A guide to preparing for total hip replacement - one of the most successful operations in modern surgery. Understanding what to expect helps you prepare and recover well.
ℹ️ This appointment takes place 2-4 weeks before surgery. Blood tests, MRSA screening, medication review, and anaesthetic assessment are performed.
Total hip replacement is performed under general or spinal anaesthetic and takes approximately 60-90 minutes. Hospital stay is typically 2-3 nights with modern enhanced recovery programmes.
Routine investigations to confirm fitness for anaesthetic.
Nasal and groin swabs. Decolonisation treatment if positive.
Blood thinners and NSAIDs paused. Blood pressure medications usually continued.
Raise toilet seat, install shower grab rail, arrange ground floor living for first 2 weeks if possible. Clear floor hazards to prevent falls.
Any planned dental treatment should be completed before your hip replacement. Dental bacteria entering the bloodstream can seed a hip prosthesis - particularly in the first 2 years after surgery.
ℹ️ You will be given a specific arrival time. Do not eat or drink (other than clear water up to 2 hours before) from midnight the night before. Bring your medication list and any documents sent by the hospital.
You will be admitted to the ward or day surgery unit, change into a gown, and be seen by the nursing, anaesthetic, and surgical teams before theatre.
Your surgeon will confirm the procedure, mark the operative side, and you will sign a consent form before going to theatre.
You will meet the anaesthetist in the anaesthetic room. Once anaesthesia is established, the procedure will begin.
After surgery you will wake in the recovery room where nurses monitor your vital signs until you are stable and comfortable.
Most patients having arthroscopic or day-case procedures go home on the day of surgery. Those having joint replacement typically stay 1–2 nights. Before discharge, the team will check your pain is controlled, give you wound care instructions, and confirm your follow-up appointment.
You will be given oral pain relief before discharge. Take it regularly for the first 48 hours rather than waiting until pain is severe.
A nurse will check the wound before you leave and explain how to keep it clean and dry.
You will receive a letter for your GP and details of your next outpatient appointment - usually at 2 weeks for a wound check.
Arrange for a family member or friend to collect you. You must not drive on the day of surgery if you have had a general anaesthetic or sedation.
⚠️ Important: Seek urgent assessment if you develop severe hip pain with or without a clunk - this may indicate dislocation. Also seek urgent assessment for wound infection signs: redness, heat, discharge, or fever.
Avoid getting the wound wet until it is fully healed - usually 10–14 days. Use a waterproof cover or cling film when showering.
Do not wait until pain is severe before taking medication. Regular simple analgesia (paracetamol, ibuprofen if appropriate) is more effective.
This is usually 2 weeks after surgery. Sutures or clips will be removed if used.
Seek urgent advice if you develop increasing redness, warmth, swelling, discharge from the wound, or a temperature above 38°C - these may indicate infection.
Blood tests, MRSA screen, anaesthetic discussion, home preparation.
60-90 minutes in theatre. Hospital stay 2-3 nights.
A physiotherapist will help you stand and walk the day after surgery.
Progress from frame to crutches to stick. Observe hip precautions throughout.
Driving at 6-8 weeks. Low-impact sport from 3 months.
Hip precautions are movement restrictions to prevent dislocation. The specific restrictions depend on the surgical approach. Most surgeons advise avoiding crossing the legs and bending the hip beyond 90 degrees for 6-12 weeks. Your surgical team will give you specific instructions.
Most patients return to driving at 6-10 weeks, when they can safely perform an emergency stop. Right hip replacement patients need a longer period off driving. Confirm with your insurer.
Flying is generally not recommended for the first 6-12 weeks due to DVT risk. After this, you can fly with compression stockings and regular movement during the flight.
Total hip replacement is one of the most successful operations in modern surgery. Over 95% of patients report significant pain relief. Improvement in walking ability, sleep, and quality of life is expected.
Under general or spinal anaesthetic, the hip is approached through a posterior, direct anterior, or lateral incision. The femoral head is removed, the acetabulum is reamed and a metal shell is inserted (press-fit or cemented). A ceramic or polyethylene liner is placed in the shell. A metal femoral stem is inserted into the femoral canal (press-fit or cemented). The ceramic femoral head is placed on the stem and reduced into the socket. Takes approximately 60-90 minutes.
Analgesics, physiotherapy, weight loss, and activity modification. Appropriate while symptoms are tolerable.
Short-term pain relief only. Not a long-term solution for advanced arthritis.
A bone-conserving option in selected younger male patients. Concerns about metal-on-metal bearings have limited its use. Not appropriate for female patients of childbearing age.
Acceptable if symptoms are manageable without significant impact on quality of life.
The prosthetic femoral head can dislocate from the socket if hip precautions are not observed. Usually managed by manipulation under anaesthetic. The risk depends on the surgical approach and implant design.
The most feared complication. May require removal of the implant and staged revision surgery. Risk is higher in patients with diabetes, obesity, immunosuppression, or previous hip surgery.
Anticoagulation for 4-6 weeks after surgery reduces this risk significantly.
The sciatic nerve (foot drop) and femoral nerve are at risk. Most injuries are temporary neurapraxias.
Modern uncemented implants have survival rates exceeding 90% at 20 years. Revision surgery is more complex than primary replacement.
Periprosthetic fracture can occur during surgery or in the post-operative period.
Minor differences in leg length are common. Significant discrepancy is rare with modern surgical techniques.
Expected in the early post-operative period.
Minor noise from the hip is common with some implant designs and is not harmful.
The scar may be tender for several months.
End-stage hip arthritis causing severe pain and functional limitation is unlikely to improve without surgery. Non-operative management may provide temporary relief. Delaying surgery does not affect the outcome of future replacement.