Ending groin pain and walking normally again
Replacing a damaged hip joint with a prosthesis — for advanced arthritis, avascular necrosis of the femoral head, or neck of femur fractures in older patients — with an early mobilisation protocol that starts on day one.
When do you need a hip replacement?
True hip joint pain is usually felt in the groin rather than the buttock, and can radiate to the knee — which is why it is sometimes misdiagnosed as knee pain. Surgery is considered when there is:
- Groin pain that worsens with walking and weight-bearing
- Restricted movement making it hard to put on shoes or socks, or cut toenails
- A clear limp or shortening of the affected leg
- Advanced avascular necrosis with collapse of the joint surface
- Advanced arthritis on X-ray with failed conservative treatment
- A neck of femur fracture in an older patient — close to an emergency
In early avascular necrosis, core decompression of the femoral head may avoid a full joint replacement by relieving intraosseous pressure and improving blood supply before the joint surface collapses — another reason not to delay diagnosis.
Conditions requiring intervention
The hip differs from the knee in the variety of its causes, and some of them affect patients in their twenties and thirties rather than only the elderly.
Hip osteoarthritis
Wearing of the articular cartilage with age or secondary to a congenital abnormality in joint shape — the commonest reason for hip replacement.
Avascular necrosis of the femoral head
Death of part of the femoral head from interrupted blood supply, affecting younger patients and sometimes linked to steroid use or blood disorders.
Neck of femur fracture
Common in older patients after a minor fall; many are treated with joint replacement to get the patient mobile quickly and avoid the complications of bed rest.
Hip dysplasia
A congenital abnormality of the socket that accelerates arthritis at a young age and requires specific surgical planning at replacement.
Inflammatory arthritis
Autoimmune disease damaging the joint cartilage, requiring coordination with a rheumatologist before and after surgery.
Revision surgery
Replacing a previous implant after loosening, wear or infection — a more complex operation requiring experience and detailed pre-operative planning.
Key numbers and treatment options
- National registry data show a hip replacement lasts 25 years in about 58% of patients, rising to 77.6% in published case series (Evans et al., The Lancet 2019).
- In a review of 6,900 patients after posterior-approach surgery, dislocation was 2.2% with traditional hip precautions and 2.0% without them — no significant difference (Crompton et al., 2020).
- In more than 10,700 dual-mobility (tripolar) hips, dislocation was 0.46% and component survival 98% at a mean of 8.5 years (Darrith et al., 2018).
- In the HEALTH trial (1,441 patients with femoral neck fractures), 7.9% needed further surgery after total hip versus 8.3% after hemiarthroplasty, while dislocation was 4.7% versus 2.4% (HEALTH, NEJM 2019).
- In the WHiTE 5 trial (1,225 patients over 60), periprosthetic fractures occurred in 0.5% with cemented hemiarthroplasty versus 2.1% uncemented, with slightly better quality of life with cement (Fernandez et al., NEJM 2022).
- 595 million people worldwide had osteoarthritis in 2020 (7.6% of the population), and hip osteoarthritis cases are projected to rise by 78.6% by 2050 (GBD, Lancet Rheumatology 2023).
At Prof. Dr. Ibrahim Shaarawi’s clinics in Nasr City, Mohandeseen and New Cairo (5th Settlement) we examine the hip and review your X-rays at the same visit, then choose conservative care or the implant that suits your age, bone quality and activity.
Treating hip joint disease
| Treatment | When we use it | What to expect |
|---|---|---|
| Conservative care: weight loss, physiotherapy, pain relief | Early and moderate arthritis | Less pain and better movement without surgery |
| Intra-articular injection | Persistent pain despite conservative care | Temporary relief that can delay surgery |
| Total hip replacement (cemented or cementless) | Severe arthritis or femoral head necrosis with pain limiting daily life | Pain usually resolves; walking on day 1–2 |
| Dual-mobility (tripolar) hip | High dislocation risk: older age, weak muscles, neurological disease, or revision | Greater stability with a very low dislocation rate |
| Bipolar hemiarthroplasty | Femoral neck fracture in less active older adults | Shorter operation and quick recovery |
| Revision with a long stem or proximal femoral replacement | Loosening of an old implant, severe bone loss, or fractures around the implant | Fixation in healthy bone further down and restored movement |
Treating upper-femur fractures in older adults
| Treatment | When we use it | What to expect |
|---|---|---|
| Screw fixation | Undisplaced fractures or younger patients | Keeps the natural femoral head |
| Bipolar hemiarthroplasty (usually cemented) | Displaced fractures in less active older adults | Early walking and fewer fractures around the implant with cement |
| Total or dual-mobility hip | Active independent patients, pre-existing arthritis, or high dislocation risk | Slightly better long-term function |
| Intramedullary nail or plate | Intertrochanteric fractures (below the femoral neck) | Strong fixation that allows early movement |
| Proximal femoral replacement | Severe bone loss, complex fractures or failed fixation | A limb-salvage solution for difficult cases |
Your treatment pathway, step by step
Examination and diagnosis
Clinical assessment of range of movement and leg length measurement, with pelvic X-rays — and MRI where early avascular necrosis is suspected, since it does not show on plain films.
Choosing the treatment
In early stages conservative treatment or core decompression may preserve the natural joint; in advanced arthritis and after femoral head collapse, replacement is the solution.
Pre-operative preparation
Full blood work, cardiac and respiratory assessment, control of diabetes and blood pressure, and treatment of any source of infection such as dental or urinary before surgery.
The operation
Replacing the femoral head and acetabulum with a prosthesis, with precise restoration of leg length and centre of rotation — the two factors that determine gait balance and joint stability.
Early mobilisation
Standing and assisted walking usually begin within the first 24 hours, with specific positions to avoid during the early weeks to prevent dislocation.
Rehabilitation and follow-up
A physiotherapy programme strengthening the hip and thigh muscles and restoring a normal gait pattern, with periodic imaging to confirm implant stability.
What determines a good outcome?
Hip replacement is among the most successful operations in relieving pain, but long-term quality of result depends on details settled in theatre and afterwards.
- Restoring leg lengthA noticeable length difference after surgery causes a limp and back pain, which is why length is measured precisely during planning and surgery.
- Centre of rotation and component positionPlacing the components at the correct angles is what prevents dislocation and reduces long-term wear.
- Choice of bearing surfaceBearing surfaces differ in wear rate and expected lifespan, and are selected by age and activity level.
- Dislocation preventionObserving safe positions in the early weeks, alongside strengthening the stabilising muscles, reduces the risk of early dislocation.
- Thrombosis and infection prophylaxisA medical and mobility protocol from day one, with any source of infection in the body treated before surgery.
- Early mobilisationMoving within the first hours reduces the complications of bed rest and speeds return to a normal gait, particularly in older patients.
Why Prof. Dr. Ibrahim Shaarawi
✅ Last medically reviewed by Prof. Dr. Ibrahim Shaarawi, Professor of Orthopaedic Surgery, on 5 October 2026
- Assessment before any decision to operateSurgery is offered only after appropriate conservative treatment has been exhausted, because many patients improve without an operation.
- Academic backgroundMD and MSc in Orthopedic Surgery from Ain Shams University, with training in the Ain Shams University hospitals.
- International trainingVisiting professor and training at Ohio State University Hospital in the United States, applying the protocols used there.
- One plan from diagnosis to rehabilitationDiagnosis, surgery, physiotherapy and follow-up handled as a single pathway rather than split across separate providers.
Read patient success stories or review the full profile and credentials.
Types of hip replacement we perform
We perform every type of hip replacement and choose the implant by your age, activity, bone quality and the reason for surgery:
| Implant | Approximate price |
|---|---|
| Total hip (conventional) | 100,000–120,000 EGP |
| Bipolar hemiarthroplasty | 80,000–90,000 EGP |
| Dual mobility (tripolar) hip | 150,000–180,000 EGP |
| Ceramic hip | 195,000–240,000 EGP |
| Revision surgery / long stem | Confirmed after assessment |
The price usually covers the implant, the operation and a short hospital stay, and varies with the implant, the hospital and your general health; the final price is confirmed after examination and X-rays. An implant should not be chosen on price alone — the right one is what suits your age, activity and bone quality.
Video: how a hip replacement is performed
Prof. Dr. Ibrahim Shaarawi explains the steps of hip replacement surgery (in Arabic).
Your complete hip replacement guide
Before surgery
Decision and cost
Cost and booking
The cost of hip replacement varies with the implant and bearing surface used, whether the components are cemented or uncemented, the hospital, length of stay and anaesthesia, and whether the operation is primary or a revision.
A final figure follows imaging and examination, because the implant appropriate for your case moves the number more than any other factor.
Important: bring all previous imaging and reports to your first visit, along with a list of your current medications, so an accurate plan can be made from the outset.
Frequently asked questions
Where exactly is hip joint pain felt?
True hip joint pain is usually felt in the groin and may radiate to the front of the thigh and even the knee. Pain in the buttock or lower back more often comes from the spine or sacroiliac joint rather than the hip joint itself.
When will I walk after hip replacement?
In most cases standing and assisted walking begin within the first 24 hours. Early mobilisation is not a luxury but a core part of treatment, because it reduces the risk of thrombosis and the complications of bed rest, particularly in older patients.
Which positions must I avoid afterwards?
Instructions vary with the surgical approach used, but generally involve avoiding deep hip flexion, crossing the legs, and strong inward rotation of the leg. These restrictions are temporary and are explained in detail before you leave hospital.
What is avascular necrosis, and can joint replacement be avoided?
Avascular necrosis is death of part of the bone from interrupted blood supply. In early stages, before the joint surface collapses, core decompression may relieve intraosseous pressure, improve blood supply and preserve the natural joint. Once the surface has collapsed, replacement becomes the practical solution.
Will the implant leave my legs different lengths?
Restoring leg length is a core part of planning before and during surgery. Some patients feel a slight difference in the early weeks because of muscle contracture and pelvic tilt present before the operation, and this sensation usually resolves with rehabilitation.
Why are hip fractures in older patients treated urgently?
Because immobility, not the fracture itself, is the greater danger: thrombosis, pneumonia and pressure sores rise sharply with prolonged bed rest. The aim is therefore to fix the fracture or replace the joint early so the patient can stand.
Book a hip assessment
If you have groin pain or have been told you have avascular necrosis of the hip, an early assessment may spare you a full joint replacement — or establish the right time for one.
Related reading
References
- American Academy of Orthopaedic Surgeons (AAOS) — Patient guidelines
- Mayo Clinic — Orthopedic procedures
- NICE — Joint replacement and arthroscopy guidance
- Cochrane Musculoskeletal reviews
- Evans JT, et al. How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet. 2019;393(10172):647-54.
- Crompton J, et al. Do hip precautions after posterior-approach total hip arthroplasty affect dislocation rates? A systematic review of 7 studies with 6,900 patients. Acta Orthop. 2020;91(6):687-92.
- Darrith B, et al. Outcomes of dual mobility components in total hip arthroplasty: a systematic review of the literature. Bone Joint J. 2018;100-B(1):11-9.
- HEALTH Investigators. Total hip arthroplasty or hemiarthroplasty for hip fracture. N Engl J Med. 2019;381(23):2199-208.
- Fernandez MA, et al. Cemented or uncemented hemiarthroplasty for intracapsular hip fracture. N Engl J Med. 2022;386(6):521-30.
- GBD 2021 Osteoarthritis Collaborators. Global, regional, and national burden of osteoarthritis, 1990-2020 and projections to 2050. Lancet Rheumatol. 2023;5(9):e508-e522.
Medical disclaimer: the content on this page is provided for medical education only. It is not a substitute for consultation and clinical examination, and must not be used as a basis for self-diagnosis or self-treatment. Read the full medical disclaimer.