Total Hip Replacement Surgery: Recovery, Preparation and Care
Total hip replacement surgery, also called total hip arthroplasty, replaces damaged parts of the hip joint with artificial parts. It may help reduce hip pain, improve movement and make daily activities easier.
Your healthcare team partners with you before surgery, during your hospital or surgery center visit, and throughout recovery. This guide explains what to expect and how to prepare.
Why Hip Replacement May be Needed
Many people have hip replacement surgery because of osteoarthritis. Osteoarthritis happens when the smooth tissue that cushions the hip joint wears down over time. This can cause pain, stiffness, swelling and trouble moving.
The hip is a ball-and-socket joint. The ball is the top of the thigh bone, called the head of the femur. The socket is part of the pelvis, called the acetabulum. During total hip replacement, damaged bone and cartilage are removed and replaced with artificial parts, called components or prostheses.
What Happens During Total Hip Replacement Surgery
An orthopedic surgeon performs total hip replacement surgery. The procedure often takes 1 to 2 hours. Most people go home the same day, while some may stay overnight.
The artificial hip usually includes four parts:
- Cup: Replaces the hip socket.
- Liner: Fits inside the cup and helps the joint move smoothly.
- Ball: Replaces the head of the thigh bone.
- Stem: Fits into the thigh bone and holds the new joint in place.
Your surgeon chooses the parts and surgical approach that best fit your body, health and activity needs.
Anesthesia and Sedation
Most people have spinal anesthesia with light sedation. This numbs the lower half of the body while you are relaxed or lightly asleep. Some people have general anesthesia, which means they are fully asleep during surgery and have breathing support.
Your care team talks with you about the safest option for you.
Surgical Approaches
Anterior approach
The anterior approach uses an incision at the front of the upper thigh. The surgeon works between muscles instead of cutting through them. Some people may walk more easily early in recovery, but recovery varies.
Anterolateral approach
The anterolateral approach uses an incision slightly toward the front and side of the hip. It gives the surgeon a clear view of the hip socket and thigh bone.
Posterior approach
The posterior approach uses an incision at the back of the hip. It may be used when there is more joint damage or when another surgery is needed on the same hip.
Talk with your surgeon about which approach is right for you.
Total Hip Replacement Recovery Timeline
Recovery happens in stages. Each person heals at a different pace.
Weeks 1 and 2
You likely need the most support during the first two weeks. Many people notice small improvements each day. You may use a walker and need help with daily activities.
Weeks 2 to 9
Progress may feel more gradual. Many people are back to about 75% of their usual movement and daily function by the third month. You may move from a walker to a cane when your care team says it is safe.
Weeks 9 to 12
You may continue to improve month by month. Some warmth, aches or swelling around the joint can continue as strength returns.
Full recovery from joint replacement surgery can take up to one year.
How to Prepare for Total Hip Replacement Surgery
Planning ahead helps you recover safely at home.
Choose a Joint Coach
A Joint Coach is an adult who helps before and after surgery. This may be a family member or friend. Your Joint Coach may help you attend appointments, prepare your home, get to and from surgery, and follow your recovery plan.
After surgery, your Joint Coach should plan to stay with you full time for the first 3 days and provide part-time help for the next 2 to 3 weeks.
Tell your care team about your health
Before surgery, tell your healthcare team about:
- Chronic conditions, such as diabetes or heart disease.
- Past blood clots.
- Blood-thinning medicines.
- All prescription medicines, over-the-counter medicines, vitamins and supplements.
- Herbal products, NSAIDs or medicines for inflammatory arthritis.
- Implanted devices, such as a pacemaker, defibrillator, insulin pump or pain pump.
- Recent illness, infection, skin problems or dental concerns.
Your care team may need to adjust medicines, delay surgery or give special instructions.
Avoid tobacco and nicotine
Stop all tobacco and nicotine products at least six weeks before surgery and continue avoiding them for at least six weeks after surgery. Nicotine and tobacco can reduce blood flow, slow healing and increase the risk of complications.
Plan around other procedures
Ask your care team before scheduling dental work, colonoscopy, steroid injections or other procedures close to your surgery date. These may increase infection risk.
Get Your Home Ready
Before surgery, prepare your home so it is easier and safer to move around.
Helpful steps include:
- Remove throw rugs and clutter from walkways.
- Make or freeze meals, or plan for food delivery.
- Move frequently used items within easy reach.
- Set up a stable chair with arms and a higher seat.
- Clear space near your bed for a walking aid.
- Arrange help with driving, cooking, cleaning, pets, children or other dependents.
For eight weeks after surgery, do not plan to be the main caregiver for pets, children or other dependents.
What to Bring on Surgery Day
Bring:
- Photo ID and insurance card.
- A list of all medicines, vitamins and supplements.
- Implanted device cards and remotes, if applicable.
- Glasses, hearing aids or dentures with labeled cases.
- Comfortable, loose-fitting clothing.
- Nonskid walking shoes.
- A 2-wheeled walker if you already have one.
- CPAP machine if you use one at home.
- Advance directive if it is not already in your medical record.
- Money or a credit card for medicines you take home.
Do not bring valuables or jewelry.
The Day Before Surgery
Follow all instructions from your care team about eating, drinking and medicines.
The evening before surgery:
- Remove piercings.
- Take a shower or bath.
- Use antibacterial soap if your care team gave it to you.
- Sleep in clean pajamas and clean sheets.
Do not shave the leg that will have surgery.
The Day of Surgery
Before leaving for surgery:
- Do not eat or drink unless your care team says it is OK.
- Take only medicines your care team told you to take.
- Shower as instructed.
- Brush your teeth.
- Wear clean, loose clothes and nonskid shoes.
- Make sure your driver is ready to stay through check-in and take you home.
Call your care team if you feel sick, have a fever or notice signs of infection.
Right After Surgery
After surgery, you rest in a recovery area. Your care team checks your blood pressure, pulse, breathing, alertness, pain level and nausea. You may receive oxygen, fluids, pain medicine or antibiotics.
Do not get up without help.
Most people go home the same day. For the rest of the day after anesthesia or sedation, do not drive, work, drink alcohol, use exercise equipment or care for children or dependent adults.
Call your care team if dizziness, nausea or vomiting continues 24 hours after surgery.
Pain and Swelling After Hip Surgery
Some pain is expected after surgery. Your care team may ask you to rate your pain on a scale from 0 to 10. The goal is often to keep pain around 4 or less.
Pain may be managed with:
- Prescription pain medicine for a short time.
- Acetaminophen or other approved over-the-counter medicine.
- Cold packs.
- Rest, walking and gentle movement.
Do not take NSAIDs, aspirin or blood-thinning medicines unless your care team says they are safe for you.
Swelling is common and often peaks 3 to 5 days after surgery. It usually improves over the next 2 to 3 weeks, though some swelling can last longer.
To help swelling:
- Use cold packs as directed.
- Raise your leg while resting.
- Take short walks.
- Do ankle pumps every hour while awake.
Walking and Activity After Surgery
Walking is one of the best ways to support recovery after total hip replacement. Use your walking aid as instructed.
Many people:
- Walk the same day as surgery.
- Use a walker for 1 to 2 weeks.
- Move to a cane around weeks 2 or 3, if safe.
- Stop using a cane when walking without a limp.
Take slow, short steps. Increase distance gradually. Stop if pain gets worse.
Ask your care team what movements are safe. If you had a posterior approach, you may need to avoid bending too far, twisting, turning or crossing your legs for a period of time.
When Can You Drive After Hip Replacement?
Ask your care team when it is safe to drive. Many people wait 2 to 3 weeks after surgery.
Do not drive until you:
- Are no longer taking prescription pain medicine.
- Can put full weight on your hip.
- Can move safely and react quickly.
Wound Care After Hip Replacement
Keep your incision clean and dry. Follow instructions about your dressing or bandage.
Most people can shower 1 to 2 days after surgery, depending on the bandage and care team instructions. Let water run gently over the area. Use mild soap, do not scrub, and pat dry with a clean towel.
Do not take a bath, use a hot tub, swim or soak in water until your care team says it is safe. This is often about six weeks.
Do not use creams, lotions, oils or ointments on the incision unless your care team tells you to.
Eating, Drinking and Constipation Prevention
After surgery, your body needs nutrition to heal.
Helpful steps include:
- Eat balanced meals with protein, calcium and vitamins.
- Drink plenty of water.
- Eat high-fiber foods, such as fruits, vegetables and whole grains.
- Use stool softeners or fiber supplements if recommended.
Prescription pain medicine and less activity can cause constipation.
Physical Therapy After Hip Replacement
Your care team may have you work with a physical therapist. Therapy may include walking practice, using a walker or cane, getting in and out of chairs or bed, stair safety, swelling reduction and strengthening exercises.
Weeks 1 to 4
Focus on gentle movements. These may include ankle pumps, thigh muscle tightening and bending or straightening the knee while sitting.
Weeks 5 and 6
If healing is going well, your care team may add light standing movements, such as standing from a chair, heel raises or gentle leg movements while holding a counter.
Do exercises slowly. Stop if pain becomes hard to tolerate or gets worse.
Possible Side Effects and Complications
Common side effects after surgery may include:
- Pain or soreness.
- Bruising.
- Swelling.
- Numbness.
- Trouble sleeping.
- Appetite changes.
- Constipation.
- Feeling tired.
Possible complications are uncommon but can include infection, delayed wound healing, dislocation, fracture, blood clot, nerve or blood vessel irritation, uneven leg feeling, or loosening or breakage of the implant.
Talk with your care team about your personal risks.
When to get Emergency Care
Call 911 or your local emergency number right away if you have:
- Chest pain or shortness of breath.
- Sudden loss of movement or feeling in your legs.
- A serious fall or injury that prevents walking.
- Heavy bleeding from the surgical area.
- A new seizure or fainting.
When to Call Your Healthcare Team
Call your care team right away if you have:
- Dizziness, nausea or vomiting that lasts more than 24 hours after surgery.
- Calf or thigh pain, tenderness or swelling.
- A fall or injury.
- An incision that opens.
- New numbness, tingling or weakness.
- A joint that feels unstable, locked or out of place.
- A urinary tract infection, bronchitis or another infection.
- Fever of 100.4 F, or 38 C, or higher.
- Chills.
- Increasing pain or pain not helped by medicine.
- Increased redness, swelling, tenderness, drainage or odor from the incision.
Frequently Asked Questions
How long does total hip replacement surgery take?
Total hip replacement surgery usually takes 1 to 2 hours.
Do most people go home the same day?
Yes. Most people go home the same day as surgery. Some people need to stay overnight.
How long does recovery take?
Many people improve greatly in the first 3 months. Full recovery can take up to one year.
When can I walk after surgery?
Many people get out of bed and walk the same day as surgery, with help from the care team.
How long will I use a walker?
Many people use a walker for the first 1 to 2 weeks, then change to a cane when their care team says it is safe.
Is swelling normal after hip replacement?
Yes. Swelling is common. It often peaks 3 to 5 days after surgery and improves over the next few weeks.
When can I shower?
Many people can shower 1 to 2 days after surgery, depending on the dressing and care team instructions.
When can I travel?
Most people should avoid long trips for the first two weeks. Ask your care team when travel is safe for you.
When can I have dental work or a colonoscopy?
Ask your care team. These procedures are often delayed for about three months after surgery because of infection risk.
What is the most important thing I can do after surgery?
Follow your care team’s instructions, walk regularly, use your walking aid safely, care for your incision and call your care team if you notice warning signs.
*This article is intended for informational purposes only and should not be substituted for medical advice. For medical questions and advice, it is always best to consult with your trained physician.