Nguyen Manh Khanh, deputy director of the hospital, said on July 26 the 51-year-old patient first developed pain in her left hip about 10 years ago. It came on during movement at first, then worsened until walking and daily activity became difficult.

Doctors in New Zealand told her years ago that she needed a replacement and put her on the public system's schedule.

She has been on the wait list for four years. Switching to private services would have cost her nearly NZ$40,000 (US$23,100).

She researched Vietnamese surgeons and compared treatment across several countries in the region before choosing Viet Duc, Vietnam's largest surgical center, and booking a more than 9,000-km flight to Hanoi.

Her left hip joint had been completely destroyed by the time she was admitted. She was in severe pain and largely dependent on a wheelchair. Her weight, close to 100 kg, complicated both anesthesia and surgery.