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The ultimate guide to

Total Hip Replacement Surgery

Understand what your hip pain means, what might be causing it, when it might be time for a hip replacement surgery and how a total hip replacement can bring you relief.

Download your copy of this total hip replacement guide.
Download your copy of this total hip replacement guide.

This guide discusses ...

Living with hip pain is not normal

Hip arthritis isn’t new, nor is a hip replacement as a way to treat its associated pain and inflammation. 

As far back as the 19th century, surgeons began attempting to reconstruct the damaged surfaces of arthritic hips. 

We’ve come a long way since then, and today things are different.

Total hip replacement surgery is safe, reliable and durable. It is one of the most effective—and one of the most common—operations of any type developed during the 20th century. 

Modern hip replacement procedure involves replacing the diseased portion of the hip joint (the damaged cartilage and part of the bone underneath) with a replacement prosthesis to relieve your pain and make your joint work better. 

New hip joints usually last 15 to 20 years for around 95 percent of patients who have a total joint replacement procedure to relieve the pain from hip arthritis.

OrthoIndy’s Ultimate Guide to Total Hip Replacement Surgery will help you better understand what your hip pain means,  your problem, what might be causing it and how a total hip replacement can bring you relief. 

Whether you’re just beginning to research hip arthritis or if you’ve already decided to have total hip replacement surgery, this guide includes a number of resources from our team of experts that you’ll find helpful.

What causes hip pain, and how can I find relief?

Every time you take a step, you use your hip, and it’s this use that makes your hip susceptible to a number of injuries, aches and pain. 

But, there are differences between temporary hip pain that is typically caused by an injury or accident, and chronic hip pain that is often caused by hip arthritis.

What is hip arthritis?

Arthritis is the medical term for inflammation of one or more of your joints, and it is common in the hip joint.

There are more than 100 different forms of arthritis that can affect a variety of joints in your body, and most hip pain is caused by one of these three kinds of arthritis:

  • Osteoarthritis. Osteoarthritis is the most common form of arthritis in the hip. It is a degenerative, wear-and-tear type of arthritis where the cartilage in the hip joint gradually wears away. As a result of this lack of cartilage, bone rubs on bone, often producing bone spurs, or bony growths that tend to develop on the edges where your bones meet each other in a joint.

    Osteoarthritis develops slowly, and the pain increases overtime.
  • Rheumatoid arthritis. Rheumatoid arthritis is a chronic disease that can attack multiple joints throughout your body. It can affect the same joint on both sides of the body.

    Rheumatoid arthritis is an autoimmune disease. This means the immune system attacks your body’s own tissues and damages the cartilage and ligaments while softening the bone. When you have hip pain and stiffness due to rheumatoid arthritis, it’s because the synovial membrane that covers your hip joint is swollen.
  • Post-traumatic arthritis. Post-traumatic arthritis is a form of arthritis that develops after an injury to your hip, such as a broken or dislocated hip. These kinds of injuries can cause instability and additional wear of your hip joint that over time can lead to arthritis.

When is total joint replacement surgery the best choice?

In most cases, your doctor will only recommend surgery once you’ve gone through all non-operative treatment options and you haven’t noticed any significant or lasting improvement.

Deciding to have a total hip replacement often has to do with your pain levels, amount of disability, the length of time you’ve been in pain and what treatments you’ve already tried.

Elective total joint replacement surgery is always your choice. But, some hip pain problems will only get better with surgery. Your total joint specialist will work with you to make sure you make an informed and educated decision.

Many patients find undergoing total hip replacement surgery is beneficial because it helps them get back to an active life, and putting off surgery sometimes means putting off getting back to your normal life.


How can I manage my pain without surgery?

Even though researchers have yet to find a cure for hip arthritis, there are a number of ways you can relieve your pain and stiffness non-surgically.

As part of a conservative treatment plan, your doctor may advise you to try to:

  • Minimize your activity by switching from high-impact activity to low-impact activity
  • If overweight, work on losing weight to decrease the force on your hip
  • Get help from a physical therapist
  • Use assistive devices, such as canes and shoe inserts
  • Take medication, such as NSAIDs (non-steroidal anti-inflammatories) like ibuprofen (Tylenol can also be effective)
  • Get corticosteroid (cortisone) injections


When is it time to have a hip replacement?

Total joint replacement surgeon, Dr. Patrick Millikan discusses when it's time to have a hip replacement.

Learn more

Do I need a hip replacement?

Your hip is a major weight-bearing joint, and it is held together by muscles and ligaments that allow your leg to rotate so that you can walk and climb stairs.

When your hip is arthritic, the cartilage wears away, causing the bones to grind together. This produces pain, loss of motion and swelling.

Is it time to consider hip replacement surgery?

Hip arthritis can be extremely uncomfortable and easily affect your quality of life. 

If you are feeling depressed or frustrated because you can’t be as mobile as you want to be, these are signs you may need a hip replacement and it’s time to speak to a total joint specialist about your options.


About diagnosis

To make a diagnosis, your doctor will conduct a physical examination and ask you for a complete medical history and description of your symptoms. An X-ray or MRI may be necessary for confirmation and to determine if there are other problems.

What are signs that I might have hip arthritis?

Meet with a physician to determine whether you have hip arthritis and signs you need a hip replacement. Signs you need a hip replacement include:

  • Hip pain during activity
  • Delayed hip pain after activity
  • Pain that interrupts sleep
  • Stiffness in your hip joint that makes it difficult to sit for long periods of time
  • Inflammation and swelling in your hip

What is total joint replacement surgery, and does it work?

Joint replacement surgery is a procedure in which a surgeon removes the arthritic areas of your joint and then caps the bone ends with man-made implants. If your OrthoIndy specialist recommends total joint surgery, OrthoIndy Hospital has been a Five-Star Recipient for Total Hip Replacement from 2014 to 2020.

Obesity and total joint replacement

If you are obese with a body mass index (BMI) higher than 39, your risk of complications during and after total joint replacement surgery, including developing a surgical site complication, are six times higher than for patients at a healthy weight.

For this reason and many others, we encourage obese patients to lose as much weight as is safe and possible before surgery to maximize beneficial surgical outcomes.

Trying to lose weight? Learn how to eat healthy, how to exercise and how to maintain a positive outlook on life to achieve your lifestyle goals.


Smoking and joint replacement surgery

According to CDC, smoking is the number one cause of preventable death and smokers often die 10 years earlier than nonsmokers. Smoking also affects your body’s ability to recover after a surgical procedure.

In fact, quitting before your procedure and not smoking afterward can significantly increase your chances of healing faster. It allows more oxygen to reach your cells and increases blood flow which helps your body heal.


The technology

Total hip replacement surgery involves removing the diseased portion of the hip joint and replacing it with an artificial hip, called a prosthesis. Your total joint specialist will custom fit your prosthesis for your body type.

For some patients double joint replacement surgery, also called bilateral joint replacement, may be an option. A bilateral joint replacement is when either both hips or both knees are being replaced at the same time. Different factors affect whether you are eligible for a double joint replacement since it’s a more intense surgery and recovery process compared to a single joint replacement surgery.


Length of surgery

Joint replacement surgery takes 35 to 45 minutes. If you are having a revision, it may take an hour, possibly two in rare circumstances.

In most cases after surgery, patients stand up with a walker or crutches within a few hours. Except for during your actual operation and when you are in the recovery room, you are not bedridden at any time.

In some cases, you may go home one to two days after surgery. Your physical therapy will take place at an outpatient facility near your home. In special cases, arrangements can be made for home physical therapy.


You may have some short-term restrictions with weight bearing or motion during the first six weeks after surgery. Your total joint specialist will evaluate you and take X-rays about six weeks after your surgery. During this visit, your doctor will let you know about any potential long-term restrictions.

The results

After your recovery, you can walk as far as you want, ride a bike, go up and down stairs without pain, swim, bowl, garden, play doubles tennis, golf, dance and more!

Hip replacements remain one of the most successful operative procedures around. Millions of people have undergone this procedure because of its dramatic ability to improve their lifestyle and allow them to return to a more active life.

Additional reported benefits include excellent pain relief as well as improved strength, motion, and the ability to stand up, climb steps and walk longer distances.

A common misconception is that a hip replacement lasts ten years. In reality, a well done hip replacement using modern devices, has at least a 95 percent chance of functioning well after ten years and an 85 percent likelihood of lasting 20 years or longer.

Many of our patients at OrthoIndy have had hip implants in place for over 25 years and they continue to return every few years for routine evaluations. We learn a great deal from observing our patients and the outcomes of their joint replacement surgeries.

Get ready for total joint replacement surgery with this checklist

Latest in hip replacement surgery

Although the traditional approach to hip replacement surgery has been used for many years, there have been many advances in the surgical procedure and the implants that make recovery faster and the new joint more durable.

Your surgeon will discuss the different approaches, types of implants and post-operative protocols that will work best for you. The type of approach used will depend on what will give you the best chance for a pain-free, well-functioning and long-lasting hip replacement.

What are the different types of hip replacements?

As medicine has advanced so have the types of hip replacements. Despite advancements, the most important part of surgery is picking a surgeon with considerable experience in the type of surgery they perform.

OrthoIndy total joint specialists are all board certified and use the latest hip replacement surgery to make sure each of their patients receives the best care possible.


Hip or knee pain
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Hip replacement physical therapy

How long does it take to recover from total joint replacement and when can I return to work?

Total hip replacement recovery takes about six weeks for most patients. However, if you had both of your hips replaced at the same time, your hospital stay and your recovery may take longer.

Hip replacement recovery and rehabilitation is just as important as the surgery itself. If you fail to follow recovery protocols, you may compromise your ultimate result of the surgery.

How soon can I go back to work?

In most cases, if you work at a sedentary job, you may be able to return to work after three to six weeks.

If your job requires frequent lifting and standing or bending, you may return to work after eight-weeks.

If you work at a more labor-intensive job, your total joint specialist will work with you on a customized estimate of when you might be able to go back. In some cases, the time frame might be up to three months.

Getting back to normal

Hip replacement recovery can be painful at first, but after returning home and completing physical therapy, you will find yourself adjusting to your new hip and enjoying the ability to be more mobile once you’re back on the job.

Learn what to expect during recovery

Rehab goes high-tech

OrthoIndy’s physical therapy team helps patients rehab faster—and train like a pro—with the AlterG® Anti-Gravity Treadmill®. This technologically advanced piece of exercise equipment uses anti-gravity technology from NASA that allows you to work out without pain, even while you’re recovering from total joint surgery.


Sex after total joint replacement

Many total joint replacement patients report that their lives improve dramatically after having a hip or knee replaced, and that includes improvements in their sex lives. Check out this guide answering the most frequently asked questions about sex after total joint replacement surgery.

Exercise after total joint replacement

Exercise and movement are important following surgery. Muscle contractions through exercise release nitric oxide, which decreases inflammation, aids in wound healing and helps prevent stiffness.

All exercises should be completed three times a day, ten to thirty repetitions of each exercise.


Hip replacement recovery

After two total hip replacements, patient completes a marathon.

Read his story

Is the cost of a hip replacement worth it?

When you know you have to have total joint replacement surgery, paying for these new medical expenses can be worrisome. First, it’s important to check with your insurance provider to ensure OrthoIndy is in your network. OrthoIndy and OrthoIndy Hospital participates in most major insurance networks.


Many insurance companies have pricing tools that take into account your benefit plan. Visit your insurance provider’s website to see if this is available to calculate surgery costs.

Another resource to review surgery pricing is the website. The Indiana Hospital Association (IHA) developed the website using data that is reported to the Centers for Medicare and Medicaid Services and the Indiana State Department of Health.

The data reported on this website includes measures of care provided in the hospital, including patient satisfaction, readmissions, infections, deaths, birthing outcomes, hospital charges and more.

Nationally, OrthoIndy Hospital performs better than average for patient experience and has low hospital-acquired infections and readmission rates.

Visit to compare hospital pricing for total joint replacement surgery.

How can I save money on my surgery?

Timing is everything. A lot of patients wait to schedule their hip replacement at the end of the year since, by that time, they have typically met their health insurance deductible.

What these patients sometimes forget to consider is that physical therapy during recovery and rehabilitation is a large part of whether or not the hip replacement surgery is successful, and physical therapy costs during recovery can be very expensive.

If you schedule your procedure for earlier in the year and meet your deductible, then your physical therapy during your recovery and rehabilitation may be covered by your health insurance, too.

Bundling costs

Bundled payments are a single payment based on expected costs for clinically-defined episode of care. The bundled payment typically covers the facility fee, physician's fee, anesthesiology, implants and other hospital costs during a single surgical episode. OrthoIndy participates in bundled payment programs through commercial insurance companies as well as Medicare’s Comprehensive Care for Joint Replacement (CJR). Contact your health plan to see if you are eligible for bundled payment options.

Patient Stories

Life after hip pain

OrthoIndy is one of the most highly respected orthopedic practices in the Midwest, and it’s our mission is to provide the highest quality, comprehensive joint care to patients throughout the Midwest, the United States and around the world.

Our team of experienced physicians have helped thousands of people suffering from hip arthritis regain mobility and get back to living full lives. Many patients express that there only regret is not having the surgery sooner.

Here are a few recent hip replacement success stories.


Download your copy of this total hip replacement guide.