What to Expect from a Total Hip Replacement: Your 5 Biggest Questions Answered

Hip replacement surgery has become increasingly common in the United States in recent years, especially among younger adults. And its popularity is only growing. A recent study conducted by the American Academy of Orthopaedic Surgeons found that the number of total hip replacements is expected to reach 635,000 by the year 2030 - a 171 percent increase. 

While there are many non-operative treatments and physical therapy routines available to patients that have proven to be very effective, there are cases where the hip is too damaged and must be replaced.

And thanks to new advances in the field, patients can expect a shorter recovery period, less pain, and fewer complications after the operation. But just because hip replacement surgery is becoming safer and more common doesn’t mean it’s a minor procedure. 

If you or someone you love is planning to undergo hip replacement surgery, it’s important to educate yourself on the process, from pre-surgery testing to the day of the operation, to the recovery period and beyond. Here, we’ve answered five of your biggest questions about total hip replacement surgery.   

1. How should I prepare?

Before hip replacement surgery, your surgeon will perform a physical examination to determine whether you're healthy enough to undergo the procedure. Your surgeon will ask about your medical history and may order blood tests, an X-ray, and/or an MRI. This appointment will also give you an opportunity to ask any questions you have about the procedure, so be sure to come prepared. 

Your surgeon will work closely with your other treating providers, like your cardiologist, to determine what medications you may need to stop taking prior to surgery to decrease the risk of complications and when it will be safe to resume taking these medications..  This may include stopping your blood thinners or supplements, like fish oil, prior to surgery, as these medications slow your body’s ability to clot which could lead to an increase risk of blood loss during surgery.   

Before your surgery, you should make arrangements for a friend, family member, or caregiver to help with your recovery once you return from the hospital. You can also prepare your home in advance by placing frequently used items within reach of a comfortable seating area, and rearranging furniture to make it easier for you to get around with a cane or walker. 

2. What can I expect on the day of surgery?

Plan to check in to the hospital several hours before your surgery. Before the procedure, you'll be given either a general anesthetic or a spinal block, which numbs the lower half of your body. 

To perform the procedure, which typically lasts about an hour, your surgeon will make an incision over the front or side of your hip and remove the diseased and damaged bone and cartilage from your joint, leaving only healthy bone intact. Your surgeon will then replace the damaged sections with prosthetic parts typically made of metal, ceramic, and plastic. 

After surgery, it will take about two hours for your anesthesia to wear off. You’ll then be moved to a hospital room, where medical staff will keep an eye on your blood pressure, pulse, alertness, and need for pain medications.  Most patients begin walking the very first day with a cane or a walker and are encouraged to do so, with supervision, while still in the hospital setting.   

 However, remember not to do too much too soon. 

3. What is the recovery period like and how long will it last?

Most patients can expect their hospital stay to last between 1 to 2 days. In fact, many patients are even able to go home the same day. If your initial recovery takes longer than that, you may be transferred to a rehabilitation center before returning home. 

“When you get home, keep in mind that the more you follow your physician’s guidelines, the quicker you will heal,” says Zachery D. Post, M.D., an orthopedic surgeon with Rothman Orthopaedic Institute who specializes in hip and knee arthroplasty and reconstruction. “You may be asked to rest or perhaps to go to physical therapy or do certain strengthening exercises at home.”

Before you leave the hospital, you’ll meet with a physical therapist, who will teach you strengthening and mobility exercises to do at home. It’s very important to stay active in the days and weeks after hip replacement surgery to help aid in your recovery and prevent blood clots. You should expect to do 10 to 15 minutes of exercise several times a day, every day, for about two months following your operation, but the best exercise for a hip replacement is walking.  It is best to transition to walking independently once you feel safe to do so, as walking with assistive devices can put strain on your wrists and back.  

Patients who undergo hip replacement surgery are at and increase risk for blood clots during the first month after surgery. To help reduce the risk, your doctor may also prescribe blood-thinning medication, sometimes something as simple as baby aspirin, and encourage you to elevate your legs above the level of your heart, wear compression socks, and get up and walk every hour while awake.  

4. Will I be able to do everything I could do before experiencing hip pain?

Studies show that nearly 90 percent of hip replacement patients feel better and resume normal activity within a few months, and sometimes even weeks, following the operation. 

Although you will experience some post-surgery discomfort, swelling, and pain as your new joint heals and your incisions close up, the main benefit of having a total hip replacement procedure done is that you should have a dramatic improvement in your daily hip pain and range of motion. After your recovery is complete, you’ll be ready to move on toward a life that is active and pain-free.

Your doctor will help determine when it’s safe for you to resume normal activities. You can typically return to work after four to six weeks, and resume driving one to four  weeks after surgery, or when you are no longer taking pain medication.

Two to 12 weeks after surgery, you'll have a follow-up appointment with your surgeon to make sure your hip is healing properly. While most people can expect to resume the majority of their normal activities by this time, a full recovery can take up to 12 months. 

Even though your new hip joint can dramatically reduce the pain you felt before surgery you may wish to avoid certain high-impact sports like running or playing basketball. Instead, experts recommend low-impact activities like swimming, golfing, hiking, or bike riding.

5. Will my hip replacement need a replacement?

You may eventually need a second hip replacement if you undergo this surgery when you're relatively young and active. However, innovations in materials have significantly reduced the possibility of hip replacements wearing out.

Patients in their early 50s were routinely told to wait until they were older before having a hip replacement. Now, age is only a minor consideration.”

Find out more about hip replacement surgery here.