Hip replacement recovery timeline
Recovery from a hip replacement is gradual and active, and for many people it’s more comfortable than they expect. You’ll be up and moving within a day of surgery, and most of your recovery happens over the first three months, with smaller gains continuing for up to a year. This is a general guide to what to expect; your own pace will vary, and your surgeon and physiotherapist will set the plan that’s right for you.
In hospital: the first few days
Recovery starts on the day of surgery. With an enhanced recovery approach, a physiotherapist helps you stand and take a few steps the same day or the next morning, which reduces stiffness and the risk of complications.¹ In most cases you can put weight through the leg straight away, using a frame or crutches at first. Pain is managed with a combination of medications rather than relying on strong opioids, and most people go home within one to three days. A muscle-sparing approach such as the direct superior approach can make these early days easier. More on the pathway in enhanced recovery after surgery.
The first two weeks at home
This is usually the most demanding stretch, though hip replacement tends to settle faster than knee replacement. The priorities are managing pain and swelling, looking after the wound, and doing your exercises.
- Take your pain relief as prescribed, so you can move and do your exercises.
- Do the exercises your physiotherapist gives you, several times a day.
- Walk little and often, with your aids.
- Ice and elevate to control swelling.
Swelling, bruising that can track down the thigh, and disturbed sleep are all normal early on. Hip replacement has traditionally come with a list of formal precautions, movements you must avoid for several weeks. With Dr Tsung there are none. Because he uses a muscle-sparing approach, the advice is simpler: be sensible and take it easy for the first six weeks while everything heals.
Weeks two to six
The wound is usually checked at around two weeks. Over this period most people move from crutches to a single stick and then to walking unaided, and return to light daily activities. Many return to desk work in this window. Driving is usually possible somewhere around four to six weeks, once you can control the car safely and are off strong pain medication, but check with your surgeon first.
The six-week review is an important checkpoint. By now the joint is moving more freely, which makes it easier to see how everything around it is recovering. Long-standing arthritis, and the surgery itself, leave the muscles around the hip weaker than usual (muscle wasting, or atrophy), and problems outside the joint itself, in the surrounding muscles and soft tissues, often only become clear once you're moving better. This is usually the point where we can pinpoint them and tailor your home exercise program to what your hip specifically needs.
It's also common to notice new or different aches around now, around the hip, the thigh, the back or elsewhere. You're moving faster, further and for longer than you have in a long time, and muscles and joints that had quietened down while your hip was bad are being used again. That's usually a normal part of getting back to it, not a sign something is wrong.
Six weeks to three months
By now the hardest part is behind most people, and the first six weeks of taking it easy are over. Walking becomes more comfortable and you can gradually build up activity and strength. More physical jobs may need a little longer before returning.
Three months to a year
Most of your recovery is usually complete by three to six months, and smaller improvements in strength, comfort and confidence continue beyond that. Around the six-month mark, many people find they simply stop thinking about the hip day to day, which is a good sign that it has become part of normal life again.
Some things take the full year. If you'd been limping for months or years before surgery, the muscles in that leg and around the hip will have weakened and tired more easily, and the difference in strength and stamina between your two legs usually evens out by about twelve months as you build back up. An early sense that the leg lengths feel uneven, which is common and usually a matter of the muscles and posture adjusting, also tends to settle over this time. Low-impact activity such as walking, swimming, cycling and golf is encouraged; high-impact activity like running and jumping is generally discouraged to protect the joint.
What's normal, and when to seek help
Normal in recovery: swelling, bruising that can track down the thigh, a feeling of warmth, occasional clicking from the implant, and disturbed sleep early on.
Contact your surgeon or seek medical advice promptly if you notice spreading redness, increasing pain or discharge from the wound, or a fever, which can signal infection; or pain, swelling or tenderness in the calf, or sudden breathlessness or chest pain, which can signal a blood clot and needs urgent attention. Sudden severe hip or groin pain, an inability to put weight on the leg, or the leg suddenly looking shorter or turned out, can signal a dislocation and needs urgent assessment. When in doubt, ask.
Helping your recovery
A few things make a difference: do your exercises consistently, keep moving without overdoing it, take pain relief so you can stay active, eat well, and avoid smoking, which slows healing. Recovery isn't linear, and good days and harder days are both normal.
Common questions
How long until I can walk without aids?
Many people are walking unaided somewhere between two and six weeks, and hip replacement often progresses a little faster than knee. Your physiotherapist will guide the progression.
Are there movements I should avoid?
With Dr Tsung there are no formal hip precautions after surgery. The advice is simply to be sensible and take it easy for the first six weeks while everything heals.
How long will I be off work?
Desk work is often possible within a few weeks; physically demanding work usually needs longer. It depends on the job and your recovery.
When can I drive again?
Usually around four to six weeks, once you can control the car safely and are off strong pain medication. Check with your surgeon.
Will my legs feel even?
An early sense of unevenness is common and usually settles as the muscles and posture adjust over the first few months.
Speak to Dr Tsung
To discuss hip replacement, you'll need a referral from your GP or another specialist. Call reception on (07) 5676 9930 to book your first appointment, or email hello@sgco.au. New patients can pre-register online before the visit; the form prepares your records and does not book an appointment. More on hip replacement and the direct superior approach.
References
- Deng QF, Gu HY, Peng WY, et al. Impact of enhanced recovery after surgery on postoperative recovery after joint arthroplasty: results from a systematic review and meta-analysis. Postgrad Med J. 2018;94(1118):678–693.