Total joint replacement surgery, including hip replacement, is one of the most commonly performed elective surgeries.
According to the American Academy of Orthopaedic Surgeons (AAOS), more than 450,000 total hip replacement surgeries are done in the United States every year. This number is expected to reach 635,000 surgeries annually by 2030.
Total hip replacement surgery, or arthroplasty, involves removing a damaged ball-and-socket hip joint and replacing it with an artificial hip joint made out of metal or durable synthetic materials.
The goal of total hip replacement surgery is to relieve pain from arthritis, including osteoarthritis and rheumatoid arthritis, or other hip-related injuries and conditions, and restoring range of motion in your joint.
The surgery is usually only done if conservative measures aren’t able to decrease your pain or improve your mobility.
Conservative treatments for hip joint issues typically include:
- pain medication
- therapeutic exercise
- physical therapy
- regular stretching
- weight management
- walking aids, like a cane
Recovery from hip joint replacement surgery can differ from one person to the next. However, having an idea of what to expect with your recovery can help you plan ahead and prepare for the best outcome.
What does the recovery timeframe look like?
Although recovery after a total hip replacement varies by individual, there are some common milestones. This is based on data that’s been compiled from many patients who’ve undergone this surgery.
You will probably be discharged to your home or a rehabilitation center several days after surgery. You will need someone to help you for several days to several weeks.
The AAOS reports that most people will be able to resume most light activities of daily living independently within 3 to 6 weeks.
Let’s take a closer look at the general timeline for recovery after hip replacement surgery.
Immediately after your surgery
Once your surgery is done, you’ll be taken to a recovery room, where nurses or other medical personnel will monitor your vital signs.
They’ll also help ensure that fluid is kept out of your lungs while the anesthesia wears off.
You’ll be given pain medication while in the recovery room. You may also be given a blood thinner and have compression stockings put on your legs to prevent blood clots.
Once the anesthesia wears off, you’ll be taken to your hospital room. Once you’re fully awake and alert, you’ll be encouraged to sit up and walk, with the help of a physical therapist.
According to clinical evidence, it’s thought that starting physical therapy right after surgery can help speed up recovery and improve outcomes.
You’ll most likely need to spend 1 to 3 days in the hospital following your surgery.
The next few days
While you’re in the hospital recovering from your surgery, a physical therapist will work with you on doing specific exercises and movements.
Participating in physical therapy after hip replacement surgery helps improve blood flow and build muscle strength. It also helps you to begin moving safely.
Shortly after your surgery, a physical therapist will work with you to help you:
- sit up in bed
- get up out of bed safely
- walk short distances with the help of a walker or crutches
Your physical therapist will also help you do specific strengthening and range-of-motion exercises in bed.
Before you leave the hospital, a physical therapist will provide you with instructions on daily exercises for you to do at home.
They’ll advise you on how much weight you can put on your leg. They may also suggest specific precautions to take when sleeping, sitting, or bending.
These precautionary measures may be in place for a few months or long term. Your surgeon will determine how long you’ll need to take these measures.
An occupational therapist will also work with you before you leave the hospital. They will help you learn and practice modified ways of doing daily tasks, such as:
- showering and bathing
- getting in and out of bed
- getting on and off the toilet
- bending down to put on socks and shoes
- transporting items like food and drink in your house while using a cane or walker
- getting in and out of a car
They will also help you get the equipment you may need during your recovery. These tools will vary depending on your lifestyle but may include such items as:
- raised toilet seat
- grab bars for your bathroom
- cane and walker
- shower seat
- reaching device, like a distance grabber
- shoes with elastic or velcro closing
An occupational therapist will also discuss your home environment with you. They will give you personal instruction and practice to navigate your home and carry out daily activities safely.
You can resume a regular diet in the days following your surgery. While you’re in the hospital, your pain levels will be carefully monitored.
Depending on your progress, your pain medication dosage may be lowered before you go home.
If your medical team feels that you would benefit from having further care or instruction before you return home, you may be released to a rehabilitation center instead. Your occupational therapy will then continue there.
After leaving the hospital
At first, doing your usual daily activities, such as bathing, cooking, and cleaning, will be hard to do on your own. That’s why it’s important to have a support system in place to ensure you’re able to get through your day safely.
If you don’t have the necessary support system, you may need to stay at a rehabilitation facility once you leave the hospital.
You’ll get supervised physical therapy every day until you’re strong and steady enough to move around safely on your own.
Once you’re at home, you’ll need to continue doing the exercises that your physical therapist recommended you do.
This will help you gain strength and flexibility in your muscles and new joint, and it’ll help speed up your recovery.
If needed, your healthcare team may arrange for a home health aide, physical therapist, or visiting nurse to come to your home to help you with your recovery or to check on your progress.
Once you’re at home, you’ll have to keep your wound dry until your stitches come out.
The next three months
As you get stronger and are able to put more weight on your leg, you’ll have an easier time keeping up with your daily activities. You’ll likely need less help than before with doing some basic chores and self-care.
It usually takes about 4 to 6 weeks to start feeling stronger and to be able to get around with less pain.
You’ll still need to continue with physical therapy by going to regular appointments.
Walking at this point is especially important for your recovery. You’ll want to walk regularly and avoid sitting for too long.
Your physical therapist will guide you on the appropriate protocol for your body, including how often to do specific exercises and stretching. However, a typical rule of thumb for rehab is that it’ll be more work upfront.
Keep in mind that after surgery, you’ll experience pain and stiffness. Working to stay as mobile as possible will help with managing your pain and stiffness.
Therefore, completing your physical therapy home exercise program multiple times throughout the day will be important.
Beyond three months
After 3 months, you may be at a point where you can fully resume your daily activities, including some low-impact sports.
Even though you’ll likely be able to get around without much help, it’s still important to keep up with physical therapy exercises and to do gentle movement and light walking on a regular basis.
This will help ensure that you continue to improve your:
- joint motion
Exercises that focus on weight-bearing and proper body mechanics and posture are especially helpful, particularly for older adults who are at a greater risk for falls.
Every individual is different, so check with your doctor or physical therapist to evaluate your situation. Based on your progress, they can advise you on the types of exercises you should be doing.
At this point, it’s also important to keep up with your appointments for follow-up examinations to make sure you’re progressing well and there are no complications.
Although you’ll likely be functioning well 4 to 6 months after your surgery, weakness in the muscles surrounding your hip may persist for up to 2 years.
What helps with recovery?
Recovery from a total hip replacement takes consistent work and patience.
Although a lot of work needs to be done after your surgery, there are important steps you can take before your surgery to help make your recovery as smooth as possible.
Before your surgery
Good preparation before your surgery can greatly help your recovery. Some steps you can take that may make your recovery easier, include:
- Strengthen the muscles around your hip. A physical therapy program will help with this.
- Put a support system in place. Arrange to have help when you come home from the hospital or make plans for a stay at a rehabilitation center.
Make adjustments to your home. Make any changes you need to ensure you’ll be able to go about your daily activities safely when you return home. You may wish to do some of the following:
- Install a higher toilet seat.
- Put a seat in your shower or bathtub.
- Install a hand-held shower spray.
- Remove things that could trip you up, like cords and rugs.
- Talk to your surgeon about what to expect. Be sure you know of any possible problems to look out for.
- Lose weight, if needed. You’ll only need to do this if you’re carrying extra weight or you’ve been diagnosed with overweight or obesity.
After your surgery
It’s very important to follow your healthcare team’s instructions, especially once you return home.
The more closely you can follow their instructions, the better your outcome will likely be. This is especially important for wound care and exercise.
Be sure to keep the incision area clean and dry for 3 weeks. You may have to change the dressing on the wound when you’re at home, or you can ask a caregiver to change it for you.
You’ll start physical therapy in the hospital, soon after surgery. Continuing with your prescribed therapy exercises is key to your recovery.
Your physical therapist will work with you on putting together an exercise routine. In most cases, you’ll need to do these prescribed exercises 3 or 4 times a day for several months.
According to the AAOS, the following basic exercises may be especially helpful right after surgery to prevent blood clots and to speed up your recovery.
- Ankle pumps. While you’re lying on your back, slowly move your foot up and down several times. Do this for one foot, then repeat with the other. Repeat this exercise as often as every 5 to 10 minutes.
- Ankle rotations. While lying on your back, move your ankle away from and then toward your other foot. Do this for one ankle and then the other. Repeat 5 times, 3 or 4 times a day.
- Knee bends. While lying on your back, bend your knee, keeping your heel on the bed. Slide your foot toward your buttocks, keeping your knee centered. Hold your bent knee for 5 to 10 seconds, then straighten it. Do this for one knee, then repeat with the other. Repeat 10 times, 3 to 4 times a day for both legs.
They also scored better in terms of function.
Be sure to work closely with your physical therapist to make sure you keep progressing with the level of exercises you’re doing.
One of the best ways to boost your recovery is by walking.
At first, you’ll use a walker and then a cane for balance. According to the AAOS, you can start off walking 5 to 10 minutes at a time, 3 or 4 times a day.
Then, as your strength improves, you can increase the duration to 20 to 30 minutes at a time, 2 or 3 times a day.
After you’ve recovered, a regular maintenance program should include walking 20 to 30 minutes at a time, 3 or 4 times a week.
Risks and complications
Complications after a total hip replacement aren’t common, but they can happen. According to the AAOS, fewer than 2 percent of patients have a serious complication, such as a joint infection.
In addition to infection, possible complications include:
- blood clots
- dislocation of the ball in the hip socket
- a difference in leg length
- wear and tear of the implant over time
Signs and symptoms to watch out for
Get immediate medical attention if you notice any of the following after you return home from your surgery:
- You have pain, redness, or swelling in your thigh, leg, ankle, or foot.
- You have sudden shortness of breath or chest pain.
- You have a fever above 100°F (37.8°C).
- Your wound is swollen, red, or oozing.
The bottom line
Total hip replacement surgery is a common surgery with a high success rate. Your recovery will begin as soon as the anesthesia wears off.
It’ll start with physical therapy and occupational therapy in the hospital. You’ll be given instructions on exercises to do at home once you leave the hospital. You’ll also receive advice on how to carry out daily activities safely.
For the best outcome, it’s important to do the prescribed exercises several times a day and to increase the level of the exercises as you gain strength and mobility.
Regular walking is also important at every stage of your recovery.
You’ll likely be able to return to most of your daily activities, including driving, in about 6 weeks. Full recovery may take 1 year or more.
It’s important to talk to your doctor about how to prepare for this surgery and what the recovery period involves.
Knowing what to expect and following your doctor’s instructions will help you to achieve the best outcome.