Total & Partial Hip Arthroplasty by Dr. Hemendra Agrawal

Hip Replacement Surgery, also known as Hip Arthroplasty, is a surgical procedure in which the damaged or diseased hip joint is replaced with an artificial prosthetic implant. The hip joint is a ball-and-socket joint where the head of the femur (thigh bone) articulates with the acetabulum (socket) of the pelvis. When arthritis, injury, or disease damages this joint, it can cause debilitating pain, stiffness, and loss of mobility that significantly impacts quality of life.
Dr. Hemendra Agrawal performs both total hip replacement (replacing both the ball and socket) and hemiarthroplasty (replacing only the femoral head, commonly done for hip fractures in elderly patients). He utilizes advanced bearing surfaces including ceramic-on-ceramic, ceramic-on-polyethylene, and oxidized zirconium-on-polyethylene, selecting the optimal combination based on each patient's age, activity level, and anatomy.
Using the direct anterior approach when appropriate, Dr. Agrawal performs hip replacement through a muscle-sparing technique that accesses the hip joint between muscles rather than cutting through them. This approach allows faster recovery, reduced risk of dislocation, less post-operative pain, and earlier return to normal activities compared to traditional posterior or lateral approaches.
Advanced uncemented (press-fit) implants with porous-coated surfaces encourage biological bone ingrowth, providing long-term fixation without cement. For elderly patients with poor bone quality, cemented fixation provides immediate stability. Dr. Agrawal's comprehensive approach — from pre-operative optimization through rehabilitation — ensures optimal outcomes for every patient.
When is this procedure recommended?
Osteoarthritis of the hip — the most common reason, causing progressive cartilage destruction and bone-on-bone contact
Avascular necrosis (AVN) of the femoral head — bone death due to disrupted blood supply, often from steroid use, alcohol, or trauma
Rheumatoid arthritis causing chronic inflammation and progressive hip joint destruction
Hip fractures in elderly patients (femoral neck fractures) — requiring hemiarthroplasty or total hip replacement
Post-traumatic arthritis following acetabular fractures, hip dislocations, or femoral head fractures
Ankylosing spondylitis with hip joint involvement causing progressive stiffness and fusion
Developmental dysplasia of the hip (DDH) with secondary arthritis in adults
Failed previous hip surgeries including osteotomy, internal fixation, or prior hip replacement
A detailed walkthrough of the surgical process
Complete medical evaluation, hip and pelvic X-rays (AP pelvis, lateral hip), MRI for complex cases, CT scan for 3D planning in dysplastic or revision cases. Templating for implant sizing. Medical optimization of diabetes, hypertension, and cardiac conditions. Pre-operative physiotherapy to strengthen hip abductors and improve walking ability.
Through a 10-12 cm incision over the front of the hip, the joint is accessed through the interval between the sartorius/rectus femoris and tensor fascia latae muscles — no muscles are cut or detached. This inter-nervous, inter-muscular approach preserves the hip abductors and external rotators, providing inherent stability against dislocation.
The damaged cartilage and bone of the acetabulum are removed using hemispherical reamers of progressively increasing size. The acetabular component (cup) is press-fit into the prepared socket at the optimal angle — approximately 40-45 degrees of inclination and 15-20 degrees of anteversion. Screws may be added for supplementary fixation. A ceramic or polyethylene liner is inserted into the cup.
The femoral neck is cut at a precise level, and the femoral head is removed. The femoral canal is prepared with broaches of increasing size to accommodate the femoral stem. A trial stem and head are placed to check leg length, offset, stability, and range of motion. The final femoral stem (titanium, uncemented) is impacted into the canal, and a ceramic or metal femoral head is placed on the taper.
The hip joint is reduced (ball placed into socket) and tested for stability in flexion, extension, internal rotation, and external rotation. Range of motion and leg length are verified. The incision is closed in layers. With the anterior approach, no precautions against posterior dislocation are needed, allowing earlier mobilization and fewer movement restrictions.
How this procedure transforms your life
Dramatic pain relief — 97% of patients report significant or complete pain relief after surgery
Restored hip mobility — sitting, walking, climbing stairs, putting on shoes, and crossing legs
Correction of leg length discrepancy (if present) for balanced, comfortable walking
Anterior approach — muscle-sparing technique with lower dislocation risk (0.5% vs. 3-5% with posterior approach)
Advanced bearing surfaces (ceramic-on-ceramic) — virtually wear-free, ideal for younger active patients
Uncemented implants with biological fixation — designed to last 30+ years in appropriate patients
Earlier return to activities — many patients walk without support within 2-4 weeks
Improved overall health — increased physical activity improves cardiovascular fitness, mood, and bone density
What to expect during your recovery journey
Walking with walker within 6-24 hours. With anterior approach, no hip precautions needed. Ankle pumps, quadriceps sets, and gluteal squeezes initiated.
Independent walking with walker, stair climbing, bathroom independence. Discharge typically on day 2-3 with anterior approach. Home exercise program and physiotherapy referral provided.
Walker to cane transition by week 2-3. Driving at 2-4 weeks. Daily exercises for hip strengthening. Outpatient physiotherapy twice weekly. Suture removal at 2 weeks.
Walking without aids, return to desk work, light recreational activities. Swimming and cycling permitted. Progressive hip abductor and extensor strengthening.
Return to all normal activities. Low-impact sports — golf, cycling, swimming, hiking. Avoid high-impact activities. Follow-up with X-rays at 6 months.
Explore our full range of joint replacement procedures
Get answers to common questions about this procedure
Book a consultation with Dr. Hemendra Agrawal to discuss your condition and explore the best treatment options for you.