Hip Replacement Surgery: Procedure, Recovery and Cost

Is hip pain making it difficult for you to walk, sleep, climb stairs or enjoy time with family? When medication, physiotherapy and lifestyle changes no longer provide enough relief, hip replacement surgery may be an option to help you move more comfortably again.

This procedure replaces damaged parts of your hip joint with artificial components designed to reduce pain and improve mobility.

Here is what you need to know about hip replacement surgery in Singapore, from when it may be considered and what happens during surgery to recovery, possible complications and costs.

What is hip replacement surgery and what types are available in Singapore?

Hip replacement surgery, also called hip arthroplasty, replaces damaged parts of the hip joint with artificial components to relieve pain and improve movement. Your hip is a ball-and-socket joint: the femoral head is the “ball” at the top of your thigh bone, while the acetabulum is the “socket” in your pelvis.

When cartilage wears away or the bone is severely damaged, the joint can become painful, stiff and difficult to move. During surgery, an orthopaedic surgeon removes the affected joint surfaces and inserts an implant, also called a prosthesis.

The implant commonly includes:

• An acetabular cup that replaces the damaged hip socket
• A liner placed inside the cup, often made from highly durable polyethylene
• A femoral stem inserted into the thigh bone
• A femoral head, which forms the new “ball” of the joint

Total hip replacement

Total hip replacement (THR) replaces both the femoral head and the hip socket. It is the most common type of hip replacement surgery and may be recommended for severe hip osteoarthritis, rheumatoid arthritis or avascular necrosis.

Partial hip replacement

Partial hip replacement replaces only the femoral head rather than the entire ball-and-socket joint. It is usually considered for selected hip fractures, particularly in older adults where repairing or preserving the original joint may not be suitable.

Hip resurfacing

Hip resurfacing preserves more of your thigh bone by covering the damaged femoral head instead of replacing it entirely. It may be considered for selected younger, active patients, but suitability depends on bone quality, anatomy and other individual factors.

Surgical approaches for hip replacement

Your surgeon may access the hip from the front, side or back, and the best approach depends on your anatomy, condition and surgeon’s assessment. These include:

• Anterior approach: Accesses the hip from the front and may work between muscles rather than detaching them.
• Posterior approach: Accesses the hip from the back and is a commonly used technique.
• Lateral approach: Accesses the hip from the side.

No single approach is automatically best for everyone. Read our guide to female hip replacement to learn about considerations that may be relevant to women. Ask your orthopaedic surgeon why a particular approach, implant type and rehabilitation plan may suit your needs.

What conditions may lead to hip replacement surgery?

Hip replacement may be considered when hip damage causes ongoing pain, stiffness and reduced movement that affects your daily life. Osteoarthritis is the most common reason, but several other conditions can damage the joint over time.

• Osteoarthritis: This happens when the cartilage that cushions your hip gradually wears away. You may develop groin pain, stiffness, reduced flexibility, a limp or trouble putting on shoes and socks. In advanced cases, the bones may rub together painfully.
• Rheumatoid arthritis and other inflammatory arthritis: Persistent inflammation can damage your hip’s lining, cartilage and bone. Conditions such as rheumatoid arthritis or ankylosing spondylitis may cause hip damage earlier in life.
• Avascular necrosis: Also called AVN, this occurs when blood flow to the femoral head is reduced, causing bone tissue to weaken or collapse. It can be linked to trauma, long-term steroid use, heavy alcohol use or certain medical treatments.
• Hip fractures and previous injuries: If you have a severe fracture or injury that cannot be repaired reliably, partial or total hip replacement may be needed. This is more common when bone quality is poor.
• Developmental hip dysplasia: This means your hip socket does not fully support the ball of the joint. It can cause instability, earlier cartilage wear and osteoarthritis.

When should you consider hip replacement surgery in Singapore?

You may consider hip replacement when hip pain and restricted movement continue to affect your quality of life despite appropriate non-surgical treatment. Surgery is a personal decision made with your orthopaedic surgeon; an X-ray result alone does not determine whether you need an operation.

Non-surgical treatment may include:

• Pain-relief medication, where medically appropriate
• Physiotherapy and strengthening exercises
• Activity modification
• Use of a walking stick or other mobility aid
• Weight management, where relevant
• Treatment for the underlying condition, such as inflammatory arthritis

You may wish to speak with an orthopaedic specialist if you have:

• Persistent hip or groin pain that limits walking, work or sleep
• Pain when getting up from a chair, climbing stairs or putting on footwear
• Stiffness that limits your ability to bend or rotate the hip
• A noticeable limp, reduced walking distance or difficulty bearing weight
• Hip pain at rest or at night
• Little improvement despite conservative treatment

The purpose of surgery is not simply to improve an X-ray. It is to help you reduce pain, regain functional movement and return to activities that matter to you, such as walking outdoors, travelling, working or exercising safely.

How is hip arthritis diagnosed and assessed before surgery?

A pre-surgical assessment confirms the cause of your symptoms, checks whether surgery is appropriate and helps your care team plan for a safer recovery. Your specialist will consider your symptoms, medical history, daily activity needs and imaging results.

Your assessment may include:

• A physical examination to check hip movement, muscle strength, leg length and walking pattern
• X-rays of the hip, usually the first imaging test used to identify joint-space narrowing, deformity or arthritis
• MRI or CT scans in selected cases, particularly when early disease or complex anatomy needs further assessment
• Blood tests and other pre-operative investigations
• An electrocardiogram (ECG), chest X-ray or specialist review when indicated by your age or health conditions

Tell your care team about all medicines and supplements you take, including blood thinners, diabetes medication and traditional remedies. You may need individual advice on which medicines to stop, adjust or continue before surgery.

Preparing your home can also make early recovery easier. Clear loose rugs and clutter, arrange a stable chair with armrests, consider bathroom grab bars, and keep essentials within easy reach.

What happens during hip replacement surgery?

Hip replacement surgery generally takes about one to two hours, although your total time in hospital will be longer because of preparation and post-operative monitoring. Your surgical plan varies depending on the type of replacement, approach, implant and your health needs.

Here is what usually happens:

1. Anaesthesia: You may have general anaesthesia, where you are asleep, or spinal anaesthesia, which numbs your lower body. Your anaesthetist will discuss the most appropriate option with you.
2. Surgical access: Your surgeon makes an incision and carefully reaches the hip joint through the planned surgical approach.
3. Removal of damaged surfaces: In a total hip replacement, the worn femoral head and damaged cartilage in the socket are removed.
4. Placement of the implant: The surgeon inserts the acetabular cup, liner, femoral stem and new femoral head. Components may be cemented or press-fit, allowing bone to grow into the implant over time.
5. Stability check: Your surgeon tests hip movement, stability and leg length before closing the wound.
6. Recovery room care: You are monitored while you wake from anaesthesia, and the team manages pain, nausea, blood pressure and other immediate post-operative needs.

Your surgeon may use intra-operative X-rays or other imaging during the procedure to help check implant size and positioning.

What does hip replacement recovery look like?

Hip replacement recovery begins soon after surgery, with early walking and physiotherapy helping you rebuild strength, confidence and safe mobility. Your exact timeline depends on your age, fitness, surgical approach, medical conditions, home support and commitment to rehabilitation.

What happens in hospital after hip replacement?

You will usually begin gentle movement and walking with assistance within the first day after surgery, if medically appropriate. The team may provide pain relief, antibiotics, compression devices and blood-clot prevention measures based on your individual risk.

A physiotherapist will show you how to:

• Get in and out of bed safely
• Walk using a walker, crutches or walking stick
• Manage stairs if needed
• Do early exercises for circulation, strength and range of motion
• Follow any hip precautions specific to your surgical approach

Hospital stays vary. Some people may go home after one or two nights, while others need longer monitoring or rehabilitation support.

What should you expect at home after hip replacement?

At home, you should increase activity gradually, follow your physiotherapy plan and protect your healing wound. It is normal to have swelling, bruising, tiredness and some discomfort in the early weeks.

Practical recovery tips include:

• Take pain medicine exactly as prescribed so you can move and exercise comfortably
• Walk little and often, increasing distance gradually
• Keep follow-up appointments and attend physiotherapy sessions
• Avoid driving until you can safely control the vehicle and your surgeon says it is appropriate
• Eat regular meals with adequate protein, fluids, fruit and vegetables to support healing
• Avoid smoking, as it can affect wound healing and recovery

Your surgeon may recommend particular movement precautions, especially during the early healing period. Do not assume that advice given to another patient applies to you.

How long does it take to recover from hip replacement?

Many people return to light daily activities within four to six weeks, while strength, confidence and overall function can continue improving for several months. Full recovery may take up to a year, especially if you had severe stiffness or muscle weakness before surgery.

Low-impact activities such as walking, cycling and swimming may be introduced gradually when your surgeon or physiotherapist advises. High-impact sports, forceful twisting or activities with a high risk of falling may not be suitable for every implant or patient.

What are the benefits, risks and complications of hip replacement surgery?

Hip replacement can reduce pain and improve mobility, but it is still major surgery with risks that you should understand before deciding. The expected benefits and risks depend on your health, diagnosis, implant type and recovery plan.

Potential benefits of hip replacement

The main benefits are pain relief, easier movement and improved independence in everyday activities. You may be able to walk farther, sleep more comfortably, return to low-impact exercise and participate more fully in work, family and social life.

Modern implants are designed for long-term function. NICE recommends hip replacement prostheses with revision rates, or projected revision rates, of 5% or less at 10 years for end-stage hip arthritis.

Possible risks and complications

Complications are uncommon but can include infection, blood clots, dislocation, fracture, nerve injury, leg-length differences, implant loosening and the need for revision surgery.

Important risks include:

• Infection: Can affect the wound or the joint around the implant.
• Blood clots: Deep vein thrombosis (DVT) can form in the leg; a clot can rarely travel to the lungs and cause pulmonary embolism.
• Dislocation: The artificial ball can come out of the socket, with the risk generally highest in the first few months while tissues heal.
• Implant wear or loosening: May develop over time and occasionally require revision hip replacement.
• Fracture or soft-tissue injury: May occur during or after surgery.
• Nerve or blood-vessel injury: Rare, but possible.
• Ongoing pain or stiffness: Some people do not achieve the level of symptom relief they expected.

Seek urgent medical care if you develop chest pain, sudden shortness of breath, coughing up blood, severe calf swelling, fever, worsening wound redness, wound discharge, sudden inability to bear weight or a visibly changed leg position.

How much does hip replacement surgery cost in Singapore?

The cost of hip replacement surgery in Singapore can vary substantially depending on the hospital type, ward class, implant, surgical complexity, length of stay and insurance coverage. Ask for a personalised financial-counselling estimate before scheduling surgery.

Based on MOH’s transacted bill data for 2023, inclusive of GST, the typical bills for a routine primary total hip replacement – TOSP code SB839H, Table 6A – are:

More complex hip replacements requiring additional implants or bone grafts are recorded separately under SB723H, Table 6B. Typical median bills are higher: $57,900 for private inpatient care, $11,473 in a subsidised B2 ward and $10,084 in a subsidised C ward. Bill ranges vary by ward class and hospital.

These figures are estimates based on MOH transacted bills and are not personalised quotes. Your final out-of-pocket cost will depend on your subsidy eligibility, MediSave and insurance claims, implant requirements, length of stay and individual medical needs. Ask your clinic or hospital for a written estimate before proceeding.

Need help finding the right next step?

If you are considering an orthopaedic review, second opinion or physiotherapy support, Health in Asia can help you compare orthopaedic specialist options in Singapore based on your preferences and indicative consultation fees.

Once you have selected a specialist, our Care Team can check appointment availability and support your booking. You can also speak with our Care Team if you would like to explore a second opinion, orthopaedic consultation or physiotherapy support.