Hip Replacement

What Is Hip Replacement Surgery?

Hip replacement surgery is most commonly performed to treat osteoarthritis, where the protective cartilage in the hip joint wears away, causing pain, stiffness, and reduced mobility. Other causes include rheumatoid arthritis, hip dysplasia, avascular necrosis, trauma, or fractures. If non-surgical treatments no longer help, surgery may be the best option. The procedure involves removing the damaged bone and cartilage, and replacing it with a metal stem, ball, and socket to restore smooth joint movement. Surgery typically lasts 60–90 minutes and takes place under regional or general anaesthesia. In some cases, both hips can be replaced during one operation, particularly if pain and stiffness affect both sides severely. The decision to proceed with surgery is made between you and your surgeon, usually when hip pain becomes daily, limits activity, affects sleep, and non-operative options have been exhausted.

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What Are the Risks?

While most hip replacements are highly successful, there are some risks involved, as with any surgery. Serious complications are uncommon—affecting fewer than 2–3% of patients—but they can include infection, blood clots, or dislocation. To reduce these risks, Dr. Bill Farrington uses strict infection control practices and prescribes antibiotics, blood thinners, and compression devices. Staying mobile and following post-operative instructions also plays a key role in preventing complications.

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Less common risks include nerve or blood vessel injury, fracture near the implant, joint stiffness, uneven leg length, trochanteric bursitis (pain over the hip), and swelling that typically settles within 4–6 weeks. Some patients may experience bleeding requiring transfusion or haematoma that may need drainage.

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There are also general risks from anaesthesia, such as stroke, heart attack, urinary retention, or temporary confusion. Your Anaesthetist will discuss these with you before surgery to ensure you are well informed and supported throughout the process.

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How Long Will I Be in Hospital?

As a general guideline, patients typically remain in hospital for 3 to 5 days after a hip replacement. Dr. Bill Farrington will make sure you are meeting a set of important recovery milestones before you’re ready to go home. These include being able to walk safely using crutches or a frame, move in and out of bed and chairs independently, and manage personal care tasks such as dressing, showering, and using the bathroom with confidence.

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How Do I Get Ready for Surgery?

The decision to have hip replacement surgery is made together with your orthopaedic surgeon. Most patients consider surgery when pain becomes daily, limits movement, disturbs sleep, and no longer responds to medication or physiotherapy. Once surgery is planned, preparing well can support your recovery.

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In the lead-up to surgery, keep active with gentle daily walks and light strength exercises—avoid anything that causes pain. Eat nutritious meals, stay hydrated, and prioritise sleep.

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Stop herbal supplements (e.g. St John’s Wort, ginseng, garlic) four weeks prior, as they can interfere with medications. If you smoke, quitting six weeks before surgery significantly improves healing—talk to your GP or contact Quitline at 0800 778 778.

Practice deep breathing exercises to maintain lung health—your nurses will assist with these after surgery.

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Good preparation, combined with careful planning, helps ensure a safer procedure, smoother recovery, and a faster return to the activities you enjoy.

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What Should I Do the Night Before?

Ensure you're well prepared for your hospital stay by packing your hospital bag in advance and including any important documents or medical information you may need.

 

Do not eat or drink anything after midnight, unless your surgical team has given you different instructions.

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Some patients may be advised to take essential morning medications—please follow these directions exactly. You may brush your teeth in the morning, but only rinse your mouth with water and avoid swallowing.

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How Long Does the Surgery Take?

We typically allocate two to three hours for your procedure, with the surgery itself taking around 90 minutes to two hours. Beforehand, you’ll be prepared by the surgical team and guided through important safety checklists. Dr. Bill Farrington will meet with you to confirm the surgical site, answer any final questions, and complete your consent form.

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You’ll also meet your Anaesthetist, who will review your medical history and discuss the most suitable type of anaesthesia. Most patients receive a spinal anaesthetic with sedation or a general anaesthetic. An IV line will be inserted for fluids and medications. Once you’re fully anaesthetised and final theatre checks are complete, the operation will begin in a modern, ultra-clean surgical environment.

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What Happens Right After the Surgery?

After your hip replacement surgery, you’ll be taken to the recovery room where nursing staff will monitor your vital signs and begin pain management. You’ll stay here for around 30 to 60 minutes, depending on how quickly you recover from the anaesthetic. Once stable, you’ll return to your room in the ward.

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Pain is usually minimal at this stage due to the use of regional or general anaesthesia, and a local anaesthetic injected into the joint during the operation. Your hip will be dressed with a padded bandage over the incision, which is typically closed with dissolvable sutures, so there’s no need for stitch removal.

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You may have a urinary catheter in place for a short time, and an IV line will be used to deliver fluids and medications. Compression stockings will be fitted to both legs, and calf pumps may be used to help blood circulation and reduce the risk of clots.

Dr. Bill Farrington will contact your nominated support person to confirm you’re safely in recovery.

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What Happens While I’m in Hospital?

During your stay in hospital after hip replacement surgery, you will be cared for by a dedicated team focused on your comfort, safety, and recovery. Your vital signs—including blood pressure, temperature, and heart rate—will be monitored regularly, along with your fluid intake and output. Pain management is a top priority, and medication will be given to keep you as comfortable as possible.

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Day One: You’ll be gently assisted out of bed and supported with showering and dressing before moving to a recliner chair. If you had a catheter inserted, it’s usually removed at this stage. Your antibiotics will be stopped, but blood thinners will continue. You may have a blood test or X-ray. A physiotherapist will begin guiding you through simple exercises, and Dr. Bill Farrington will check in with you on the ward.

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Day Two: You’ll start doing more independently. Mild pain may persist but is typically well controlled with oral medication. Most patients begin walking with a frame and may transition to crutches.

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Day Three and Onward: Your mobility will continue to improve, and your care team will help prepare you for discharge.

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On leaving the hospital, you’ll be provided with crutches, a prescription for pain relief and blood thinners, and instructions for follow-up care.

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How Do I Prepare to Go Home?

Preparing to go home after your hip replacement surgery is an important part of your recovery plan. Most patients return home directly after their hospital stay, where healing continues in a familiar and comfortable environment. In the first few weeks, you may need help with meals, shopping, or housework—especially if you live alone. Try to organise support from a friend or family member ahead of time.

Before you leave for hospital, take simple steps to get your home ready. Clean the house, change your bed linen, and prepare some easy-to-reheat meals. These efforts will help reduce stress and allow you to focus fully on your recovery.

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To stay safe and prevent falls once you're home, consider the following:

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• Remove any tripping hazards such as loose rugs or cords

• Use non-slip mats in the kitchen and bathroom

• Install night lights for better visibility at night

• Avoid open-toe or backless footwear

• Keep frequently used items at waist level to avoid bending

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Walking daily is essential for rebuilding strength and flexibility. Pay special attention to skin care, as infections can occur if wounds or skin issues go untreated. Good dental hygiene is also important, as infections in the mouth can travel through the bloodstream and affect your hip joint.

Planning ahead will make your return home safer, smoother, and more focused on healing.

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What Can I Expect in the First 6 Weeks?

Recovery after hip replacement varies for each person, but the first six weeks are critical for healing and regaining independence. You may need help from a partner, friend, or family member during this time. It’s normal to experience some swelling in the thigh or ankle on the operated side—this may take up to 3 months to fully settle. If the swelling becomes hot or painful, contact Dr. Bill Farrington’s office for advice.

You’ll likely use crutches for several weeks to help with balance and mobility. As your strength improves, you may transition to using one crutch before walking unaided. A physiotherapist will guide you with exercises to rebuild muscle strength and reduce stiffness. Gentle walking on flat ground daily is highly recommended.

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Most people take about six weeks off work, depending on their job and recovery progress. It's important to focus on rest and rehabilitation early on, as fatigue is common during the first few weeks.

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You won’t be able to drive for the first 4–6 weeks following surgery. After this period, and once you’re no longer taking strong pain relief and can perform an emergency stop, you may begin driving short distances. If you're unsure, take a gentle test drive a few days before your follow-up appointment.

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Your waterproof dressing allows you to shower safely, and your GP should check your wound around 12 days post-op. While recovery takes time, pain will lessen, mobility will return, and confidence in your new hip will steadily grow.

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How Do I Take Care of My New Hip?

Taking care of your new hip begins at home with daily walking and gradual activity to rebuild strength and prevent stiffness. Movement helps restore muscle function, improve bone density, and promote long-term joint health. You’ll also need to protect your hip by avoiding certain movements—don’t cross your legs, bend your hip past 90 degrees, or twist at the waist. Use tools like a long-handled grabber or shoehorn to avoid bending too far. Take good care of your skin and dental hygiene to prevent infections that could reach the joint. If you develop an infection, seek treatment quickly. Most hip replacements last 20 to 25 years, though this depends on your activity level, general health, and the type of implant. While revision surgery is possible if needed, it carries more risks—so ongoing care is key to making your hip last.

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What Follow-Up Appointments Will I Have?

You will have a follow-up appointment with Dr. Bill Farrington around 6–8 weeks after surgery, either in person or via telehealth. This visit reviews your recovery and may include advice on starting a rehabilitation programme. Further check-ups with X-rays are recommended at 1 year and 10 years, or sooner if any concerns arise.

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What If I Have Any Problems After?

All patients are reviewed around 6–8 weeks after surgery, either in person or via telehealth clinic. This is a chance to assess your progress, address any concerns, and, if appropriate, begin a tailored rehabilitation programme to rebuild strength and mobility. While complications are rare, issues such as infection, blood clots, joint dislocation, or excessive swelling can occur. If you develop fever, increased pain, redness, unusual swelling, or any other concerns, please contact Dr. Bill Farrington’s office (Auckland Joint Surgeon) or your GP immediately. Your recovery and well-being are our top priorities—never hesitate to reach out if something doesn’t feel right.