What Is Hip Replacement Surgery and What Should You Expect?

Updated

Hip replacement surgery removes damaged parts of the hip joint and replaces them with artificial components, most often to relieve pain and restore movement when the joint has been worn down by arthritis or injured by a fracture. It is typically considered when pain and stiffness no longer respond well to non-surgical treatment and begin to limit walking, sleep, or daily activities. The sections below cover who it is for, how total and partial replacement differ, what happens during and after surgery, and what to ask before scheduling it.

What the surgery actually does

The hip is a ball-and-socket joint: the rounded head of the femur (thigh bone) sits in a socket in the pelvis. Hip replacement replaces one or both sides of that joint with prosthetic parts.

  • The ball — the femoral head is removed and replaced with a stem and ball implant inserted into the femur.
  • The socket — the worn cartilage surface of the acetabulum (pelvic socket) is reshaped and fitted with a cup liner.

The goal is a joint that moves smoothly without the bone-on-bone contact that causes arthritis pain.

When hip replacement is recommended

Surgery is usually discussed after other options have been tried or ruled out. Common reasons include:

  • Osteoarthritis — the most frequent cause, where cartilage gradually wears away.
  • Rheumatoid or other inflammatory arthritis — joint damage from chronic inflammation.
  • Hip fracture — especially in older adults, where the blood supply to the femoral head may be disrupted.
  • Osteonecrosis (avascular necrosis) — bone death from interrupted blood flow.
  • Other joint damage — from injury, dysplasia, or prior surgery.

Typical signs that it may be time to consider surgery: pain that persists at rest or at night, difficulty walking or climbing stairs, stiffness that limits normal movement, and little relief from medication, injections, or physical therapy.

Total vs. partial hip replacement

Total hip replacement Partial hip replacement
What is replaced Both the femoral head and the socket Usually only the femoral head; the socket is left intact
Typical use Arthritis and widespread joint damage Certain femoral neck fractures, particularly in older patients
Decision factors Condition of the socket cartilage, age, activity level, overall health Whether the socket is still healthy and the fracture pattern

Surgeons choose based on how much of the joint is damaged, the patient's age and activity level, bone quality, and the underlying reason for surgery. A partial replacement is not simply a "smaller" version of a total — it addresses a different problem.

How the procedure is performed

Hip replacement is most often an inpatient procedure under anesthesia. The general steps are:

  1. Anesthesia and positioning — regional or general anesthesia; the patient is positioned on their side or back.
  2. Approach — the surgeon reaches the joint through an incision, using an approach chosen for the patient's anatomy and the surgeon's preference.
  3. Removing damaged bone — the femoral head is removed and the socket is prepared.
  4. Placing implants — the cup and the femoral stem/ball are fixed in place, sometimes with bone cement and sometimes designed to bond with bone directly.
  5. Closing and checking — the incision is closed, and leg length and joint stability are checked.

Robotic-assisted approaches are also used for hip replacement. In these, the surgeon still performs the operation, but robotic guidance helps with planning implant position and placement. Kansas Surgery & Recovery Center lists robotic-assisted options including Mako for total hip, alongside its total hip surgery service. Robotic assistance is a tool within the procedure, not a different operation — the recovery and implant basics are similar.

What recovery involves

Recovery timelines vary by patient, procedure, and general health, but the general arc looks like this:

  • Hospital stay — often a short inpatient stay; some patients are discharged within a day or two.
  • Early movement — walking with support usually begins soon after surgery, often the same day or the next.
  • First weeks — managing swelling and pain, using a walker or crutches, and following a physical therapy program.
  • First months — gradual return to walking without aids, driving, and lighter daily activities.
  • Longer term — most people return to routine activities over several months; high-impact activities may be limited.

Rehabilitation is a core part of the result, not an optional add-on. Following the therapy plan and movement precautions given by your surgeon affects how well and how quickly you recover.

Risks and complications

As with any surgery, there are risks. These include:

  • Infection
  • Blood clots (deep vein thrombosis)
  • Dislocation of the new joint
  • Leg-length difference
  • Nerve or blood vessel injury
  • Implant loosening or wear over time
  • Reactions to anesthesia or medication

Your care team will discuss which risks matter most for your situation and what is done to reduce them, such as blood clot prevention and infection control measures.

Questions to ask before scheduling

  • Am I a candidate for total or partial replacement, and why?
  • Is robotic-assisted surgery an option for me, and what difference would it make?
  • What implant type and fixation method do you recommend, and why?
  • How long should I expect to stay in the hospital?
  • What does the rehabilitation plan look like, and where will it take place?
  • What are my risks, and how are they managed?
  • What will the cost be, and what payment options are available?

Kansas Surgery & Recovery Center provides patient information, financial planning, price transparency, a self-pay option, and online payment through its patient resources, along with a contact line at (316) 634-0090 for questions.