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This article was reviewed by Dr. Nima Mehran, M.D and Orthopedic Surgeon and Dr. Trevor North, M.D and Orthopedic Surgeon.

One of the most common questions orthopedic surgeons hear is, “how long does it take to do a hip replacement?”. In other words, “Doc, how long will I be under?!”. This question is actually a bit of a joke because with a spinal block, you may not go under at all…Ba Dum Si! But really, knowing what’s actually going on during your total or partial hip replacement surgery is key to being comfortable with the procedure. Even if you don’t want to know the technical nitty gritty, a play-by-play of your actual surgery day will be helpful.

How long does hip replacement surgery take to perform? The average hip replacement surgery takes just 1-2 hours to perform.

How long your hip operation takes will depend on how complicated your case is, your physical state and weight, the severity of your joint osteoarthritis, the type of replacement you’re receiving (like anterior or posterior lateral) and of course, whether you’re getting a partial (hip hemiarthroplasty) or full hip replacement.

What Hip Replacement Surgery Day Will Look Like: The First 24 Hours

What Hip Replacement Surgery Day Will Look Like

1. Get Checked-in to the Hospital

Come surgery day, hopefully you’re feeling prepared for joint replacement surgery and have done some hip replacement PreHab to better your health and readiness. At the hospital, you will be checked-in upon arrival. After check-in, you will be escorted to your room where you’ll change into a hospital gown. Here, you will wait for your surgeon and meet briefly before being escorted to the operating room.

In the operating room, you will likely be given either: general anesthetic (being put to sleep), spinal anesthetic, or a combination of the two. There are pluses and minuses to the various types of anesthetic but a common preference by care teams is to go for spinal anesthetic with sedative medication. A spinal block is administered with medication to help your relax. Spinal blocks have lower risk for serious complications than general anesthetic, cause less nausea, and let the patient breath on their own during the operation.

A huge perk for a spinal block (regional anesthetic): pain is blocked for up to 24 hours following surgery.

After you’re comfortable or you’ve gone completely under, it’s go time!

2. Surgery Time

On Your Mark…

After your surgeon and team have created a completely sterile environment (yes, there’s a good chance your care team will be wearing space suits), they will make the incision. If you’re having minimally invasive surgery this cut will be 3-5 inches long, whereas a traditional incision may be as large as 8-10 inches. The incision will cut through the skin, tissue and muscles at the top of your thighbone, allowing your surgeon to gain access to your hip bone.

Get Your Bone Set…

 Image from OrthoInfo AAOS

Once your surgeon can see your troubled ol’ hip joint, he or she will get busy. The first step is generally dislocating your hip (pulling the ball out of its socket). Next, the ball-shaped head of your femur (upper thigh bone) is removed. The socket is then grated down (resurfaced), removing damage caused by arthritis so that a new, artificial cup can be fit into place. The cup is a small metal dome that fits perfectly into the hollow of your bone and is press fit on. As you heal, new bone will naturally grow around this component, securing it even more into place. A plastic, bowl-shaped insert is fastened into the cup and your new socket is formed. This bionic socket is called the “acetabular component” by the medical community.

With the ball-shaped head of the femur already removed, your surgeon will prepare the inside of your thigh bone (femur) and then place an artificial part into your femur. This piece is called the femoral component. Your surgeon will then need to fit the stem of this piece with a new head (also called a ball). There are many femoral head (ball) sizes and variations, so your surgeon will test which one fits your new, artificial socket the best. Once attached, the ball piece will be “plugged” into the bowl-shaped socket (the acetabular component). Combined, these pieces replace your hip’s natural ball and socket. Just like that, you’ve got yourself a new hip!


Before surgery is a wrap, your surgeon will test the fit and movement of your new artificial joint. Sometimes this means x-raying to ensure everything is properly fitting. In all cases, your surgeon will stretch your surgical leg into everyday positions. For example, your surgeon will bring your knee toward to your chest, lift your leg upward and so forth. Once your care team is confident that your new joint fits well and can perform natural movements without dislocating, it’s time to lock everything into place.

A final evaluation is done to make sure your new surgical leg is stable, that both leg lengths match, and once again, that there’s little chance for dislocation. From here, the incision site is rinsed with sterile fluid and the wound is closed with stitches and staples.

Ta da! Your hip replacement is done!

3. Recovery in the Hospital

After your surgery, you will be moved into the recovery room until you come to. Depending on the type of anesthetic you’ve had, this could take several hours. During this period, you will be closely monitored. Once you’re with it again, you will be moved to your hospital room. Here, you will spend a minimum of 1-2 days before being discharged home or to a secondary care facility.

During your hospital stay, you will be visited by doctor and nurses who will check your wound and labs and review your progress. You may also be visited by a social worker who will help determine if you can be discharged straight home or if a secondary care center is better for you. Another key member of your care team is a physical therapist. It is not unusual for patients to begin physical therapy on the same day as surgery or in the following morning. Early movement in the hip joint is pivotal to regaining range of motion, avoiding stiffness, reducing swelling and inflammation and ultimately, setting yourself up for future success.

Wondering what type of pain you’ll feel after surgery and into the first several months of recovery? Check out our article, “What Pain Can I Expect After Joint Replacement Surgery

This pretty well sums up the timeline for the first 24 hours of hip replacement surgery. Surgery day will be a big one with some serious stress on your body. Remember, that you’re in great hands and that the surgery you are enduring is among the most successful in all of modern medicine. Stay as calm and relaxed as possible, and try to focus on the reasons why you’re doing this: a healthier, more mobile tomorrow.

Are you thinking about a hip or knee replacement? Get matched with a top orthopaedic surgeon near you who offers PeerWell PreHab and ReHab for free. PreHab gets you mentally, physically and environmentally prepared for surgery, putting YOU to greater control your outcome and recovery.

Get matched for FREE to a top surgeon, today.

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