Hip replacement recovery: What to expect

Hip replacement surgery has come a long way in recent years. New surgical advances, including robotic arm-assisted surgery and minimally invasive approaches for hip replacement, are helping people achieve a faster recovery and better results. Improved anesthetic techniques and better pain management protocols are helping patients to start rehabilitation earlier, as soon as on the day of surgery. Longer-lasting implants are also making hip replacement an option for many people in their 40s and 50s with hip pain.

If you are thinking about a hip replacement, it helps to know what to expect. Here are some answers to common questions about recovering from a total hip replacement.

Who needs hip replacement surgery?

Hip replacement, also known as hip arthroplasty, is one of the most common orthopedic surgeries in the United States. Your orthopedic surgeon may recommend that you have a total hip replacement if you are suffering from arthritis, an injury or another problem that causes hip pain. If you have hip pain every day, and if that pain is interfering with your quality of life, then you may benefit from hip replacement.

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What happens during hip replacement?

During a hip replacement surgery, your orthopedic surgeon will replace the top of your femur (thigh bone) with a metal or ceramic implant. This is the “ball” of your hip joint. Your surgeon will also resurface the “socket” of your hip joint, known as the acetabulum, with a metal and plastic cup that fits inside your pelvic bone.

Orthopedic surgeons can perform hip replacements through the back of the hip (posterior approach), the side of the hip (lateral approach) or front of the hip (anterior approach). Regardless of the approach, a minimally invasive technique that preserves muscle and minimizes disruption of your body’s soft tissue, can lead to a quicker recovery. Most hip replacements are performed with regional anesthesia.

When can I go home after a hip replacement?

You should be able to go home the day of surgery or the day after surgery. Home health services are commonly recommended for a couple of weeks after surgery so that you do not need to leave your home to start early physical therapy. Needing a rehabilitation facility after a planned hip replacement has become increasingly rare. 

How much pain will I have after a hip replacement?

It’s normal to have some mild to moderate pain after a hip replacement. Your care team will recommend prescription or over-the-counter pain medications to manage your pain. Icing your hip can also ease pain and reduce swelling.

The pain usually peaks a few days after surgery but gradually improves over the next few weeks.

Do I need to use a walker or cane after hip replacement?

Getting up and moving after hip replacement surgery can help you recover more quickly and reduce your risk of blood clots. Using a walker, cane or crutches for a few weeks after hip replacement can help you keep your balance as you become more active.

Before your surgery, your care team will offer recommendations on assistive devices like walkers, canes and crutches that can support your recovery. Other devices that can help you recover at home include a raised toilet seat, a shower chair and a grabber tool to help you pick items off the floor.

Prevention of falls during your recovery is key.

Is there anything I can do before surgery to recover faster from a hip replacement?

Physical therapy or low-impact exercise can help to build muscle before surgery. For some patients, this can make recovery a bit easier.

Some of the exercises we may recommend before your surgery will be the same exercises we suggest after your surgery to support your recovery.

When do I start physical therapy (PT) after hip replacement?

You will start PT in the hospital after your surgery, often in the postoperative recovery area. After you leave the hospital, PT will continue to be important for your recovery. In most cases, you will have PT at home a few times a week for two to three weeks following surgery, followed by weekly PT at an outpatient clinic for up to two to three months after surgery. You, your surgeon and your therapist will together decide how much PT is necessary.

What hip precautions do I need to take during my recovery? 

It is possible to “over-do-it” during your recovery. Listen to your body and have patience with yourself.

Your care team will provide a list of specific positions or movements to avoid during your early recovery. These “hip precautions” will help reduce your risk of dislocating your hip after your total hip replacement. Your precautions will depend on the type of surgery you had.

Some examples of hip precautions:

• Do not cross your knees.
• Use a pillow between your knees when sleeping on your side.
• Do not pick up objects from the floor or bend at your waist more than 90 degrees.
• Avoid sitting on low chairs.
• Avoid extreme bending or twisting.
• You will need to follow your hip precautions for about six weeks after your surgery.

When can I go back to work after a hip replacement?

Your care team will help you decide when you can return to work. On average, most patients return to work in about six weeks. But if you sit most of the time at a desk, you may be able to return to your job in two to four weeks. If you have a more physical job, you may need to take off more than six weeks, maybe as long as three months.

When can I start driving after a hip replacement?

Most patients can return to driving after their first follow-up visit and after discontinuing all pain medications. This timing is different for every patient. While you should plan to have a ride to your first follow-up visit with your surgical team, some physical therapy centers offer rides to and from appointments.

When can I have sex after a hip replacement?

Having sex a few weeks after a total hip replacement is fine if you follow your hip precautions. This may require a little creativity. For example, if your incision is on the back of your hip, you should avoid positions that require bringing your knee to your chest. If your incision is on the front of your hip, you should avoid positions that involve rotating your leg out to the side. Your team will provide you with guidelines on positions to avoid during your recovery.

What is the typical hip replacement recovery time?

Recovery after a hip replacement varies from person to person. Your recovery will depend on several factors, including:

• Your activity level and strength leading up to your surgery (This is the most important factor.)
• Your participation in physical therapy and independent activity once you return home (A close second!)

Your age and overall health may also play a role. In general, most people can return to their usual activities around the house about two weeks after surgery. Full recovery and completion of physical therapy may take two to three months. For some, recovery may take even longer.

Does a replaced hip feel like a natural hip?

As surgeons, our goal is for you to forget that you ever had your hip replaced. Some stiffness, particularly during the first year after surgery, is common, but this should improve with time. Once you have recovered, your replaced hip will feel a lot like a natural hip.

Eventually, you should be able to move your new hip without the hip pain you had before your surgery.

What can I do to recover faster from a hip replacement surgery?

To help speed up your recovery, try these steps:

• Take short walks, which help prevent blood clots after surgery. Be sure to take your walker, cane or crutches during early recovery to prevent falls. Even moving around the house frequently is important.
• Do your PT exercises every day, as recommended.
• Do not smoke or drink alcohol, which can slow down the healing process.
• Eat a healthy diet with plenty of protein, calcium and vitamin D.
• Get enough rest and sleep.
• Keep your follow-up appointments with your orthopedic surgeon, and stay in touch with your primary care doctor.

Regular communication with your surgical team, such as through the MyChart patient portal, will allow us to help you reach your goals faster.