The surgery itself usually lasts one to two hours

A hip replacement surgery typically takes between 60 and 120 minutes from the moment you enter the operating room until the surgeon closes the incision. The exact time depends on whether you are having a traditional open surgery or a minimally invasive approach, your anatomy, and whether any complications arise during the procedure. Most surgeons plan for about 90 minutes as a standard timeline.

The actual time the surgeon spends working on your hip is only part of the story. Before the surgery begins, you will spend time in pre-op where staff will verify your identity, confirm your medical history, start an IV line, and administer anesthesia. This preparation phase typically takes 30 to 45 minutes. After the surgeon finishes, the surgical team will move you to the recovery room, where you will wake up from anesthesia under close monitoring — this usually takes another 30 to 60 minutes.

Key Takeaways

  • The actual surgical procedure takes one to two hours, but plan to be at the hospital or surgery center for four to six hours total when you include pre-op and recovery time.
  • Minimally invasive hip replacement may take slightly longer than traditional open surgery because the surgeon works through smaller incisions, though recovery afterward is often faster.
  • Your total time in the operating room and recovery area depends on your age, overall health, bone quality, and whether the surgeon encounters unexpected findings.
  • You will not be able to drive or make important decisions for at least 24 hours after surgery because of the anesthesia, so arrange transportation in advance.

What happens during the first hour in the operating room

Once you are under anesthesia, the surgeon begins by positioning your leg and preparing the surgical site. For a traditional open hip replacement, the surgeon makes an incision (usually four to six inches long) to access the hip joint. Removing the damaged bone and cartilage takes time because the surgeon must work carefully to preserve healthy bone and may support proper alignment. This preparation and removal phase typically accounts for 20 to 30 minutes of the total surgery time.

Next, the surgeon inserts the new hip components — the socket (acetabular cup) and the ball and stem (femoral component). Positioning these parts correctly is critical for your long-term outcome, so the surgeon may take time to check alignment and test the fit. Installing the components and confirming they are stable usually takes another 20 to 30 minutes. The surgeon then closes the muscles and tissues layer by layer, which adds another 15 to 20 minutes.

How minimally invasive surgery changes the timeline

A minimally invasive hip replacement uses one or two smaller incisions (usually two to three inches) instead of one larger one. Because the surgeon has less direct visibility through a smaller opening, the procedure may actually take 10 to 20 minutes longer than traditional open surgery — sometimes stretching to two hours or slightly beyond. However, the smaller incisions mean less muscle damage, which often leads to faster recovery and less pain after surgery.

Not all patients are candidates for minimally invasive surgery. Your surgeon will consider your body size, bone quality, and the severity of your hip damage when deciding which approach is best for you. If you have severe arthritis, previous hip surgery, or certain anatomical variations, traditional open surgery may be safer and more predictable in timing.

Total time from arrival to discharge

Plan to spend four to six hours at the hospital or surgery center on the day of your procedure. You will arrive one to two hours before your scheduled surgery time for check-in and pre-operative preparation. The surgery itself takes one to two hours. Recovery from anesthesia in the post-op area takes another 30 to 60 minutes, during which nurses will monitor your vital signs, manage pain, and begin helping you move your leg gently.

Before you leave, the surgical team will confirm you can urinate, keep food down if you have eaten, and move your leg without severe pain. You will receive written instructions for wound care, medication, and activity restrictions. A nurse will review these with you before discharge. If you had general anesthesia, you must have someone drive you home — you cannot drive yourself for at least 24 hours.

Recovery timeline in the days and weeks after surgery

The first two weeks after surgery are the most intensive. You will likely spend the first night in the hospital (or go home the same day if you had outpatient surgery, depending on your surgeon's protocol and your overall health). During this time, physical therapists will begin working with you to regain movement and strength. Most people can walk with a walker or crutches within a few days.

By four to six weeks, many people can walk without assistive devices and resume light activities like sitting at a desk or short car rides. Full recovery — meaning return to normal activities, exercise, and sports — typically takes three to six months. Some people continue to see improvement in strength and range of motion for up to a year after surgery. Your surgeon and physical therapist will give you a specific timeline based on your progress.

Factors that can make surgery take longer

Several things can extend the time you spend in the operating room. If you have severe arthritis, extra bone growth, or scar tissue from a previous hip surgery, the surgeon may need more time to remove damaged tissue and prepare the bone. Patients with very dense bone or unusual hip anatomy may also require additional surgical time. Obesity can make positioning and access more challenging, potentially adding 15 to 30 minutes.

Unexpected bleeding, difficulty fitting components, or the need to adjust your implant position can also extend surgery time. Your surgeon will communicate with your family if the procedure is taking longer than expected. These delays are usually not a cause for concern — they reflect the surgeon taking the time needed to do the job correctly rather than rushing to meet a preset timeline.

What to expect if complications arise during surgery

Serious complications during hip replacement surgery are uncommon, but they can happen. If the surgeon discovers a fracture in your femur (thighbone) that was not visible on pre-operative imaging, they may need to use additional fixation devices, adding 20 to 40 minutes. If there is unexpected bleeding that requires careful management, surgery time will extend. In rare cases, the surgeon may need to switch from a minimally invasive approach to an open approach for safety, which also adds time.

Your surgical team is trained to handle these situations, and taking extra time to manage a complication correctly is always the right choice. Your surgeon will explain what happened and how it affects your recovery plan before you leave the hospital.

Frequently Asked Questions

Can I eat or drink before my hip replacement surgery?

No. You will receive fasting instructions from your surgeon's office, typically asking you to stop eating solid food six to eight hours before surgery and stop drinking clear liquids two hours before. Eating or drinking before surgery increases the risk of vomiting while under anesthesia, which can be dangerous. Follow these instructions exactly, even if you are hungry or thirsty.

Will I be awake during the surgery?

Most hip replacements use general anesthesia, meaning you will be completely asleep and unaware during the procedure. Some surgeons offer regional anesthesia (numbing from the waist down) combined with sedation, which keeps you unconscious but may allow faster recovery. Your anesthesiologist will discuss which option is safest for you based on your medical history.

How long will I need pain medication after surgery?

Most people need prescription pain medication for the first two to four weeks after surgery. As swelling decreases and you become more active, you can usually transition to over-the-counter pain relievers like acetaminophen or ibuprofen. Some people need pain medication longer if they have a slower recovery or higher pain sensitivity. Your surgeon will adjust your medication plan based on your progress.

What if my surgery gets cancelled or postponed?

If your surgery is cancelled on the day of the procedure — due to a medical issue, an emergency that takes priority, or a scheduling conflict — your surgeon's office will reschedule you for the next available date. This can be frustrating, but cancellations usually happen because something was discovered during pre-op that makes surgery unsafe at that moment. You will not lose your place in the surgical schedule.

Can I watch a video of my hip replacement surgery?

Some surgeons record their procedures and can show you a recording afterward if you request it. This can help you understand what was done and why. Ask your surgeon before surgery whether this is something they offer. Watching the video is optional and not necessary for your recovery — it is purely educational if you are interested.