Living with constant hip pain can be exhausting and discouraging. Everyday tasks may start to hurt or feel out of reach. Total hip replacement is a common, highly successful surgery that can ease your pain and help you move more comfortably.
This comprehensive guide explains what a hip replacement involves, how to prepare, what happens during surgery, and how to recover safely. It also answers common questions and outlines risks so you can make informed choices with your care team.
Why Your Hip Hurts
At a Glance: Review the common causes of hip pain and joint damage.
Hip pain can affect people at any age and can make work, exercise, and hobbies harder to enjoy. For many, pain and stiffness limit basic movements like walking, bending, or even resting comfortably.
Common causes of chronic hip pain include:
Osteoarthritis, which is the gradual wear and tear of joint cartilage over time.
A prior hip fracture that has not healed correctly or has led to post-traumatic arthritis.
Inflammatory conditions like rheumatoid arthritis, which causes the body's immune system to attack the joint lining.
Avascular necrosis, a condition where reduced blood supply causes bone tissue to die and the joint to collapse.
Hip Anatomy in Plain English
The hip is one of the largest weight-bearing joints in the body. It is a ball-and-socket joint designed for both stability and a wide range of motion. In a healthy hip, the rounded head of the thighbone (femur) fits perfectly into a cup-shaped socket in the pelvis (acetabulum). Smooth cartilage covers both surfaces so the ball glides easily, while strong muscles and tendons move the joint.
When the Hip Joint Is Damaged
If any part of the hip is injured or worn out, movement can become painful and stiff. As cartilage thins or wears away completely, bones may rub directly against each other, which causes grinding, inflammation, and significant soreness.
How Hip Replacement Helps
At a Glance: Learn how hip replacement works and the significant benefits it offers.
An orthopedic surgeon is a medical doctor who specializes in treating bone and joint problems. Together, you and your surgeon will decide if hip replacement is the right choice for you. During the surgery, the damaged parts of your hip are removed and replaced with an artificial joint, called a prosthesis. This new joint is engineered to relieve pain and restore function so you can move with greater ease.
Benefits You Can Expect
Most people experience meaningful, life-changing improvements after total hip replacement. Surgery is highly likely to:
Lessen or eliminate hip pain. Discomfort from the operation itself typically improves over a few weeks.
Strengthen your legs. With less pain, you can be more active and rebuild atrophied muscle.
Improve daily comfort. Everyday tasks and low-impact activities usually become much easier.
Provide long-term relief. More than 90% of modern hip replacements last 15 to 20 years or more.
Is Surgery the Right Choice for You?
At a Glance: Explore the evaluation process, your treatment options, and the potential surgical risks.
Your surgeon will perform a thorough evaluation, which includes examining your hip, reviewing your medical history, and ordering imaging tests to pinpoint the cause of your pain. X-rays clearly show bones and joint space, while an MRI provides detailed views of soft tissues like cartilage and tendons.
Based on these findings, you will discuss whether hip replacement offers the best chance to relieve your pain and restore your movement. You will also review other options if surgery is not the immediate next step.
Your Treatment Options
Your personalized care plan may include one or more of the following:
Nonsurgical care, such as weight loss, changing activities, medications or supplements, physical therapy, exercises, and using walking aids like a cane.
Other procedures, such as hip resurfacing, arthroscopy to treat problems inside the joint, or an osteotomy to realign the bone.
Be Informed: Risks and Questions to Ask
Every surgery has risks. Understanding them helps you prepare mentally and sets realistic expectations. Be sure to ask your surgeon what the procedure can and cannot do, what alternatives exist, and how to best get ready for surgery and recovery.
Possible risks and complications include:
Infection
Bleeding that may require a transfusion
Blood clots in the legs, pelvis, or lungs
Ongoing pain, stiffness, or other joint problems
Injury to nearby blood vessels, bones, or nerves
Loosening or wear of the implant that may require another surgery (revision)
Hip fracture or dislocation
A change in leg length
Risks related to anesthesia
Get Ready for Surgery
At a Glance: Prepare your home and optimize your health before surgery for a smoother recovery.
You can make your recovery safer and smoother by preparing ahead of time. Your surgeon will provide specific instructions for medical tests, exercises, and timing. If you smoke or use nicotine, stopping or cutting down significantly lowers surgical risks and supports better healing.
Prepare Your Home
Set up your living space so daily tasks are easier after surgery:
Install helpful equipment, such as handrails in hallways, grab bars in the bathroom, and a raised toilet or shower seat.
Arrange a resting area on your main living level to avoid stairs.
Remove clutter, secure loose cords, and take up all throw rugs to prevent falls.
Store frequently used supplies between waist and shoulder height to limit bending or reaching.
Arrange Short-Term Help
You will not be able to drive for a few weeks. Ask a family member or friend to help with rides, groceries, and chores. If you live alone, consider having someone stay with you or arranging for a home health aide. Some people benefit from a short stay at a dedicated rehabilitation facility.
See Your Primary Care Doctor
Your primary care clinician will help you prepare medically. You may have blood work, a chest X-ray, and an ECG to check your heart rhythm. Chronic conditions like diabetes or high blood pressure must be well-controlled before surgery. Any active infections should be fully treated first.
Share Your Medications
Tell your surgeon about all medicines, vitamins, herbs, and over-the-counter products you take. Some, including blood thinners, aspirin, and anti-inflammatory drugs like ibuprofen, increase bleeding risk and may need to be paused before surgery. Follow the plan your care team provides.
Start 'Prehab'
Prehabilitation, or prehab, is a program of stretching and strengthening exercises performed before surgery. Practicing everyday activities and learning safe movements can help you recover your function faster.
Finish Dental Work
Bacteria from the mouth can travel through the bloodstream and infect a new joint. It is crucial to complete any pending dental procedures and treat tooth or gum problems well before your surgery date.
The Day of Surgery and Your New Hip
At a Glance: Understand the surgical procedure and the different types of hip implants.
You will be asked not to eat or drink anything after a specific time the night before your procedure. At the hospital, you will meet the anesthesiologist, the doctor who administers anesthesia to prevent pain. You may receive general anesthesia (fully asleep) or regional anesthesia (numb from the waist down), often combined with medication that leaves you drowsy. An IV line will be placed to give you fluids and medicines. For your safety, the staff will confirm your name, procedure, and which hip is being treated, and the operative hip will be clearly marked.
Your New Hip Implant
A prosthesis is an artificial joint designed to mimic a healthy hip, with a ball and a socket similar to your natural anatomy. Components may be made of ceramic, highly durable plastic, metal, or a combination of these materials. Implants can be held in place with bone cement or by a 'press-fit' method. A press-fit implant has a textured surface with tiny pores that your own bone grows into over time, creating a strong biological bond.
Inside the Operating Room: The Procedure
When it is time, you will be taken to the operating room. Your surgeon may use a posterior approach (from the back of the hip), an anterior approach (from the front), or a lateral approach (from the side). First, the damaged ball at the top of the thighbone is removed. The socket is shaped to accept the new cup, which is usually press-fit and may be secured with screws. A stem is then placed inside the thighbone, the new ball is attached, and it is joined with the new socket. Finally, the incisions are closed with stitches, staples, or surgical glue.
Your Recovery Journey
At a Glance: Follow key recovery tips, movement precautions, and milestones for a successful outcome.
You will wake up in a recovery area where the team monitors your comfort and vital signs. Pain control is a top priority, and you should speak up if you are uncomfortable. Blood clot prevention starts early. You may receive blood-thinning medicine, wear support stockings, and use compression boots on your legs. Breathing exercises help keep your lungs clear. Your team will teach you how to move in ways that protect the new joint. These movement precautions vary based on the surgical approach.
Posterior Approach Precautions
Sit with your hips higher than your knees.
Sit with both feet on the floor and keep your knees about 6 inches apart.
Do not bend your hip past 90 degrees (so your upper body goes below your waist).
Do not cross the knee of your operated leg over the midline of your body.
Do not turn your operated leg inward into a "pigeon-toed" position.
Anterior Approach Precautions
Avoid stepping too far backward with your operated leg.
Do not turn your operated leg outward excessively.
Going Home and Getting Moving
Most people go directly home when they are medically ready. You will likely stand and walk within hours after surgery using a walker or crutches. Your physical therapist will teach you how to do daily tasks safely and with less strain on your hip:
Sitting: Back up until a chair touches your legs, use the armrests to lower yourself, and keep your operated leg out in front.
Dressing: Use long-handled tools, like a sock aid or reacher, to put on socks and shoes. Slip-on shoes are a great option.
Stairs: Step up first with your non-operated leg ("up with the good"), then bring the operated leg up. When going down, lead with the operated leg ("down with the bad").
Returning to Daily Life
Walk every day and continue your exercises to build strength and motion. Increase your activity a little each week as you feel able. Your surgeon will tell you when it is safe to drive and return to work. Most people can resume sexual activity once the incision has healed and hip motion improves; ask your surgeon about safe positions.
Long-Term Care for Your New Joint
At a Glance: Protect your new joint for years to come and know when to call your surgeon.
Always tell any doctor or dentist that you have an artificial hip. You may need to take antibiotics before certain medical or dental procedures to lower the risk of infection traveling to the implant. Your surgeon may also order periodic X-rays over the years to check the position and wear of the joint.
When to Call Your Surgeon
Contact your surgeon's office right away if you have:
Trouble breathing or chest pain
Increased or severe hip pain
Pain, swelling, or redness in your calf or leg
Unusual redness, warmth, or drainage at the incision site
A fever of 100.4° F (38° C) or higher
Quick Summary
Total hip replacement is a transformative procedure that can reduce pain and help you return to the activities you value. Success depends on a partnership between you and your care team. Set yourself up for the best possible outcome by following these key steps:
Follow all preoperative instructions.
Take reasonable steps to optimize your health.
Arrange for support at home during your recovery.
Keep every follow-up appointment.
Commit to and complete your physical therapy program as directed.
Have Questions?
If you have any questions or concerns, please contact one of our offices. This information is provided solely for educational purposes and is not a substitute for personalized medical advice. For detailed advice please contact us at (609) 924-8131, text us at (609) 757-9992 or send us a message via our contact form.
