Total Hip Replacement Recovery Guide

Recovery after a total hip replacement is gradual, and the most important thing you can do is follow the instructions your surgeon and physical therapist give you.

There is no magic way to speed it up, but staying on top of your exercises, walking regularly, and caring for your incision all help. Most people feel much better by 6 weeks, close to normal by 3 months, and fully recovered by about 6 months.

Total Hip Replacement on X-ray in frog legged lateral view.

Caring for your incision

Follow your surgeon’s instructions about your dressing or bandage closely. Do not remove it early or before you have been told to.

Taking the dressing off too soon exposes the wound before it has healed, which raises your risk of infection. An infection that reaches the new joint (a periprosthetic joint infection) is serious and worth every effort to avoid. When in doubt, leave the dressing alone and call your care team.

Walking after hip replacement

Walk regularly. It is one of the best things you can do to recover, and there is no set limit on how much you can do.

In the first few weeks your hip and general tiredness will naturally limit you, and that is normal. If you need a walker or cane to get around, use it.

A gait aid is not a sign of slow progress or failure, and using a cane even out to the 6-week mark is perfectly reasonable. The goal is to walk often and gradually need the aid less.

Hip replacement recovery timeline

Right after surgery you spend an hour or so in the recovery room. If you had a spinal anesthetic you may still be numb from the waist down; if you had a general anesthetic you will wake up with no numbness and may notice the hip is sore from that point on. You will have a dressing on or around the hip, so do not touch or remove it.

On the ward, nurses and a physical therapist help you start walking, usually with a gait aid such as a rollator walker or a cane, and you begin your pain medication plan. How long you stay in the hospital depends on the type of hip replacement and the surgical approach.

You go home with similar pain medications, instructions for your dressing, and exercises to keep doing. Your pain should ease within 2 to 3 weeks, and you should be weaning off the stronger (narcotic) medications as you tolerate.

By about 6 weeks, most of your strength is back and the pain is much lower. It keeps improving up to 3 months, and your strength continues to build until around 6 months, which is usually when you are considered back to your baseline. From about 6 months, most people feel fully recovered with no restrictions on what they could not do before.

Recovery in older adults

Hip replacement is very common in older patients, and the recovery steps are exactly the same. The difference is that an older patient may simply take longer to recover, because the body has less reserve to draw on than a younger person’s. This is normal. A slower recovery does not mean the hip replacement has failed.

Hip replacement recovery exercises

Walking works all the muscles you need to strengthen, but a couple of simple exercises help your hip get its strength back faster. Both can be done at home without equipment.

• Straight leg raises (for the hip flexors): lie on your back, raise the straight leg into the air, hold it for a count of 8, then lower it gently. Repeat 8 times, twice a day.
• Active abduction (for the side muscles, helpful after a lateral approach): stand with your good side against a wall, move the operated leg out to the side, hold for a count of 8, then bring it back to the middle. Do 8 in a row, two or three times a day. You can also do this lying on your good side and lifting the operated leg toward the ceiling.

Exercises and movements to avoid

Avoid anything that pushes the hip to the extremes of its range of motion. Depending on your surgical approach, your surgeon may give you hip precautions, which often include not crossing your legs, not turning the leg outward more than 90 degrees, and not extending the hip past neutral.

These are usually lifted after about 6 weeks, sometimes sooner for patients who had a lateral approach.

Also avoid jarring, high-strain activities in the early weeks. That means no jumping, and holding off on sports that stress the hip such as tennis, soccer, and weightlifting until your surgeon clears you.

Pain medication after hip replacement

Typically pain is controlled with ” multi- modal analgesia”. This means we use nerve blocks, and mediations that work in different mechanisms to control your pain. This offloads the amount of opiates that are required for pain control after surgery.

Your medication plan is tailored to you, so tell your surgeon if you have reacted badly to any pain medicine in the past. First-line options are acetaminophen (Tylenol) and anti-inflammatory medicines. Stronger medicines like hydromorphone or oxycodone may be used in the first phase, but as sparingly as possible.

Most people wean off the stronger (narcotic) medicines within 2 to 3 weeks. By around 6 weeks, pain is usually well controlled with only occasional Tylenol or a milder option like codeine or tramadol, and by 3 months most people need no pain medication at all. Everyone is different, so your timeline may vary.

Life after hip replacement

Hip replacement is one of the most successful operations in all of surgery. Studies report patient satisfaction of 95% or higher, and most people return to active, healthy lives with a clear improvement in their quality of life.

The main thing your surgeon may ask you to watch is the range of motion at the very extremes. Most people notice no limits in everyday activities, but movements that push the hip to its limits, such as advanced yoga poses or gymnastics, can risk a dislocation.

You can often still do these activities; just keep the hip a little inside its full range. For example, after a lateral approach, yoga poses that avoid pulling the leg across the body or turning it outward are fine, and after a posterior approach, poses that avoid spreading the leg out or turning it inward are fine. Your surgeon will tell you what applies to your approach.