Hip arthroplasty
Hip replacement and NSW CTP permanent impairment
A total or partial hip replacement does not carry one automatic WPI. Clause 6.101 requires the Table 65 point score for the replacement result, and that score is converted through Table 64.
Motor accident injury
How can this injury happen?
Car or passenger collision
A severe femoral neck, head or acetabular injury may lead to acute or later replacement.
Motorcycle accident
High-energy landing can cause fracture, avascular necrosis or arthritis requiring arthroplasty.
Pedestrian or cyclist impact
Direct hip and pelvic trauma may ultimately require replacement when reconstruction or joint preservation fails.
Injuries that can occur
- total hip replacement
- hemiarthroplasty or revision arthroplasty
- replacement after fracture or avascular necrosis
- post-operative dislocation, infection, loosening or leg-length issue
Symptoms and functional problems
- walking and stair limits
- difficulty sitting, transfers and putting on shoes
- pain, instability or recurrent dislocation
- need for a walking aid or revision surgery
Seek urgent medical assessment
Suspected prosthetic dislocation, infection, acute shortening or inability to weight-bear requires urgent assessment.
Clinical evidence
What findings matter?
The table score needs the replacement result, including pain, function, walking and examination findings. Operative and rehabilitation records explain the context but do not replace the point assessment.
| Record or examination | What it may establish | What it cannot prove alone |
|---|---|---|
| Operative and implant record | Confirms procedure, indication, components and complications. | The operation name does not set the score. |
| Table 65 clinical assessment | Scores the actual hip replacement result, including function and examination items. | Exact points require the readable AMA4 table. |
| X-ray and rehabilitation evidence | Shows component position, complications and sustained walking capacity. | A satisfactory X-ray does not decide all functional points. |
Movement in daily life
How movement affects real activities
Hip replacement function is reflected in walking, transfers, stairs, sitting and shoe care. Table 65 uses a point system rather than simply converting one ROM angle.
Walking distance
Community mobility, shopping and work travel.
Clause 6.102 reads six blocks as 600 metres and three blocks as 300 metres in Table 65.
Transfers and stairs
Rising, entering a vehicle and moving between levels.
Functional evidence should match the Table 65 point items.
Hip examination
Stability and practical movement for dressing and sitting.
The clinical findings form part of the replacement result, not a separate duplicate ROM rating.
Threshold injury is a separate question: replacement is treatment, not a threshold classification. The underlying fracture, cartilage injury or other accident-related pathology determines classification.
Part 6 permanent impairment
How is CTP WPI assessed?
Clause 6.101 directs hip replacement to AMA4 Table 65. The Table 65 points are added and the total is converted to impairment through Table 64; the site does not publish point rows because the supplied AMA4 chapter is unreadable.
Measurement rules that apply
- Clauses 6.69 and 6.70 require the method that most specifically addresses the lower-limb impairment. Gait should not replace a joint, nerve, fracture or replacement method that can be applied reliably.
- Clause 6.84 requires active range of motion, a goniometer where clinically indicated and consistent repetitions when reliability is uncertain. Passive movement may inform the examination but does not set the impairment value.
- Clause 6.85 says only the most severe deficit in one direction or axis from the same lower-limb ROM table is rated. Deficits from separate tables may be combined only as the Guidelines permit.
| Method | CTP source | When it is relevant | Important limit |
|---|---|---|---|
| Hip replacement point score | Clause 6.101; AMA4 Table 65 | The permanent result after hip arthroplasty. | All points are added, but exact row values require readable AMA4. |
| Distance modification | Clause 6.102 | Interprets the walking-distance items in Table 65. | Six blocks means 600 m and three blocks means 300 m. |
| Conversion | Table 64 and Table 6.4 | Converts the replacement result to WPI as directed. | Do not add surgery or ROM again for the same result. |
- Assess after the replacement result is permanent or well stabilised.
- Record aids, walking tolerance and complications accurately.
- A revision or poor outcome may change the point result but does not create a fixed percentage by label.
What cannot be combined?
- separate hip ROM rating for the same replacement result
- gait derangement with the replacement evaluation
- pain or surgery as additional percentages
What does not establish WPI by itself?
- implant on X-ray
- operation date
- pain score
- use of a cane without necessity and permanence
Motor accident examples
Fracture treated with total hip replacement
The assessor applies Table 65 to the actual result; the fracture and surgery are not separately stacked for the same hip impairment.
Replacement with revision planned
If the condition is likely to change substantially, permanent assessment may be premature.
Claim file preparation
Evidence checklist
Assessment source
Hip replacement WPI source
Assessment source: Motor Accident Guidelines v10.1 clauses 6.19-6.21 and 6.101-6.102; AMA4 Tables 65 and 64; Table 6.4 conversion.
Threshold injury: Hip replacement is treatment. Threshold status depends on the underlying accident-related injury.
What the assessor checks
- Table 65 point system
- points added
- distance modification
- Table 64 conversion
What does not establish the result by itself
- surgery
- implant
- pain
- walking aid alone
Official sources
Related NSW CTP guides
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Frequently asked questions
- Does hip replacement equal a fixed WPI?
- No. Clause 6.101 requires Table 65 point scoring for the actual replacement result.
- Are the Table 65 points added?
- Yes. Clause 6.101 distinguishes Table 65, where points are added, from Table 66 for the knee.
- How are walking blocks interpreted?
- Clause 6.102 says six blocks means 600 metres and three blocks means 300 metres.
- Can ROM be added?
- Not when it rates the same replacement result. The combination rules prevent duplicate assessment.
- When should assessment occur?
- When the replacement outcome is permanent or sufficiently stable and unlikely to change substantially.