A full hip replacement removes your damaged hip joint and replaces it with artificial parts
A total hip replacement (also called total hip arthroplasty) is surgery to remove the ball-and-socket joint at your hip and replace it with man-made components. The surgeon removes the femoral head—the ball at the top of your thighbone—and replaces it with a metal or ceramic ball attached to a metal stem that goes down inside your thighbone. The socket (acetabulum) is reamed out and fitted with a new cup, usually made of metal with a plastic, ceramic, or metal liner inside.
The surgery takes about one to two hours. You receive general anesthesia or spinal anesthesia so you are asleep or numb during the procedure. Most people stay in the hospital for one to three days afterward, though some go home the same day depending on their age, overall health, and how well they recover when ready after surgery.
Key Takeaways
- A full hip replacement removes the damaged ball-and-socket joint and replaces both the femoral head and the hip socket with artificial components.
- The surgery typically lasts one to two hours and requires general or spinal anesthesia.
- Recovery in the hospital is usually one to three days, followed by several weeks of physical therapy at home or in an outpatient clinic.
- Most people can return to light activities within four to six weeks and resume normal activities within three to six months.
- Artificial hip joints typically last 15 to 20 years, though this varies based on your age, activity level, and the materials used.
Why surgeons recommend a full hip replacement
Your doctor may recommend hip replacement when arthritis, injury, or other damage makes your hip joint painful and stiff enough to limit daily life. Osteoarthritis is the most common reason—the cartilage that cushions your hip joint wears away over time, causing bone-on-bone friction. Rheumatoid arthritis, avascular necrosis (death of bone tissue), hip fractures, and failed previous hip surgeries are other reasons.
Before recommending surgery, your surgeon will usually try non-surgical options first: physical therapy, weight management, anti-inflammatory medications, and injections. If those do not reduce pain enough to let you walk, climb stairs, or sleep without waking, your doctor may discuss replacement as an option.
What the surgeon does step by step
The surgeon makes an incision over your hip, usually four to six inches long, though the exact location depends on the surgical approach your doctor chooses. There are three main approaches: anterior (front of the hip), lateral (side of the hip), and posterior (back of the hip). Each has trade-offs in terms of which muscles are cut, how quickly you recover, and the risk of dislocation afterward.
Once the incision is open, the surgeon removes the damaged femoral head by cutting it off the thighbone. The socket is then reamed out—enlarged and shaped to fit the new cup. The surgeon inserts the new cup into the socket and secures it, usually with screws or a press fit (where the cup is forced in tightly enough to stay without fasteners). A liner is placed inside the cup to create a smooth surface.
Next, the surgeon prepares the inside of your thighbone by reaming it out to fit the new stem. The stem is inserted and secured, and the new ball is attached to the top of the stem. The surgeon tests the hip to make sure it moves smoothly and is stable, then closes the incision with stitches or staples.
Hospital stay and when ready recovery
You will wake up in a recovery room where nurses monitor your vital signs and pain level. Your leg may be in a continuous passive motion (CPM) machine, which slowly moves your hip and knee to prevent stiffness. You will receive pain medication and blood thinners to prevent clots.
Physical therapists will visit you in the hospital, usually the day after surgery, to teach you how to walk with a walker or crutches and how to move safely without dislocating your new hip. You will learn which positions to avoid—usually crossing your legs, bending your hip more than 90 degrees, or rotating your leg inward. A nurse will help you get in and out of bed, use the toilet, and bathe.
Most people go home after one to three days. Before you leave, your surgical team will give you written instructions on wound care, activity limits, medications, and warning signs (fever, increased swelling, drainage from the incision, or chest pain) that mean you should call your doctor.
Physical therapy and the first weeks at home
Physical therapy is the most important part of recovery. You will do exercises at home and attend outpatient therapy sessions two to three times per week for four to six weeks. Early exercises focus on preventing blood clots, reducing swelling, and restoring basic movement: ankle pumps, quad sets (tightening your thigh muscle), glute sets, and short walks with your walker or crutches.
As weeks pass, your therapist will add exercises to strengthen your hip, improve your balance, and increase how far you can walk. You will practice stairs, getting in and out of a car, and other movements you need for daily life. Pain and swelling usually peak around two to three weeks after surgery, then gradually improve.
Most people stop using a walker or crutches within two to four weeks and can walk without aids by six to eight weeks. Returning to driving depends on which leg was operated on and your pain level—usually four to six weeks for the non-operated leg, longer for the operated leg.
Long-term recovery and activity
Full recovery takes three to six months. By then, most people can return to normal daily activities: walking, climbing stairs, light housework, and work that does not involve heavy lifting or standing all day. You can swim, walk, golf, and do other low-impact activities.
High-impact activities—running, jumping, contact sports—are generally not recommended because they can loosen the artificial joint faster. Your surgeon will give you specific guidance based on your age, the type of implant, and your overall health.
Artificial hip joints have a lifespan. Most last 15 to 20 years, though some last longer and some wear out sooner depending on how active you are, your weight, and the materials used. If your implant loosens or wears out, you may need revision surgery to replace it.
Risks and complications
Hip replacement is generally safe, but like any surgery it carries risks. Blood clots in the legs (deep vein thrombosis) are the most common complication, which is why you receive blood thinners and compression stockings. Infection is rare but serious. Dislocation—where the ball slips out of the socket—can happen if you move your hip in certain ways during the first weeks, which is why your therapist teaches you safe movement patterns.
Nerve or blood vessel injury, excessive bleeding, and anesthesia reactions are uncommon. Some people experience leg length differences if the new hip is slightly longer or shorter than the old one, though surgeons try to match the original length. Persistent pain or stiffness can occur but usually improves with continued therapy.
Your surgeon will discuss your individual risk factors before surgery and explain how to reduce them.
Frequently Asked Questions
How long does a hip replacement last?
Most artificial hips last 15 to 20 years. Younger, more active people may wear out their implant sooner; older, less active people may have theirs last longer. If your implant loosens or wears out, revision surgery can replace it, though this is more complex than the first surgery.
Can I bend my hip normally after replacement?
Yes, but not when ready. For the first six weeks, you must avoid bending your hip more than 90 degrees to prevent dislocation. After that, most people regain normal hip motion. Your physical therapist will guide you on when it is safe to increase your range of motion.
Will I need a walker or crutches forever?
No. Most people use a walker or crutches for two to four weeks, then transition to a cane for another few weeks if needed. By six to eight weeks, most people walk without any aids. The timeline depends on your age, strength, and how well you progress in therapy.
What activities should I avoid after hip replacement?
Avoid high-impact activities like running and jumping, which can loosen the implant faster. You can walk, swim, golf, and do low-impact exercise. Your surgeon will give you specific restrictions based on your implant type and overall health.
Can I fly after hip replacement?
Most surgeons clear you to fly four to six weeks after surgery, once you can walk without aids and swelling has decreased. Long flights increase the risk of blood clots, so ask your doctor about compression stockings and whether you need blood thinners during travel.