<P> Total hip replacement incidence varies in developed countries between 30 (Romania) and 290 (Germany) procedures per 100,000 population per year . Approximately 0.8% of Americans have undergone the procedure . </P> <P> According to the International Federation of Healthcare Plans, the average cost of a total hip replacement in 2012 was $40,364 in the United States, $11,889 in the United Kingdom, $10,987 in France, $9,574 in Switzerland, and $7,731 in Spain . In the United States, the average cost of a total hip replacement varies widely by geographic region, ranging from $11,327 (Birmingham, Alabama) to $73,927 (Boston, Massachusetts). </P> <P> The earliest recorded attempts at hip replacement were carried out in Germany in 1891 by Themistocles Gluck (1853--1942), who used ivory to replace the femoral head (the ball on the femur), attaching it with nickel - plated screws, Plaster of Paris, and glue . </P> <P> On September 28, 1940 at Columbia Hospital in Columbia, South Carolina, American surgeon Dr. Austin T. Moore (1899--1963) performed the first metallic hip replacement surgery . The original prosthesis he designed was a proximal femoral replacement, with a large fixed head made of the cobalt - chrome alloy Vitallium . It was about a foot in length and bolted to the resected end of the femoral shaft (hemiarthroplasty). A later version, the so - called Austin Moore Prosthesis which was introduced in 1952, is still in use today, although rarely . Like modern hip implants, it is inserted into the medullary canal of the femur, and depends on bone growth through a hole in the stem for long - term attachment . </P>

When was the first hip replacement surgery performed