Total hip replacement: preparing for surgery and recovery

Choosing a total hip replacement is a significant decision. Understanding what happens before, during and after surgery can make the discussion more useful and help you prepare for the practical demands of recovery.

Deciding whether replacement is appropriate

The decision starts with the pain and loss of function caused by the hip. Your surgeon reviews symptoms, examines the joint and considers relevant imaging alongside the treatments already tried.

Explain how the problem affects sleep, walking, work and ordinary tasks. Ask what the operation is expected to improve, what alternatives remain and which symptoms may have another cause. A consultation is an opportunity to make an informed decision, not a commitment to proceed.

Preparing your health and home

Before surgery, the team reviews your medical history and medicines. Tests and an anaesthetic assessment are arranged according to your needs. Tell the team about infections, dental concerns or changes in health, and follow their advice about any treatment needed beforehand.

Do not stop regular medication unless instructed. Ask about exercise, smoking and other preparation that may help you approach surgery in the best condition possible.

At home, arrange support with meals, shopping and transport. Consider whether stairs, bathroom access or low chairs will be difficult. The team can advise on equipment and whether additional assistance is needed. Discuss driving individually, including surgical advice, medication effects and insurance requirements.

What happens during the operation?

A total replacement addresses the damaged ball-and-socket surfaces. A socket component is placed in the pelvis, and a stem in the thigh bone supports a new ball. The components and bearing materials are selected for the procedure.

The surgeon may reach the joint from the front, side or back, depending on the agreed approach. Ask why the proposed technique is suitable and whether it changes the precautions you should follow afterwards.

The first stage of hospital recovery

After the operation, staff monitor you as the anaesthetic wears off and help manage discomfort. Measures to reduce infection and blood-clot risk are selected for your circumstances. These may include medicines, compression devices and supported movement.

The nursing and physiotherapy teams help you begin moving when appropriate. Early tasks may include getting out of bed, standing and walking with an aid. Follow the specific instructions about weight-bearing and movement rather than copying another patient’s routine.

Managing pain and swelling

A combination of medicines and other comfort measures may be used. Tell the team if pain prevents movement or rest, or if treatment causes troublesome side effects. Ask for a clear plan for medicines after discharge.

Some swelling can occur during recovery, but a new or marked change needs assessment. Do not assume that all leg swelling or worsening pain is routine. The discharge advice should explain what to expect and when to seek help.

Leaving hospital safely

Discharge depends on readiness, not a fixed number of nights. The team considers your general health, comfort, mobility, essential daily tasks and the support available at home.

Many people recover at home, while others need additional support or rehabilitation. Discuss this before admission where possible. Before leaving, confirm wound-care instructions, medication, exercises, follow-up appointments and the contact number for concerns.

Walking and rehabilitation at home

Use the recommended walking aid while it supports a safe, even pattern. There is no prize for abandoning it early. Gradually build activity within your instructions, balancing practice with rest.

The rehabilitation plan depends on your starting condition and progress. Ask whether further physiotherapy is needed and which milestones should guide a return to work, driving and recreation. Recovery can continue well beyond the point when the hip first feels more comfortable.

Risks to understand before surgery

Possible complications include infection, blood clots, dislocation, fracture, nerve or blood-vessel injury, differences in leg length and persistent symptoms. Some problems can require further surgery. Anaesthetic risks should also be discussed with the anaesthetist.

Your surgeon can explain how your health and the proposed procedure affect these risks. A list of general complications cannot replace that individual discussion.

Seek urgent advice for concerning wound changes, fever, severe worsening pain or significant new leg swelling. Chest pain or sudden breathlessness requires emergency help.

Planning for the longer term

A hip replacement is designed for long-term use, but follow-up remains important. Report new symptoms and keep the recommended review appointments. Discuss your longer-term activity goals so the plan supports both function and appropriate care of the replacement.

The total hip replacement pathway

Dr Daniel Mandziak explains assessment, surgery and recovery after total hip replacement.

Read more about implant longevity, pain relief and walking after surgery.