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Hip Surgery 9 min read

Hip Replacement
Recovery Week by Week

A realistic, week-by-week guide to what you can expect after total hip replacement - from the day of surgery through to your 3-month review with Dr Liew.

Dr Chien-Wen Liew
Orthopaedics 360

Recovery from total hip replacement is faster than most patients expect - particularly with the direct anterior approach. This guide walks through what is typical at each stage, from waking up in recovery through to your 3-month review with Dr Liew. Individual timelines vary, and Dr Liew will provide you with a personalised plan at your pre-operative and post-operative appointments.

01

Surgery Day & Days 1-2

Hip replacement is performed under general or spinal anaesthesia and typically takes 60-90 minutes. Most patients are up and walking - with the assistance of a physiotherapist and a walking frame - on the same day as surgery or the morning after. This early mobilisation is deliberate and important: it reduces the risk of blood clots, prevents stiffness, and promotes circulation to the healing tissues.

Pain in the first 24-48 hours is managed with a combination of local anaesthetic infiltration during surgery, regular paracetamol and anti-inflammatory medication, and short-term opioid analgesia as required. Most patients are surprised by how manageable the early pain is.

You will typically spend 1-3 nights in hospital. Discharge depends on your walking ability, pain control, and the results of any post-operative blood tests. Before going home, the physiotherapy team will ensure you are confident on the stairs.

"We get patients walking on the day of surgery. Early movement is one of the most important things we can do - it reduces complications and starts the rehabilitation process immediately."

Dr Chien-Wen Liew - FRACS (Orthopaedics)
02

Weeks 1-2: Home Recovery Begins

The first two weeks at home are focused on rest, gentle mobilisation, and wound care. You will be walking with a frame or elbow crutches, and progressively increasing your walking distance each day. Short, frequent walks are more beneficial than one long walk.

Week 1
Getting established at home Walking 5-10 minutes, 3-4 times per day. Wound still closed; keep dry until reviewed. Sleeping on your back or non-operative side with a pillow between knees. Pain reducing with regular oral analgesia. Light activities around the home only.
Week 2
First post-operative review Walking distance increasing to 15-20 minutes. Many patients transition from frame to a single crutch. Wound reviewed and clips or sutures removed (if not absorbable). Opioid analgesia typically being weaned or ceased. Routine post-operative X-rays are taken at this visit to confirm implant position. If clinically indicated, a Doppler ultrasound may also be arranged to screen for deep vein thrombosis (DVT).

Most patients with the direct anterior approach have no formal hip precautions (no restriction on bending, crossing legs, or internal rotation), unlike the traditional posterior approach. Dr Liew will confirm what applies to you specifically based on your surgical approach and implant.

03

Weeks 3-6: Functional Independence

This is the phase where most patients notice significant day-to-day improvement. Walking becomes more comfortable, sleep improves, and many routine activities can be resumed.

Week 3
Return to driving (if applicable) Most patients are cleared to drive at 2-3 weeks - provided they are off opioids and can perform an emergency stop. Walking without aids is becoming possible for short distances on flat surfaces.
Week 4
Walking without aids for most activities Physiotherapy exercises progressing to include strengthening. Light shopping and outings possible. Desk-based workers often return to work around this time. Hip feels more secure and natural.
Weeks 5-6
Increasing activity and confidence Walking distance now largely unlimited for most patients. Swimming (non-chlorinated or once wound fully healed) may be appropriate. Physiotherapy transitioning to progressive strengthening and balance work. Swelling reducing gradually.
04

Weeks 6-12: Rebuilding Strength

At the 6-week mark, most patients feel well but may still notice muscular fatigue, occasional swelling around the thigh and knee, and some stiffness after prolonged sitting. These are normal and expected - the soft tissues and bone are still healing and adapting, even if you feel largely well.

This phase is about progressive strengthening rather than rushing back to high-demand activities. Low-impact exercise such as walking, swimming, and stationary cycling is encouraged. High-impact activities - running, contact sports, heavy lifting - remain on hold.

  • Light hiking on flat, stable terrain is typically appropriate from 6-8 weeks
  • Golf (riding, no full swing) from approximately 6 weeks; full swing from 10-12 weeks
  • Swimming from 6 weeks once the wound is fully healed and confirmed by Dr Liew
  • Cycling (stationary) from 4-6 weeks; road cycling from 8-10 weeks
  • Physically demanding work assessed on an individual basis - typically 8-12 weeks

Swelling in the thigh and sometimes around the knee is common throughout this phase and is not a cause for concern. Elevation of the leg when resting and compression stockings (if still worn) help manage this.

05

3 Months: Final Review and Beyond

Many patients are surprised to learn that hip replacement recovery continues well beyond the first few months. The implant is secure and the major healing is done, but the muscles, nerves, and surrounding tissues continue to adapt and strengthen over a longer period.

Most patients reach their functional plateau somewhere between 3 and 6 months. This varies significantly - patients who were very debilitated before surgery, or who had significant muscular atrophy, may take longer to rebuild full strength and confidence.

3 Months
Final post-operative review with Dr Liew Provided recovery is progressing as expected, the 3-month appointment is Dr Liew's final scheduled review. Routine X-rays are taken at this visit to confirm implant position and bone integration. Higher-impact activities such as running may be cleared at this point. Most patients feel strong and capable in daily life, with residual muscular asymmetry continuing to resolve.
Beyond 3 Months
Ongoing improvement Strength and confidence continue to build gradually. Most patients feel they have their life back by 3-6 months. Minor residual stiffness after prolonged sitting is normal and continues to improve. The new hip should increasingly feel like a natural part of the body. If any concerns arise after discharge from Dr Liew's care, the rooms remain available on (08) 7077 0157.

If you are not progressing as expected, or if you develop new pain, significant swelling, or any wound concerns at any stage, contact Orthopaedics 360 promptly on (08) 7077 0157.

06

Frequently Asked Questions

When can I walk after hip replacement?+
Most patients are walking with a frame or crutches on the day of surgery or the morning after. With the direct anterior approach, you can typically bear full weight immediately. The distance you walk increases steadily over the first 2-4 weeks.
When can I drive after hip replacement?+
Most patients are safe to return to driving around 2-3 weeks after surgery, provided they are no longer taking opioid pain medication and can perform an emergency stop comfortably. This depends on which leg was operated on and the type of vehicle. Check with Dr Liew at your post-operative review.
How long will I need crutches or a walking frame?+
With the direct anterior approach, most patients progress from a frame to a single crutch within 1-2 weeks, and many discard aids altogether by 3-4 weeks. Individual progression depends on strength, confidence, and comfort.
When can I return to work after hip replacement?+
Desk-based workers typically return at 2-4 weeks. Those with physically demanding roles may require 6-12 weeks off depending on the nature of the work. Dr Liew will advise based on your specific occupation and recovery.
Will I need physiotherapy after hip replacement?+
Yes. Physiotherapy is an important part of recovery and helps restore strength, balance, and confidence. Your physiotherapy programme will be tailored to your progress and is typically most intensive in the first 6-8 weeks after surgery.

Download the Recovery Guide

A printable PDF summary of your hip replacement recovery timeline

Download PDF
General Information Only. This article is intended to provide a general guide to hip replacement recovery and does not constitute personal medical advice. Individual recovery timelines vary based on surgical approach, implant choice, pre-operative health, and patient factors. Always follow the specific instructions provided by Dr Liew and your treating physiotherapist.