Hip Replacement Surgery

Hip replacement surgery — also called total hip arthroplasty — is a procedure to remove a damaged or diseased hip joint and replace it with an artificial joint. Your doctor may recommend hip replacement surgery if you have pain or reduced mobility caused by hip arthritis or injury.

UPMC experts provide comprehensive hip care, including hip joint replacement surgery to treat arthritis, injury, or other musculoskeletal conditions. Our team will develop a treatment plan that improves your symptoms, restores your mobility, and improves your quality of life.

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What Is Hip Replacement Surgery?

Hip replacement surgery aims to reduce pain, restore mobility, and improve the quality of life for people with hip arthritis, injury, or other musculoskeletal conditions.

Types of hip replacement surgery

There are multiple ways hip replacement surgery can be performed. Your doctor will recommend the approach that is best for you.

Hip replacement surgery may be performed using:

Anterior approach — Accesses the hip joint through an incision in the front of the body.
Lateral approach — Accesses the hip through an incision on the side of the body.
Posterior approach — Accesses the hip through an incision in the back of the body.

Your doctor may also recommend a traditional or robotic hip replacement, depending on your condition and other factors.

Traditional hip replacement surgery

Traditional hip replacement surgery uses a single incision to access your hip joint.

Robotic hip replacement surgery

Robotic hip replacement is similar to a traditional hip replacement, but your surgeon uses a robotic surgical system.

The robotic surgical system will allow your surgeon to plan each step of your procedure using presurgical imaging scans. During your procedure, the robot will serve as a guide to help your surgeon follow your surgical plan and precisely place your new hip joint.

Conditions we treat with hip replacement surgery

Hip disorders that occur during childhood.
Hip fracture or injury.
Hip tumors.
Osteoarthritis.
Osteonecrosis.
Posttraumatic arthritis.
Rheumatoid arthritis.

Why Would I Need Hip Replacement Surgery?

If your hip joint is damaged by arthritis, injury, or another health condition, you may need hip replacement surgery.

Hip replacement for arthritis

Arthritis is the most common condition that causes hip damage. It causes the cartilage that provides cushioning between the bones in your hip joint to break down.

Without the cushioning that cartilage provides, your bones will rub together. Bone rubbing causes pain, inflammation, and reduced joint mobility — which may cause problems with walking and performing everyday activities.

Hip replacement after injury

If you fracture your hip during a fall or other accident, your doctor may recommend a hip replacement. Your doctor may also recommend a hip replacement if you have a tumor or bone disease that causes hip damage.

Is hip replacement right for me?

You may be a candidate for hip replacement surgery if you have:

A hip fracture or bone disease that requires a joint replacement.
Hip pain or other symptoms that cause problems with walking or everyday activities.
Symptoms that do not respond to over-the-counter medications, physical therapy, activity changes, or other nonsurgical treatments.

Your doctor will discuss the pros and cons of hip replacement surgery with you.

Alternatives to hip replacement surgery

Alternatives to hip replacement surgery include:

Activity changes to reduce hip strain.
Assistive devices, such as canes, crutches, or walkers.
Heat and/or ice.
Over-the-counter medications to manage pain.
Physical therapy.

What Are the Risks and Complications of Hip Replacement Surgery?

As with any surgical procedure, hip replacement surgery comes with some risks.

Hip replacement surgery risks include:

Bleeding.
Blood clots.
Different leg lengths.
Dislocation.
Fracture.
Infection.
Nerve injury.
Pain or stiffness that doesn’t improve after surgery.
Problems with your artificial joint, such as wear and tear over time.

What Should I Expect From Hip Replacement Surgery?

Before your procedure, you will meet with your care team and have a physical exam. Your care team will talk with you about how to prepare for your procedure, including what you might need to help you recover safely at home.

Your care team may order tests, such as:

Blood or urine tests — Your doctor may order blood work and urine studies to ensure you are healthy enough for the procedure and check for signs of illness or infection.
CT scan — A computed tomography (CT) scan creates images of the bones and structures in your hip.
Electrocardiogram (ECG or EKG) — This test records the electrical activity of your heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and can sometimes detect heart muscle damage. EKGs are often performed before a procedure to ensure your heart is healthy and identify potential problems.
MRI — MRI is a diagnostic procedure that combines large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within your body.
X-ray — Your doctor may order an x-ray to learn more about the condition of the bones and tissues in your hip.

Your doctor will explain the procedure to you and answer your questions. To prepare for the procedure, you should:

Fast for a certain period prior to the procedure. Your doctor will tell you if you need to fast or how long to fast (usually overnight).
Have any tests that your doctor recommends. For example, your doctor may request a blood test before the procedure to determine how long it takes your blood to clot.
Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
Tell your doctor if you have any other health conditions. Your care team may need to take certain precautions during your procedure for your safety.
Tell your doctor if you have a history of bleeding disorders or if you are taking any blood-thinning medications, aspirin, or other medications that affect blood clotting. You may need to stop some of the medications before the procedure.

On the day of your procedure, bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home.

You may need to stay overnight in the hospital for a few days after your hip replacement surgery. However, hip replacement surgery can be performed as an outpatient procedure in some cases, so you can go home the same day.

Your doctor will let you know if you will need to stay overnight in the hospital or if you will be discharged the same day. If you stay overnight, you should bring toiletries, a robe, slippers, a cell phone and charger, medications, and a change of clothes.

Whether you stay overnight or are discharged the same day, you must arrange for someone to drive you home after discharge.

How long does hip replacement surgery take?

Hip replacement surgery usually takes one to two hours. However, it may take longer if your procedure is more complex.

When you arrive at the hospital, you will meet with your care team for final preparations.

You will receive an IV in your hand or arm. You will have either general anesthesia to put you to sleep or an epidural to prevent you from feeling pain below your waist.

After you are positioned on a procedure table, your doctor will:

Load your images and surgical plan into the robotic surgical system if you are having a robotic hip replacement.
Make an incision (cut) in the front, side, or back of your body to access your hip joint, depending on the approach your surgeon is using.
Remove your damaged hip joint.
Replace your damaged hip joint with an artificial hip joint. If you are having a robotic hip replacement, your surgeon will position and place your joint using the robotic surgical system for guidance.
Move and bend your leg to ensure your new hip joint functions properly.
Close your incision with stitches or glue.

After your procedure, your surgeon will place a bandage over your incision and make sure your condition is stable.

After your procedure is complete, you will be monitored in the recovery area. Your care team will encourage you to get out of bed and move around as soon as possible. If you stay overnight in the hospital, you will be transferred to your hospital room.

If you have outpatient hip replacement surgery, your doctor will tell you when it is safe to go home. You will need someone to drive you home from the hospital after your discharge.

Before you go home, your doctor will tell you:

How to care for your wound and watch for signs of infection or complications.
What medications you need to take.
When you should begin physical therapy.
When to call your doctor or 911 if you have certain symptoms.
When you should schedule your follow-up appointments, if one has not been scheduled already.
When you can return to your normal activities, such as driving and bathing.

How long are you in the hospital after a hip replacement?

Most people who require an inpatient hospital stay are discharged within one to three days.

If you need additional recovery time before you return home, you may be transferred to an inpatient rehabilitation unit or facility for several days or weeks. Inpatient rehabilitation provides physical and occupational therapy to improve your strength, range of motion, and confidence in performing everyday activities as you recover.