramic ball and socket, which provides excellent durability but may produce noise.

• Metal on Metal: 

  • These implants were popular in the past but are less commonly used today due to concerns about metal ions being released into the body.

Early surgical intervention based on your personal needs can help prevent further damage to the hip joint and aid your healthcare provider in devising a more effective treatment plan. Consult with our hip specialists at Thomson Medical today for an accurate diagnosis and a personalised treatment plan.

Procedures of hip replacement surgery

Below are the procedures taken before and during surgery to ensure a successful hip placement surgery for a patient: 

Before surgery

• Preoperative evaluation

  • This includes a complete medical assessment for any health condition, physical examination, blood tests, and imaging tests like X-rays or MRIs to evaluate the extent of hip damage in the bones and soft tissues.

• Preparing for surgery

  • Patients may need to stop certain medications, adjust their diet, and work with a physical therapist to strengthen the hip muscles before surgery. 

During surgery

• Anesthesia

  • The procedure typically takes 1 to 2 hours and is performed under general anesthesia (the patient is asleep) or spinal anesthesia (the patient is awake but numb from the waist down).

• Incision & bone removal

  • The orthopedic surgeon will make an incision in the hip, remove the damaged bone and cartilage. This is done by posterior approach, anterior approach, or lateral approach.

• Implantation

  • The surgeon will implant the artificial joint components depending on what diseased part has been removed. 

• Closing the incision

  • After ensuring the new artificial joint fits properly and functions correctly, the incision is closed.

Recovery phase (post - surgery)

The rehabilitation process for the hip replacement surgery involves a combination of medical care, physical therapy, and self-care. Here are the typical stages of recovery:

 Immediate post-operative care

• Monitoring

  • During the postoperative period,  patients are assessed for pain after surgery. They are also monitored for infection, blood pressure, and blood clots. Pain medication and blood thinners are commonly prescribed.

• Gentle exercising

  • It begins the day after surgery, focusing on gentle exercises to regain movement and strength in the hip joint.

Rehabilitation process

• Continued physical therapy

  • A crucial part of recovery, physical therapy helps strengthen muscles around the hip and improve flexibility. Such physiotherapy sessions will guide patients through exercises that promote walking, balance, and mobility with good activity modification.

• Assistive devices

  • Patients may need some precautions such as use walking aids such as crutches, a walker, or a cane for a few weeks to aid walking.

• Home adaptations

  • Setting up the home for recovery by making it safer (e.g., installing grab bars, clearing walkways) can aid in smooth recovery.

 Timeline for recovery

• First few weeks after surgery

  • Most patients can resume light physical activities like walking and basic household tasks in the postoperative period, typically within 2 to 4 weeks after surgery.

• 3 to 6 months

  • Most patients can return to low-impact physical activities like swimming or cycling within 3 to 6 months after surgery. During this time, high-impact activities are typically discouraged.

• Full recovery

  • Full recovery time can take up to a year, but many patients experience significant pain relief, improved mobility and muscle strength within a few months.

Risks & complications of hip replacement surgery

While hip replacement surgery is generally safe and highly effective, risk factors and common complications in the postoperative period include:

• Infection: 

  • This may occur at the incision site or around the new joint.

• Blood clots: 

  • There is a risk of blood clots developing in the legs or lungs (deep vein thrombosis or pulmonary embolism).

  • Deep vein thrombosis (DVT) is a condition where a blood clot forms in a deep vein, usually in the legs. It can cause swelling, pain, and redness, and poses a risk of serious complications if the clot travels to the lungs, causing a pulmonary embolism.

  • A pulmonary embolism (PE) occurs when a blood clot, often originating in the leg, breaks loose and travels through the bloodstream to the lungs. Once it reaches the lung, it can block an artery, leading to sudden disruption of blood flow and oxygen exchange.

• Risk of dislocation: 

  • The ball of the new artificial hip joint may dislocate from the socket, particularly in the early recovery period.

• Loosening of the implant: 

  • Over time, the implant may loosen, causing pain or instability.

• Nerve or blood vessel damage: 

  • Nerve damage may occur leading to loss of sensation or movement in the hip. Similarly, blood vessels near the hip can be injured during surgery causing significant blood loss. This is very rare.

Cost of hip replacement surgery in Singapore 2025

The cost of hip replacement surgery in Singapore can vary based on the hospital, orthopaedic surgeon, type of surgery, and the artificial hip joint used. Here’s a breakdown of costs across the major types of hip replacement surgeries:

• Total hip replacement (THR)

  • Private hospital: SGD 35,000 to  SGD 40,000.

  • Public hospital (subsidized):SGD 10,000 to SGD 18,000

• Partial hip replacement

  • Private hospital: 30,000 to SGD 35,000

  • Public hospital (subsidized): SGD 8,000 to SGD 12,000.

• Hip resurfacing

  • Private hospital: SGD 35,000 to SGD 45,000.

  • Public hospital (subsidized): SGD 10,000 and SGD 20,000.

• Minimally invasive hip replacement

  • Private hospital: SGD 45,000 to SGD 50,000.

  • Public hospital (subsidized): SGD 15,000 and SGD 25,000.

The information provided above is intended for general reference only. Actual costs may vary based on individual medical conditions. For detailed fee information and payment options, please consult a specialist by requesting an appointment with Thomson Medical today.

FAQ

How long does it take to recover from a hip replacement?

Recovery from a hip replacement typically takes 3 to 6 months for most daily activities, with initial improvements in pain and mobility seen within 4 to 6 weeks. Full healing of the hip joint may take up to a year, and physical therapy is crucial for a successful recovery.

Will I need another hip replacement in the future?

There is a possibility that you may need a second surgery, known as a revision hip replacement, if the implant wears out over time. However, with current advancements, many patients do not require revision surgery for 15 to 20 years or more.

How long do hip replacements last?

Modern hip replacements can last 15 to 20 years or longer, depending on factors like activity level, weight, and overall health. Advances in implant materials and surgical techniques have improved the outcomes of hip replacements and reduction in revision rates.

What are the signs of a failing or loosening hip implant?

Signs of a failing implant may include:

• Persistent and severe hip pain

• Instability or clicking sensation in the hip joint

• Difficulty walking or bearing weight

• Noticeable shortening of the leg

If these symptoms occur, you should consult your doctor to determine if revision surgery is necessary.

 How should I care for my new hip joint?

• Follow your physical therapist’s instructions on exercises.

• Avoid high-impact activities that can damage the implant.

• Maintain a healthy weight to reduce stress on the joint.

• Attend regular follow-up appointments to monitor the condition of the implant.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist by requesting an appointment with Thomson Medical today.