Hip replacement surgery is a procedure that removes a damaged hip joint and replaces it with an artificial one made of metal, ceramic, or plastic components. It is one of the most successful operations in modern medicine, with nearly 95% of patients reporting satisfaction after surgery. Most people undergo it because osteoarthritis has worn away the cartilage in their hip, leaving bone grinding on bone, though fractures and other conditions can also make it necessary.
Why People Need a Hip Replacement
The most common reason is osteoarthritis, a condition where the protective cartilage inside the joint gradually breaks down. Over time, this causes pain, stiffness, and difficulty walking. Other causes include rheumatoid arthritis, hip fractures (especially in older adults), and a condition called avascular necrosis, where the bone loses its blood supply and begins to collapse.
Surgery isn’t the first option. Doctors typically recommend it only after non-surgical treatments have failed to provide enough relief. That includes physical therapy, anti-inflammatory medications, weight management, corticosteroid injections, and assistive devices like canes. The decision depends on several factors: the severity of your pain, how much it limits your daily life, what imaging shows about the joint, and whether simpler treatments have stopped working. Pain, limited range of motion, and reduced walking distance are the criteria surgeons weigh most heavily. Ultimately, the choice is a shared decision between you and your surgeon based on both objective findings and how much the hip is affecting your quality of life.
Total vs. Partial Hip Replacement
Your hip joint works like a ball and socket. The ball is the rounded top of your thighbone (femur), and the socket is a cup-shaped part of your pelvis. In a total hip replacement, both the ball and socket are removed and replaced with artificial components. In a partial hip replacement, only the ball is swapped out while the natural socket stays in place.
Partial replacements are most often performed after a hip fracture in older patients. They involve a smaller operation and a shorter recovery, but because the natural socket still wears over time, some people eventually need a second surgery to replace it. Total hip replacement is far more common for arthritis because it addresses both sides of the joint and tends to last longer.
Surgical Approaches
Beyond what gets replaced, surgeons also choose how to access the joint. The two most common routes are the anterior (front) approach and the posterior (back) approach. The difference matters because it affects your early recovery experience.
The anterior approach works between the muscles rather than cutting through them. Because less muscle is disrupted, patients often have less pain in the first few weeks, stop using a walker or cane about six days sooner, and typically have no restrictions on how they bend or move the hip after surgery. Dislocation rates also tend to be slightly lower, around 1.25% compared to roughly 2.6% with the posterior approach, though the difference is small.
The posterior approach requires moving through the gluteal muscles and small rotator muscles at the back of the hip. This can mean more discomfort with sitting early on, and patients are usually told to avoid bending the hip past 90 degrees or crossing their legs for several weeks to reduce dislocation risk. By three months, however, functional outcomes are essentially the same regardless of approach. Your surgeon will recommend one based on your anatomy, their experience, and the specifics of your case.
What the Implant Is Made Of
Modern hip implants typically combine a few materials. The stem that fits into your thighbone is usually made of titanium or a cobalt-chromium alloy. The ball can be metal or ceramic. The socket liner, which sits inside the cup and provides a smooth gliding surface, is most often made of highly cross-linked polyethylene (a durable medical-grade plastic) or ceramic.
Ceramic-on-ceramic and ceramic-on-polyethylene combinations are the most widely used today. Metal-on-metal implants, once popular for younger patients, fell out of favor because of concerns about metal particles wearing into surrounding tissue. The choice of materials affects how long the implant lasts and how it wears, and your surgeon will select a combination based on your age, activity level, and anatomy.
How Long Implants Last
Hip replacements are remarkably durable. About 90% of implants are still functioning well at the 10-year mark. After 15 years, the risk of needing a revision drops significantly, and many implants last 20 years or more. In large studies, the 10-year revision rate has ranged from about 6% to 17%, with an average around 9%.
If an implant does eventually fail, the most common reason is aseptic loosening, where the implant gradually loses its bond with the surrounding bone without any infection present. This accounts for about 37% of revisions. Infection causes roughly 15% of revisions, and dislocation accounts for about 18%. Revision surgery is more complex than the original procedure and carries higher complication rates, which is one reason surgeons and patients carefully weigh the timing of a first replacement, particularly in younger, more active individuals.
Risks and Complications
Overall complication rates after a first-time hip replacement range from about 2% to 10%. The most notable risks include dislocation, infection, and blood clots in the legs or lungs.
Dislocation, where the new ball slips out of the socket, happens in about 2% of patients within the first year. The risk is highest in the first month and decreases as the surrounding muscles and tissue heal and strengthen. Following your surgeon’s movement precautions during early recovery significantly lowers this risk. Infection occurs in a small percentage of cases and can sometimes require additional surgery to clear. Blood clots are managed with blood-thinning medication started shortly after the operation. Other possible complications include a difference in leg length after surgery and nerve injury, though both are uncommon.
Recovery Timeline
Recovery starts the same day as surgery. Most people stand and take a few steps within hours of the procedure. Rehabilitation focuses first on basic movements like getting out of bed, sitting in a chair, and walking short distances. Within a few days, you progress to more challenging tasks like climbing stairs and getting in and out of a car.
After leaving the hospital (often within one to three days), you’ll work with physical and occupational therapists two to three times per week and do exercises at home. You can put weight on the new hip right away in most cases, though a cane or walker helps with balance early on. If you had surgery on your right hip, plan on about a month before driving safely. For left hip surgery, you may be driving again in one to two weeks.
Returning to a desk job takes about two weeks. Physically demanding jobs require closer to six weeks off. Low-impact activities like golf can resume whenever you feel ready, while high-impact sports and swimming should wait about six weeks to allow the incision to fully heal. Pain levels typically decrease steadily and reach a 1 or 2 out of 10 by about 12 weeks after surgery.
Robotic-Assisted Surgery
A growing number of hip replacements are performed with robotic assistance. The surgeon still does the operation, but a robotic arm helps position the implant with greater precision. Studies comparing robotic-assisted and traditional surgery in the same patient (one hip done each way) found that the robotic side had more accurate implant placement, smaller leg-length differences (averaging less than half a centimeter), and better functional scores at one year. In one study, hip function scores improved from 46 to 89 with robotic assistance, compared to 55 to 82 with the traditional method.
Robotic-assisted surgery is not available everywhere and may add to the cost, but it represents a meaningful improvement in implant accuracy. Not every patient needs it, and excellent outcomes are achieved with traditional techniques as well.
Cost and Insurance Coverage
For Medicare beneficiaries, the total Medicare-approved cost for a hip replacement averages about $10,800 at an ambulatory surgical center and roughly $14,300 at a hospital outpatient department (based on 2026 national averages). Medicare typically covers 80% of the approved amount, leaving patients responsible for approximately $1,970 to $2,150 out of pocket, though hospital outpatient copayments are capped at $1,676. Supplemental Medicare plans or Medigap policies can reduce this further.
For those with private insurance, costs vary widely depending on your plan, your deductible, and whether the surgeon and facility are in-network. Without insurance, a hip replacement in the United States can range from $30,000 to $75,000 or more. Most insurers require documentation that conservative treatments have been tried and that imaging confirms significant joint damage before approving the procedure.