There is no single hip replacement recovery time. The arthritic pain that brought you to surgery is often gone almost immediately, replaced by surgical soreness that settles over several weeks. Independence with walking usually returns within days. The deeper part of recovery — muscle bulk, endurance, a level pelvis and an unthinking, even gait — takes months.

Three things shape the pace more than anything else: how much muscle strength and general fitness you had beforehand, whether the early weeks go smoothly, and how consistently you do the rehabilitation. Age, other medical conditions, body weight and whether you live alone all play a part too. Two people having the same operation on the same day can be several weeks apart at the six-week mark, and both can be doing well.

Modern hip replacement is built around an enhanced recovery pathway, an approach the BOA and British Hip Society describe as appropriate for most patients having hip replacement surgery.⁵ The principle is simple: good pain relief without heavy sedation, eating and drinking early, and getting upright quickly.

NICE guideline NG157 recommends that a physiotherapist or occupational therapist offers rehabilitation on the day of surgery if possible, and no more than 24 hours after the operation.¹ In practice that means standing, taking your first steps with a frame or crutches, and learning the safe way to get in and out of bed. Before you leave hospital, the therapy team should also give you advice on self-directed rehabilitation, so that you understand your rehabilitation goals and why the prescribed exercises matter.^1,2

Weight-bearing

You will be allowed to put your full weight through the operated leg as soon as you are judged safe to do so — on the day of surgery, or the following day. There is no period of partial weight-bearing and no need to protect the leg by keeping weight off it. Walking normally, within comfort, is part of the treatment rather than a risk to the implant.

How long will I stay in hospital?

Many people go home within one to three days after an uncomplicated hip replacement, and some go home the same day. Others need longer for medical, mobility or home-support reasons. Discharge depends on safe walking, controlled pain, a settled wound and clinical stability — not on a set number of nights.

Before you are discharged

• You can get in and out of bed, stand from a chair and use the toilet safely.
• You can walk a practical distance with your walking aid and manage the stairs at home.
• Your pain is controlled with the medicines you are going home with.
• You have your clot-prevention medication and know how long to take it for.
• You have your exercise sheet, a contact number and your wound review appointment.

I use the posterior approach for hip replacement because it produces consistent outcomes for my patients. Standard hip-protection advice for a posterolateral approach will be discussed with you, and demonstrated by the physiotherapy team before discharge, so that you know exactly what applies to your operation.

The purpose of hip precautions is to protect the soft tissues at the back of the hip and to keep the joint out of the one position a replaced hip tolerates least well.

The movements to avoid

• Do not bend the hip beyond a right angle. Keep your hips higher than your knees when sitting, and avoid low chairs, deep sofas and low toilet seats. Bend at the knees rather than folding forward at the waist.
• Do not bring your knees together, cross your legs, or bring the operated leg across the midline of your body. This applies sitting, standing and lying. Crossing at the ankles is usually acceptable; crossing at the knees is not. A pillow between the knees in bed keeps the leg in a safe position while you are asleep and not thinking about it.
• Do not turn the operated leg inwards. Avoid pivoting on the operated leg when you turn — take small steps to change direction instead.
• Do not squat down. A deep squat takes the hip well past a right angle, and at the lowest point the knees tend to come together and turn inwards. That is all three restricted movements at once, which is why I ask patients to avoid it rather than treat it as a matter of degree. Use a grabber for anything on the floor.

It is the combination that matters. Bending, bringing the knees together and turning inwards together is the position associated with dislocation, which is why these are taught as a set rather than as separate rules.

Restrictions on deep flexion, adduction and internal rotation are the three that are retained even in the reduced or "minimal" precaution protocols that some units now use, and avoiding leg crossing is the restriction most consistently kept of all.¹² Keeping a small amount of space between the knees, rather than letting them fall together, meaningfully widens the range of positions your hip can tolerate.

How long do hip precautions last?

I ask my patients to keep to these precautions indefinitely, and to treat them as a permanent habit rather than a temporary restriction. The reasoning is that dislocation risk is highest in the first few months but does not disappear after them: a substantial share of first dislocations occur years after the operation, often with an awkward movement rather than an injury. Once the three movements have become second nature they cost you almost nothing, and they go on protecting the hip for as long as you have it.

You will see different advice elsewhere, and it is worth knowing why. Many units apply precautions for only six to twelve weeks, and some have stopped prescribing them altogether. A systematic review of seven studies covering around 6,900 patients found no clear increase in dislocation rates when precautions were relaxed after posterior-approach hip replacement,¹¹ and modern practice — careful repair of the posterior soft tissues, and larger-diameter femoral heads — has reduced dislocation risk considerably. The advice on this page sits deliberately at the cautious end of that range. It is my own position, and it is what I will ask of you.

Hip replacement exercises do two jobs: they keep the circulation moving in the first days, and they rebuild the muscles that arthritis has weakened over years. The gluteal muscles at the side of the hip are usually the priority, because they control your pelvis when you stand on one leg — which is what walking is.

Short, frequent sessions work better than one long effort. A common pattern is a small set of exercises several times a day rather than a single daily block. Therapeutic exercise is a core treatment for hip osteoarthritis before surgery⁴, and the same principle holds afterwards: strength is rebuilt actively rather than regained by resting.

Early exercises, from day one

• Ankle pumps. Pull the toes up and push them down, repeatedly. This helps circulation and reduces swelling.
• Static quadriceps. Press the back of the knee down into the bed, tighten the thigh, hold, then release.
• Buttock squeezes. Tighten the buttock muscles, hold briefly, relax.
• Heel slides. Slide the heel towards you to bend the hip and knee within a comfortable range, then straighten.
• Hip abduction. Lying flat, slide the operated leg out to the side keeping the kneecap facing the ceiling, then back.

Progressive exercises, as you are advised

• Standing exercises holding a worktop: hip abduction, hip extension, mini knee bends.
• Sit-to-stand practice from a firm chair, progressing to fewer hands.
• Step-ups and controlled step-downs on a single step.
• Stationary cycling with the saddle set high, once you have the movement to turn the pedals.
• Walking itself, gradually increasing distance — the single most useful exercise you have.

Walking aids are not a sign of weakness; they are what allows you to walk properly while the muscles catch up. The sequence usually runs from a frame or two crutches, to two sticks or one crutch, to a single stick used in the opposite hand, to nothing.

The rule for moving down a level is straightforward: you drop an aid when your walking pattern stays even and safe without it, not when a certain number of weeks have passed. If you abandon a stick early and start limping, you teach your body a limp that then has to be unlearned. Many people are walking unaided somewhere between two and six weeks, but some need longer, and people who used a walking aid before surgery may keep one permanently for other reasons.

Build distance gradually. Several short walks a day beat one long walk that leaves you sore for two days afterwards. Outdoor walking on uneven ground and gentle slopes is worth introducing deliberately once you are steady indoors, because that is what real life demands.

Managing pain

Expect the most pain in the first two weeks. It is managed with a combination of medicines rather than strong opioids alone, which is both more effective and easier to tolerate.¹ Take the medication regularly at first, particularly before physiotherapy, then reduce it gradually as recovery allows rather than stopping abruptly. Opioid painkillers can cause nausea, constipation, drowsiness or confusion, so a laxative is often sensible while you are taking them.

Pain that fluctuates — better in the morning, worse after activity or in the evening — is normal and does not mean something is wrong. Pain that is steadily increasing, rather than gradually settling, should be assessed.

Managing swelling

Swelling in the thigh, calf, ankle and foot is common for several weeks and can look alarming. Elevating the leg when resting, keeping walks short and frequent rather than long, and continuing ankle pumps all help. Swelling that is one-sided, accompanied by calf pain or tenderness, or that appears suddenly needs to be reported, because it can indicate a blood clot.

Sleeping after a hip replacement

Broken sleep is one of the most under-warned parts of hip replacement recovery, and one of the most tiring. Most people sleep on their back in the early weeks, with a pillow between the knees to keep the legs from crossing. Rolling onto the side becomes comfortable once the soft tissues settle, and the timing depends on the surgical approach and the advice you have been given. Taking pain relief before bed and keeping daytime naps short both help re-establish a normal pattern.

My wound care instructions are deliberately simple, because the evidence-based approach is to leave a healing wound alone.

• Keep the dressing dry. Moisture is the main thing that turns a healthy wound into a problem.
• Do not change the dressing unless it becomes fully soaked. A small amount of ooze or staining under the dressing is expected and is not a reason to remove it.
• Do not use a bath, and do not soak the dressing, at any point before your clinic review. Showering is possible provided the dressing stays dry — a waterproof cover is the usual way to manage this.
• Do not apply creams, antiseptics or powders to the wound.
• Your wound is reviewed at clinic at two to three weeks, and the dressing is changed then.

Occasionally a wound needs looking at sooner. In that situation some patients are seen by their practice nurse for a wound review between discharge and the clinic appointment. This is the exception rather than the routine, and it should follow a conversation with the team rather than being arranged independently.

A numb or altered-feeling patch of skin beside the scar is very common and usually improves slowly over months.

The risk of deep vein thrombosis (DVT) and pulmonary embolism is highest in the early weeks after hip replacement. NICE guideline NG89 recommends venous thromboembolism prophylaxis after elective hip replacement where the risk of clotting outweighs the risk of bleeding, and sets out several acceptable drug and duration combinations.³

Your post-operative mobilisation and clot-prevention plan is recorded as part of your operation record, in line with GIRFT, British Hip Society and BOA documentation standards⁷, so that everyone involved in your care is working to the same plan.

Medication is only part of clot prevention. Early walking, moving your ankles regularly when sitting, and drinking enough fluid all matter, and they are the parts you control. Take the full course you are prescribed even once you feel well, because the risk period outlasts the symptoms.

There is no legally fixed date. You may drive again when you can get in and out of the car safely, control the pedals normally, perform an emergency stop without hesitation, are not impaired by pain or by sedating medication, and your insurer is satisfied. Many people reach that point at around six weeks. It can be earlier when the non-driving leg was operated on and an automatic car is used, and later when a manual clutch is involved on the left side.

The DVLA does not need to be notified after a routine hip replacement unless your doctor advises it, or unless you are still unable to drive three months after the operation.¹⁰ Higher medical standards apply to Group 2 (lorry and bus) licences, so ask specifically if you hold one. Tell your insurer either way: driving before you are medically fit can invalidate a policy.

A useful self-test is to sit in a stationary car and practise moving your foot firmly between the pedals. If you hesitate, you are not ready.

Return to work depends on the recovery and on the job. Desk-based work is possible for some people from around four to six weeks, particularly with a phased return, the ability to stand and move regularly, and a manageable commute. Jobs involving prolonged standing, lifting, ladders, kneeling, uneven ground or manual labour usually take considerably longer, often three months or more.

BOA standards are clear that patients should be given information about expected functional recovery, including advice on returning to normal activities such as work and driving.⁶ Ask for that advice specifically, and ask early, so that you can talk to your employer about a phased return before you need it.

My routine follow-up has two fixed points:

• Two to three weeks after surgery — wound review clinic, with a dressing change. This is also the point to raise anything that has surprised you about the first fortnight.
• Three months after surgery — clinic review with me, assessing pain, movement, gait, strength and your return to the activities that matter to you.

Between and beyond those appointments, most hip replacement recovery is self-directed, with the physiotherapist as coach rather than daily supervisor. NICE recommends that the physiotherapy or occupational therapy team gives advice on self-directed rehabilitation before you leave hospital, including a clear understanding of your rehabilitation goals and the importance of doing the prescribed exercises to reach them.¹ Supervised outpatient rehabilitation is considered for people who need more support.¹

The British Hip Society also publishes patient resources on hip surgery and recovery that you may find useful alongside this page.⁸

NICE does not currently specify one universal long-term follow-up schedule after primary joint replacement, because the evidence is insufficient.¹ New or persistent hip pain later on should always be assessed rather than accepted as normal.

• Doing too much too soon. A single long day usually costs two quieter ones. Progress is steadier when activity increases in small steps.
• Doing too little. Sitting for long periods stiffens the hip, weakens the muscles and increases clot risk.
• Interfering with the dressing. Changing it unnecessarily, or getting it wet, introduces the wound problems it exists to prevent.
• Stopping the exercises once walking feels easy. Walking alone does not rebuild the hip abductors, and this is a common reason a limp persists at three months.
• Poorly controlled pain. Pain that stops you exercising slows everything downstream. Say so rather than enduring it.
• Anaemia, poor nutrition or uncontrolled diabetes. These affect healing and stamina and are worth addressing actively.
• Trochanteric or abductor pain. Pain and tenderness over the bony point at the side of the hip, sometimes with a limp, is a recognised cause of a slower recovery and usually improves with targeted physiotherapy.

How long does it take to recover from a hip replacement?

Most people walk with an aid within a day of surgery, go home within one to three days, and manage most daily activities by six to twelve weeks. Strength, stamina and gait continue to improve for six to twelve months, and sometimes beyond. The arthritic pain often goes almost immediately, while surgical soreness settles over several weeks.

Can I put my full weight on the leg after a hip replacement?

Yes. You will be allowed to put your full weight through the operated leg as soon as you are judged safe to do so, on the day of surgery or the following day. There is no period of partial weight-bearing, and walking normally within comfort is part of the treatment rather than a risk to the implant.

How long will I need crutches after a hip replacement?

Many people move from two crutches to one, then to a single stick, over the first two to six weeks, and walk unaided after that. The right time to drop an aid is when your walking pattern stays even and safe without it, not when a set number of weeks has passed.

How long do hip precautions last after a hip replacement?

I ask my patients to keep to hip precautions indefinitely: no bending the hip beyond a right angle, no bringing the knees together or crossing the legs, no turning the operated leg inwards, and no squatting. Dislocation risk is highest in the first few months but does not disappear afterwards, and a substantial share of first dislocations happen years after the operation. Once these movements become second nature they cost you very little.

Can I shower after a hip replacement, and when can I have a bath?

Keep the dressing dry and do not change it unless it becomes fully soaked. Showering is possible provided the dressing stays dry, using a waterproof cover. Do not use a bath and do not soak the dressing at any point before your wound review clinic at two to three weeks, when the dressing is changed.

How long do I take blood thinners after a hip replacement?

My standard protocol follows one of the options recommended by NICE: low-molecular-weight heparin for 10 days, followed by aspirin at 75 mg or 150 mg daily for a further 28 days, which is 38 days of cover in total. If you already take an anticoagulant, your usual medication is restarted 24 to 48 hours after surgery, and this is discussed and planned with you at clinic before your operation.

When can I drive after a hip replacement?

Only when you can get in and out of the car safely, control the pedals normally, perform an emergency stop without hesitation, are not impaired by pain or sedating medication, and your insurer is satisfied. Many people reach that point at around six weeks. The DVLA does not need to be notified after a routine hip replacement unless your doctor advises it, or unless you are still unable to drive three months after surgery.

Can I swim breaststroke after a hip replacement?

I do not encourage breaststroke after hip replacement, because the leg action combines wide abduction with external rotation. Front crawl and backstroke are the strokes I recommend, once the wound has fully healed and you have been reviewed. A pull buoy lets you swim without the leg kick if you want to return to the water earlier.

How should I sleep after a hip replacement?

Most people sleep on their back in the early weeks, often with a pillow between the knees. Sleeping on the side becomes comfortable once the soft tissues settle, and the timing depends on the surgical approach and the advice you have been given. Broken sleep is common for several weeks and gradually improves.

Is it normal for my leg and ankle to swell after a hip replacement?

Yes. Swelling in the thigh, calf, ankle and foot is common for several weeks. Elevating the leg when resting and continuing ankle pump exercises both help. Swelling that is one-sided, sudden, or accompanied by calf pain or tenderness should be reported promptly, because it can indicate a blood clot.

When can I return to work after a hip replacement?

Desk-based work is possible for some people from around four to six weeks, particularly with a phased return. Jobs involving prolonged standing, lifting, ladders, kneeling, uneven ground or manual labour usually take considerably longer, often three months or more.

Why am I still limping weeks after my hip replacement?

A limp usually reflects weakness in the gluteal muscles at the side of the hip rather than a problem with the implant. Those muscles are often weak after years of arthritis and need targeted strengthening, because walking alone does not rebuild them. Pain over the bony point at the side of the hip can also cause a limp. Persistent limping should be reviewed.

When will I be seen after my hip replacement?

You are reviewed at two to three weeks for a wound check and dressing change, and again at three months for a clinic review assessing pain, movement, gait, strength and your return to activity. Anything that concerns you between those appointments should be raised rather than saved for the next visit.

This page is independently written for patient education. It summarises published guidance rather than reproducing guideline text, and states my own protocol where it is specific to my practice. Guidance was checked on 10 September 2026.

1. NICE NG157. Joint replacement (primary): hip, knee and shoulder. Inpatient and outpatient rehabilitation, anaesthesia and analgesia recommendations. nice.org.uk/guidance/ng157
2. NICE QS206. Joint replacement (primary): hip, knee and shoulder quality standard. nice.org.uk/guidance/qs206
3. NICE NG89. Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism. Elective hip replacement prophylaxis options. nice.org.uk/guidance/ng89
4. NICE NG226. Osteoarthritis in over 16s: diagnosis and management. nice.org.uk/guidance/ng226
5. British Orthopaedic Association and British Hip Society. Primary Total Hip Replacement: A Guide to Good Practice (the "Blue Book"), including enhanced recovery pathways. britishhipsociety.com
6. British Orthopaedic Association Standards for Trauma and Orthopaedics (BOAST), on rehabilitation, discharge planning and information about return to normal activities including work and driving. boa.ac.uk
7. GIRFT, British Hip Society and BOA. Best Practice for Hip Arthroplasty Surgery Documentation, including post-operative mobilisation and thromboprophylaxis planning. boa.ac.uk
8. British Hip Society. Patient information and resources. britishhipsociety.com/patient-information
9. National Joint Registry. Patient information on hip replacement, recovery and infection. njrcentre.org.uk/patients
10. DVLA. Assessing fitness to drive: a guide for medical professionals, on notification requirements after surgery. gov.uk
11. Crompton J, Osagie-Clouard L, Patel A. Do hip precautions after posterior-approach total hip arthroplasty affect dislocation rates? A systematic review of 7 studies with 6,900 patients. Acta Orthopaedica 2020. doi.org/10.1080/17453674.2020.1795598
12. Chan PHA, Chiu CH, Leung YC, et al. A scoping review on the recommendations of hip precautions after posterior total hip arthroplasty. 2025. doi.org/10.1177/22104917251336772