Total Hip Replacement (Arthroplasty)

A Surgical Option for Advanced Hip Arthritis

Total hip replacement, also known as total hip arthroplasty, is a surgical procedure used to relieve pain and restore function in hips affected by severe arthritis, degeneration, or injury. If non-surgical treatments such as physiotherapy, medications, or joint injections no longer provide relief, replacing the damaged hip joint with a prosthetic implant may help improve mobility, reduce discomfort, and enhance your quality of life.

Dr George Awwad performs hip replacement surgery using advanced techniques, including anterior minimally invasive approaches, supported by personalised pre-operative planning. His focus is on achieving precise outcomes and guiding each patient through a well-supported recovery process.

When is hip replacement surgery recommended?

Total hip replacement is typically recommended when the hip joint has been significantly damaged by conditions such as osteoarthritis, rheumatoid arthritis, or past injury, resulting in ongoing pain, stiffness, and reduced function. It is a treatment option considered when non-operative management is no longer effective, and when joint damage begins to interfere with quality of life.

Most patients start with conservative treatments including physiotherapy, anti-inflammatory medications, weight management, and joint injections. These may provide temporary relief, but if symptoms persist or worsen over time, surgery may be discussed as the next step.

Hip replacement may be considered appropriate when:

Hip replacement is not considered routine or urgent surgery; rather, it is planned when the goal is to restore mobility and reduce discomfort in a joint that is no longer functioning well. The timing of surgery depends on the severity of joint damage, how much your symptoms affect your daily life, and your individual health status.

 

Dr George Awwad takes a careful and considered approach to this decision. If you’re experiencing ongoing limitations due to hip joint damage, he will guide you through a full assessment and help determine whether surgery may be a reasonable next step in your treatment pathway.

Symptoms that may indicate hip arthritis

Hip arthritis is a degenerative condition that causes inflammation, stiffness, and progressive wear of the hip joint. It is most commonly due to osteoarthritis but may also result from rheumatoid arthritis or previous trauma to the joint. As the cartilage that normally cushions the ball-and-socket joint breaks down, the bones begin to rub directly against each other, leading to pain, reduced movement, and increasing joint dysfunction.

Recognising the signs of hip arthritis

Symptoms of hip arthritis tend to develop gradually. In the early stages, many people notice only occasional discomfort. Over time, symptoms may become more persistent and start to interfere with everyday activity.

Common signs that may indicate hip arthritis include:

When to seek further assessment

If you’re experiencing these symptoms regularly, especially if they are worsening over time, it’s important to speak with your GP. They may refer you for imaging (such as an X-ray) or to a specialist like Dr George Awwad for further evaluation. Early diagnosis can help guide the most appropriate treatment options and support your long-term joint health.

Are you a candidate for hip replacement surgery?

If you’re living with long-standing hip pain that no longer responds to non-surgical treatments, you may be considering whether hip replacement surgery could help. Total hip replacement is typically considered for individuals with advanced joint damage that affects mobility, independence, and quality of life, particularly when conservative measures are no longer effective.

Key factors that may indicate surgery is appropriate

You may be considered a suitable candidate for hip replacement if:

General health and surgical readiness

Candidacy for hip replacement is not based on age alone. What matters most is your overall health, your ability to participate in rehabilitation, and whether surgery is likely to improve your long-term mobility and comfort. Some patients with other medical conditions may require additional planning to ensure safety and optimal outcomes. Dr George Awwad will carry out a thorough assessment, taking into account your symptoms, imaging, lifestyle, and health history. If surgery is suitable, he will discuss the most appropriate timing and approach and guide you through a personalised care plan from preparation to recovery.

Who may not be suitable for hip replacement surgery?

While total hip replacement can be an effective treatment for advanced arthritis, it is not the right option for everyone at every stage. In some cases, surgery may be delayed, avoided, or reconsidered based on your symptoms, medical history, or current life circumstances. The decision to proceed with surgery involves careful consideration of risks, benefits, and overall readiness.

Reasons hip replacement may not be recommended at this time

You may not be considered suitable for hip replacement surgery if:

Ongoing review and reassessment

Hip arthritis is often a progressive condition. Even if surgery is not appropriate now, your situation may change over time. Regular follow-up allows for timely reassessment of your symptoms, imaging, and overall health. If pain worsens or your function declines, Dr George Awwad will review your options and discuss whether hip replacement may be suitable at a later stage.

Anterior & posterior hip replacement surgical approaches explained

Total hip replacement surgery can be performed through different surgical approaches, depending on the patient’s anatomy, the extent of joint damage, and the surgeon’s clinical judgement. The two most common techniques are the anterior approach and the posterior approach. Dr George Awwad performs the majority of hip replacements using the anterior minimally invasive approach, based on its advantages for suitable patients.

The anterior approach involves accessing the hip joint through an incision at the front of the hip. This technique uses a natural intermuscular plane, meaning no major muscles are cut during the procedure. As a result, there may be less soft tissue trauma and a quicker return to mobility in the early stages of recovery.

Potential benefits of the anterior approach include:

The anterior approach is technically demanding and requires specific training, experience, and equipment. Dr Awwad has completed dedicated training in this technique and performs it in most cases where it is considered safe and appropriate for the individual.

The posterior approach: A traditional and effective option

In some situations, the posterior approach, which involves an incision at the back of the hip, may be the most appropriate option. It provides excellent visibility of the hip joint and may be preferred in patients with:

The posterior approach remains a safe and effective technique, and when performed carefully, can provide excellent long-term outcomes similar to the anterior approach.

A patient-specific decision

Dr Awwad selects the surgical approach based on your individual condition, medical history, and goals. During your consultation, he will explain the approach recommended for your surgery, outline the reasoning behind it, and answer any questions you may have. Regardless of the technique used, the goal is always the same: to restore comfort, mobility, and long-term joint function with precision and care.

The role of imaging and surgical planning in hip replacement surgery

A well executed hip replacement begins with careful planning. Before entering the operating theatre, Dr George Awwad uses a combination of advanced imaging and digital planning tools to ensure your hip replacement is accurately tailored to your anatomy. This level of detail helps improve implant positioning, joint alignment, and long-term function.

Imaging used to assess your hip joint

The planning process typically begins with X-rays to assess joint space, bone structure, leg length, and the degree of arthritis present. In most cases, a CT scan is also arranged to provide a high resolution, three dimensional view of the hip joint and surrounding bone.

These images allow Dr Awwad to:

Digital 3D planning with MyHip software

Using specialised planning software (such as MyHip), Dr Awwad creates a 3D model of your hip based on the CT scan. This virtual model allows for precise pre-operative templating, helping to optimise:

This detailed plan is used to guide surgical decisions and supports consistent, personalised outcomes for each patient.

Patient-specific surgical tools

In select cases, Dr Awwad may also use patient-specific surgical instruments, which are created using your individual imaging data. These custom guides help accurately position the implants during surgery and are particularly useful in patients with complex anatomy or when performing revision hip replacement.

 

A focus on precision and safety

By combining high-quality imaging with digital planning, Dr Awwad is able to take a tailored, evidence-based approach to every procedure. This technology supports greater surgical precision, reduced variability, and improved post-operative joint function, all with the goal of helping you return to movement with confidence.

Types of hip implants used in total hip replacement

During a total hip replacement, the damaged parts of the hip joint are replaced with prosthetic components designed to restore function, reduce pain, and support long-term mobility. Dr Awwad selects each implant based on your unique anatomy, lifestyle, and long-term goals.

Main components of a hip replacement

A typical total hip replacement involves three key components:

Implant fixation: Cemented vs uncemented

Dr Awwad uses either cemented, uncemented, or hybrid fixation methods based on your bone quality and health profile:

Implant designs: Dual mobility for enhanced stability

In many cases, Dr Awwad uses a dual mobility cup, a specialised design intended to reduce the risk of dislocation and provide greater joint stability. This implant includes two points of articulation:

This type of implant may be especially beneficial for patients with a higher risk of instability or those with increased activity demands.

Bearing surface combinations

The bearing surface refers to the contact point between the femoral head and the cup liner. The right combination is selected based on your age, activity level, and risk profile:mobility cup, a specialised design intended to reduce the risk of dislocation and provide greater joint stability. This implant includes two points of articulation:

Dr Awwad selects the most appropriate combination based on clinical evidence and individual factors to support a lasting result.

Implant system: The AMIS femoral stem

For most anterior approach hip replacements, Dr Awwad uses the AMIS femoral stem, a prosthesis designed specifically for minimally invasive surgery. This stem supports a secure fit in the femur, allows for reduced soft tissue disruption, and may assist with early mobilisation and long-term stability when used in the right patient.

Implant longevity and performance

Modern hip implants are engineered to last. While results vary, many prosthetic joints continue to perform well for 15 to 20 years or longer. Implant longevity depends on several factors:file:

Dr Awwad is committed to using high-quality, evidence-based implants and tailoring each component to suit your individual needs and goals.

What are the potential risks of hip replacement surgery?

While total hip replacement is generally a safe and effective procedure, as with all surgeries, there are potential risks and complications. Understanding these risks can help you make an informed decision and take proactive steps to support a smooth recovery.

Common risks of hip replacement surgery

How risks are minimised

Dr George Awwad takes a meticulous approach to surgical planning and post-operative care. During your consultation, he will assess your individual risk factors including any medical conditions or medications that may affect healing and discuss strategies to reduce your risk of complications. 

Following pre-operative instructions, attending your post-operative reviews, and participating in rehabilitation as advised can all play a key role in reducing risks and supporting your recovery.

What are the benefits of total hip replacement surgery?

For individuals living with advanced hip arthritis or joint damage, persistent pain and reduced mobility can significantly affect everyday life. When non-surgical treatments no longer provide relief, total hip replacement surgery may offer a way to restore comfort and function.

Potential benefits of hip replacement surgery

Managing expectations

While most patients experience meaningful improvement in pain and function, outcomes can vary depending on factors such as age, overall health, and the degree of joint damage. The goal of surgery is to improve mobility and reduce pain, not necessarily to return to high-impact sports or intense physical activity.

During your consultation, Dr Awwad will provide clear guidance on what you can expect based on your individual condition, and how to prepare for the best possible outcome.

Your hip replacement journey with Dr George Awaad

Choosing to undergo total hip replacement is a major decision. Dr George Awwad is committed to guiding you through the process with clear communication, careful planning, and individualised care. From your initial consultation to your recovery at home, every stage is designed to support your safety, comfort, and confidence.

1. Initial consultation and assessment

Your journey begins with a comprehensive consultation at one of Dr Awwad’s clinics in Adelaide. During this visit:

If surgery is appropriate, Dr Awwad will explain the benefits, risks, and timing, and provide guidance on how to prepare for the next steps.

2. Imaging and surgical planning

Pre-operative planning plays a critical role in the accuracy and success of your surgery:

This technology allows Dr Awwad to tailor the surgery to your anatomy before entering the operating theatre.

3. Preparing for surgery

In the lead-up to your procedure, you may be asked to:

You’ll also receive instructions on planning for your recovery, including organising transport home, preparing a safe recovery space, and arranging help during the early stages.

4. The day of surgery and hospital admission

Most patients are admitted to hospital on the morning of surgery. You’ll receive specific fasting and fluid instructions from the anaesthetist before admission.

Bring along:

The hospital team will assist you through check-in and preparation for surgery.

5. The surgical procedure

Dr Awwad performs most hip replacements using the anterior minimally invasive approach (AMIS) but may use the posterior approach if clinically appropriate.

Key steps include:

You are then transferred to recovery where your vital signs and comfort are closely monitored.

6. Hospital stay and early mobilisation

Most patients stay in hospital for 2 to 4 days. During this time:

7. Recovery at home and follow-up care

Your rehabilitation continues after you return home and typically includes:

Follow-up schedule:

This personalised care ensures your recovery stays on track and any concerns are addressed promptly.

Pain management after hip replacement

Effective pain control is an important part of your recovery after total hip replacement. Well-managed pain can help you move more comfortably, sleep better, and fully engage in physiotherapy, all of which support faster healing and reduce the risk of complications.

Dr George Awwad and the hospital team use a multimodal approach to pain relief, combining different strategies to manage discomfort from multiple sources while minimising side effects.

How pain is managed after surgery

Pain control begins in the operating theatre and continues throughout your hospital stay and return home. Techniques may include:

Immediately after surgery

In the recovery room, your pain will be closely monitored. Some discomfort around the incision and hip is expected, but the goal is to keep pain well controlled. You may have:

You’ll be supported to begin gentle movement soon after surgery, as early mobility plays a key role in reducing stiffness and enhancing recovery.

Pain management during your hospital stay

Once the effects of spinal or nerve block wear off, oral pain medications become the primary method of control. These will be:

Physiotherapy will begin during this time, and your pain relief plan will be designed to support comfortable participation in movement and walking.

Pain relief at home

After discharge, you’ll receive a personalised pain management plan, which may include:

Most patients are able to stop using strong pain medication within 1 to 2 weeks, continuing with paracetamol or anti-inflammatories as needed.

What to expect during recovery

It’s normal to experience some discomfort in the early recovery phase. You may notice:

These symptoms typically improve over the first few weeks and continue to settle as your joint heals.

Monitoring and long-term improvement

Pain should gradually reduce over time. Most patients report significant improvement in discomfort within 4 to 6 weeks, with ongoing gains in comfort and function in the months that follow. If you experience increasing pain, signs of infection, or anything unusual, Dr Awwad’s team is available to provide prompt support.

Follow-up appointments allow your pain relief plan to be reviewed and adjusted as needed, ensuring your recovery remains on track.

Hip replacement recovery timelines: what to expect

Recovery after total hip replacement is a gradual process, and healing timelines vary between individuals. Your progress will depend on factors such as age, general health, activity level, and the complexity of your surgery. Dr George Awwad will guide you through each stage of your recovery and tailor your plan to match your individual needs.

In hospital (Day 0 to Day 2–4)

Before discharge, you must be able to:

Week 1 to Week 3

Week 4 to Week 6

Week 6 to Week 12

Month 3 to Month 12

Long-term considerations

Precautions to follow during your hip replacement recovery

Recovering safely after hip replacement surgery is essential for protecting your new joint and achieving the best possible outcome. In the first few weeks after surgery, being careful with your movements, taking your medications as directed, and following your physiotherapy plan can reduce the risk of complications and support your long-term recovery.

Wound care

Medication and pain control

Mobility and weight-bearing

Movement precautions

The precautions you need to follow depend on whether your surgery was performed using the anterior (front) or posterior (back) approach. These guidelines help protect the joint while the surrounding muscles and soft tissues heal.

If you had an ANTERIOR APPROACH (AMIS):

This method typically allows for quicker mobilisation and has fewer movement restrictions, however:

If you had a POSTERIOR APPROACH:

This method requires more specific precautions to help prevent dislocation:

Dr Awwad or the physiotherapist will advise you when it is safe to relax these precautions, typically after 6 weeks.

Sleeping and resting positions

Avoiding falls and injury

Returning to daily activities

Physiotherapy after hip replacement surgery

Physiotherapy is an essential part of your recovery following total hip replacement. A structured rehabilitation program helps restore strength, balance, and flexibility so you can safely return to your daily activities. Your physiotherapy journey begins within the first 24 hours after surgery and continues for several weeks or months as you progress.

Early physiotherapy in hospital

Soon after surgery, your physiotherapist will help you begin gentle exercises. Early movement is important to:

Initial exercises may include:

The focus is on helping you regain confidence and mobility while protecting your new joint.

Rehabilitation after discharge

Once you return home or to a rehabilitation centre, your physiotherapy program becomes more targeted and intensive. It will be tailored to your condition, goals, and progress.

You may work on:

Your physiotherapist will monitor your progress and adjust your program as needed to suit your comfort and goals.

Benefits of physiotherapy after hip replacement

Ongoing physiotherapy can:

Staying committed to your recovery

Your success depends on your active participation. Consistency is key:

Even once your formal rehab ends, continuing a regular exercise routine can help protect your joint and maintain your mobility in the long term.

Returning to activity after hip replacement surgery

A key goal of total hip replacement is to help you return to a more active and comfortable life. As you recover, you may find that everyday tasks become easier and that you are able to enjoy more of the activities you once loved. While it is important to protect your new joint during the healing period, many patients are able to resume a wide range of hobbies and routines with the right support and guidance.

Activities you can expect to return to

With time and recovery, you may gradually return to:

The timeline will vary based on your general health, the physical demands of each activity, and how your recovery progresses.

Activities that may need to be modified

Some high-impact or contact sports may not be recommended after hip replacement because of the increased risk of wear or dislocation. These may include:

If you are unsure whether a certain activity is safe, speak with your GP, physiotherapist or call Dr Awaad’s room for individualised advice.

Safe movement habits to protect your new hip

As you resume daily activities, you may be given strategies to reduce stress on the joint, such as:

These habits can help preserve your hip replacement and support long-term function.

Staying active for long-term joint health

Ongoing movement is vital. Low-impact exercise not only helps to strengthen muscles and maintain joint mobility but also supports your cardiovascular health and overall wellbeing. Many people find that they are more confident, active, and independent after surgery than they were before.

You will be guided through this transition with regular follow-up and support to make sure your return to activity is safe and sustainable.

Hip replacement surgery FAQ’s

How long does total hip replacement surgery take?

The procedure generally takes about 60 to 90 minutes. Additional time may be required for preparation, anaesthesia, and post-operative monitoring. Most patients spend 2 to 4 days in hospital after surgery, depending on your recovery and overall health.

Most modern hip implants are designed to last 15 to 25 years or more, especially when looked after properly. Factors like your activity level, weight, and general health can all influence the lifespan of your implant. Dr Awwad will discuss the most suitable implant for your situation during your consultation.

Hip replacements typically involve three main components:

  • Acetabular cup (socket)
  • Femoral stem
  • Femoral head

Dr Awwad selects implants made from durable materials such as ceramic, polyethylene, or metal, based on your age, anatomy, bone quality, and lifestyle.

Although most patients recover well, potential complications include:

  • Infection
  • Blood clots
  • Dislocation
  • Nerve or blood vessel injury
  • Leg length discrepancy
  • Implant loosening or wear over time

Dr Awwad will explain all potential risks and steps taken to reduce them during your consultation and surgical planning.

Preparation includes:

  • Completing any pre-operative tests
  • Attending a pre-admission clinic
  • Reviewing your medications
  • Getting your home ready (e.g. removing trip hazards, arranging mobility aids)

Maintaining a healthy weight and strengthening surrounding muscles may help improve your recovery. Dr Awwad and his team will guide you through every step.

You will begin walking, usually with a frame or crutches, within 24 hours after surgery. Physiotherapy starts early and continues after discharge. Most patients return to routine activities within 6 to 12 weeks, with ongoing improvements up to 12 months. Everyone’s recovery is different and tailored advice will be provided based on your progress.

This depends on your job and activity level:

  • Desk-based work: 4–6 weeks
  • Physical jobs: 10–12 weeks or more
  • Low-impact hobbies (like swimming or cycling): often resumed after 6–8 weeks
  • High-impact sports (like running or football): may need to be avoided or modified long term

Dr Awwad will provide specific recommendations based on your goals.

Most patients return to driving around 4–6 weeks after surgery, once they are no longer taking strong pain medication and can confidently move their leg and operate pedals. Always check with Dr Awwad before resuming driving.

Yes. Dr Awwad uses a surgical approach based on your anatomy and surgical needs. Common approaches include:

  • Anterior approach (from the front)
  • Posterior approach (from the back)

Each approach has benefits, and there is no proven long-term advantage of one over another. The key factor is that your surgery is well-planned and performed safely.

To protect your new hip in the early recovery phase, you may be advised to:

  • Avoid deep bending or twisting
  • Refrain from high-impact activities
  • Use supportive footwear
  • Maintain a healthy weight

Your physiotherapist will provide specific precautions to follow.

You will have regular follow-up appointments with Dr Awwad to monitor your recovery, check your wound, assess your mobility, and take post-operative imaging if required. If you experience increasing pain, swelling, or other concerning symptoms, you should contact Dr Awwad’s rooms promptly.

If you’re living with hip pain or stiffness that’s affecting your quality of life, a thorough assessment can help determine the cause and guide the right treatment path.