The first 24 hours: what happens in the hospital
You will wake up in the recovery room with your new hip in a protective position. A nurse will check your vital signs, pain level, and the surgical site every few hours. You will have a catheter (a tube that drains urine), an IV line for fluids and medication, and possibly a drain near the incision to prevent fluid buildup. All of these are temporary and will be removed within the first day or two.
Pain is normal and expected. The surgical team will offer pain medication on a schedule, not just when you ask—this keeps pain from building up and makes movement easier. You may feel groggy from anesthesia for several hours. A physical therapist will visit your bed the same day or the next morning to help you sit up, stand, and take a few steps with a walker. This early movement prevents blood clots and stiffness, even though it feels uncomfortable.
Most people go home after one or two nights in the hospital. Before discharge, a nurse will show you how to use crutches or a walker, how to get in and out of bed safely, and what activities to avoid. You will receive written instructions about wound care, medication timing, and warning signs that mean you should call your surgeon.
Key Takeaways
- Pain, swelling, and stiffness are normal for the first 6 to 12 weeks and do not mean something went wrong.
- Physical therapy starts in the hospital and continues at home or an outpatient clinic for 6 to 12 weeks; skipping sessions slows your recovery.
- You will need crutches or a walker for 2 to 6 weeks depending on your strength and your surgeon's protocol.
- Driving, returning to work, and resuming hobbies happen on different timelines—ask your surgeon for specific clearance before each activity.
- Blood clots, infection, and dislocation are rare but serious; know the warning signs and call your surgeon when ready if they occur.
Swelling, bruising, and wound care in the first two weeks
Swelling peaks around day three to five after surgery and can last 6 to 12 weeks. This is your body's normal response to the trauma of surgery and does not mean the surgery failed. Bruising around the incision and down the thigh is also normal and fades over weeks. Ice, elevation, and compression help reduce swelling faster than time alone.
Your incision will be closed with stitches or staples that come out 10 to 14 days after surgery. Until then, keep it clean and dry. Shower with a waterproof bandage over the incision or follow your surgeon's specific instructions—some surgeons allow gentle soap and water when ready, others prefer you wait a few days. Do not soak the wound in a bath, hot tub, or pool until your surgeon says it is healed, usually 4 to 6 weeks after surgery.
Watch for signs of infection: increasing redness, warmth, pus, foul odor, fever above 101°F, or opening of the incision. These are rare but require when ready attention. Call your surgeon if any occur. Mild oozing and slight redness around the stitches are normal.
Pain management and medication timing
You will go home with prescription pain medication, usually an opioid like oxycodone or hydrocodone for the first 1 to 2 weeks, and over-the-counter options like acetaminophen or ibuprofen for longer-term use. Take pain medication on schedule before pain builds up, not just when you are in severe pain. This makes physical therapy easier and helps you sleep.
Most people need strong pain medication for 1 to 3 weeks, then switch to over-the-counter options. Some surgeons recommend ice and elevation instead of medication for mild discomfort. Constipation is a common side effect of opioid pain medication—ask your surgeon or pharmacist about a stool softener or laxative before you leave the hospital.
Do not drive or operate machinery while taking prescription pain medication. If you live alone or have limited help at home, arrange for someone to stay with you for at least the first week, or plan to stay with family or a friend.
Physical therapy: what to do at home and in the clinic
Physical therapy is the single most important part of your recovery. It starts in the hospital and continues for 6 to 12 weeks at an outpatient clinic or at home. Your therapist will teach you exercises to regain strength, range of motion, and balance. Early on, these are gentle: ankle pumps, quad sets (tightening your thigh muscle), and glute sets. As weeks pass, you will progress to standing exercises, walking, stairs, and eventually light resistance work.
Attend every session your surgeon recommends. Missing sessions or skipping home exercises delays your recovery by weeks. Your therapist will also teach you how to move safely to protect your new hip—for example, keeping your knee below your hip when sitting, and not crossing your legs or bending your hip past 90 degrees for the first 6 weeks (some surgeons extend this to 12 weeks).
Pain during therapy is normal, but sharp pain or pain that worsens after exercise may signal a problem. Tell your therapist when ready if this happens. Expect to feel sore the day after therapy, similar to muscle soreness after a new workout—this is normal and improves as you adapt.
When you can walk, drive, and return to daily activities
Walking with a walker or crutches begins the day of surgery or the next day. Most people walk without aids by 4 to 6 weeks, though some take longer depending on strength and confidence. Do not rush this timeline. Walking too much too soon can cause swelling and setbacks.
Driving depends on which hip was replaced and your surgeon's clearance. If your right hip was replaced, you cannot drive until you can safely press the brake pedal without pain and have normal reflexes—usually 4 to 6 weeks. Left hip replacement may allow driving sooner if your surgeon agrees. Do not drive while taking prescription pain medication.
Returning to work depends on your job. Desk work may be possible in 2 to 4 weeks if you can position yourself comfortably and attend physical therapy. Jobs requiring standing, walking, or heavy lifting typically require 8 to 12 weeks or longer. Ask your surgeon for a specific timeline before your surgery date so you can plan with your employer.
Light hobbies like reading, watching television, and short outings are fine when ready. Hiking, golf, tennis, and high-impact sports require 3 to 6 months of recovery and your surgeon's clearance. Swimming is usually allowed once the incision is fully healed, around 6 weeks.
Blood clots, infection, and other complications to watch for
Blood clots are the most common serious complication after hip replacement, occurring in 1 to 2 percent of people even with preventive measures. Your surgeon may prescribe blood thinner medication or recommend compression stockings to lower this risk. Signs of a blood clot include sudden swelling in one calf, calf pain or tenderness, warmth, redness, or a cord-like vein. Call your surgeon or go to the emergency room when ready if you notice these.
Infection is rare but serious. Signs include fever above 101°F, increasing redness or warmth around the incision, pus, foul odor, or opening of the wound. Call your surgeon when ready if any of these occur. Infection caught early is easier to treat.
Hip dislocation happens when the ball of your new hip slips out of the socket. This is painful and feels like the hip "gave out" or popped. It is rare if you follow movement restrictions (no hip bending past 90 degrees, no crossing legs, no internal rotation of the hip). If you feel a sudden sharp pain or the hip feels unstable, go to the emergency room. Do not try to move the hip or put weight on it.
Numbness or tingling around the incision is common and usually fades over months. Persistent or worsening numbness should be reported to your surgeon. Stiffness that does not improve with therapy after 12 weeks may require additional intervention.
Sleep, positioning, and comfort at home
Sleep will be difficult for the first few weeks because of pain and the need to keep your hip in a safe position. Sleep on your back or your non-surgical side with a pillow between your knees to prevent the hip from crossing the midline. Do not sleep on your surgical side for at least 6 weeks.
Use ice and elevation to reduce swelling before bed. Prop your leg on pillows so your knee is slightly bent and your hip is not bent more than 90 degrees. Take pain medication 30 minutes before bed to help you sleep through the night.
A firm mattress and a bed at a comfortable height make getting in and out easier. If your bed is very low, ask your surgeon about a bed rail or ask a physical therapist about safe techniques. Avoid soft couches that sink and make it hard to stand up.
Frequently Asked Questions
How long does it take to fully recover from hip replacement?
Most people feel significantly better by 6 to 12 weeks and return to normal daily activities by 3 to 6 months. Full recovery, including bone healing and muscle strength, takes 12 months or longer. You may notice continued improvement in strength and range of motion even after a year.
Can I shower or bathe after hip replacement surgery?
Showering is usually safe once your incision is closed and stitches are removed, typically 10 to 14 days after surgery. Ask your surgeon before your first shower. Bathing and soaking in water should wait until the incision is fully healed, usually 4 to 6 weeks. Keep the incision dry and covered with a waterproof bandage if you shower before full healing.
What if I fall or twist my hip after surgery?
Falls are a real risk in the first weeks when you are using crutches or a walker. If you fall, do not try to stand when ready. Call for help or use a phone to call 911 if you are alone. Even if you feel okay, call your surgeon to report the fall. Twisting or sudden movements can cause dislocation, which requires emergency care.
When can I stop using a walker or crutches?
This depends on your strength, balance, and confidence. Most people transition from a walker to a cane around 4 to 6 weeks, then stop using a cane by 8 to 12 weeks. Your physical therapist will tell you when it is safe to walk without aids. Do not rush this—using an aid longer than necessary is safer than dropping it too soon and risking a fall.
Is it normal to feel depressed or anxious after hip replacement?
Yes. Pain, limited mobility, and the stress of recovery can trigger depression or anxiety in the weeks after surgery. This is temporary and common. Talk to your surgeon or primary care doctor if you feel persistently sad, anxious, or unable to cope. Counseling or medication can help, and both are normal parts of recovery for some people.