Principal Director & Unit Head, Orthopaedics, Fortis Memorial Research Institute, Gurgaon
Part 5 of 9 in Recent Advances in Joint Replacement
Hip Replacement Surgery: Implant Design, Materials and Durability
April 13, 2025
A hip replacement is often described to patients simply as swapping out a worn joint, but the materials and design choices behind that swap are what actually determine whether the implant lasts 15 years or 40.
How a hip replacement is built
In a hip replacement, the damaged ball of the femoral head is replaced with a new metal component fixed inside the thigh bone, topped with a separate head component. A plastic liner sits between this head and a new socket component fitted into the pelvis, the same basic three-part design used in the knee. Depending on the extent of damage, this can be a surface replacement of just the worn cartilage, or a more complete reconstruction where the whole joint surface is replaced.
Material choices that extend implant life
On the hip side, Dr. Jangid's practice uses highly cross-linked polyethylene liners paired with ceramic components and larger femoral heads, which together improve both range of motion and wear resistance. On the knee side, implant coatings have moved on from older nickel-based coatings to an oxidised zirconium and niobium coating, combined with a highly polished, highly cross-linked polyethylene tibial component. The result is what he calls low friction arthroplasty: friction and wear are reduced enough that implant life extends to 25 to 30 years or more.
Why the first surgery matters most
Modern hip implants can last 35 to 40 years, and knee implants 20 to 30 years, but Dr. Jangid was direct that a revision surgery, replacing a joint replacement that has already failed, is never as good as getting the original surgery right. That is the practical argument for durable materials and precise placement from the outset: the best chance a patient has for a lasting, natural-feeling joint is the first operation, not a later correction.
This article is based on a Jivo Masterclass session conducted by Dr. Subhash Jangid, Senior Director, Orthopaedics & Joint Reconstruction, Fortis Memorial Research Institute, Gurgaon. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
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This guide is based on a live Jivo Masterclass: Dr. Subhash Jangid taught doctors across Africa on April 13, 2025.
FROM THE LIVE Q&A
Doctor on the call (name unclear from transcript)
Could an 80-year-old patient with a knee fracture still be considered a candidate for joint replacement surgery?
Dr. Subhash Jangid
Yes. Age alone should never be the reason to deny treatment. What matters is whether the patient is physiologically fit and medically able to tolerate surgery, not their chronological age. Every patient deserves the chance to keep leading an active life, fracture or not.
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Frequently Asked Questions
Most post-operative painkillers are known to affect the liver. What pain medication is recommended after joint replacement that avoids this?▼
Opioids are used at a very low dose, delivered through a transdermal skin patch or a nasal spray rather than as tablets or injections, giving good pain control without sedation, headache or nausea. Alongside this, the only oral tablet used is paracetamol, which does not affect the stomach or the kidneys.
Sharing an update: how valuable has attending these weekly sessions been?▼
The attendee said he joins every Sunday and is never disappointed, describing the sessions as consistently insightful and helpful for improving his own practice. He mentioned he had further questions and would send them on separately to be passed along to Dr. Jangid.
Could the presentation be shared as a PDF in French as well as English, and was a translator available for the French-speaking doctors on the call?▼
Yes to both. The English PDF was shared with the group, the French version had already been sent separately, and a dedicated French translator was present throughout the session to help the doctors from Congo follow along.
Could the presentation be shared as an English-language PDF?▼
Yes, the English PDF was shared again on request.
One attendee thanked Dr. Jangid for the presentation and asked about opportunities to train under him.▼
Doctors from Africa can apply for a one-year fellowship programme in India to learn joint replacement surgery. Interested doctors need to email the team and register with India's National Medical Council before joining for the year-long training.
How long do modern hip and knee implants typically last?▼
Hip implants can last 35 to 40 years and knee implants 20 to 30 years, according to Dr. Jangid, with robotically placed partial knee replacements also exceeding 25 years.
Why is getting the first joint replacement surgery right so important?▼
Because a revision surgery, replacing an implant that has already failed, is never as successful as the original operation. Durable materials and precise placement the first time give the patient the best chance at a lasting result.
In This Series: Recent Advances in Joint Replacement
- 1.Recent Advances in Joint Replacement
- 2.Who Needs a Knee or Hip Replacement: Symptoms and Warning Signs
- 3.Partial or Total Knee Replacement: Matching the Procedure to the Patient
- 4.How Robotic Surgery Is Changing Joint Replacement
- 5.Hip Replacement Surgery: Implant Design, Materials and Durability
- 6.When Joint Replacement Surgery Should Be Delayed or Avoided
- 7.Correcting Severe and Bilateral Knee Deformities
- 8.Recovery, Pain Management and Rehabilitation After Joint Replacement
- 9.Joint Replacement Surgery in India: What International Patients Should Know