03/11/2020
Hip replacements have progressed significantly since 1891, when Professor Themistocles Glück first attempted to use ivory to replace the head of the femur, in patients whose hip joints had been destroyed by tuberculosis. These days the entire hip joint can be replaced, and patients can even be up and walking again within a day.
A new hip is no longer viewed as a last resort; nor the preserve of the elderly. The latest prostheses last longer, recovery times continue to reduce, and many of the risks have been eliminated entirely. Hip replacement is one of the most common elective surgical procedures in Britain; it has completely revolutionised arthritic hip treatment and is considered one of the most successful orthopaedic interventions of its generation.
The Royal College of Surgeons analysis of HES data showed a 47% increase in all hip replacements between 2004-05 to 2014-15 and a staggering 76% increase in hip replacements for those under 60. [1]
Patients no longer want to wait. Understandably so - chronic hip pain can have a devastating effect on quality of life. As a nation of active elders, patients aren’t just looking for a pain free night’s sleep. They want to get back on the golf course or the tennis court – and the sooner the better.
Hip replacements on the rise
In England, Wales and Northern Ireland, 91,953 hip replacements were performed in 2017, up from 70,931 in 2010, according to figures from the National Joint Registry. [2]
According to projections in a study published in the Osteoarthritis and Cartilage journal, this trajectory is expected to continue. They predict the NHS will need to perform 439,097 hip replacements in 2035 to keep the population mobile and pain free. [3]
This is no mean feat, and when Stephen Cannon, vice president of the Royal College of Surgeons, claimed the demand for joint replacement surgery would soon outstrip supply and the UK’s ageing population presented a ‘perfect storm’, few health practitioners disagreed with him. This was before the COVID-19 pandemic even began.
Why the increase?
More operations are required, because the causes of damage to hips are on the increase and the operation risks are on the decrease:
- Osteoarthritis is the predominant cause of damage to the joint, and your risk of developing the disease increases with age. It’s no secret we have an ageing population in the UK - thus an increasing proportion are more susceptible to osteoarthritis in their hips.
- Average BMI and obesity are also on the rise. Adult obesity in England has risen from 15% in 1993 to 29% in 2017 [6]. The added strain on the joints from excess weight is particularly bad on hips and knees and increases the likelihood of osteoarthritis in the joints. (Check out The Perfect Fit for more on how health insurance can help with obesity).
- Improved prostheses, made of ceramic and polyethylene, have made treatments less daunting, by eliminating the risk of carcinogenic metal ions entering the blood and causing damage. They also last much longer, so don’t wear out and need replacing so often.
- Reduced recovery times are also making hip replacements more attractive. Modern techniques cause less damage to the surrounding muscle and therefore heal quicker. Most patients are up and walking the same or following day - some have even been treated as outpatients, never even spending a night in hospital.
What’s the effect on hip replacement waiting times?
The statistics specifically referring to joint replacements aren’t regularly published, but data from 57 NHS Trusts was collected by Versus Arthritis charity this year, revealing; ‘of the 63,464 surgeries:
- Almost half of those who had a hip or knee joint replacement waited more than 18 weeks
- Over a quarter waited more than six months
- At least 2,400 people waited over a year
Hip replacements are subject to postponement at the best of times, and in instances such as adverse weather they are often the first operations to be called off. In January 2020, before COVID-19 began to impact the UK, more than one in six patients were already waiting more than 18 weeks for routine treatments. The disruption to hospitals during the pandemic has meant the number of patients facing a long wait for routine operations has soared.
All non-urgent planned treatments were postponed for three months in April to free up NHS capacity to treat COVID-19 cases. Treatments have now resumed, but at a reduced capacity due to non-contamination measures.
Even before the pandemic, the NHS would have needed to treat an additional 500,000 non-urgent patients a year for the next 4 years, to meet the 18-week target and clear the backlog. At the end of July 2020, 4 million patients were waiting to start treatment, and of those, 83,203 were waiting more than 52 weeks. [5]
How do I skip the queue, what are my options?
If you don’t want to wait on an NHS waiting list, private healthcare offers prompt access to hip replacement treatments and the chance to skip the queue. Going private can also mean access to the latest ground-breaking techniques, including cutting-edge robotic technology, which enables highly accurate placement of personalised implants, smaller incisions and faster recovery times.
Private hospitals also offer increased flexibility; to decide which consultant, when and where you would like to be treated. You will also have the luxury of your own bedroom and bathroom and much more flexible visiting times. For more on how the NHS and private healthcare complement each other, read our blog post For the Love of the NHS.
You can either pay directly for the individual treatment, or it could be covered by a health insurance policy, for which you pay a monthly or annual premium.
What's the cost of private hip replacement?
The cost of hip replacements privately if you pay directly for the treatment will vary, depending on the location and your specific requirements, but the cheapest hip replacement costs in the UK start from around £12,000. Below are some examples of the base prices from various areas and providers:
- Bristol Hospital £12,305
- Cheltenham Hospital £14,230
- Edinburgh £12,430
- Warwickshire Hospital £14, 880
- Cromwell Hospital London £13,995
- Guildford Hospital £14,035
- Newcastle Upon Tyne Hospital £14,480
The exact specification of what is included can also vary between providers. The final price can increase depending on the specific prosthesis and drugs you require, or the exact care pathway you need due to any pre-existing medical conditions.
Most providers aim to provide a fixed, all-inclusive price, following your initial consultation with a consultant. Below is a typical example of what you would expect to be included within your fixed price.
- Overnight accommodation in a private en-suite room, including nursing care and meals
- Professional fees for Consultant Surgeon and Consultant Anaesthetist
- Theatre procedure
- Standard prosthesis
- Pre-admission assessment
- Inpatient physiotherapy
It’s also important to consider this is obviously just for one hip. Were you to require both replacing, or in-fact a knee or ankle replacement, this would be in addition, and can quickly add up. Even just the one operation, is a significant outlay for most people; devastatingly out of reach for many, who are forced to suffer the wait.
A more accessible way to pay
Health insurance policies can cover hip replacement operations and offer a more accessible route to private treatment. The policy must be in place prior to diagnosis, or it would probably class as an existing condition and could therefore be excluded from cover. But health insurance provides the peace of mind that other conditions will be covered as well; it’s a holistic solution for your health, supporting prevention and cure. For more information check out our health insurance guide.
Health insurance policies are paid for on a monthly or annual premium basis, offering much smaller, regular payments and many additional benefits. The cost of health insurance policies can also vary, depending on factors such as your age or location of hospitals you would like to access. The below provides an insight into potential indicative costs of premiums, which could cover you for a hip replacement. For detailed expert advice, our advisers are on the end of the phone to find you the best and most affordable policies to suit you.
The below price indications are based on an individual who; lives in the same postcode as our Head Quarters in Gloucestershire, is a non-smoker who’s generally in good health, and is happy to pay a £250 excess.
25 year old - £25.86/month
45 year old - £39.70/month
65 year old - £80.17/month
Whilst hip replacements are still generally associated with older people – they can be a life changing procedure for anyone with a worn hip, at any age. Hip dysplasia, fractions and infections have caused people in very early adulthood to require the treatment – as early as their twenties. Even tennis Grand-Slam Champion Andy Murray has had a hip resurfacing operation at 31, to try and extend his tennis career and ease the pain.
Non-surgical options such as physiotherapy, steroid injections and painkillers, will always be the initial course of action, but if these don’t work, day-to-day life can quickly become a struggle. The question then becomes less ‘what’s the cost to skip the queue?’, and more, ‘what’s the cost of waiting?’. Living with hip pain can bring extended periods unable to work, exercise, or even do regular day-to-day things. The damage to the joint can get worse and cause issues in other areas of the body, which are trying to compensate. It’s not just physical health that can suffer - your mental health can also take a hit. According to a 2018 study by Clinical Orthopaedics and Related Research, hip replacements have such a positive impact they are even associated with increased life expectancy. [6] But even if hip replacements can’t increase the years in your life, they can certainly increase the life in your years, and health insurance can make them accessible - without the wait.
If you think you may require a hip replacement but you’re not sure, check out Nuffield Health’s 4 signs you may need a hip replacement article.
To receive free, expert advice about health insurance policies, fill out the short form and speak to one of our advisers to get a quote.
[2] https://reports.njrcentre.org.uk/hips-reports
[3] https://www.oarsijournal.com/
[4] https://www.england.nhs.uk/statistics
[5] https://www.sciencedirect.com/