The surgery itself usually takes 60 to 90 minutes
A total hip replacement surgery typically lasts between one and one and a half hours once you are in the operating room. The surgeon removes the damaged hip joint and replaces it with an artificial one made of metal, ceramic, or plastic. The exact time depends on your anatomy, the surgeon's experience, whether complications arise during the procedure, and which surgical approach your surgeon uses.
The time you spend in the hospital or surgical center is much longer than the surgery itself. You will arrive early for pre-operative checks, spend time in recovery after anesthesia wears off, and stay for observation. Plan to be at the facility for four to six hours total, even if the surgery takes only 90 minutes.
Key Takeaways
- The actual surgical procedure takes 60 to 90 minutes, but you will be at the hospital or surgery center for four to six hours total.
- Pre-operative preparation—bloodwork, X-rays, anesthesia consultation—can add one to two hours before surgery begins.
- Recovery from anesthesia takes 30 to 60 minutes, and you will be monitored in a recovery room before discharge or hospital admission.
- Hospital stay after surgery ranges from same-day discharge to two to three days, depending on your health and your surgeon's protocol.
- Full recovery from hip replacement takes three to six months, though you will begin physical therapy within days of surgery.
What happens before the surgeon starts
You will arrive at the hospital or surgical center 60 to 90 minutes before your scheduled surgery time. During this period, nursing staff will check your vital signs, review your medical history, insert an IV line, and confirm that all pre-operative tests (bloodwork, X-rays, EKG) are complete and on file. An anesthesiologist will meet with you to discuss pain management and any concerns about anesthesia.
You will change into a surgical gown and may receive a sedative to help you relax. The surgical team will mark the surgical site and answer any last-minute questions. Once you are moved to the operating room, the anesthesiologist will administer anesthesia—usually general anesthesia, regional anesthesia, or a combination—which takes 10 to 15 minutes to take full effect before the surgeon begins.
The three main steps of the surgery
Once you are fully anesthetized, the surgeon makes an incision, typically four to six inches long, to access the hip joint. The location and size of the incision depend on the surgical approach—anterior (front), posterior (back), or lateral (side)—which your surgeon will have discussed with you beforehand. Exposure and preparation of the joint takes 15 to 20 minutes.
The surgeon then removes the damaged cartilage and bone from the femoral head and acetabulum (hip socket) and prepares the bone surfaces to receive the artificial implants. This step takes 20 to 30 minutes. Finally, the surgeon inserts the new hip components—the acetabular cup, femoral stem, and ball—and tests the joint for stability and proper alignment. Closing the incision with sutures or staples takes 10 to 15 minutes.
Recovery room time and discharge
After surgery ends, you move to the recovery room while anesthesia wears off. This phase typically takes 30 to 60 minutes. Nursing staff will monitor your heart rate, blood pressure, oxygen level, and pain. You may feel groggy, cold, or nauseated—all normal responses to anesthesia. Pain medication is given as needed.
If you are having same-day discharge, you will be moved to a discharge area once you are alert, can drink fluids without nausea, and can move your leg slightly. A nurse will review your discharge instructions, medications, and activity restrictions. You must have a responsible adult drive you home; you cannot drive yourself because anesthesia impairs judgment and reaction time for at least 24 hours.
Hospital admission and overnight stay
Some patients stay overnight or for two to three days after surgery. Your surgeon may recommend admission if you have other health conditions, live alone, or need extra monitoring. During a hospital stay, physical therapists will begin working with you within hours of surgery—usually the same day—to help you move your leg, sit up, and eventually stand and walk with information.
Nurses will manage your pain with medication, monitor your incision for signs of infection, and help you with basic activities like using the bathroom and eating. Blood clot prevention is a priority; you may wear compression stockings or receive injections to reduce clot risk. Most patients are discharged when they can walk safely with a walker or crutches, manage stairs if needed, and understand their home care routine.
Timeline from surgery to going home
| Stage | Duration | What Happens |
|---|---|---|
| Pre-operative preparation | 60–90 minutes | Vital signs, IV insertion, anesthesia setup |
| Anesthesia administration | 10–15 minutes | Anesthesiologist prepares you for surgery |
| Surgical procedure | 60–90 minutes | Surgeon removes damaged joint and inserts implants |
| Recovery room | 30–60 minutes | Anesthesia wears off; vital signs monitored |
| Discharge or admission | 1–2 hours | Final checks, instructions, transport home or to hospital room |
What affects how long surgery takes
Several factors can make your surgery shorter or longer than the typical 60 to 90 minutes. If you have a straightforward hip anatomy with no previous hip surgery, your procedure may be on the faster end. If you have bone loss, arthritis affecting multiple areas, or scar tissue from a prior surgery, the surgeon may need extra time to prepare the bone surfaces and position implants correctly.
Your surgeon's experience and the surgical approach also matter. Minimally invasive techniques sometimes take longer initially but may reduce recovery time overall. Complications discovered during surgery—such as unexpected bone quality issues or the need to adjust implant positioning—can add 15 to 30 minutes. Your age, weight, and overall health do not directly lengthen surgery time, but they may affect how quickly you recover afterward and whether you stay overnight.
Frequently Asked Questions
Can I eat or drink before surgery?
No. You will receive fasting instructions—typically no food after midnight and no clear liquids after two hours before surgery. Eating or drinking increases the risk of aspiration (food entering your lungs) during anesthesia. Your surgical team will confirm your fasting status during pre-operative checks.
Will I be awake during the surgery?
Most total hip replacements use general anesthesia, so you will be unconscious throughout. Some surgeons offer regional anesthesia (spinal or epidural), which numbs you from the waist down while you remain awake or lightly sedated. Discuss your preference with your anesthesiologist before surgery.
How long until I can walk after surgery?
Physical therapists typically begin working with you the same day as surgery or the next morning. You may stand and take a few steps with a walker or crutches within 24 hours. Full weight-bearing and walking without assistive devices usually takes four to six weeks, depending on your progress and your surgeon's protocol.
What if something goes wrong during surgery?
Serious complications during hip replacement are uncommon, but your surgical team is trained to handle unexpected findings. If a problem arises—such as bone fracture or implant fit issues—the surgeon will address it during the procedure, which may extend surgery time. Your surgeon will discuss any changes with you after you wake up.
When can I go home after surgery?
Same-day discharge is common and safe for many patients; you go home four to six hours after surgery. Others stay one to three nights in the hospital. Your surgeon will decide based on your age, health, living situation, and how well you are moving and managing pain. Either way, you will need a responsible adult to stay with you for at least the first 24 hours.