A total hip replacement (THR) is a salvage operation that is undertaken when medical management fails. The coxofemoral joint is replaced to maintain function of the limb and to provide a better quality of life for that patient. As this is a complex and painful procedure, thought must be given to providing adequate analgesia both peri- and postoperatively. The VN who runs the instrument table for each THR needs an extensive knowledge of the equipment required and the order in which it is used. Postoperative nursing care is paramount with every THR.