Choosing the right prosthetic hip: Materials, durability and risks

Written by: Mr Pramod Achan
Published: | Updated: 30/05/2023
Edited by: Cameron Gibson-Watt

Choosing the right prosthetic hip is a decision that you and your surgeon will make together. Your new hip will become part of you for the next 15 years or more, so knowing all the characteristics of it - including the materials used, durability and any associated risks - is important.


Leading consultant orthopaedic surgeon, Mr Pramod Achan, has put together this quick guide to inform you of the types of hip implants he routinely uses at his practice and the risks you should be aware of following this life-changing procedure.



What are the different types of hip implants?


Artificial hips are generally divided up into categories based on their features. The most common being their method of fixation to the patient’s bone. There are generally two approaches:


  • Cemented implants: These rely on a grout to fix and hold the implant in place.
  • Uncemented implants: These have a coating that allows the patient’s bone to grow into them.


Hip implants can also be classified by their lengths: short stems, long stems and “normal” stems. The stem is the part of the hip prosthesis that is cemented into the femur (thigh bone) and the ball that is fitted into the hip socket. Cemented stems are usually made of stainless steel and the uncemented stems more commonly of titanium.


Patients are often concerned about metal allergies (e.g. nickel), but the high-grade alloys used in the manufacture of these implants mean proven cases of metal allergy after hip replacement is extremely rare.


Which one is most commonly used?


Both cemented and uncemented hips are commonly used in the UK. At my practice, I tend to use cemented implants in older patients, as we don’t want to rely on the host bone doing any crucial load-bearing work. However, in younger patients where the host bone is healthy and can be relied upon, I tend to use an uncemented implant.


How durable are hip implants?


Most of the implants I use at my practice have good survivorship data at 15 years with over 85% surviving beyond 20 years. Once they are implanted, they can tolerate all loads of normal day-to-day activity and most general sporting activities. 


What are the risks related to hip implants?


The risks of this procedure are low. Most commonly, we divide the risks up into those associated with anaesthesia and those related to the hip replacement itself.


With regards to the risks related to the hip replacement procedure, the greatest risks are:


Some risks or complications can be made worse by hip or knee symptoms in the other leg during the recovery phase. Low back pain can also cause problems because the pelvis is reoriented and needs to get used to walking without pain.


Are there any new developments in prosthetic hips?


There are constant developments in prosthetic hips with people trying to address the perceived shortcomings. The problems with these innovations are that they don’t have the same tried and tested track record as more established, older implants. These older implants are not only predictable in their behaviour and longevity, but surgeons like myself have vast experience in dealing with their complications or problems. Newer implants, however, have been shown to sometimes bring about new, unforeseen problems, especially in metal-on-metal hips. Therefore, these should be implanted as part of a closely monitored study group to get better and more frequent surveillance.



If you need a hip replacement or any other orthopaedic treatment, do not hesitate to visit Mr Pramod Achan’s Top Doctors profile today to check his availability.

By Mr Pramod Achan
Orthopaedic surgery

Mr Pramod Achan is a leading consultant orthopaedic surgeon based in London, specialising in hip and knee surgery, arthroscopy, lower limb joint replacement, and sports surgery.

He started his medical training at St Bartholomew's Hospital Medical School, where he continued training in the professional surgical unit and orthopaedic department. It was here that Mr Achan discovered his passion for orthopaedics and orthopaedic surgery. His officer postings were carried out at various hospitals afterwards where he was under the mentorship of renowned surgeons in the orthopaedic field. Mr Achan's post-fellowship specialised training experience spans all over the world, from the UK to the USA to Australia. 

After these years training, he held the position of clinical director at Barts Health NHS Trust for five years, and has been directing training programmes in orthopaedics on the prestigious Percival Pott training programme for nearly 10 years, which is one of the oldest orthopaedic training programmes in the UK. Currently Mr Achan is a department chair and consultant orthopaedic surgeon at OneWelback and continues to hold his role as consultant orthopaedic surgeon at The Princess Grace Hospital and Barts and The London Health NHS Trust Hospital.

In 2009, Mr Achan was one of two upcoming 'Best of British' surgeons chosen to represent the British Hip Society Travelling Fellowship to the USA, as a guest of the American Hip Society. Here he lectured at places such as Stanford University, Mayo Clinic, and Harvard. In 2014, Mr Achan was awarded the American-British-Canadian Travelling Fellowship - the most distinguished award in orthopaedics - by the American Orthopaedics Association. Mr Achan lectured at institutes like Harvard, NYU, Duke, Emory, McMaster, The Campbell Clinic, and Vanderbilt while he was travelling under this award.

Mr Achan can still be found dividing his time between lecturing, contributing articles in his field, and directing orthopaedic training programmes alongside his clinical work. He is dedicated to education of his trainees, as well as himself. He is actively involved with research at Queen Mary University, the William Harvey Institute, and the Trauma Clinical Academic Unit. Mr Achan's research interests include trauma and outcomes in high energy trauma, and basic science of early osteoarthritis and its intervention.

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