Total Hip Replacement: a guide for surgery and recovery


You are probably reading this because your surgeon has recommended total joint replacement to treat your hip problem. This article answers general questions about hip replacement surgery, and hopefully can put some of your fears to rest. This article gives you basic facts about hip replacement surgery, your hospital stay and recovery. Share this article with your family. It explains what happens before, during, and after hip replacement surgery. But, it cannot answer all of the questions you might have about your own hip problem and the treatment of it. Your surgeon can answer any questions you and your family still have after reading this booklet. This article is not meant to replace the advice of your doctor, surgeon, therapist, or nurse.

A Healthy Hip Joint

Bones of the hip joint
A joint is formed where two or more bones meet. The hip joint is a ball-and-socket type joint and is formed where the thighbone (femur) meets the hipbone (pelvis). The thighbone has a ball-shaped knob on the end that fits into a socket formed in the hipbone. A smooth cushion of articular cartilage covers the ends of the bones. The articular cartilage is kept slippery by fluid made in the synovial membrane (joint lining). Since the cartilage is smooth and slippery, the bones move against each other easily and without pain. Large ligaments, tendons, and muscles around the hip joint hold the bones (ball and socket) in place. A healthy hip can support your weight and allow you to move without pain.

Causes for Hip Joint Replacement

Degenerative Hip (Copyright MMG)
If your hip is injured or worn down, the joint does not move smoothly or without pain. You can have pain when you put weight on that leg, get up from a chair or go up and down stairs. You may even walk with a limp. As your pain worsens you may stop using the joint causing the muscles to weaken.

There are many conditions that can result in degeneration of the hip joint. Osteoarthritis is perhaps the most common cause for hip replacement surgery. This condition is commonly referred to as “wear and tear arthritis”. Osteoarthritis can occur with no previous history of injury to the hip joint—the hip simply “wears out”. Once the articular cartilage wears out, a hip replacement is often needed. Pain occurs because the articular cartilage on the head of the femur and inside the acetabulum wears thin and the bones rub against each other. You would be considered for total hip replacement if you have pain every day and a lot of pain at night, your pain limits your work, play, or activities of daily living. There may be a genetic tendency in some people that increases their chances of developing osteoarthritis.

Avascular necrosis is another cause of degeneration of the hip joint. The blood supply for the ball part of the hip joint comes from a small artery. If the artery is injured or becomes clogged the blood supply to the femoral head is interrupted or destroyed and the bone dies (necrosis). This leads to collapse of the femoral head, the ball becomes flat instead of round and causes the joint not to move smoothly which leads to degeneration of the joint. The result is a very painful joint. Avascular necrosis (AVN) has been linked to alcoholism, hip fractures, dislocations of the hip, and long term cortisone treatment for other diseases.

Hip Fracture. A hip fracture (“broken hip”) can result in the hip joint no longer working as it should. Some hip fractures are treated by replacing the hip joint. Fractures occur most often at the narrow neck of the thighbone. Hip fractures are a common injury in people who have osteoporosis, or thinning of the bones.

Abnormalities of hip joint function resulting from fractures of the hip and some types of hip conditions that appear in childhood can also lead to degeneration many years after an injury. The mechanical abnormality of the joint causes excessive wear and tear— just like the out-of-balance tire on your car that wears out too soon.


The symptoms of a degenerative hip joint usually begin as pain when bearing weight on the affected hip. You may limp, which is the body’s way of reducing the forces that the hip has to deal with. The degeneration will lead to a reduction in the range-of-motion of the affected hip. Bone spurs will usually develop which limit movement of the hip joint. Finally, as the condition becomes worse, the pain may be present all the time and may keep you awake at night.


Table of Contents

The information presented here—in timeline order—can help you learn what to expect when having a hip replacement from planning through recovery.

If you have questions after going through this information or the information brings up questions for you write them down and contact your surgeon.