Hybrid Hip Replacement (Exeter — Trident)

What is a hip replacement?

A total hip replacement (total hip arthroplasty) is one of the most successful and well-established operations in modern surgery. More than 100,000 hip replacements are performed each year in the UK. The aim of the operation is to remove the damaged surfaces of the hip joint — the ball (femoral head) and the socket (acetabulum) — and replace them with precision-engineered implant components that recreate the smooth, pain-free movement of a healthy hip.

The implant — Exeter Trident system

• Exeter femoral stem: a polished, tapered cemented stem with one of the longest clinical track records of any hip implant in the world — over 50 years of proven performance.
• Trident acetabular cup: a versatile press-fit cementless socket fixed by a precise interference fit with the bone.
• MDM Dual Mobility: in patients at higher dislocation risk (neuromuscular conditions, previous hip surgery, high-demand lifestyles) a double-articulation cup is used to reduce dislocation while preserving range of movement.

How the operation is performed

The procedure is performed under general or spinal anaesthesia, usually taking 60–90 minutes, through a posterior approach with the sciatic nerve identified and protected throughout.

• Skin incision and careful division of the posterior hip muscles to expose the joint
• Dislocation of the damaged femoral head and a calibrated bone cut to remove the head and neck
• Acetabular preparation and impaction of the Trident cup
• Femoral canal preparation and insertion of the Exeter stem with bone cement
• Ceramic or metal head attached and the joint relocated
• Ligament and soft tissue balancing through the full range of motion
• Restoration of leg length and hip offset to match your pre-operative plan

Who is this for?

• End-stage osteoarthritis, rheumatoid arthritis, or avascular necrosis of the hip
• Patients in whom bone stock and quality favour cemented fixation
• Patients at elevated dislocation risk (MDM dual mobility option)
• Patients who have failed non-surgical management

My approach

• Posterior approach with full sciatic nerve protection
• Leg length and offset carefully restored to match the other side
• Ceramic head with polyethylene liner as standard; MDM dual mobility where dislocation risk is elevated
• Available at: Meriden Nuffield Health Hospital and University Hospitals Coventry & Warwickshire

Risks

• Dislocation
• Leg length discrepancy
• Injury to nerves and vessels
• Deep vein thrombosis (DVT) and pulmonary embolism (PE)
• Further surgery
• Failure of the implant
• Infection
• Fracture

Recovery

• Walking the same day or the day after surgery with physiotherapy
• Hospital stay: 1 day
• Hip precautions for 6 weeks to prevent dislocation
• Driving: approximately 6–8 weeks
• Full recovery: 3 months