Evidence based practice is aimed at reducing variation within the NHS. It ensures that the most clinically and cost-effective procedures are used to treat patients. This research explores decision-making for hip replacement by orthopaedic surgeons, to identify potential barriers and facilitators to the implementation of evidence based guidance in practice. The research will include an initial meta-ethnographic review, followed by ethnographic case studies (interviews, observations and document analysis) of two orthopaedic centres in NHS hospitals. The findings will inform the design of an intervention aimed at improving uptake and understanding of evidence by orthopaedic surgeons in the NHS.