Hip pain is quite common, but for some people, the pain can be severe enough to affect daily activities and reduce quality of life. This may be a sign that it's time to talk with a surgeon about whether a hip replacement is an excellent choice.
During a total hip replacement, a surgeon removes the damaged parts of the hip joint and replaces them with new artificial parts. This reduces pain and helps restore smooth movement.
Hip replacements are getting more common every year. In 2023, there were more than 600,000 total hip replacements performed in the U.S. For many people, they can vastly improve quality of life.
If you're considering a hip replacement, you probably have questions. UC Davis Health orthopaedic surgeon Zachary Lum has answers about the procedure, the recovery and any restrictions after surgery.
Learn more about joint replacements for hips and knees
What is a hip replacement?
A total hip replacement, also called a total hip arthroplasty, is a very straightforward elective procedure. The hip works like a ball and socket. The ball is the top of your thighbone, or femur — it's also called the femoral head. The socket is part of the pelvis, also known as the acetabulum.
The ball of your thighbone fits into the socket of your pelvis within your hip. In a total hip replacement surgery, a surgeon uses artificial parts to replace the ball and the socket of the joint.
On the pelvis, or socket side, the surgeon removes the arthritic or damaged bone. Then, they implant a new socket that is usually titanium with a plastic liner. On the femur side, the surgeon inserts a metal stem into the hollow center of the bone. A prosthetic ball is attached to the top of the stem. Usually, the ball and stem are metal or ceramic.
The new ball fits right into the new socket and functions like a normal, healthy joint.
Read about the preparation for hip replacement surgery
What are the possible complications of hip replacement surgery?
Hip replacement has improved a great deal over the past two decades. The infection rate and the dislocation rate are both very low. It's a very successful operation. Most patients get a significant amount of relief and have great success.
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How can I tell if I'm ready for a hip replacement?
Every patient is different, but there are some clear signals that you might be a good candidate for a hip replacement. These include:
- Arthritis of the hip that is "bone on bone" or close to it, as seen with imaging
- Pain that is directly related to the hip, which often shows up as groin pain
- Pain that is significantly affecting your daily activities
Sometimes hip pain is not actually coming from the hip but could be from the back or the thigh. That's why it's important to be evaluated by a surgeon. They will do a physical exam and may order imaging such as an X-ray or MRI. They'll also look at your health history, including whether you have a history of arthritis, rheumatoid arthritis or other conditions.
Some patients manage pain differently than others, so it's important that you consider all factors: imaging, pain level and impact on daily life. A good question to ask yourself is, "Am I avoiding certain activities because I'm worried about having pain in the moment or the next day?" If the answer is yes, it may be a good idea to talk to an orthopaedic surgeon.
Why is hip pain often confused with groin pain?
It's very common for people with serious hip pain to think they may have a hernia or groin pull because the pain most commonly manifests in the groin. In fact, 50-75% of the time, groin pain is actually hip pain. But not always, which is why it’s important to get imaging and a physical exam.
Are there other treatments to help relieve hip pain without surgery?
There are medications that can help relieve hip pain, including acetaminophen (such as Tylenol), which is recommended by the American Academy of Orthopaedic Surgeons. Anti-inflammatory medications are also recommended, including ibuprofen (such as Advil or Motrin) and naproxen (such as Aleve).
You can also try cortisone injections in the hip, which can be beneficial for two reasons: It can help with pain if the pain is coming from the hip, and if the pain isn’t from the hip, it can help doctors diagnose the real cause. Cortisone injections do carry some risks. About 2-5% of people may have worsening symptoms.
Physical therapy can also help with hip pain.
What are the most common conditions that lead to a hip replacement?
The most common reason patients need a hip replacement is osteoarthritis, a disease that breaks down joints in the body, causing pain, stiffness and swelling.
Other common causes include other types of arthritis such as rheumatoid arthritis or inflammatory arthritis. Another possibility is avascular necrosis, where bone dies around the femoral head.
Patients with a femoral neck fracture may also need a hip replacement. This is often a result of a fall when skiing or cycling. In addition, some patients with a labral tear that is symptomatic and they're older – 40 or 50 – a hip replacement may be a good choice for them as well.
Learn more about the different types of arthritis
Can you really go home the same day with a hip replacement?
Thanks to advances with anesthesia and surgical techniques, many patients can safely go home the same day of their hip replacement surgery. Some patients may need a little extra time to recover and may spend a night in the hospital. Many hip replacements at UC Davis Health are done at the new state-of-the-art 48X surgical complex.
Learn more about joint disorders and conditions at UC Davis Health
What is the recovery for a hip replacement?
Pain after hip replacement surgery
The first few days are usually the most painful because the surgery causes inflammation around the new joint. You'll have different options for medication to help ease the pain during this short time. Your doctor may also advise you to ice the hip area to help with swelling.
You're likely to be sore for at least the first two weeks. But you'll likely notice that the arthritis pain you had before surgery is dramatically improved right away.
Movement and strength after hip replacement
You'll likely be able to walk and put your full weight on the hip right away. Typically, patients walk about 100 to 200 additional feet every day after surgery.
By six weeks or so, you may be able to walk about a mile. You'll also likely be prescribed physical therapy for several weeks or even months to help your muscles adjust to using the new joint. Every day, you'll be able to walk a bit more, the pain will be less and you’ll be stronger.
Each patient is different, but some surgeons may advise you to restrict certain movements, such as crossing your legs, during the first few months. You'll want to follow your surgeon's guidelines.
Between three and 12 months, you'll pick up strength and endurance and incorporate more of your activities. At about a year after surgery, you should have a full recovery.
Find out about the home care after hip replacement surgery
When can you return to playing sports after a hip replacement?
It depends on the patient and their sport of choice. If the incision from the surgery is healed, and you are comfortable, you can start to return to some sports, such as golf, cycling or swimming around six weeks after your operation.
For sports such as skiing, snowboarding, tennis or pickleball, you should wait three months or so and start gradually. It's a good idea to start at maybe 25% effort, then increase that slowly over time.
There are some sports that are not the best fit for someone with a hip replacement. You should not run or engage in very heavy weightlifting after a hip replacement.
Learn more about knee replacement surgery
Find out how to prevent ski and snowboard injuries
How long does a hip replacement last?
A hip replacement can last anywhere between 20 and 40 years. However, sometimes patients need what's called hip revision surgery, or a new procedure for the same hip that already had a joint replacement.
Each year after you have a hip replacement, you have about a 0.5% to 1% chance of needing a revision. The most common reason for revision is infection. The second most common is hip dislocation and the third is that the implant may loosen.
It's important to get an X-ray and consult with your orthopaedic surgeon every five years or so to make sure your new joint is wearing well.
Is one leg longer than another after hip replacement?
In the first three months after a hip replacement, patients may feel that one leg is longer than the other. This is known as a pseudo leg length discrepancy. The leg is not usually actually longer, but it feels that way because the muscles are weaker. As you walk, you engage the surgical leg on the ground sooner, so it feels like it's longer. This usually goes away after about three months.
Surgeons use x-ray during the procedure to make sure that the legs are as close to the same length as possible. Rarely, with very complex procedures, there could be a minor difference in leg length.
To make an appointment with our orthopaedic surgeons, you can call 800-2-UCDAVIS (800-282-3284).
This blog was reviewed by orthopaedic surgeon Zachary C. Lum. He's chief of community orthopaedics and an assistant professor in the Department of Orthopaedic Surgery at UC Davis.
