How Long Does it Last to Recover after Hip Replacement?

Last update: June 2023
Disclaimer:

Why is there a recovery period after hip surgery?

There are at least two reasons why you need some recovery time after hip replacement surgery:

1. Direct consequences of the surgery: You need to recover from the local or regional anesthesia and the implantation of the prosthesis. Your tissues need to heal, and your body needs to adjust to functioning with the new prosthesis.
2. If you had the surgery due to hip arthritis (coxarthrosis): There are consequences of hip arthritis, including discomfort and pain before the operation. Even though you now have a “brand-new” hip, your body needs time to recover from the months or years when it was not in the best condition due to coxarthrosis. You may have lost muscle strength and flexibility before the surgery, and it takes some time to regain them.
3. If you had the surgery due to a femur fracture: There are consequences of the fall or accident. Our bodies need time to recover from such events. In older individuals, there may be what is called a post-fall syndrome. For everyone, there is a sudden transition from a “normal” life with few limitations to a life as a convalescent person! It is no coincidence that we call a patient… patient 🙂

Hence, the need for a few weeks or months to recover properly and resume everything you want to do after hip replacement!

Let’s now take a closer look at how long it takes to recover from this type of hip surgery.

What is the recovery time after hip replacement?

To my knowledge, there are no precise numerical data available regarding the duration of all stages of recovery after hip arthroplasty. I have supplemented them with those derived from my own professional experience.

Of course, these timelines will vary based on various factors such as:

• Your overall health at the time of surgery, your physical condition.
• The reason that led to this operation (advanced coxarthrosis, complex femoral hip fracture, revision of a gamma nail, etc.).
• The living environment you are in.
• Your general coping mechanisms for stress, pain, and change.

That’s why it is impossible to provide very specific timelines, even though it would be helpful to have them for better planning!

Here are the usual timelines:

	Timelines
You have significantly less pain.	Few days to a few weeks. One out of three people has no pain at all 6 months after the hip operation (Ninomiya 2020).
Hip replacement incision healing time
Swelling in the hip, leg, or foot reduces.	Few weeks, occasionally a few months.
You walk with crutches or a walker.	Immediately to a few days. Average time of 4 days (Kim 2022).
You walk without a cane or assistive device.	Few weeks to a few months. 6 to 8 weeks in static position, slightly longer during walking (Alves 2022).
You can drive again.	1 to 2 months.
You can resume cycling.	Few weeks.
You can return to sports activities.	Few months.
You are fully recovered from the surgery.	Few months. At 6 to 8 months after the operation, an average of 80% recovery of capacity (Vissers 2011).

Is the recovery time different for hemiarthroplasty of the hip?

Yes, the recovery time for hemiarthroplasty of the hip may differ from that of a full hip replacement. Hemiarthroplasty involves replacing only the femoral head (ball) of the hip joint, while the socket is left intact.

The recovery time for hemiarthroplasty is generally shorter compared to a full hip replacement.

Is the recovery time different for hip replacement for elderly?

The recovery time for hip replacement surgery can vary for elderly individuals compared to younger patients. Generally, the recovery process may take longer for older adults due to factors such as age-related physiological changes, reduced muscle strength, and potential comorbidities.

Elderly people may experience a slower healing process, which can prolong their overall recovery time.

There are always exceptions. Age is just one factor among others, and some individuals over 70 or 80 years old recover very quickly.

Is the recovery time different for double hip replacement?

Yes, the recovery time for double hip replacement (bilateral hip replacement) may differ from that of a single hip replacement. It is typically more challenging and may require a longer recovery period. It can place additional stress on the body and require more time for healing and rehabilitation.

However, if a surgeon decided to operate on 2 hips at the same time, it was because he felt that you could recover very well.

When can you resume driving after hip replacement?

You will find varying opinions on the subject of resuming driving after a hip replacement.

If you have a strict contraindication (such as bone grafting in addition to the prosthesis), the use of pedals is not recommended, even though you will put much less weight on the pedals compared to walking.

In an academic publication dedicated to resuming driving after total hip replacement through anterior or posterior approach, the following timeframes are provided (MacKenzie 2019):

For resuming driving after a total hip replacement, the recommended timeframes range from a minimum of 6 days to a maximum of 8 weeks. The timeframes are generally longer for surgeries performed on the right side compared to the left side.

Six weeks after the operation, 84% of people who underwent left hip replacement had resumed driving, compared to 79% of those who underwent right hip replacement.

In practice, some of my patients resume driving early, ranging from a few days to 2-3 weeks after the operation.

Upcoming blog post: When to drive after a fracture or surgery?

What can be done to shorten the recovery time?

The sooner you begin physiotherapy after hip replacement surgery:

• the faster and better you recover,
• the fewer certain side effects you experience (such as lower limb deep vein thrombosis),
• and the lower the overall cost of care related to the operation, pre- and post-operative appointments, and post-operative follow-up. It’s a win-win situation!

Starting rehabilitation within two weeks of hip replacement is considered “early initiation of physiotherapy,” which is the case in the vast majority of cases in France.

Source: Masaracchio 2017

Typically, you will be seen daily at the hospital and then at least once a week after your discharge for the first two or three weeks. After that, appointments can be spaced out even further or discontinued for individuals who are doing well and have no concerns.

Some individuals respond well to self-rehabilitation, are not particularly anxious, and have straightforward recoveries. In such cases, fewer than eight physiotherapy sessions may suffice (this happens regularly in my practice)!

Others may have more concerns, a strong desire for “active rehabilitation” with physiotherapy, and require more sessions for a longer duration.

If you want to maximize your chances of recovery, here are four general tips in addition to the personalized advice your physiotherapist will provide:

1. Emphasize walking or lying down in a semi-recumbent position. Limit the time spent sitting or standing statically for several weeks. These positions (sitting, static standing) are less beneficial for blood circulation and hip flexibility.
2. Several times a day (but not for extended periods: just a few seconds), get up and walk, preferably for at least a few dozen meters, depending on your pain tolerance. Every day, try to do a little more than the previous day, gradually increasing your activity.
3. You can use supportive cushions to find a comfortable position and alleviate pain. Some people sleep with a bolster pillow or nursing pillow or use a specially designed cushion between their legs.
4. Some people find significant relief by applying ice to their hip, especially at night. You can purchase an ice pack from a pharmacy or use a bag of frozen peas that conforms to the shape of your knee.

Where should you go during the recovery time after hip replacement?

It is known that starting rehabilitation promptly after a hip replacement is important. However, there is no evidence to suggest that “intensive” rehabilitation is necessary.

It is reasonable to assume that people who receive:

• daily rehabilitation in a rehabilitation center,
• 2-3 sessions per week in a private clinic,
• or once a week physiotherapy at home, or even through telehealth at a later stage, recover in a similar manner on average.

I have personally supervised hip replacement rehabilitations with 1-2 sessions per day, 5 days a week, for 6-8 weeks, with sessions lasting between 30 minutes to 1 hour. I have also supervised rehabilitations with one session per week for about 20 minutes, and I have not observed any differences related to the frequency of sessions!

In France, it is theoretically no longer possible to receive post-acute rehabilitation specifically for a hip replacement. When people do go for rehabilitation, it is not primarily for physiotherapy but rather for other aspects such as:

• assistance with dressing and undressing,
• help with meals and household chores,
• living in a non-adapted home with stairs,
• other medical conditions exacerbating disability or significant post-operative complications.

It is beneficial that convalescent facilities exist, especially for individuals living alone. However, this does not mean that daily supervised rehabilitation is necessary!

On a broader scale, three high-quality studies conducted in the United States, Singapore, and Italy aimed to determine the cost-effectiveness of physiotherapy after hip replacement (Francis 2022). According to the research team’s conclusion, it is indeed cost-effective.