Hip Replacement Recovery: Expert Tips on Timeline and What to Expect

The average amount of time spent in the hospital by patients following a hip replacement was four days, according to a study by the Journal of Clinical Medicine.^[01]

Schmidt explains that although some hip replacements are performed as outpatient procedures, doctors often have older adults stay in the hospital for a few days to manage pain and reduce the chance of infection.

Recent research reveals that the post-op length of stay has continued to decrease.^[02] However, it’s critical to make sure that a shorter hospital stay doesn’t compromise a successful long-term recovery. Some of the early discharge criteria include milestones in pain management and mobility.

“The surgeon provides detailed instructions for pain management,” Schmidt says. “Usually, a combination of prescription narcotics and over-the-counter medications such as acetaminophen or ibuprofen. Due to the risk of bleeding and blood clots, you may also be prescribed blood thinners.”

Schmidt emphasizes the importance of following all medication recommendations and precautions to avoid hindering or slowing recovery time or hospital release. She encourages patients to speak with their health care providers during a hospital stay about unmanaged pain, or to ask questions regarding dosage and timing.

Here are some of the side effects of narcotics to look out for in older adults:^[03]

• Severe constipation
• Trouble breathing
• Addiction

The first few days are the most painful after hip replacement surgery, but the pain should decrease after a couple of weeks.

Some physical restrictions for a few months post-surgery while the joint is healing include:

• Not crossing your legs
• Not bending forward more than 90 degrees
• Not turning the affected leg in or out

Schmidt says healing from hip replacement varies from person to person. She explores with us a little of what to expect from week to week and for the total duration of the recovery period.

1-3 days

Recovering in the hospital will be the priority for days one through three, particularly for older adults.

“The early post-op period focuses on pain management, mobilization, and reducing the risk of blood clots and infection,” says Schmidt.

There will likely be daily physical therapy exercises starting as early as one day after surgery. Patients work directly with a physical therapist or occupational therapist, under the advisement of their doctor. There is also a significant emphasis during this early phase of recovery on keeping the dressing over the incision clean and dry.

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1-3 weeks

Pain generally decreases after two weeks following hip replacement surgery, but there is not an exact time frame as everyone is different. Most people take prescription-strength pain medication for no longer than 14 days, then switch to over-the-counter options. Pain should continue to decrease as time goes on.

In terms of resuming some semblance of normal activity after hip replacement surgery, Schmidt says driving could be an option after two or three weeks.

“If individuals were safely driving before the surgery, it will probably be two to three weeks before they can drive again. They will need to be off all prescription pain medication and have enough strength in their legs to operate the vehicle. This is something the physical therapist or surgeon will clear them for after surgery.”

3-6 weeks

“Incisions from hip replacement usually heal within six weeks. You will receive detailed instructions about cleaning the area and dressing changes,” says Schmidt. “Most times dissolvable or absorbable sutures are used. The dressing can be removed to shower, but people will need to avoid submerging themselves in a bathtub until fully healed.”

Schmidt urges the same precautions regarding soaking in hot tubs, swimming in pools, and other bodies of water during the first six weeks. Generally, the surgeon will conduct a six-week follow-up during which people will be cleared of certain wound healing precautions after the incision is checked.

3-12 months

The one-year mark can be a time for celebration, considering complete healing from the surgery is possible at this stage of recovery. Plus, a hip replacement can be expected to last a reassuring 25 years in around 58% of people.^[04]

Research conducted in 2023 revealed that three months after total hip replacement:^[05]

• Around 80% of people were able to return to their daily activities.
• Around 70% of people were capable of returning to work.
• Around 50% of people were able to return to sports.

Schmidt reminds us that while three to 12 months is the typical range for complete hip replacement surgery recovery, the older a person is, the longer recovery may take.

“Hip replacement at 50 years old versus 80 years old can significantly impact the time it takes to recover and regain baseline physical functioning.”

Potential complications arise at a rate of 27% with total hip replacement procedures.^[06]. Complications can include dislocation or instability, loosening, fracture, mechanical complications, and infection. Anemia following the operation was noted as the most common cause of complications.^[06,07]

As outlined by Schmidt, the following are other possible complications in hip replacement recovery, specifically for older adults:

• Secondary infections such as pneumonia from spending prolonged periods in bed
• Pain management difficulties due to seniors having more sensitive livers and kidneys, which increases the risk of side effects from narcotics
• Infection, blood clots, unmanaged pain, and overall changes or decline in physical function

Although hip replacement surgery is considered safe, effective, and has a positive effect on quality of life, this does not mean complications won’t occur.^[07,08]

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The top three tips for a successful hip replacement recovery, according to Schmidt, are adhering to the following:

• Follow pain management direction, dosage, and timing.
• Follow physical therapy and rehabilitation instructions.
• Follow the surgeon and nurse’s directions pre- and post-operatively.

“There has been a lot of research lately about the benefits of pre-rehabilitation and preparing prior to hip surgery with a certain level of activity to improve recovery,” Schmidt explains. “Unfortunately with older adults, this is not always possible due to other limiting factors, such as additional mobility challenges and chronic disease.”

According to research, pre-rehabilitation prior to hip replacement surgery has shown improved function, health-related quality of life, and muscle strength after surgery for some people. Pre-rehabilitation therapies may include:

• Acupuncture or electrical stimulation^[09]
• Physical exercises for 45 minutes, twice weekly for 8 weeks^[10]
• A 15-minute group education session, twice a week for 8 weeks^[10]

There are also several steps to improve at-home recovery after hip replacement surgery. However, if your loved one needs more support than you can provide, there are rehab options to help them get better safely. Skilled nursing facilities, for instance, offer short-term stays for seniors who need rehabilitation after surgery. Rehab services may also be offered at assisted living communities or at home in combination with home care.

If you or your loved one want assistance deciding what senior living or care option works best for you, our Senior Living Advisors can help you find the best option to fit your needs.

Note: This article is for general information purposes only. Speak to a medical professional if you are concerned about you or your loved one having post-op symptoms due to hip replacement surgery.