Direct answer
Hip replacement surgery removes the damaged ball and socket of the hip and replaces them with an implant. The operation takes about 1 to 2 hours, most people walk the same day, and modern implants are expected to last decades. The essentials:
- Who it is for: people whose hip arthritis causes pain or stiffness that limits daily life after other treatments have been tried.
- How it is done: through the front of the hip (anterior) or the back (posterior), sometimes with robotic or navigation assistance.
- Hospital stay: home the same day or after 1–3 nights, depending on your health and your surgeon’s plan.
- Recovery: light daily activities within 3–6 weeks, most normal activities by about 3 months, gains for up to a year.
- How long it lasts: registry data put modern implants at about 94% still in place at 20 years.
- Waiting in Canada: 68% of public-system patients had their hip replaced within the 182-day benchmark in 2024. Pathway’s surgeons consult within 1–4 business days and typically operate 2–4 weeks after consultation and quote approval.
This guide is for people who have been told they may need a hip replacement, and for the family helping them decide. The figures come from public health guides, joint-replacement registries, and peer-reviewed studies. Your own plan depends on your imaging, your health, and your surgeon’s judgement.
What is hip replacement surgery?
The hip is a ball-and-socket joint. The ball is the top of the thigh bone (the femoral head) and the socket is part of the pelvis (the acetabulum). When arthritis wears away the cartilage covering both surfaces, bone rubs on bone and the joint becomes painful and stiff.
A total hip replacement, also called total hip arthroplasty, removes the damaged ball and socket and replaces them with an implant. The American Academy of Orthopaedic Surgeons describes four parts: a metal stem that sits inside the thigh bone, a metal or ceramic ball on top of the stem, a metal socket fixed into the pelvis, and a liner between the ball and socket that gives the joint a smooth gliding surface.
The implant can be press-fit, so bone grows onto a textured surface, or fixed with bone cement, or a combination of the two. Your surgeon chooses based on your bone quality and age.
Who is hip replacement surgery for?
Osteoarthritis is the most common reason. The NHS also lists rheumatoid arthritis and hip damage from a fall or injury, and says surgery is usually considered when hip pain and stiffness have a big effect on your life and other treatments have been tried.
The AAOS lists the symptoms that typically lead to surgery: hip pain that limits walking or bending, pain at rest during the day or at night, stiffness that limits movement or lifting the leg, and inadequate relief from anti-inflammatory medication, physiotherapy, or walking aids. Most patients are between 50 and 80 years old, but there are no absolute age or weight restrictions. Surgeons assess each person individually.
If you are still weighing surgery against other options, Pathway’s guide to surgery versus non-surgical treatment for hip arthritis covers injections, physiotherapy, and the signs that conservative care has run its course.
Anterior vs posterior approach: what is the difference?
The approach is the path the surgeon takes to reach the joint. The two most common are the direct anterior approach, through the front of the hip between muscles, and the posterior approach, through the back of the hip, where some muscles are released and repaired.
A 2020 meta-analysis of randomized trials covering 932 patients found that people who had the direct anterior approach reported less early pain and stopped using walking aids about 11 days sooner, on average, than people who had the posterior approach. Operating time, hospital stay, and blood loss were similar. The trade-off was a higher rate of numbness on the outer thigh, from irritation of a skin nerve that crosses the front of the hip.
Pathway’s hip surgeons perform direct anterior hip replacement. Dr. Sebastian Rodriguez-Elizalde was the first surgeon in the Greater Toronto Area to perform direct anterior hip replacement on a Hana table, Dr. Michael Zywiel is fellowship-trained in the direct anterior approach, and Dr. Thomas Zochowski performs anterior hip replacement. Pathway’s guide to anterior versus posterior hip replacement goes through the evidence on precautions and dislocation in more detail.
Does robotic or navigation assistance help?
Robotic systems and computer navigation help the surgeon plan the implant position from your imaging and then place the components to that plan. The surgeon still performs the operation and stays in control throughout.
A 2025 meta-analysis of 38 studies and 10,055 patients found robotic assistance placed the socket within the target “safe zone” more often and was linked to lower complication rates, with no difference in revision rates and similar patient-reported scores at follow-up. Operating time was longer. A 2026 meta-analysis of 15 studies found robotic guidance cut socket positioning outliers and was associated with fewer early dislocations in the first year.
Pathway’s hip replacement procedure page describes the robotic and navigation systems Pathway’s surgeons use. Dr. Rodriguez-Elizalde has performed more than 5,000 combined robotic knee and hip replacements. Your surgeon decides whether assistance suits your anatomy.
What are the implants made of?
The “bearing” is the pair of surfaces that rub together: the ball and the liner. The ball is usually cobalt-chrome metal or ceramic. The liner is usually highly cross-linked polyethylene, a dense medical plastic engineered to wear slowly. The combinations you will hear about are metal-on-polyethylene, ceramic-on-polyethylene, and ceramic-on-ceramic.
An analysis of 1,026,481 hip replacements in the National Joint Registry for England and Wales found the lowest revision risk with a ceramic or oxidised zirconium head paired with a highly cross-linked polyethylene liner. Compared with a cobalt-chrome head on the same liner, the hazard of revision was 21% lower with a delta ceramic head and 35% lower with an oxidised zirconium head.
Metal-on-metal bearings, used in some older implants, can shed metal ions and are rarely used now; the NHS advises regular check-ups for people who have one.
What happens on the day of surgery?
| Step | What typically happens |
|---|---|
| Arrival | You usually come in on the day of the operation. The team confirms your health checks, imaging, and the plan you agreed with your surgeon. |
| Anaesthetic | A spinal anaesthetic, which numbs you from the waist down while you stay awake or lightly sedated, or a general anaesthetic, which puts you to sleep. The anaesthesia team chooses with you. |
| The operation | About 1 to 2 hours. The surgeon removes the damaged femoral head, prepares the socket, fits the new socket and liner, places the stem and ball, checks leg length and stability, and closes the incision. |
| Recovery room | Several hours while the anaesthetic wears off and the team manages pain and checks the wound. |
| First steps | Most people stand and walk with a walker or crutches on the day of surgery, with a physiotherapist. |
| Going home | The same day for selected patients, or after 1–3 nights, once you can walk safely and your pain is controlled. |
The timings above come from the AAOS and the NHS. A 2022 systematic review of 41 studies found same-day discharge pathways as safe as inpatient stays in selected, generally younger and healthier patients, with 92% of planned same-day patients going home as planned. Your surgeon decides which plan fits you.
What does recovery look like?
Recovery runs in phases. The AAOS says most normal light daily activities return within 3 to 6 weeks, and that sitting, bending, and sleeping precautions usually apply for the first 6 weeks, depending on the approach. The NHS says most people can return to work around 6 weeks, depending on the job, and should wait at least 6 weeks before driving. Alberta Health Services gives the same 6-week driving guide and advises against lifting more than 11 kg in the first months.
- Day of surgery to week 2: walking with an aid, short frequent walks, wound care, and blood-clot prevention. Staples or stitches come out at about 2 weeks.
- Weeks 2–6: moving from a walker or crutches to a cane, longer walks, and light daily activities.
- Weeks 6–12: driving and desk work for most people, with precautions reviewed by your surgeon.
- Months 3–12: most normal activities and low-impact sport such as walking, swimming, cycling, and golf, with strength and stamina still improving.
The AAOS advises against high-impact activities such as running and jumping after a hip replacement, because they speed implant wear. Pathway’s week-by-week hip replacement recovery guide covers walking aids, stairs, sleep, driving, work, and sport in detail.
What are the risks of hip replacement surgery?
The AAOS puts serious complications such as joint infection at less than 2% of patients. The main risks are:
- Blood clots in the leg or pelvis, which can travel to the lungs. Blood thinners, compression stockings, ankle exercises, and early walking lower the risk.
- Infection, which can appear days, weeks, or years after surgery. Minor wound infections respond to antibiotics; deep infections may need further surgery.
- Dislocation, when the ball comes out of the socket. The risk is highest in the first few months. A 2023 review of reviews covering 895,734 conventional total hip replacements found a mean dislocation rate of 2.1%, with larger heads and the anterior approach among the few factors that modestly lower the risk.
- Leg-length difference. Surgeons aim for equal lengths, and most differences are too small to notice. A shoe insert helps when they are.
- Nerve or blood vessel injury, fracture, stiffness, and ongoing pain, which are uncommon.
- Loosening and wear over years, which can eventually need a revision.
Call 911 for chest pain or sudden shortness of breath. Call your surgeon or care team for a fever over 38.5 °C, increasing redness, swelling, or drainage at the wound, calf pain or swelling, or sudden severe hip pain with a leg that looks shorter or will not bear weight.
How long does a hip replacement last?
Longer than most people expect. The NHS says modern hip replacements are designed to last at least 15 years. Registry data say more. A 2019 Lancet analysis of national registries, covering implants of all types and eras, found 89% of hip replacements still in place at 15 years, 70% at 20 years, and 58% at 25 years.
A 2026 Lancet study looked only at modern bearings, pooling 1.9 million hip replacements from eight national registries. It found 93.6% survivorship at 20 years and projected 92.8% at 25 years and 92.1% at 30 years. Pathway’s guide to how long a hip replacement lasts explains revision rates by age and implant type.
How long is the wait for hip replacement in Canada?
Canada’s benchmark for hip replacement is 26 weeks, or 182 days, from the date a patient is ready for surgery. The Canadian Institute for Health Information reported that in 2024, 68% of hip replacement patients were treated within that benchmark, below the 2019 pre-pandemic level even though hospitals performed 26% more hip replacements than in 2019. That clock starts after you have seen a surgeon; the wait for a consultation comes first.
Volume is also rising. CIHI’s joint replacement registry counted more than 62,000 hip replacements in 2018–2019, up 20.1% over five years. Pathway’s guide to hip replacement wait times in Canada breaks the numbers down by province.
What are the private options with Pathway?
Pathway’s surgeons perform direct anterior hip replacement at Pathway’s partner surgical centres in Toronto and Montreal, for patients from every province. No referral is required. A consultation takes place within 1–4 business days, and surgery typically follows 2–4 weeks after consultation and quote approval. Pathway’s dedicated care team — patient liaison, patient care, and nursing — handles records, scheduling, travel, pre-operative preparation, and follow-up.
Three surgeons on Pathway’s roster perform hip replacement. Dr. Sebastian Rodriguez-Elizalde completed his fellowship at the Hospital for Special Surgery in New York, practises at Humber River Health, and directs the Humber Hip and Knee Fellowship; he consults in Toronto and Montreal. Dr. Michael Zywiel is fellowship-trained in the direct anterior approach, practises at Toronto Western Hospital, and is an Assistant Professor of Surgery at the University of Toronto. Dr. Thomas Zochowski completed fellowships in adult lower-extremity reconstruction at UHN and orthopaedic sports medicine at the University of Toronto. Patients travelling from outside Ontario or Quebec can read Pathway’s guide to out-of-province surgery in Canada.
Quick answers
How long does hip replacement surgery take?
The operation itself usually takes about 1 to 2 hours. Add several hours in the recovery room while the anaesthetic wears off. Most people take their first steps with a walker on the day of surgery.
Is hip replacement surgery a major surgery?
Yes. It is a major operation under spinal or general anaesthetic, but it is also one of the most common and most studied procedures in medicine. Serious complications such as joint infection occur in less than 2% of patients, and most people are home within a day or two.
What is the difference between anterior and posterior hip replacement?
The anterior approach reaches the hip through the front, between muscles; the posterior approach goes through the back and releases muscles that are repaired afterwards. Trials show less early pain and earlier walking without aids with the anterior approach, and a higher rate of temporary numbness on the outer thigh. Long-term results are similar.
How long does a hip replacement last?
Registry data on modern bearings show about 94% of hip replacements still in place at 20 years, with a projected 92% at 30 years. Older data covering all implant types found 89% at 15 years and 58% at 25 years. Activity level, weight, and age affect wear.
How long is the wait for a hip replacement in Canada?
The national benchmark is 182 days from the decision to operate. In 2024, 68% of patients in the public system were treated within it, and the wait to see a surgeon comes before that clock starts. Pathway’s surgeons consult within 1 to 4 business days and typically operate 2 to 4 weeks after consultation and quote approval.
Questions to ask your surgeon
- Is my hip arthritis advanced enough that surgery is the right next step, or is there a non-surgical option worth trying first?
- Which approach do you plan to use for my hip, and why?
- Will you use robotic or navigation assistance, and what does it change for me?
- Which implant and bearing will I receive, and what is its registry track record?
- Will I go home the same day or stay overnight?
- Which movement precautions will I follow, and for how long?
- When do you expect me to drive, return to my job, and return to my sport?
- What blood-clot prevention will I use, and who do I call after hours if I notice a warning sign?
If recovery is your next question, Pathway’s hip replacement recovery guide walks through each phase week by week.
References
- American Academy of Orthopaedic Surgeons (OrthoInfo). Total Hip Replacement. Accessed October 20, 2026.
- NHS. Why a hip replacement is done, How a hip replacement is done, Recovering from a hip replacement, and Complications of a hip replacement. Last reviewed March 6, 2024. Accessed October 20, 2026.
- Alberta Health Services. Hip Replacement Surgery: What to Expect at Home. MyHealth.Alberta.ca; current as of August 28, 2023. Accessed October 20, 2026.
- Yang XT, Huang HF, Sun L, et al. Direct anterior approach versus posterolateral approach in total hip arthroplasty: a systematic review and meta-analysis of randomized controlled studies. Orthop Surg. 2020;12(4):1065–1073.
- Bensa A, Pagliazzi G, Miele A, et al. Robotic-assisted total hip arthroplasty provides greater implant placement accuracy and lower complication rates, but not superior clinical results compared to the conventional manual approach: a systematic review and meta-analysis. J Arthroplasty. 2025;40(7):1921–1931.
- Arun Kumar G, Sharma G, Ali AFU, et al. Robotic-assisted versus conventional manual total hip arthroplasty: a systematic review and meta-analysis of component position accuracy, Lewinnek zone outliers, and early dislocation rates. J Robot Surg. 2026;20(1):717.
- Whitehouse MR, Patel R, French JMR, et al. The association of bearing surface materials with the risk of revision following primary total hip replacement: a cohort analysis of 1,026,481 hip replacements from the National Joint Registry. PLoS Med. 2024;21(11):e1004478.
- Bemelmans YFL, Keulen MHF, Heymans M, et al. Safety and efficacy of outpatient hip and knee arthroplasty: a systematic review with meta-analysis. Arch Orthop Trauma Surg. 2022;142(8):1775–1791.
- Hernigou P, Barbier O, Chenaie P. Hip arthroplasty dislocation risk calculator: evaluation of one million primary implants and twenty-five thousand dislocations with deep learning artificial intelligence in a systematic review of reviews. Int Orthop. 2023;47(2):557–571.
- Evans JT, Evans JP, Walker RW, et al. How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet. 2019;393(10172):647–654.
- Pentland V, Thompson Z, Dayimu A, et al. Survivorship of modern total hip replacement to 30 years: systematic review, meta-analysis, and extrapolation of global joint registry data. Lancet. 2026;407(10531):855–866.
- Canadian Institute for Health Information. Wait Times for Hip Replacement: Percentage Meeting Benchmark (indicator definition). Accessed October 20, 2026.
- Canadian Institute for Health Information. Wait times for priority procedures in Canada, 2025. Released June 12, 2025. Accessed October 20, 2026.
- Canadian Institute for Health Information. Hip and Knee Replacements in Canada: CJRR Annual Report. Accessed October 20, 2026.
Health information notice: This article provides general information about hip replacement surgery and cannot replace individual medical advice. Your surgeon decides whether surgery is right for you, which approach and implant to use, and how your recovery is planned.