What Happens During a Hip Replacement — Step by Step
Dr. Soutrik Mukherjee
MS (Ortho) · AO Masters · Advanced Ortho and Spine Clinic, Kolkata
One of the most common reasons patients delay hip replacement surgery is anxiety about the unknown — what exactly happens, what will they feel, what will recovery look like? This article walks you through everything from the day before surgery to your first steps, so you know exactly what to expect.
The day before surgery
You will typically be asked to fast from midnight. A pre-anaesthesia check will have been done in the days prior. Stop any blood-thinning medications as instructed. Get your home ready for recovery — remove trip hazards, arrange a raised toilet seat, ensure your bed is at a comfortable height, and have someone with you for the first few days.
The surgery itself (about 60–90 minutes)
Hip replacement is performed under spinal anaesthesia (you are awake but numb from the waist down) or general anaesthesia. An incision is made over the hip, the arthritic femoral head is removed, the acetabulum (hip socket) is prepared and fitted with a metal cup and plastic liner, and a metal stem with a ceramic or metal head is inserted into the femur. All components are fixed either with cement or press-fit. The incision is closed and you are taken to recovery.
Within the first 24 hours
This is the part that surprises most patients: you will be asked to stand and take a few steps with a physiotherapist within 6–12 hours of surgery. Early mobilisation is one of the most important advances in hip replacement care — it reduces the risk of blood clots, pneumonia, and stiffness, and significantly improves outcomes. You will have a drip, a catheter, and a drain initially; most are removed within 24 hours.
Days 2–5 (hospital stay)
Physiotherapy continues twice daily. You will practise walking with a walker, climbing a few stairs, and sitting in and out of a chair safely. Pain is managed with a combination of oral medications. Most patients are discharged home within 3–5 days once they can walk safely and manage basic activities.
Recovery at home (weeks 2–12)
Walking distances gradually increase. You will use a walker for 2–4 weeks, then progress to a walking stick. Driving is usually permitted at 6 weeks (left hip) or 8 weeks (right hip). By 3 months, most patients are walking comfortably without aids and have returned to light daily activities. Swelling and mild discomfort can persist up to 6 months.
In Summary
Hip replacement is one of the most reliably successful operations in medicine. The vast majority of patients look back and wish they had done it sooner. If you have been putting it off due to fear of the procedure, I hope this article helps. Please feel free to come in and ask any questions — no question is too small.
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