Hip replacement: Everything you need to know.

If pain from a damaged hip joint is keeping you from feeling your best, hip replacement surgery, also called hip arthroplasty, can ease discomfort and improve your quality of life. It’s one of the most common orthopedic procedures in the U.S. and often has great outcomes to match. 

Although hip replacement is a major surgery, it’s proven to be safe and can offer life-changing benefits. Still, understanding what to expect before, during and after surgery can help you feel more confident about your decision.

What is hip replacement surgery?

During hip replacement surgery, your doctor removes the damaged parts of your hip joint and replaces them with a new, artificial joint (prosthesis). The prosthesis can be made from different materials like metal, plastic or ceramic. Benefits include reduced pain, improved joint function and increased mobility — all of which can help you return to the activities you enjoy.

Thanks to advancements in materials, hip replacements can last for decades. A study in The Lancet found that more than half of hip replacements lasted at least 25 years. However, younger patients may require a new hip replacement sooner, often due to higher activity levels that place more stress on their new joints.

Types of hip replacement surgery

Your surgeon will work with you to determine the best hip replacement option for your condition. If you have damage in both hips, your doctor may recommend a procedure called simultaneous bilateral total hip replacement to treat both hip joints at the same time. If only part of your hip bone is damaged, your surgeon may suggest a partial hip replacement or hip resurfacing. In some cases, your provider may even be able to perform robot-assisted hip replacement, a minimally invasive alternative to traditional surgery. 

For a total hip replacement, which involves replacing both the ball of the thighbone and the socket of the pelvis, your doctor may recommend doing an anterior or posterior hip replacement. These terms refer to the location on your body where the incision is made to access your hip joint. Long term, both approaches produce similar outcomes.

Posterior hip replacement

Your surgeon may start your procedure from the back of your hip during a “posterior” approach. You’ll be on your side during this procedure and your surgeon will cut through muscles and tendons near your seat to get to your hip joint. This surgery typically takes about an hour to complete. 

Anterior hip replacement

If your surgeon starts your hip replacement procedure from the front of the pelvis, they are following an anterior approach. During this procedure, you’ll lie on your back while the incision is made in the upper thigh. This approach is more complex and may take longer to perform, but it often allows the surgeon to avoid cutting through major muscles and tendons, which can make for a smoother recovery. 

Patients who undergo the anterior approach may face fewer post-operative restrictions and experience a faster recovery. However, this technique is less common than a posterior hip replacement and may not be an option for patients who are overweight or obese. 

Lateral hip replacement

With a lateral hip replacement, the surgeon accesses the hip joint from the side. You’ll be positioned on your side as the surgeon replaces the damaged joint. This approach typically avoids cutting through major muscles, which can ease your recovery and reduce post-operative pain. The procedure usually takes under two hours, but it may not be appropriate for all patients. Your surgeon will help determine whether this option is right for you.

Who is a candidate for hip replacement surgery?

Hip replacement surgery may be an option for you if you have consistent pain, damage or inflammation in your hip joint. These symptoms can be caused by osteoarthritis or rheumatoid arthritis, the most common reasons for hip replacement. Other causes include hip dysplasia (a condition where the ball and socket of the hip don’t fit together properly), hip fractures or osteonecrosis (a condition where bone tissue dies due to a lack of blood supply).

How do you know if you need a hip replacement?

Your doctor will likely recommend trying other, less-invasive treatment options to ease pain before recommending hip replacement surgery. These include pain medication, physical therapy and exercise modifications. Your doctor may also suggest using assistive devices such as a walker, cane or crutch to get weight off your hip. However, if your pain doesn’t get better with these treatments, you may benefit from surgery. 

When something is wrong with your bones or joints, it can be painful and debilitating. We offer quick knee and hip health risk assessments to help you get started on a path to recovery and wellness. Take our hip health risk assessment.

What to expect during hip replacement surgery

Depending on the approach your surgeon uses, hip replacement surgery can take 1–2 hours, but the time you spend preparing for and recovering from your procedure is a valuable investment in your long-term health. 

How to prepare for hip replacement surgery

Being as healthy as possible before your hip arthroplasty can significantly improve your outcomes, including ensuring a smoother recovery and reducing the risk of complications. Steps include quitting smoking, achieving a healthy weight if you are overweight or obese and strengthening your muscles —particularly your core. If you have diabetes, managing your glucose levels or A1C to optimal levels can further minimize the risk of post-surgical complications.

You might also consider participating in “prehabilitation” to prepare your body for your surgery. These exercises can improve your strength and flexibility and help you have an easier recovery. 

It’s equally important to plan for your recovery and the support you’ll need during the weeks and months following surgery. For instance, you’ll likely need help cooking, cleaning and getting around your home for at least the first couple of weeks after surgery. Depending on which hip is replaced, you may be unable to drive for two to four weeks. Having a plan for assistance with these daily activities, including transportation, can make a big difference.

You can also prepare your home to aid your recovery. This might include installing a safety bar or bench in your shower, raising your toilet seat and removing tripping hazards. Consider where you’ll be spending most of your time during recovery and placing any frequently used items within arm’s reach. 

Before hip replacement surgery

Before your hip arthroplasty, you’ll meet with an orthopedic surgeon. They’ll examine your hip, including the surrounding muscle, to understand what is causing your pain and how the joint is damaged. They’ll also ask about your medical history, including medications, and may order tests like blood tests and X-rays. 

You’ll have a chance to ask any questions you have about your surgery, including whether you should stop any medications, what activities you can return to and when, and how to plan for physical therapy. You won’t be able to eat or drink anything after midnight the night before your procedure. 

During hip replacement surgery

On the day of your surgery, you’ll check in at the surgical center and wait for your care team to call you back for your hip replacement. Make sure to bring your insurance information and identification with you. 

After you are taken to the surgery area, your nurses will prepare you for your procedure, including starting an IV and drawing any blood needed for tests. You’ll also meet with your anesthesiologist and go over what to expect with your general anesthesia. 

Your care team will then move you to the surgical suite and start your general anesthesia. You will be asleep throughout your procedure and shouldn’t feel or remember anything. 

After you’re asleep, your surgeon will make incisions, remove the damaged ball and/or socket of your hip joint and replace it with a prosthesis. 

After hip replacement surgery

Following your surgery, a nurse will take you to a recovery area, where your vital signs will be monitored for several hours as you wake up from anesthesia. While some patients stay in the hospital overnight, many go home the same day. Most people are also able to walk the same day. 

Your first physical therapy session will likely take place in the hospital, where you’ll learn helpful exercises to do at home to aid your recovery. Once you’re home, keep an eye out for signs of infection, such as fever, pus or drainage at your incision site, or severe pain in your hip. If you have any of these symptoms, contact your doctor right away. You’ll have a follow-up appointment with your surgeon after a few weeks to make sure your new joint is working properly. 

It can take 2–3 months to fully recover from hip replacement surgery, but most people can return to work and some daily activities about two weeks after surgery. Early on, you’ll use an assistive device to walk, such as a cane, walker or crutch. For a couple of months, you’ll need to avoid bending your hip beyond 90 degrees (such as when tying your shoes) or crossing your legs. Staying consistent with physical therapy will help improve your strength and mobility and, over time, help you walk without assistance and move with greater ease. 

You can resume many of your normal activities after hip replacement surgery. Low-impact activities like walking, swimming or riding a stationary bike can all help you rebuild strength. Avoid high-impact activities like running and jumping since they can damage your new joint. 

Find relief and regain mobility

If hip pain is holding you back from the activities and people you love, HCA Florida’s orthopedic team is ready to help. You can count on us to partner with you every step of the way — from diagnosis to recovery. Learn more about the comprehensive orthopedic services we offer.