Hip replacement surgery, or hip arthroplasty, is a common procedure that can improve mobility and decrease pain in a hip joint that’s no longer functioning properly. The American College of Rheumatology reports that about 544,000 hip replacement surgeries are performed in the United States each year, and that number continues to climb as the population ages.
Advancements in medical technology, technique and pain management have made it possible for most patients to have a total hip replacement as an outpatient procedure, called a rapid-recovery hip replacement, which means you may choose to have the surgery done at a hospital or at an ambulatory surgery center.
If you’re planning to get a hip replacement, read on to learn more about what to expect and recovery post-surgery.
What Is a Hip Replacement?
The hip is one of the largest joints in the body and is shaped as a ball-and-socket joint. The ball sits at the top of the femur (thigh bone), which rests in a socket in the pelvis (the hip) to allow the legs to move across several planes of motion.
Over time, however, the cushion between the ball and the socket can wear away, leading to bone grinding against bone, which can become quite painful.
Contributing factors that can lead to needing hip replacement surgery include:
— Osteoarthritis, a common type of arthritis associated with aging, and the most common reason for replacement surgery
— Inflammatory arthritis, such as rheumatoid arthritis, an autoimmune disease that damages the joints
— Osteonecrosis, the formal name for death of the bone cells, that results from decreased blood flow
— Developmental dysplasia, or instability of the hip, in childhood may lead to surgery as an adult
— Trauma or injury, such as a broken hip from a fall, could require a partial or complete replacement
For a hip replacement, an orthopedic surgeon removes the diseased parts of the hip joint and replaces them with prosthetic parts that mimic the function of the normal hip joint. The prosthetic components may be made from metal (usually titanium), ceramic and/or very hard plastic.
The various hip joint replacement options include:
— Metal ball with a plastic socket lining
— Ceramic ball with a plastic socket lining
— Ceramic ball with a ceramic socket or lining
Pain relief, improved function of the hip and increased mobility are the main goals of hip replacement surgery.
Signs You Need a Hip Replacement
When nonsurgical, conservative treatments — such as physical therapy, medications, assistive devices and weight loss — don’t improve hip pain, it may be time for a more invasive approach.
Signs you need a hip replacement often include:
— Groin, side or buttock pain
— Decreased range of motion in the hip
— An inability to walk significant distances
— Pain that interferes with daily activities or sleep
An X-ray can usually confirm the loss of cartilage as occurs with osteoarthritis.
Surgical Approaches
There are several ways your surgeon can replace or partially replace your hip joint. Your specific anatomy, the nature of the hip problem and your surgeon’s preferences and experience will all inform the decision of which approach is best for you. Here’s how they compare to one another.
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These approaches may also include artificial intelligence-driven surgical planning, the use of 3D modeling, CT scans and X-rays along with robotic devices to improve accuracy of tissue removal, prosthetic placement and overall outcomes. These new tools can help reduce the risk of complications such as dislocations while offering ideal, personalized placement of the new parts to improve hip stability.
Such advanced techniques may also reduce the time it takes to complete the surgery as well as speed recovery.
Hip Replacement Surgery: Where to Go
Both hospitals and ambulatory surgery centers offer hip replacement surgery. When you’re looking for a physician to conduct hip replacement surgery, keep in mind that some orthopedic surgeons are generalists and some specialize in joint replacement. Surgical outcomes are also usually better in a high-volume setting, which means the more often a surgeon does this particular procedure, the better the outcomes tend to be. Practice makes perfect, after all, plus high-volume centers have refined their protocols to support patients in the operating room and the hospital if they need additional care after the surgery.
If you’re looking for a hip replacement surgeon, be sure to ask about the surgeon’s complication and infection rates. Complication rates below 4% and infection rates below 1% generally suggest the surgeon is well-versed in this procedure.
Surgery in an ASC
Advancements in techniques and materials science now enable more people than ever to go home the same day after a hip replacement surgery. This is fueling a rise in the use of ambulatory surgery centers for these procedures, rather than traditional hospital inpatient settings.
Regardless of whether the procedure is performed in a conventional hospital setting or an ASC, “the procedure itself is the same,” explains Dr. Pratik Desai, an orthopedic surgeon with Orlando Health Jewett Orthopedic Institute in Florida.
“Patients arrive at the surgery center a few hours before surgery, undergo the procedure in the operating room and then spend two to four hours in the recovery area working with physical therapists to prepare for discharge.”
After leaving the surgery center, you’ll begin outpatient physical therapy and follow the standard recovery protocol, he adds.
The key to being able to have hip arthroplasty in an ASC revolves around “safe for home” criteria, which include:
— Being medically stable
— Being able to take oral medications to manage pain
— Being able to walk with a walker or cane
— Being able to eat, drink and use the toilet
— Being able to move from your bed to the bathroom and other locations with a walker or cane
— Being able to walk up or down two or three stairs at a time with assistance
— Being able to perform your prescribed at-home exercises
— Understanding your recovery care plan and the precautions you need to take to protect your new joint
— Having an appropriate home setting to support your recovery
[READ: How to Set Up Home Health Care After a Hospital Stay]
Prepping for Total Hip Replacement Surgery
Before surgery, it’s important to prepare for your recovery.
For many people, hip replacement surgery is conducted as an outpatient procedure and you may not spend a single night in the hospital. This means you’ll have to prepare your home ahead of time to make it easier for you to get around. You will likely need some assistance from a friend, loved one or home health aide in the beginning.
Some individuals who’ve undergone hip replacement surgery need to be discharged to a rehabilitation center or a skilled nursing facility afterward. This can be helpful for people who:
— Have had complex surgeries
— Lack support at home
— May benefit from starting their recovery with intensive physical and occupational therapy to regain mobility and strength
— Need help managing pain and medications
In all cases, the American Academy of Orthopaedic Surgeons recommends making changes to your home before surgery to ensure it’s safe when you come home. Recommended aids include:
— A raised toilet seat to prevent bending your hips beyond 90 degrees
— A grabber for accessing higher cabinets
— A walker or similar mobility aid
— A handheld shower head
You should also ensure rugs are tacked down to avoid falls. Rearranging frequently accessed items to easy reach can help you avoid unnecessary bending over.
[READ: 10 Tips to Prepare Your Home After a Hospital Stay]
The benefits of “pre-hab”
In some cases, preparing for hip surgery will involve pre-habilitation work, or pre-hab, which is a type of physical therapy that’s performed before you undergo the surgical procedure. This would be in addition to post-surgical rehabilitation and physical therapy.
Most people who need a hip replacement don’t need to pre-hab, but “it may be recommended for individuals who have significant mobility limitations prior to surgery, such as those using a walker or wheelchair,” Desai says.
In cases where pre?hab is recommended, “it can help build strength and endurance before surgery, allowing for a more efficient recovery afterward,” he notes.
Will I Have to Stay in the Hospital?
Just a few years ago, many doctors would have their patients stay in the hospital for several days following hip replacement surgery, but advances in surgical techniques and technology have changed that. Increasingly, patients who undergo hip replacement surgery go home the same day.
“Our ability to perform the surgery in a less invasive manner affords us the opportunity to send patients home safely and comfortably soon after their procedure,” says Dr. Michael B. Gerhardt, a sports medicine specialist and orthopedic surgeon with Cedars-Sinai Orthopaedics — Santa Monica in California.
“Smaller incisions, less blood loss and expedited physical therapy allows patients to get up and comfortably walk within hours after surgery.”
Same-day discharge is generally reserved for younger, healthier patients without significant medical conditions. But some patients, particularly older adults or those with comorbidities, still require at least one overnight stay.
But even those stays are usually kept short Desai says. “If a hospital stay is required, it is typically brief and often limited to a 23?hour stay.”
Hip Surgery Recovery: What to Expect and How to Prepare
Typically, hip replacement surgery takes about two hours, but times can vary by surgeon, says Dr. Nader A. Nassif, chief of joint replacement surgery at Hoag Orthopedic Institute in Southern California.
Most patients can expect to resume walking and handle basic daily activities within six to eight weeks, but complete recovery — regaining full strength, balance and the ability to participate in more demanding activities — often takes three to six months or longer.
Recovery timelines vary depending on several factors including:
— Age
— Overall health
— Commitment to physical therapy
Following your surgeon’s recommended rehabilitation program is essential for the best outcomes
What happens during hip replacement surgery?
During surgery, your doctor will cut into your body and remove damaged parts of the hip and replace the removed bone with prosthetic joint components. These prostheses are attached to the remaining bone with epoxy cement or with mesh that bone can grow into.
Since a hip replacement requires anesthesia, you’ll spend an hour or more in recovery.
Risks of hip arthroplasty
As with all surgical procedures, there are some risks associated with this common surgery. These include:
— Infection
— Nerve damage
— Blood clots
— Bone fracture
— Blood vessel injury
In general, these complications occur in only about 1% of cases. Blood clots are the most common complication of hip replacement surgery, so physicians routinely prescribe blood thinners to patients. Getting you up and moving as soon as possible after the procedure can also reduce the risk of developing blood clots.
To reduce the risk of infection, your surgeon may prescribe an antibiotic medication. They will also likely advise you to take preventive antibiotics before you have any dental work, including routine cleanings, or other surgical procedures. For some patients, this directive will stay in place for the rest of your life.
Recovery Timeline for Total Hip Replacement Surgery
Once your surgery is complete, you’ll begin the recovery phase. There are two distinct phases of recovery. Here’s what to expect during each.
The first 24 hours
The first 24 hours after any surgical procedure can be challenging, and many patients need pain medicine to get through the first couple nights. However, “the truth is, most people have less pain immediately after surgery than they did the day before the surgery,” says Dr. Matthew Miller, medical director of orthopedic surgery El Camino Health in California.
During the first several days after surgery, you may be sore and more tired than usual. This is normal, as your body is recovering from a major surgery. Give yourself time to rest and be sure to follow your discharge instructions closely, including:
— Eating a balanced diet that emphasizes lean protein to help you rebuild muscle and heal damaged tissue
— Taking your medications as prescribed
— Doing your PT exercises as directed
Your doctor may advise you not to sit in a car — either to drive or be a passenger — for a period after your surgery, as a seated position and bumps or jostling along the way can be painful or create complications. Pain medications also impede your ability to drive, so follow your doctor’s orders.
Weeks 2 through 6
Patients typically need physical therapy for at least two months following surgery, and you will likely start with PT on day one.
In the beginning you’ll most likely be using a walker to help you get around your home. For most patients, you’ll begin transitioning from this walker to a cane in about one to four weeks. You can begin making that transition when you feel steadier on your feet and are able to bear weight on the side where the surgery was performed.
During this recovery period, physical therapy is critical to helping you get stronger, regain mobility and feel better. Virtual physical therapy via telehealth platforms has made it much easier for many patients to get the support of a PT in their home. For some, however, you may need to travel to a physical therapist’s office for session. In all cases, you’ll likely be given exercises to complete at home, and it’s important to do these as instructed to keep your recovery on track.
Lower-impact exercises such as swimming, water aerobics and cycling are all great ways to stay in shape and be active, without putting the kind of impact loads on a joint that may lead to wear and tear over time — and ultimately to the need for a new joint replacement. However, most surgeons recommend keeping the wound dry for at least a month until the incision is fully healed to prevent infection. You’ll also likely be told to avoid high-impact activities such as running for at least a month post surgery.
While many patients say they’re surprised by how quickly they were able to move around after hip replacement surgery, it’s important to underscore that this is a “major orthopedic surgery,” Miller notes. “You should exhaust the conservative measures before you move forward with surgical intervention like hip replacement.”
Week 7 and beyond
In general, patients return to normal activities within four to six weeks, Desai says, but your body will continue healing for a while longer. “The metal and bone typically bond together over three to six months, and by 12 to 18 months, patients usually reach the maximum benefit from their procedure,” he notes.
Each patient recovers at their own pace, but “the best ways to speed recovery include actively participating in physical therapy, both independently and during formal therapy visits, and maintaining a healthy diet that is high in protein to support tissue healing,” Desai notes.
Most patients feel better by about six to eight weeks after surgery. Eventually hip replacements can come to feel so natural that people may forget they even have them.
How Long Does a Replacement Hip Last?
The durability of hip replacements has increased in the past several years, Miller says.
Modern hip replacements are generally expected to last 20 to 30 years, depending on factors such as:
— Your age
— Your activity level
— The type of materials used in the implant
Some implants may last longer in certain patients, but the decision about having the surgery should be based on your current situation.
“I counsel patients that the decision to have a hip replacement should be more about how severe your symptoms are and how much pain and dysfunction you’re living with rather than how long it’s going to last,” Miller adds.
How Much Does Hip Replacement Surgery Cost?
Data from the Centers for Medicare & Medicaid Services offers some insight into how much total hip arthroplasty costs on average across the U.S.
| Costs | Ambulatory surgical centers | Hospital outpatient departments |
| Doctor fee | $1,162 | $1,162 |
| Facility fee | $9,614 | $13,116 |
| Total cost | $10,776 | $14,278 |
| Medicare pays | $8,620 | $12,309 |
| Patient portion | $2,154 | $1,968 |
Other estimates suggest hip replacement surgery can cost upwards of $30,000 or more, depending on a range of factors including geographic location.
“Most people would not be able to have the surgery performed if they didn’t have appropriate insurance,” Miller says.
The good news is that virtually all health insurance plans will cover this procedure when it’s deemed medically necessary. However, each insurance policy has its own mix of benefits, copays and deductibles. Therefore, it’s best to check with your insurer before you schedule a surgery to ensure that the hospital, surgeon, anesthesiologist and everyone else you’ll encounter during surgery is in network. Otherwise, you could get hit with an unexpected bill after the procedure.
“For the average patient, the copay or their responsibility is a manageable cost compared to the cash price of the surgery,” Miller says.
And for most people, it’s worth it, as hip replacement surgery will make a big difference in your ability to live comfortably and engage in the activities you enjoy most.
FAQ
Anterior vs. posterior hip surgery? Which is better?
Total hip arthroplasty can be performed in a variety of ways, with anterior and posterior approach being two of these options. They differ in how your surgeon accesses the joint and how much of the joint they can see during the procedure. Each has pros and cons, and one might be better for you than another. Discuss these options with your surgeon who can provide tailored advice based on your unique situation.
How long does a hip replacement last in 2026?
A 2026 study published in the Lancet that analyzed data from nearly 2 million hip replacements worldwide found that 94% of modern hip replacements are still functioning at 20 years, 93% lasted 25 years and 92% survived 30 years. This suggests that barring any significant complications, you can expect your hip to last 20 to 30 years.
What are the benefits of robotic-assisted hip replacement?
Robotic-assisted surgical procedures can provide:
— Enhanced precision and accuracy in removal of bone
— Optimal alignment of replacement parts
— Reduced risk of dislocation
— Less tissue damage and blood loss
— Reduced pain and faster recovery
— Better mobility and flexibility
Your surgeon’s skill and experience with robotic-assisted tools can influence the outcome, so be sure to discuss your options before any surgical procedure.
If both hips are bad, is it worth getting them replaced at the same time?
Experts generally advise against a bilateral procedure because the medical risks of doing it are higher, with a much higher risk of blood clots. The risk of developing cardiovascular and pulmonary complications are also higher when replacing both hips at once. Therefore, experts recommend you get one done, get stronger, then get the other side done.
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Total Hip Replacement: Costs, Recovery and New Technologies originally appeared on usnews.com
