Hip replacement is a surgical procedure where a surgeon removes a damaged hip joint and replaces it with an artificial one

The surgery typically takes one to two hours. A surgeon makes an incision near your hip, removes the ball-and-socket joint that has worn down or broken, and inserts a prosthetic joint made of metal, ceramic, or plastic. Most people stay in the hospital for one to three days after the procedure, though some facilities now perform outpatient hip replacements where you go home the same day.

The goal is to reduce pain and restore movement. People usually pursue hip replacement when arthritis, injury, or other damage makes walking, climbing stairs, or sleeping difficult despite other treatments like physical therapy or medication. Your doctor will typically recommend it only after other options have not worked well enough.

Key Takeaways

  • Hip replacement surgery removes a damaged joint and replaces it with an artificial one, usually taking one to two hours with a hospital stay of one to three days.
  • Recovery typically involves physical therapy starting within days of surgery, with most people walking with information when ready and returning to normal activities within three to six months.
  • The artificial joint usually lasts 15 to 20 years, though this varies based on your age, activity level, and the materials used.
  • Complications are uncommon but can include infection, blood clots, or hip dislocation, which is why following post-surgery instructions matters.
  • Insurance coverage varies widely—Medicare covers hip replacement, but private insurance and out-of-pocket costs depend on your plan and provider.

Why people need hip replacement and when doctors recommend it

Hip replacement becomes necessary when the cartilage inside your hip joint wears away or the joint is damaged by injury or disease. Osteoarthritis is the most common reason—the smooth cartilage that lets bones glide against each other gradually breaks down, causing pain and stiffness. Rheumatoid arthritis, avascular necrosis (where bone dies from lack of blood supply), and hip fractures are other reasons people need the surgery.

Doctors typically recommend hip replacement only after other treatments have been tried for several months. These might include physical therapy, anti-inflammatory medications, corticosteroid injections, or activity changes. If pain still prevents you from walking, sleeping, or doing daily tasks, and imaging shows significant joint damage, your doctor may suggest surgery as the next step.

What happens before surgery: preparation and testing

Before your surgery date, your doctor will order blood tests, an EKG (heart rhythm test), and possibly imaging to confirm the damage and plan the procedure. You will meet with an anesthesiologist who will review your medical history and any medications you take. Tell them about all supplements, blood thinners, and over-the-counter drugs—some need to be stopped before surgery.

In the week before surgery, you may be asked to stop eating and drinking after midnight the night before. Your surgeon will give you specific instructions about which medications to take or skip that morning. Arrange for someone to drive you home and help you for the first few days, since you will not be able to drive or live alone when ready after.

Some hospitals offer pre-surgery classes where you learn what to expect, see the operating room, and practice using crutches or a walker. Attending these classes, if offered, reduces anxiety and helps you prepare your home—removing tripping hazards, setting up a bedroom on the ground floor if possible, and placing frequently used items at waist height.

The surgery itself and the first days after

On surgery day, you will receive anesthesia (usually general anesthesia, though some surgeons use regional anesthesia that numbs only your lower body). The surgeon makes an incision, typically four to six inches long, removes the damaged joint surfaces, and cements or presses the new prosthetic joint into place. The incision is closed with stitches or staples.

You will wake in a recovery room where nurses monitor your heart rate, blood pressure, and oxygen level. Pain medication is given through an IV or as a pill. Most people stay overnight or for a few days. During this time, a physical therapist will have you sit up, stand with help, and take a few steps—movement begins when ready to prevent blood clots and stiffness.

Before leaving the hospital, you will receive instructions on wound care, pain management, and when to call your surgeon. You will likely go home with crutches or a walker, compression stockings to prevent blood clots, and a list of movements to avoid (such as crossing your legs or bending your hip more than 90 degrees) while the joint heals.

Recovery and physical therapy after hip replacement

Recovery happens in stages. The first two weeks focus on protecting the incision and preventing complications. You will keep the wound clean and dry, take antibiotics if prescribed, and wear compression stockings. Pain and swelling are normal and usually peak around day three to five before gradually improving.

Physical therapy typically starts within days of surgery, either in the hospital or at home with a therapist visiting you. Early exercises are gentle—ankle pumps, quadriceps tightening, and short walks with a walker or crutches. By week three to four, you usually progress to walking without aids, climbing stairs with a rail, and gentle range-of-motion exercises.

Most people return to light activities like driving and desk work within four to six weeks. Returning to higher-impact activities like running or playing sports takes longer—usually three to six months—and your surgeon will tell you when it is safe. Full recovery, where swelling is gone and strength is restored, typically takes six to twelve months.

How long the artificial joint lasts and when revision surgery might be needed

Modern hip replacements usually last 15 to 20 years, though this varies. Younger, more active people may wear out their prosthetic joint faster. Older, less active people may have their replacement last 20 years or longer. The materials matter too—ceramic-on-ceramic joints often last longer than metal-on-plastic, but they cost more.

If your artificial joint loosens, wears out, or becomes infected years later, you may need revision surgery to replace it. This is a more complex procedure than the first surgery because the surgeon must remove the old prosthetic and any bone that has deteriorated. Recovery from revision surgery is also longer. Staying active but not overloading your joint—avoiding high-impact sports and maintaining a healthy weight—helps extend the life of your replacement.

Possible complications and how they are managed

Serious complications are uncommon, occurring in fewer than 5 percent of hip replacements, but they can happen. Infection is one of the most serious and may require antibiotics or, rarely, another surgery to clean the joint. Blood clots can form in your legs after surgery, which is why compression stockings and early movement are important; signs include calf swelling or warmth.

Hip dislocation—where the artificial ball slips out of the socket—can occur if you move your hip beyond its limits during the first few weeks. This is why surgeons give you specific precautions, such as not crossing your legs or bending your hip past 90 degrees. If dislocation happens, you will need to return to the hospital for the joint to be repositioned.

Nerve or blood vessel injury during surgery is rare but possible. Leg length differences, where one leg feels slightly longer or shorter than before, occur in a small number of cases. Persistent pain or stiffness can happen if scar tissue forms or if the joint was not positioned perfectly, though this is uncommon with modern surgical techniques.

Cost and insurance coverage for hip replacement

Hip replacement is one of the most common surgeries in the United States, and costs vary widely by location, hospital, and surgeon. The total cost—including surgeon fees, hospital charges, anesthesia, and physical therapy—typically ranges from $30,000 to $70,000 before insurance, though this varies significantly by region and facility.

Medicare covers hip replacement for people 65 and older, though you will pay a deductible and coinsurance. Private insurance coverage depends on your specific plan; most cover hip replacement when medically necessary, but you may have a deductible, copay, or coinsurance. Some insurance companies require pre-authorization before surgery, meaning your surgeon must submit documentation proving the surgery is medically necessary.

If you do not have insurance or your insurance does not cover the full cost, ask your surgeon's office about payment plans or financial information programs. Some hospitals offer reduced rates for uninsured patients or have charity care programs. Getting a cost estimate from your hospital before surgery helps you plan and understand what you will owe.

Frequently Asked Questions

How long does hip replacement surgery take?

The surgery itself typically takes one to two hours. Add another hour or two for anesthesia preparation and recovery room time. The total time from when you arrive until you are moved to a hospital room is usually three to four hours.

Can I drive after hip replacement?

Most people cannot drive for four to six weeks after surgery. You need to be off narcotic pain medication, have enough hip mobility and strength to operate the pedals safely, and be able to react quickly in an emergency. Your surgeon will tell you when it is safe to resume driving.

Will I set off metal detectors after hip replacement?

Yes, most artificial hip joints contain metal and will trigger airport metal detectors and some other security scanners. You will receive a card from your surgeon stating you have a prosthetic joint. Show this card at security, and they will typically pat you down instead of using the metal detector.

What activities should I avoid after hip replacement?

Avoid high-impact activities like running, jumping, and contact sports indefinitely—these can wear out or damage your artificial joint. Most surgeons recommend low-impact activities like walking, swimming, cycling, and golf. Ask your surgeon specifically about activities you enjoy, as recommendations vary based on your age and the type of prosthetic you received.

What if I fall after hip replacement?

Falls are a concern because they can dislocate or damage your new joint. If you fall, try not to move the hip and call for help. Go to the emergency room for evaluation even if you do not feel severe pain—imaging can show whether the joint is still properly positioned. This is why preventing falls through home safety and physical therapy is so important during recovery.