Hip Replacement Surgery: What the Operation Is, and What It Was Like

A total hip replacement removes the worn ball and socket of an arthritic hip and replaces them with an artificial ball, stem, and socket made of metal, ceramic, and hard plastic, and for most people it ends years of arthritis pain. I had mine at 58, and the thing I most wanted beforehand was a plain account of what the operation actually is and what the day feels like from the inside. This is that, set in order, with the medical figures checked.

What a hip replacement actually replaces

The operation rebuilds the hip joint, which is a ball-and-socket joint where the top of the thigh bone meets the pelvis. In a total hip replacement (total hip arthroplasty), the surgeon takes out the worn ball (the femoral head) and resurfaces the socket (the acetabulum), then fits an artificial ball, stem, and socket made of metal, ceramic, and hard plastic. The far and away most common reason for needing it is osteoarthritis of the hip, the slow wearing-away of the smooth cartilage that lets the joint glide. Osteoarthritis is one of the leading causes of disability worldwide, which is part of why this is now one of the most performed operations there is ¹.

Before any of that, the honest first step is making sure surgery is the right move at all. International guidance is consistent that exercise, weight management, and pain relief come first, and that an operation is for when those have stopped holding the pain and the loss of function at bay ². For me that line was crossed when I could no longer sleep on either side and had quietly stopped doing things I loved.

What the day of surgery is like

On the day, the part that surprised me most was the anaesthetic. You are not necessarily put fully to sleep. A spinal (regional) anaesthetic, which numbs you from the waist down, is common, and many people stay awake through the whole thing, sometimes with light sedation so you doze. A general anaesthetic is the other route. Reviews of the evidence find both are safe and effective, with spinal anaesthesia linked to some advantages in the immediate recovery, which is one reason it is so often used ³. I had a spinal, heard the quiet talk of the team, and felt nothing below my hips.

The surgery itself takes about 1 to 2 hours. The surgeon reaches the joint through one of three main approaches: posterior (from behind), anterior (from the front), or lateral (from the side). Each has its trade-offs and none is clearly best for everyone, so the choice depends on your anatomy and your surgeon’s experience. The old joint comes out, the new components go in, and you are stitched and moved to recovery. From there most people stay in hospital just 1 to 3 days, and some selected patients go home the same day.

Getting up and the first weeks

Here is the part no one quite believed when I told them: you usually stand and take a few steps the same day or the day after, with a frame, then crutches, guided by a physiotherapist. It is slow and strange, but it is real walking on the new hip. You will lean on walking aids for about 2 to 6 weeks.

If you have the posterior approach, you will be given dislocation precautions to follow for roughly the first 6 to 12 weeks while the soft tissues heal: things like not crossing your legs, not bending the hip past 90 degrees, and not twisting it inward. They feel fussy and they matter. Driving typically resumes around 6 weeks, once you are off strong painkillers and can do an emergency stop. Desk work often returns around 2 to 6 weeks, physical or manual work around 3 months, and most normal activities within about 3 months. Full recovery, meaning your strength, confidence, and the last of the swelling, takes 6 to 12 months. I kept expecting to feel finished at three months and had to let go of the calendar.

How well it works, and how long it lasts

This is the reassuring part, and the reason so many people are glad they did it. The operation is one of the most effective in modern surgery for relieving arthritis pain, and around 90% of people, about 9 in 10, are satisfied with the result, a higher figure than for knee replacement. A new hip more often comes to feel like your own joint than a new knee does.

The implants are durable. Around 90 to 95% are still in place at 10 years, and a large pooled analysis of registry and study data estimated that about 6 to 8 in 10 are still working at 25 years ⁴. In everyday terms a hip replacement typically lasts 15 to 25 years, often longer, and it is most commonly done between the ages of 60 and 80, though younger and older people have it too. If one does wear out or loosen, it can be redone in a second operation called a revision.

The risks, stated plainly

Most hip replacements go well, but it is real surgery and it carries real risks, so it is worth knowing the numbers rather than the word “rare”. Dislocation, where the new ball slips out of the socket, happens in about 1 to 2 in 100 people, with the risk highest in the first weeks, which is exactly what the precautions are for. Deep infection occurs in about 1 in 100 and is serious, sometimes needing further surgery. Blood clots in the legs or lungs are guarded against with blood thinners, compression, and getting you moving early. A small difference in leg length is common and usually unnoticeable; a noticeable one is uncommon. Nerve or blood-vessel injury and a fracture around the implant are uncommon. Over the long term, loosening or wear is the main reason a hip may eventually need that revision.

For the wider decision of whether to operate at all, see my notes on signs it is time for a hip replacement and on the alternatives worth trying first. For what came after for me, day by day, there is the recovery timeline.

This is general information from my own experience, checked for accuracy, and not medical advice. Your hip, your health, and your options are particular to you, so please talk them through with a qualified clinician before making any decision.