Hip Replacement Surgery

Hip replacement surgery (also called hip arthroplasty) is one of the most effective orthopaedic procedures for relieving chronic pain and restoring mobility in patients with advanced joint damage.

As a Sydney-based orthopaedic surgeon with over 15 years of experience in hip replacement surgery, Dr Anthony Keeley offers personalised treatment using the latest surgical techniques to help patients regain mobility and function and improve quality of life.

Dr Keeley has trained in both posterior and anterior approaches to hip replacement surgery, and now primarily uses the anterior approach for most cases due to its well-documented advantages in recovery, comfort, and patient outcomes.

Conditions Treated by Hip Replacement Surgery

Hip replacement is generally recommended for patients with severe arthritis or structural damage that no longer responds to conservative management. Below are the most common conditions for which hip replacement is performed:

The most frequent indication for hip replacement in Australia, osteoarthritis involves the gradual breakdown/wear of cartilage in the hip joint, causing pain and reduced mobility.

  • Symptoms: Groin or buttock pain, stiffness, difficulty walking, pain at night or during activity, difficulty putting shoes / socks on and off, difficulty getting in and out of cars
  • Causes: Age-related wear and tear, prior joint injury, obesity, genetics
  • Risks: Progressive joint deformity, limited mobility, reliance on pain medications
  • Investigations: X-rays, MRI
  • Treatment Options: Physiotherapy, weight management, pain killers and anti-inflammatory medications, joint injections, hip replacement surgery

An autoimmune disease that leads to chronic inflammation of the joint lining, resulting in progressive joint damage.

  • Symptoms: Aching, swollen hips, morning stiffness, general fatigue
  • Causes: Immune system dysfunction attacking healthy joint tissues
  • Risks: Severe joint damage, disability, systemic inflammation
  • Investigations: X-rays, MRI
  • Treatment Options: Disease-modifying drugs, physiotherapy, lifestyle changes, surgery

A condition where the blood supply to the femoral head is impaired, causing bone tissue to die and the joint to collapse.

  • Symptoms: Sudden or gradual hip pain, stiffness, reduced mobility
  • Causes: Trauma, steroid use, alcohol abuse, underlying medical conditions
  • Risks: Joint collapse, severe arthritis, rapid deterioration
  • Investigations: X-rays, MRI
  • Treatment Options: Early intervention with medications, joint-preserving techniques; hip replacement in later stages

Arthritis that develops following hip fractures or dislocations, often years after the initial injury.

  • Symptoms: Persistent hip pain, limping, stiffness
  • Causes: Previous trauma altering joint structure
  • Risks: Accelerated joint degeneration, impaired movement
  • Investigations: X-rays, MRI, CT
  • Treatment Options: Pain management, physiotherapy, total hip replacement for advanced damage

In some case hip fractures cannot be “fixed” and are best treated with replacement.

  • Symptoms: Usually following a fall causing hip pain, limping or inability to stand on leg
  • Causes: Recent fall
  • Risks: Fracture displacement, increasing pain, inability to weight bear
  • Investigations: X-rays, CT
  • Treatment Options: Usually total hip replacement for displaced fractures

Surgical Approaches to Hip Replacement​

Dr Keeley is skilled in both anterior and posterior approaches to hip joint replacement. The choice of approach can influence the recovery experience, surgical risks, and functional outcomes.

This is a traditional method of hip replacement where the surgeon accesses the joint through an incision at the back of the hip. It is widely used and highly effective, particularly in complex or revision cases.

  • Provides excellent visibility of the joint
  • Well-established with a long track record of success
  • Slightly higher risk of post-operative dislocation compared to anterior approach
  • Requires a longer incision and more soft tissue (muscle) disruption
  • Initial recovery is slower than anterior approach

Dr Keeley primarily uses the anterior approach for hip replacement surgery due to advantages in patient recovery, safety, and overall experience. This method involves accessing the hip joint from the front, avoiding the need to cut through any muscles or tendons.

  • Muscle-sparing technique: Unlike posterior approaches, the anterior approach allows access between muscles, reducing muscle damage and minimising post-operative weakness and intra-operative and post-operative bleeding
  • Faster recovery: Patients often experience less post-operative pain, regain mobility more quickly, and usually walk unaided sooner
  • Lower risk of dislocation: Because the posterior capsule and surrounding muscles are preserved, the hip is generally more stable post-surgery, especially posteriorly, which is the most common direction for dislocation to occur
  • More accurate implant placement: With the patient lying on their back (supine), intraoperative imaging is easier, improving the precision of implant positioning
  • More accurate restoration of tension: The patient being supine also means intraoperative assessment of joint tension is more reliable/reproducible, which aids accurate restoration of leg length and offset
  • Smaller incision and cosmetic benefit: Anterior approach incisions are typically shorter and located at the front of the thigh, which many patients find preferable. “Bikini” incisions are also an option, which usually heal with very minimal visible scar.
  • Earlier return to activity: Many patients resume everyday tasks and driving sooner compared to posterior approach

This minimally invasive technique aligns with Dr Keeley’s commitment to delivering high-function outcomes with the least disruption possible, helping his patients return to work, sport and life with confidence.

Dedicated to Clinical Excellence & Patient Care

Dr Anthony Keeley draws on years of experience and a deep understanding of hip biomechanics to tailor each procedure to the patient’s anatomy, goals and lifestyle.

Whether you’re struggling with arthritis, injury, or a complex, long standing hip condition, Dr Keeley offers a high level of technical skill combined with a personal, compassionate approach to care.
Learn more about Dr Anthony Keeley