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), in 2014 more than 370,770 total hip replacement surgeries were done in the United States.

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.

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.

The AAOS reports that most people can expect rapid improvement for the first 3 to 4 months after hip replacement surgery. After that, recovery may slow down. You’ll likely still see improvements, just at a slower pace.

Let’s take a closer look at the general timeline for recovery after hip replacement 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 walker.

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.

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.

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.

At first, doing your usual daily activities, like 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.

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.

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:

  • strength
  • flexibility
  • joint motion
  • balance

According to an early study of 75 people who had hip replacement surgery due to osteoarthritis, it was common for patients to reach a plateau in their progression around 30 to 35 weeks post-surgery.

This same study found that it was important to continue with a targeted exercise program beyond this point.

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.

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:

  • strengthening the muscles around your hip with a physical therapy program
  • putting a support system in place so you have help when you come home from the hospital or are making plans for a stay at a rehabilitation center
  • making adjustments to your home so that it’ll be easier and safer for you to go about your daily activities and can include things like:
    • installing a higher toilet seat
    • putting a seat in your shower or bathtub
    • installing a hand-held shower spray
    • removing things that could trip you up, like cords and scatter rugs
  • talking to your surgeon about what to expect and the possible problems to look out for
  • losing weight, but only 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.

Wound care

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.

Exercises

You’ll start physical therapy in the hospital, soon after your 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 your 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 every few 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 and then lower it. Do this for one knee, then repeat with the other. Repeat 10 times, 3 to 4 times a day for both legs.

A 2019 study noted that people who progressively increased their level of exercise during the course of their recovery were happier with their results, compared with people who didn’t increase their exercise.

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.

Walk often

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.

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

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.

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 in the hospital. You’ll be given instructions on exercises to do at home once you leave the hospital.

For the best outcome, it’s important to do these 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 a 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.