As my father used to say, “Here we go again!” I’m having my third(!) hip replacement. The first two have been great but I’ve worn one of them out. It was put in 20 years ago, so I’m doing a little research to find out what’s changed since that time and what I should look out for.

Probably the thing that has changed the most in the last 15 to 20 years is the shift from cemented to cementless implants. Around about 1995, the National Institutes of Health (NIH) said the research showed using a hybrid implant with one part cemented in and one part cementless was the way to go.

Gradually, with improved designs, materials, and surgical techniques, surgeons are now using completely cementless joint replacements in up to 90 per cent of all cases. Sometimes bone loss from osteoporosis and/or deformities dictate the use of a specific type of implant design and cemented fixation. But otherwise, there are six basic designs to choose from and all have equally good results.

With your previous surgery, these two factors (condition of the bone and alignment) may be critical or important enough to guide a specific implant choice. Your surgeon will be able to make that determination based on physical examination, X-rays, MRIs and/or CT scans.