Total hip replacement is the definitive surgical treatment for end-stage hip arthritis. Dr Chien-Wen Liew performs all hip replacements via the direct anterior approach, combined with 3D pre-operative planning and patient-specific technology - an approach refined over more than a decade of subspecialty practice in Adelaide.
What Is a Total Hip Replacement?
The hip is a ball-and-socket joint. In hip arthritis, the cartilage that cushions the joint gradually wears away, leaving bone rubbing on bone. This causes progressive pain, stiffness, and loss of function that eventually cannot be managed with non-surgical treatment.
Total hip replacement involves removing the arthritic ball and socket and replacing them with precisely engineered prosthetic components - a titanium stem in the femur, a ceramic head, and a titanium cup with a ceramic liner in the pelvis. The result is a new, smooth, pain-free joint surface.
When performed correctly, with well-matched components positioned to suit the patient's anatomy, the procedure is among the most consistently successful in all of medicine.
Who Needs a Hip Replacement?
Hip replacement is considered when hip arthritis has progressed to the point where pain and disability significantly affect daily life, and non-surgical measures are no longer providing adequate relief. The decision is based on symptoms and quality of life - not simply on X-ray findings.
Common indicators that hip replacement is appropriate include:
- Hip pain that is constant or present at rest and at night
- Significant limitation in walking distance or daily activities
- Stiffness that makes dressing or putting on shoes difficult
- Failed or insufficient response to physiotherapy, weight loss, walking aids, and anti-inflammatory medication
- X-ray evidence of advanced joint space narrowing consistent with symptoms
Age alone is not a determining factor. Dr Liew assesses each patient individually - both younger and older patients can be appropriate candidates depending on their overall health, activity goals, and expectations.
Hip Replacement in Adelaide — Direct Anterior Approach with 3D Planning
Dr Liew performs all hip replacements using the direct anterior approach (DAA) - a muscle-sparing technique that accesses the hip from the front of the body, between the muscle planes, without cutting or detaching any muscle.
This approach is combined with detailed 3D pre-operative planning using CT-based software. Before any patient enters the operating theatre, Dr Liew maps the patient's specific anatomy in three dimensions and determines the precise size, orientation, and position of each implant component.
"We no longer guess where the implants need to go. We have the ability to map out the pre-arthritic state of a joint and test it in a 3D space before we even enter the operating theatre."
Dr Chien-Wen Liew, FRACSOn the day of surgery, patient-specific cutting guides and intra-operative imaging are used to confirm implant position in real time. This combination of pre-operative precision and intra-operative verification aims to reproduce the patient's natural hip anatomy as closely as possible.
The direct anterior approach also eliminates the traditional hip movement precautions associated with posterior approaches - patients can move freely from the day of surgery.
What to Expect - From Consultation to Recovery
Initial consultation - Dr Liew reviews your imaging, medical history, symptoms, and goals. If hip replacement is appropriate, a surgical date is planned and pre-operative investigations are arranged.
Pre-operative planning - A CT scan is used to create a three-dimensional model of your hip. Dr Liew uses this to plan implant sizing and positioning before surgery.
Surgery day - The procedure takes approximately 60-90 minutes under spinal or general anaesthesia. Most patients are walking with a frame on the day of surgery or the morning after.
Hospital stay - Most patients spend 2-3 nights at Eastwood Private Hospital before being discharged home.
Early recovery (weeks 1-6) - Walking gradually increases. Return to driving typically occurs at 2-3 weeks for automatic vehicles. Physiotherapy supports strength and mobility recovery.
Full recovery (3-12 months) - Most patients reach their functional plateau between 3 and 12 months. Activities such as walking, swimming, cycling, and golf are typically well-supported by a hip replacement.
Why Subspecialty Focus Matters for Hip Replacement Outcomes
Surgical volume is one of the strongest predictors of outcome in joint replacement. Surgeons who perform a procedure at high volume, repeatedly and exclusively, develop a depth of technical precision that broad-scope practitioners cannot match. This is not a controversial claim — it is consistently supported by data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), which tracks revision rates by surgeon and hospital across Australia.
Dr Liew's practice is limited to two operations only: total hip replacement and total knee replacement. No sports injuries, no trauma, no shoulder or ankle work. Every operating session, every planning session, and every post-operative review is focused on these two procedures. The direct anterior approach is used for all primary hip replacements — not as one technique among several, but as the only technique. This concentration produces a consistency of preparation, execution, and outcome that is difficult to achieve in a broader practice.
The AOANJRR data show that ceramic-on-ceramic bearing surfaces — the articulation used in Dr Liew's practice — exhibit among the lowest revision rates for total hip replacement in the Australian data. Combined with 3D pre-operative planning and intraoperative imaging, this represents a coherent approach to minimising the risk of revision and maximising the longevity of each procedure.
"A focused surgeon is a better surgeon. Operating on the same two joints, using the same approach, with the same technology — every case builds on the last."
Dr Chien-Wen Liew, FRACS — Orthopaedics 360, AdelaideHip Replacement Surgery in Adelaide — Hospitals and Referrals
Dr Liew consults at Orthopaedics 360, located at Eastwood Private Hospital, 204 Greenhill Road, Eastwood SA 5063. Hip replacement surgery is performed at both Eastwood Private Hospital in Eastwood, Adelaide, and Calvary Adelaide Hospital, 120 Angas Street, Adelaide SA 5000.
A GP referral is required to access Dr Liew's services under Medicare. Your general practitioner can provide a standard specialist referral, which should be addressed to Dr Chien-Wen Liew, Orthopaedics 360. Once your referral is in place, contact the rooms on (08) 7077 0158 to arrange an appointment.
At your initial consultation, Dr Liew will review your imaging, examine your hip, discuss your symptoms and goals, and determine whether surgery is appropriate. If hip replacement is recommended, a surgical date is planned and pre-operative investigations are arranged. The CT scan for 3D planning is typically organised 6–8 weeks before the procedure.
For a comprehensive guide to the direct anterior approach — including technique details, implant selection, recovery timeline, and survivorship data — visit anteriorhipadelaide.com.au, a dedicated patient resource by Orthopaedics 360.
Frequently Asked Questions — Hip Replacement Adelaide
Request a Consultation
A GP referral is required. Contact Orthopaedics 360 to arrange your appointment at Eastwood Private Hospital.