Hip replacement
You need to decide with the surgeon whether to have a general anaesthetic or an epidural, where you will be awake to see and hear the drilling, although not feel it. There are fewer risks with an epidural, although it's not for the squeamish. Around half of all hip operations are done with a general, the rest with an epidural.
Before the operation, you will usually see an occupational therapist, who will tell you the movements which aren't allowed for three months after the operation (bending down to the floor, for example, and twisting round to see someone behind you).
They will also assess whether your loo, bed and chair need to be raised in height. If you are tall they almost certainly will.
How long will it take to recover?
Traditionally, patients spend eight to ten days in hospital. With new minimally invasive techniques, which involve doing the same operation through a smaller incision - 10cm rather than 20-30cm - people can be up and about the same day, and leave hospital one or two days later. (Minimally invasive surgery is used in 12 per cent of cementless hip operations and 6.5 per cent of cemented hips.)
Usually patients can sit up within two days, and physiotherapy will begin on the second day; you will be taught how to get out of a chair and to walk using two sticks.
You'll probably be down to one stick by a couple of weeks and may be walking unaided within two or three months, although older patients (80+) may always need a stick. Driving is usually fine after 4-6 weeks, as is sex after 6-8 weeks.
You will be properly back on your feet within three months, although patients are often surprised to discover that it will probably be a year before they reach their full potential.
Will the new hip last forever?
No: 90 per cent of hips will last 10 years, and 80 per cent will last 20 years, says Mr Hodgkinson, who has even seen them working well after 30 years. But all will fail in the end.
The most common problem is the hip loosening and becoming unstable. It is possible to re-do the operation (called a revision), but it will always be less successful than the first.
However, 80 per cent of revision patients report success for 10 years or more, and the earlier you catch it - ideally before the hip fails totally - then the better the potential outcome.
How long will I have to wait?
The Government says no one should wait more than six months for any operation. Although orthopaedic surgeons are still the ones with the longest lists, the situation has vastly improved in the past three years.
The latest figures show that of the 197,492 people waiting for an orthopaedic operation (not all of these will be hips), just under half will have waited up to two months and only 10,797 will have waited five months or more.
What about private treatment?
Going privately will eliminate the wait, but costs are high. You can expect to pay between £7,500 and £11,000 for one new hip, depending on the type of joint; resurfacing costs slightly more, usually up to £12,000.
BUPA carries out 3,000 hip operations a year, and charges between £7,500 and £9,400 for a hip replacement. Private medical insurance will generally cover you.
Check how many hip operations the surgeon carries out each year - the more the better. Patients often prefer to go to a hospital which has intensive care facilities in case anything goes wrong.
Is going abroad a good idea?
It can be. In Europe, surgeons prefer the minimally invasive technique, which leaves you with a much smaller scar.
A hip replacement with high quality joints and minimally invasive surgery costs around £6,000 in France, just over half that of private care in the UK.
If you do opt for surgery abroad, doctors advise finding out as much as possible about the surgeon, the hospital and the operation beforehand - writing down any questions you want to ask. It's also vital to get your GP 'on side' - and your specialist too if possible - so that your notes can be sent to the foreign doctor. Also ask what arrangements are in place if things go wrong.
Recovery tips
When you go home from hospital, don't cross your legs or your ankles as it could dislocate your new hip. Don't bend over more than 90 degrees, which could also dislocate the hip
- Sleep on your back for six weeks
- Don't be tempted to test the new joint to see how far it will bend in the first 12 weeks. You probably won't be able to lift your leg as high as you would like.
- When getting into the car, sit sideways on the seat first, then swing your legs around.