A Patient’s Guide to Total Hip Replacement Recovery

What’s a typical hip replacement recovery timeline? How much pain will you be in? When will you be able to get back to work? When can you return to your favorite sports? 

You may think that a total hip replacement will be a dreadfully painful surgery, after which you’ll be laid up in the hospital and then flat on your back at home even longer. 

You would be wrong. 

Because in reality, the opposite is true. Advancements in medical technology, anesthesia, surgical techniques and pain management have made it possible for most healthy people to go home the same day as their surgery, walk without assistance within a few days and get back to most regular activities within a few weeks, says HSS orthopedic surgeon William J. Long, MD, FRCSC.

The Importance of “Prehab”

One of the keys to a successful recovery begins even before you get on the surgical table. During this “prehab,” you’ll speak to a physical therapist to discuss your goals and establish a plan for recovery, as well as consider any barriers you may have at home that would hinder recovery. The important aspect of this step is the focus on education and preparation.

“At HSS, this is standard practice and helps to facilitate early discharge and a proactive approach to recovery,” says Dr. Long.

What Happens on the Day of Surgery

After your surgery, the spinal anesthetic will wear off within less than an hour and you’ll have something to drink and eat. Then you’ll meet with a physical therapist in the recovery room. You’ll sit up, stand up, begin to move independently with a walker or crutches and learn how to walk up and down stairs safely. 

While some post-operative pain is normal, your care team’s goal is to help you feel as comfortable as possible. “Probably one of the most significant advances in modern hip replacement has been in pain management,” says Dr. Long.

Surgical techniques have advanced to the point where there are smaller incisions and no major muscles are impacted. Anesthesia techniques have seen great advancements as well. Because of all this, doctors are able to prescribe far fewer narcotics—indeed, some patients take no narcotics at all following discharge—helping to make patients feel alert and healthy almost immediately after surgery.

“That’s been crucial to getting people moving faster, more safely, and more consistently,” says Dr. Long. And the quicker you start to move, the better your surgical site will heal, the less stiff your new hip will be and the less chance you have of developing a post-surgical complication.

“Before the end of the day, if all goes well, you’ll leave the hospital to rest and recover at home,” says Dr. Long. “You may have some bruising and swelling in the operative leg, which benefits from ice and elevation when you are at rest, but otherwise you should be up and moving without specific precautions.”

Recovering at Home

Because surgeons at HSS no longer use traditional stitches and staples, you can shower the day after surgery. “We use a dissolvable stitch and glue with a waterproof dressing, which you can simply peel off after a week. It’s much more patient-friendly than it used to be,” says Dr. Long.

For between two days and two weeks, a physical therapist will come to your home to help you through exercises designed to strengthen the muscles around your hip, and also to help you learn to navigate your daily life activities, like getting in and out of bed, going up and down stairs and getting in and out of the car. Other patients elect to follow an online program through our HSS portal.  

Most people will move to in-office PT once they can get in and out of the car themselves (though typically people aren’t able to drive for two to four weeks after surgery). There, you’ll continue to work on strength, endurance, range of motion and balance, with the goal being to return to your typical activities. 

Getting Back in Action

“The key to any recovery is activity,” says Dr. Long. Paul Olewnicki, who had a total hip replacement at age 52 performed by Dr. Long, is a prime example. “After one day of rest, I was determined to get back to my normal routine,” he says.

After three days, Paul used crutches while visiting colleges with his wife and daughter; by day six, he no longer needed any walking assistance. A week after surgery, Paul mowed his lawn. And he was able to set sail for a day of fishing a day after that. Within a month, Paul was back to work as a high school science teacher, using the stairs instead of the elevator. “At the two-month mark, the benefits from surgery were clear,” he says.  The key to his quick road back? “A positive attitude and determination with an active lifestyle,” he stresses.

While Paul is young and healthy, his recovery isn’t totally out of the norm. “The only thing that we’re really worried about is a fall, and some very advanced yoga moves,” says Dr. Long. “But other than that, as long as it’s comfortable, whatever you do to use the hip is fine. The way we perform the surgery, coupled with the modern implants we use, allows people to be much more active much earlier than ever before.”

Life After Surgery

Most people can return to a desk job within days to a few weeks, though if your job is a physical one, you may require a longer period to regain the strength and stability required for a more demanding role. Low-impact, low-fall-risk exercises like stationary biking are okay within days of surgery; after about six to eight weeks you’ll be able to return to higher-impact activities that involve agility.

Dr. Long likes to see patients for post-operative visits between three and six weeks from surgery, and usually not again until a year from surgery. 

Within six to eight weeks, you’ll see most of your function return to pre-surgery condition—or better. “In many cases, people have been walking around in pain for years to decades,” says Dr. Long. “You are going to feel better than you did before fairly quickly, reliably and durably, with most patients enjoying the benefits of a modern total hip replacement for life—even if they require one at a younger age.”