What is a Total Hip Replacement

Dr Liew's Surgical Approach

Over the years I have been exposed to almost every form of hip replacement. I trained predominantly in the Posterior Approach for total hip replacements and the Lateral Approach for trauma hip replacements or partial (hemi) hip replacements. In 2012, I made the decision to transition into Total Hip Replacements performed via the Direct Anterior approach. This led me on a journey across the world, with highlights from Switzerland, France, UK and USA, where I saw some of the very best surgeons in the world perform the most elegant surgery. Fast forward to now, and I have performed the direct anterior approach exclusively for my patients for over 10 years. The direct anterior approach is a fantastic operation, providing a safe and effective method for performing hip replacements.

A hip replacement is only required once you have reached a point where your quality of life is impaired. It is something that you should never jump into, but once you have noticed that your quality of life is impaired, it will be a suitable option for you.

I utilise a hip replacement that comes in 4 main parts. I have a video about materials here. The stem, ball, cup, and liner. There are some variations to this, including the dual mobility system which we use for patients with neuromuscular disorders, or who are at very high risks of dislocation. This may include those with severe connective tissue disorders. I do not tend to use the dual mobility implant for standard patients as its longevity is not as studied as the conventional hip replacements which have very long term data.

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The Modular Prosthesis

We use a modular prosthesis for all of our total hip replacements. This means that the prosthesis comes in 4 main parts. This allows for finer adjustments of position, size, and optimises matching of the prosthesis geometry to the patients native anatomy. The stem can have different size, shapes and geometries to accurately reproduce the correct replication of your own anatomical nuances. This is al determined during our 3D pre-operative scan, which allows us to simulate surgery before the actual day.

The stem and acetabular shell are composed in general of Niobium, Vanadium, Titanium alloy.

The ball and liner articular are in general - Ceramic on Ceramic.

Implant Variations and Considerations

This may change for those with Dual mobility implants, or those requiring cementation of their implants.

To learn about the materials used, please follow this link. WHAT IS MY HIP REPLACEMENT MADE OF

Whilst cement can be used, I do not routinely use cement for my hip replacements. If your bone quality is very low with osteoporosis, then cement may be a good option for this. My aim is to place an uncemented prosthesis to allow biological fixation between the bone and the stem. The implants are coated with a material that allows bone to grow into it.

Frequently Asked Questions