Hip Replacement Surgery: What to Expect Before, During, and After

Total hip arthroplasty replaces a damaged hip joint with prosthetic components. Here's the typical patient journey from preparation through full recovery.

Setting

• Performed in a hospital operating room (increasingly in outpatient/ambulatory surgery centers for healthy, selected patients).
• Team: orthopedic surgeon, anesthesiologist, surgical nurses, physician assistant.

Procedure (1–2 Hours)

1. Anesthesia: Spinal/epidural with sedation, or general anesthesia.
2. Surgical approach: Posterior, anterior, lateral, or superior (surgeon preference and patient factors).
3. Damaged femoral head removed; acetabulum (socket) reamed.
4. Prosthetic socket (cup) placed in pelvis; liner inserted.
5. Femoral stem inserted into thigh bone; ceramic or metal ball attached.
6. Components: metal, ceramic, or polyethylene; fixed with cement or press-fit (bone ingrowth).
7. Incision closed; drain sometimes placed temporarily.

Hospital Stay

• Traditional: 2–4 days.
• Enhanced Recovery After Surgery (ERAS): Same-day or 1-night discharge for selected patients.

Recovery Timeline

• Days 1–3: Pain control, anticoagulation, physical therapy starts (bed exercises, standing, walking with walker).
• Weeks 1–3: Walker → cane; home exercise program; wound care; hip precautions (no crossing legs, bending >90°, internal rotation).
• Weeks 4–6: Cane weaning; light activities; driving if off opioids and adequate control.
• Months 3–6: Progressive strengthening; most daily activities resumed; high-impact sports discouraged.
• Year 1: Full recovery; modern bearing surfaces last 15–20+ years.

Key Success Factors

• Pre-operative optimization (weight management, smoking cessation, diabetes control, "prehab" exercises)
• Adherence to hip precautions and physical therapy protocol
• Long-term follow-up for wear and loosening surveillance