The surgery itself usually lasts one to two hours

Hip replacement surgery typically takes between 60 and 120 minutes from the moment you go under anesthesia until the surgeon closes the incision. The exact time depends on whether you're having a standard replacement or a revision (replacing an implant that's already in place), your anatomy, and how smoothly the procedure goes. Revisions often run longer because the surgeon has to remove the old implant first.

The surgeon makes an incision, removes the damaged bone and cartilage, and positions the new hip socket and femoral stem. If your implant is cemented in place, that adds a few minutes while the cement sets. If it's press-fit (designed to bond directly to your bone), the procedure moves a bit faster.

Key Takeaways

  • The actual surgery lasts one to two hours, but you'll be at the hospital or surgical center for four to six hours total because of preparation and recovery time.
  • Your surgeon will tell you the expected length during your pre-op visit, and anesthesia staff will give you a more precise estimate on surgery day based on your specific case.
  • Revision surgery (replacing an existing implant) usually takes longer than a first-time replacement because the old hardware must be removed first.
  • Most people go home the same day or stay overnight, depending on your age, overall health, and the surgical approach your surgeon used.

What happens before and after the surgery time

You'll arrive at the surgical facility 60 to 90 minutes before your scheduled surgery time. During this window, staff check your vital signs, review your medical history, insert an IV line, and confirm which hip is being replaced (a safety step called site marking). An anesthesiologist or nurse anesthetist talks with you about pain management and sedation options.

After surgery ends, you move to a recovery room where nursing staff monitor your vital signs, pain level, and how you're waking up from anesthesia. This phase typically lasts one to two hours. You'll receive pain medication and may have ice packs on your hip. Once you're alert enough and your vital signs are stable, you either go home (if it's outpatient surgery) or move to a hospital room for overnight observation.

Why the total time at the facility is longer than surgery time

The 60 to 120 minutes of actual surgery is only part of your day. From the moment you check in until you leave, plan on four to six hours at the surgical center or hospital. This includes prep time, the surgery itself, and recovery room time before discharge or transfer to a room.

If you're staying overnight, you'll spend additional time in your hospital room where physical therapists may begin gentle movement exercises and nurses help you manage pain and monitor for complications like blood clots or infection. Most people who stay overnight go home the next morning or afternoon.

Factors that can make surgery take longer

Certain conditions or circumstances can extend the surgical time. If you have severe arthritis, bone loss, or unusual hip anatomy, the surgeon may need extra time to prepare the bone surface or position the implant correctly. Patients who are significantly overweight may require a longer incision and more time to access the hip joint.

If you've had previous hip surgery on the same side, scar tissue can make the procedure take longer. Complications discovered during surgery—such as unexpected bone fractures or damage to surrounding tissue—also extend the time in the operating room. Your surgeon will discuss any factors that might affect your specific timeline during your pre-operative appointment.

Different surgical approaches and their timing

Your surgeon may use one of several approaches to reach your hip: anterior (through the front), posterior (through the back), or lateral (through the side). The anterior approach sometimes takes slightly longer because it requires working between muscle groups rather than through them, but the difference is usually only 10 to 15 minutes. Some surgeons use minimally invasive techniques with smaller incisions, which can reduce overall time slightly but requires specialized training.

Robotic-assisted surgery is becoming more common and can add 15 to 30 minutes to the procedure because the surgeon uses imaging and computer guidance to position the implant with high precision. Your surgeon will explain which approach they recommend and why during your consultation.

What to expect on the day of surgery

Arrive at the facility at the time your surgical team gave you—usually two hours before your scheduled surgery. Wear loose, comfortable clothing and leave jewelry, watches, and valuables at home. You'll change into a surgical gown, and staff will place compression stockings on your legs to prevent blood clots during and after surgery.

Your surgeon and anesthesiologist will visit you before you go to the operating room to answer last-minute questions. Once in the operating room, you'll be positioned on the surgical table, monitors are attached, and anesthesia is administered. You won't remember anything after that until you wake in recovery.

Recovery timeline after you leave the surgical facility

The first two weeks at home focus on pain management, keeping your hip stable, and beginning gentle movement. You'll use crutches or a walker and ice your hip regularly. Most people can put weight on the leg within a few days, though your surgeon will give you specific instructions based on your implant type.

Physical therapy usually starts within a few days of surgery, either at home or at an outpatient clinic. Full recovery—when you can return to normal activities without restrictions—typically takes three to six months. Some people feel significantly better by six weeks, while others need the full six months to regain strength and confidence.

Frequently Asked Questions

Can my surgeon tell me exactly how long my surgery will take?

Your surgeon can give you a realistic estimate based on your specific situation, usually during your pre-operative visit. On surgery day, the anesthesia team may refine that estimate. However, the exact time won't be known until the surgeon is in the operating room and can see your anatomy firsthand.

Will I be asleep the whole time?

Yes. You receive general anesthesia or regional anesthesia (numbing your lower body while you sleep), so you won't feel pain or be aware of time passing during the surgery. You'll wake in the recovery room after the procedure is complete.

What if my surgery takes longer than expected?

Your surgical team will contact your family if the procedure takes significantly longer than planned. This can happen if unexpected bone damage is found or if your anatomy requires extra time to work with safely. Longer surgery doesn't automatically mean something went wrong—sometimes it means your surgeon is taking extra care to get the implant positioned perfectly.

Do I have to stay overnight after hip replacement?

Many hip replacements are now done as outpatient surgery, meaning you go home the same day. However, your surgeon may recommend an overnight stay if you're older, have other health conditions, live alone, or had complications during surgery. Your surgical team will discuss this option with you before surgery.

How soon after surgery can I start physical therapy?

Physical therapy often begins the day of surgery or the next morning, starting with gentle range-of-motion exercises in bed. More active therapy begins within a few days. Your surgeon and physical therapist will create a schedule based on your recovery and pain level.