Total Hip
Replacement
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 ways to manage hip arthritis are no longer providing adequate relief. The decision is based on symptoms and quality of life - not simply on X-ray findings, and Dr Liew is transparent about the cost of joint replacement from the outset.

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.

On 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.

Why muscle preservation matters

The fundamental difference between hip approaches is which soft tissues are divided to reach the joint. The DAA is unique in working through a natural anatomical corridor - the interval between the tensor fasciae latae and sartorius muscles - without cutting or detaching any major muscle from bone. By contrast, the posterior approach requires detachment of the short external rotators, and the lateral approach splits the gluteus medius; both then need reattachment and a period of protected healing before full strength returns.

Because nothing is divided that must later heal, patients can bear full weight immediately. Published studies support this: Nakata et al. (2009) reported shorter hospital stays and better early gait scores with the DAA compared with the posterolateral approach, and Taunton et al. (2014) reported equivalent or better patient-reported outcomes at mid-term follow-up.

Direct Anterior vs Posterior Approach

Implant Specifications

Intra-operative X-ray: confirming the result before closing

A practical advantage of the supine (on-your-back) position used in the anterior approach is direct access to live X-ray (fluoroscopy) during surgery. A C-arm can be brought in at any point to confirm cup position (inclination and anteversion), stem seating, and leg-length restoration before the final components are locked in and the wound is closed. If a measurement falls outside the planned target, it can be corrected in that moment - the real-time link between the pre-operative 3D plan and the final result. Accurate component position matters: Vigdorchik et al. (2019) identified cup malpositioning as a primary risk factor for dislocation and accelerated wear.

Read more about what your hip replacement is made of and the direct anterior approach.

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 or Calvary Adelaide 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.

Long-term outlook - Modern hip replacements are durable. According to the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), around 91% of total hip replacements are still in place at 20 years. You can read more about what the registry data shows about hip replacement longevity, and use the Oxford Hip Score self-assessment to gauge how your hip is currently affecting you.

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.

Hip 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 used for patient-specific 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