Hip replacement surgery in Turkey is a journey towards regaining freedom of movement and an active life. In the heart of the Middle East, Turkey is emerging as a favorite destination for patients seeking excellent medical care at affordable prices. A unique combination of advanced technology and medical expertise makes Turkey an ideal place for critical surgeries such as hip replacement.
Hip replacement surgery is one of the most advanced and complex medical procedures. It involves replacing a damaged joint with an artificial one that restores the patient’s mobility without pain. In Turkey, medical teams of highly experienced surgeons, the latest robotic surgery techniques, and precise medical imaging work together to ensure optimal results.
Medical centers in Turkey offer medical treatments and comprehensive experiences that cater to patients’ needs in every aspect, from initial evaluation to post-operative care and rehabilitation. This dedication to comprehensive healthcare makes Turkey a preferred destination for patients from all over the world.
In this article, we will detail everything you need to know about hip replacement surgery in Turkey, from pre-surgical preparations to the medical procedures and techniques used to post-operative care and recovery. Join us to discover how Turkey can be the gateway to regain your active and pain-free life.
What is hip replacement surgery in Turkey?
Total hip replacement has become so successful that it is known as the surgery of the century. It is the leading surgical procedure in orthopedics and a cost-effective treatment for restoring pain-free movement in patients with degenerative bone and joint diseases such as osteoarthritis.
Total hip replacement can generally be considered a safe intervention that results in high patient satisfaction. More than 90% of degenerative arthritis patients report satisfaction with the results of total hip replacement one year after surgery, and most are able to return to their normal lives. This success has led to high expectations for the results of the surgery among patients, orthopedic surgeons, and researchers.
Patients must understand and accept that total hip replacement is “the beginning of treatment, not the end,” although there is almost immediate pain relief and mobility gain after surgery.
Improved surgical techniques and the introduction of new surgical techniques and prosthetic materials have transformed total hip replacement into one of the most successful contemporary treatments.
Degenerative hip arthritis (osteoarthritis) is a degenerative disease of the synovial joints and the most common musculoskeletal disease. It is prevalent among middle-aged and older adults, and in this population, there is a clear relationship between this disease and overweight and physical activity.
The affected hip joint is characterized by the following: Focal degeneration of the articular cartilage, microfractures, abscesses, subchondral osteosclerosis, osteophytes at the articular border, post-arthritic deformity, and progressive loss of joint mobility. The severity of symptoms does not always correspond to the degree of damage seen on radiographs.
There is currently no cure for degenerative arthritis. Available treatments focus on controlling pain and improving function (physical therapy is one such treatment). In case of no response, total hip replacement is the preferred surgical procedure as it improves the patient’s quality of life and facilitates their return to daily activities and even work.
Causes of hip replacement
Symptomatic end-stage degenerative hip arthritis is the most common reason for total hip replacement surgery.
Degenerative hip arthritis is associated with both aging and strenuous physical activity. As cartilage becomes less flexible over time, it accounts for more than two-thirds of total hip replacement cases.
Rheumatoid hip arthritis is the second most common, a systemic inflammatory disorder possibly caused by a systemic autoimmune response, and severely affected joints are candidates for joint replacement surgery when medications (containing analgesics, anti-inflammatory drugs, and steroids) fail to control symptoms.
Other reasons for a total hip replacement include:
- Hip dysplasia
- Bone defects caused by accidents or diseases
- Vascular necrosis (necrosis of bone tissue due to ischemia)
- Other rare diseases that affect the function of the hip region.
Osteonecrosis of the hip is most commonly seen in people between the ages of 35 and 50 and accounts for about 10% of total hip replacements annually.
Reasons not to have a total hip replacement surgery in Turkey
Total hip replacement surgery is contraindicated in the following clinical situations:
- Hip inflammation or abscesses
- Distant (i.e., extra-articular) active or persistent infection or bacteremia
- Severe cases of vascular disease
Patient evaluation prior to total hip replacement surgery in Turkey
Clinical assessment
Before a total hip replacement, a thorough clinical examination and history are performed, and previous interventions and treatments should be discussed.
Previous joint replacements, arthroscopic procedures, or other surgeries around the pelvic joint should be considered before deciding on a surgical procedure, and the presence of prosthetic material in the femur or joint cavity can significantly affect the planned surgery and/or the choice of artificial joint replacement.
A thorough medical evaluation, medical clearance, and risk assessment are also required before deciding to have a total hip replacement.
Other things to consider before surgery include The patient’s body habits, previous functional activity, postoperative goals or expectations, pattern of arthritis, and any history of traumatic hip injury.
The hip should be examined for skin pigmentation and previous wounds or scars, and the soft tissues should be examined for severe atrophy, general symmetry, and stability.
An assessment of the mechanical axis and overall alignment of the limb should be performed. Before any hip surgery, it is important to exclude or at least consider spine and/or knee pathology. Any leg length discrepancy should also be investigated.
Atypical leg discomfort and pain at rest are common symptoms of peripheral vascular disease, while these symptoms are absent in about 50% of patients, so clinical suspicion of these diseases may require consultation with a vascular surgeon before a total hip replacement is approved.
Radiographic evaluation
Preoperative radiographic evaluation, including an anteroposterior and lateral pelvic image of the affected hip, is recommended. Whenevere hip joint dysplasia, a 1 mm CT is used., a 1 mm CT is used
A radiographic evaluation of the hip joint looks for narrowing of the interarticular space, osteophytes, subchondral sclerosis, and/or degenerative cysts.
Stages of hip replacement surgery in Turkey
A total hip replacement replaces damaged bone and cartilage with ceramic, metal, or plastic surfaces to restore hip motion and function.
The articular socket and replacement femoral head replace the damaged natural articular surfaces in the affected hip joint, so prosthetic materials must have low friction and withstand wear and mechanical load during movement.
An artificial hip joint consists of two parts:
- The articular hollow component (calyx) fits into the socket of the pelvic bone.
- The femoral (leg) component fits into the thigh bone.

Hip replacement surgery steps in Turkey
- The surgeon usually makes an incision at the top of the thigh bone.
- The muscles that hold the hip in place are partially detached, and the surgeon exposes the end of the femur and the pelvic cavity (acetabulum).
- Damaged cartilage and bones in the pelvic cavity are removed.
- The articular hollow component (cup) and the high-quality polyethylene liner (new cartilage) are fitted in place.
- The head of the femur is removed.
- The inside of the femur is prepared for the femoral component (the metal leg), which is held in place, and the head of the femur (the ball portion) is placed on the implanted leg.
Once the components are in place, the hip is repositioned, the joint is tested for movement and stability, the incision is closed, and the surgery usually takes 45-90 minutes.
Types of artificial hip joints
Any of the following types of artificial joints can be used in hip replacement surgery, depending on the patient’s condition.
- Metal-on-polyethylene joint: The femoral head is replaced with a metal ball, and the socket is replaced with polyethylene or lined with polyethylene.
- Ceramic joint on polyethylene: The femoral head is replaced with a ceramic ball, and the socket is replaced with polyethylene or lined with polyethylene.
- A metal-on-metal joint: In this type of joint, the femoral head and socket in the hip joint are replaced with a metal implant. Compared to metal-on-polyethylene joints, metal-on-metal joints are more durable.
- Ceramic-on-ceramic joint: The femoral head is replaced with a ceramic ball and the socket is lined with ceramic. This type is less susceptible to wear than metal-on-metal joints and is the most durable hip joint available.
- Ceramic-on-metal joint: The femoral head is replaced with a ceramic ball, and the socket is lined with metal.
How to stabilize an artificial hip joint
Depending on the age and health of the patient undergoing hip replacement surgery, the surgeon may recommend any of the three available types of implant stabilization:
- Fixation with cement: The femoral and acetabular components are held together with a special bone cement made from polymethylmethacrylate (PMMA). Cemented stabilization is an option for patients with moderate activity. Too much pressure on the stabilizing cement can lead to fractures.
- Cementless fixation: The joint is coated with a porous material that adheres to the new bone that grows into the joint surface. The implant can be stabilized using screws and pegs. Patients need to use crutches or a walker after cemented fixation to allow the bone to adhere to the new joint, while cementless fixation is an option for patients who want to maintain higher physical activity.
- Hybrid or mixed fixation: Hybrid fixation uses a combination of cemented and uncemented fixation, where the acetabulum is inserted without cement, and the femur is inserted with cement.
Video hip replacement surgery in Istanbul
Types of surgical interventions for hip replacement surgery
A total hip replacement is done using three methods that are the most common:
Posterior intervention for hip replacement surgery
This approach’s main advantage is avoiding the hip abductor muscles, excellent exposure of both the acetabulum and femur, and elective stretching in the proximal or distal direction. It is the most common way to perform total hip replacement and revision surgeries.
Direct anterior intervention for hip replacement surgery
This approach has become increasingly popular among surgeons, with proponents citing low theoretical rates of postoperative hip dislocation and avoidance of the hip abductor muscles. Problems with this approach include increased wound complications in obese patients in particular, difficulty in exposing the thigh, risk of paresthesia of the lateral femoral cutaneous nerve, and potentially higher rate of intraoperative femur fractures.
Anterolateral interference (Watson-Jones)
Anterolateral interposition is the least utilized method compared to other interposition methods due to its direct effect on the hip abductor muscles.
Choosing components for an artificial hip joint
It has been reported that the most common prosthetic materials used to fabricate the femoral head and acetabulum in hip prostheses are metal-on-metal (MoM), ceramic-on-ceramic (CoC), or a classic metal-on-polyethylene (MoP) combination. The most common prosthetic materials are metal-on-metal, ceramic-on-ceramic, or a classic metal-on-polyethylene combination.
The first decision regarding the artificial hip joint is whether or not to stabilize it with bone fixation materials (cement). Currently, fixation materials are mainly used in patients with poor bone quality older than 60-65, while no fixation materials are preferred for younger patients with good bone quality.
Hospitalization and rehabilitation after total hip replacement in Turkey
Postoperative rehabilitation is of paramount importance after total hip replacement surgery in order to ensure the pain-free function of the joint and improve the patient’s quality of life. Appropriate and timely rehabilitation is very important to accelerate the healing process and prevent complications.
If a rehabilitation program is not implemented for patients who have undergone total hip replacement surgery, they will develop functional issues within one year after surgery. Physical therapy plays an important role in the care of these patients as it improves strength and walking speed after total hip replacement and helps prevent recurrent complications, including joint dislocation and thromboembolic disease
In addition, physical therapy increases patient mobility and provides education on exercises and precautions during hospitalization and after discharge home; however, there is no consensus on what type of physical therapy program is most effective.
Early mobility after total hip replacement
Prolonged bed rest has adverse physiological effects such as increased insulin resistance, myopathy, decreased lung function, impaired tissue oxygenation, and increased risk of blood clots, and safe and effective pain relief is a prerequisite to encourage early mobility after surgery.
There is good evidence that early mobilization facilitates recovery after total hip replacement surgery. Recent meta-analyses have shown that patients who move within 24 hours of replacement surgery significantly reduce their hospital length of stay (by 1.8 days), improve functional recovery, and reduce the incidence of deep vein thrombosis.
Pain after hip replacement
It is normal to feel pain, swelling, and even some bruising after the procedure. The intensity and amount of pain will begin to decrease over time, and it may take up to 6 months for the pain and swelling to completely disappear.
You will be given a prescription for a range of painkillers before leaving the hospital to help you manage your pain, and you may be advised to take the following:
- A pain reliever taken regularly for 4 days and then as needed
- A stronger pain reliever that can be taken every two hours as needed
- NSAID (ibuprofen) taken regularly for 4 days
Physical therapy at home after hip replacement
Some patients may choose to attend private physical therapy sessions after discharge home from the hospital, while most patients can perform the exercise regimen independently. A basic home exercise program begins immediately after total hip replacement surgery to restore the range of motion and strength in the joint. These exercises should be practiced before the replacement surgery to become familiar with them.
Nutrition after hip replacement
A healthy diet helps prepare the body for surgery. Good nutrition helps heal the bones, muscles, and skin after replacement surgery, and people who eat well are less likely to develop infections.
The goal of a healthy diet is to have a source of protein and vegetables or fruits and grains at every meal. Protein can be especially important after a total hip replacement as protein needs will increase as it can aid in the healing process.
Hip replacement surgery recovery time
Recovery time from hip replacement surgery depends on several factors, including:
- Surgery type:
- Total hip replacement: This is the most common surgery, in which the entire hip joint is replaced with an artificial joint. Full recovery from this surgery usually takes 3 to 6 months.
- Partial hip replacement: This surgery replaces only part of the hip joint. Recovery is usually shorter than that from a total hip replacement and it may take 6 to 12 weeks.
- Age:
- Young people tend to recover faster than older people.
- Public Health:
- If you are generally healthy, you are more likely to recover faster than someone with other health conditions.
- Incision size:
- The larger the incision, the longer the recovery time.
- Anesthesia Type:
- The use of spinal anesthesia may result in a faster recovery than general anesthesia.
- Your commitment to the rehabilitation program:
- It is important to follow your doctor’s instructions regarding exercise and physical therapy after surgery. This will help you regain your strength, improve your range of motion, and prevent complications.
In general, here’s what you can expect during your recovery from hip replacement surgery:
- In the hospital: You will spend a day or two in the hospital after surgery. The nursing staff will teach you how to care for your incision and walk with crutches or a walker.
- For the first six weeks: You’ll need to use crutches or a walker to walk. You’ll also need to elevate your affected leg when you sit or lie down. You’ll work with a physical therapist to learn exercises to help improve your strength and range of motion.
- 6 to 12 weeks: You can walk without crutches or a walker. You’ll also be able to drive and return to work.
- 3 to 6 months: You will be able to resume most of the activities you did before surgery.
It’s important to remember that these are just rough estimates. The actual recovery time may vary from person to person. Talk to your doctor about what you can expect in your particular case.
Tips after hip replacement surgery
- Follow your doctor’s instructions exactly.
- Get enough rest.
- Eat a healthy diet.
- Exercise regularly as directed by your physical therapist.
- Avoid lifting heavy objects.
- Do not smoke.
- Watch out for signs of infection, such as redness, swelling, and fever.
Risks and complications after hip replacement
Dislocation of the joint: Recurrent dislocation, which occurs about 1-3% of the time, usually leads to repeat hip replacement surgery (revision surgery), which involves replacing the articular components.
Periprosthetic hip fracture: Intraoperative fractures can occur involving either the acetabulum or femur. Acetabular fractures occur in 0.4% of total hip replacements and often during component implantation, while intraoperative femur fractures occur in up to 5% of total hip replacements.
Aseptic dislocation: Occurs after a total hip replacement as a result of a confluence of steps involving particle debris formation, micromotion of the artificial joint, and osteolysis caused by phagocytic cells.
Wound infections: The spectrum of wound complications after total hip replacement ranges from superficial surgical infections such as cellulitis and/or delayed wound healing to deep infections leading to full-thickness necrosis. Deep infections require a return to the operating room for debridement and drainage.
Joint infections: The medical literature reports that about 1-2% of patients with total hip replacements infect the artificial hip joint.
Venous thromboembolism: Pulmonary embolism and deep vein thrombosis are collectively referred to as venous thromboembolism, the most serious complication after total hip replacement, with an in-hospital incidence of about 0.6%.
Hematoma: Bleeding (hematoma) in the muscles around a total hip replacement may occur and may require a trip to the operating room to drain excess blood that has accumulated under the skin
Complications and other risks after total hip replacement:
- Sciatic nerve palsy
- Different leg lengths
- Iliopsoas muscle injury
- Heterotopic ossification
- Vascular injury
Hip arthroplasty for the elderly
Hip replacement surgery in the elderly is no different than in younger patients, but the complications in these patients may be more serious and more frequent. In the case of older patients, doctors need to make sure that the patient is free of heart conditions or chronic diseases such as diabetes because these diseases affect the anesthesia phase and may lead to serious medical complications during the surgery itself. Various tests are performed to get a comprehensive diagnosis:
- Blood analysis: A complete blood test is done to rule out any type of infection.
- Electrocardiogram (ECG): This test checks the patient’s cardiovascular status, which is a very important factor to consider so that the anesthesiologist and surgeon can work safely.
- Chest x-ray: To rule out the possibility of infection.
Hip replacement surgery results
The life expectancy of a total hip replacement (new joint) is influenced by the amount of stress placed on it. Controlling body weight and adhering to activity recommendations increases the life of the joint, and in general, more than 90% of artificial joints should last at least 15 years.
People who have undergone total hip replacement can expect to regain pain-free mobility and overcome limitations in their daily and professional activities. Total hip replacement is a highly successful treatment, as more than 80% of patients are satisfied with the outcome after surgery. In a survey of 806 patients, 94% returned to their usual jobs after surgery, and the number of patients with hip-related functional limitations decreased from 20% before surgery to only 3% after surgery.
The long-term clinical outcome of total hip replacement is determined by the materials and components used by the surgeon and the patient. Permanent solutions can only be achieved with total hip replacement if the surgeon can reconstruct the hip joint so that it can perform its proper function and if a stable fixation of all components of the artificial joint can be achieved.
Hip replacement surgery success rate
The success rate of hip replacement surgery is very high, ranging from 90% to 95%, according to many studies and medical reports. This rate is influenced by several factors, including the surgeon’s skill, the technique used in the operation, and the patient’s subsequent care.
Here are some factors that contribute to the success of the process:
- Choosing the right surgeon and hospital: The experience of the surgeon and hospital is one of the most important factors affecting the success rate. In Turkey, there are many hospitals and clinics that have an excellent reputation in this field.
- Modern surgical techniques: Advanced techniques, such as robotic surgery and 3D imaging, increase the accuracy and minimize the risks of the procedure.
- Aftercare and rehabilitation: Good post-operative care and effective rehabilitation programs help speed up the healing process and improve long-term outcomes.
- The patient’s state of health: The patient’s overall health and response to treatment play a big role in the success of the procedure.
Thanks to these factors, Turkey has a reputation as a destination for hip replacement surgeries with high success rates, making it an excellent choice for patients seeking effective and sustainable solutions to their health issues.
Hip replacement surgery costs in Turkey
The cost of hip replacement surgery in Turkey varies according to the type of joint used, the competence of the surgeon, and the quality of the hospital where the operation will be performed.
The cost of installing the best type of single hip joint in Turkey, the American ZIMMER type, starts at about 7.5 thousand US dollars. This includes operating under the supervision of a professor specialized in joint surgery in Turkey and using modern techniques that require only a small incision and do not cause muscle rupture.
The price of the procedure may vary depending on the patient’s condition, the technique used, and the quality of the artificial joint. However, the procedure to replace both knee joints for a patient costs about 9.5 thousand US dollars.
Sources:
- Holzwarth U, Cotogno G. Total Hip Arthroplasty. Publications Office of the European Union, 2012.
- UMPIERRES et al. Rehabilitation after hip arthroplasty: Randomized trial. JRRD 2014;51(10):1567-1578.
- Krastanova MS, Ilieva EM, Valcheva DE. Rehabilitation of patients with hip joint arthroplasty. Folia Medica 2017;59(2):217-221.
- Varacallo M, Luo TD, Johanson NA. Total Hip Arthroplasty Techniques. StatPearls Publishing 2022.
- Outpatient Hip and Hip Replacement Information Manual. Winnipeg Regional Health Authority 2020.
- Soffin E. M, YaDeau J. T. Enhanced recovery after surgery for primary hip and hip arthroplasty: a review of the evidence. British Journal of Anaesthesia 2016; 117:62-72.