Hip replacement surgery is a commonly performed procedure that can significantly reduce pain and improve mobility for people with severe hip joint disease. Like any major operation, however, it can cause temporary side effects and carries a small risk of complications.
Knowing the difference between expected effects during recovery and symptoms that may indicate a complication can make the recovery period less confusing. If you are preparing for or recovering from hip replacement surgery, understanding what to expect can also help you know when to contact your medical team.
What side effects are common after hip replacement?
Some discomfort and physical changes are expected during the early recovery period. They usually improve as the tissues heal and strength and mobility return. Common short-term effects can include:
- Pain or soreness around the operated hip.
- Swelling around the hip, thigh or leg.
- Bruising around the surgical area.
- Temporary stiffness and reduced range of movement.
- Muscle weakness around the hip and leg.
- Fatigue after surgery.
- Temporary difficulty walking normally.
- Numbness or altered sensation around the surgical scar.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
These effects do not necessarily mean that something has gone wrong. Swelling, bruising and discomfort can persist for weeks and gradually improve during rehabilitation.
Why does the hip hurt after replacement surgery?
Hip replacement involves operating on bone, joint tissues and the surrounding soft tissues. It is therefore normal to experience pain or soreness after the procedure.
The intensity of pain varies between individuals and usually changes as recovery progresses. Pain medication, appropriate movement and physiotherapy are commonly used as part of recovery.
What matters is the overall pattern. Pain that gradually improves is generally different from pain that becomes increasingly severe, returns after an initial improvement or occurs together with other concerning symptoms.
Is swelling normal after hip replacement?
Yes. Swelling around the operated hip and leg is common after surgery. Bruising may also extend down the thigh or leg as blood and fluid move through the tissues.
Swelling can take several weeks to settle and, in some people, may remain noticeable for longer. Gradual improvement is generally expected.
However, swelling accompanied by increasing pain, redness, warmth or other symptoms should be assessed because these can sometimes indicate a complication such as infection or a blood clot.
Side effects versus complications: what is the difference?
Not every unpleasant symptom after surgery is a complication. Some are part of normal healing.
| Expected recovery effects | Possible warning signs |
|---|---|
| Mild to moderate pain that gradually improves | Pain that becomes increasingly severe or suddenly worsens |
| Swelling that gradually decreases | Increasing swelling with significant pain or redness |
| Bruising around the operated area | Persistent wound drainage or pus |
| Temporary stiffness | Sudden loss of movement or inability to bear weight |
| Some numbness around the scar | Significant or worsening weakness or loss of sensation |
The table is only a general guide. Your surgical team should assess symptoms that are new, severe, persistent or worsening.
What are the important complications after hip replacement?
Most people recover without a major complication, but several risks are associated with hip replacement surgery.
1. Blood clots
A deep vein thrombosis, or DVT, is a blood clot that can develop in a vein of the leg after surgery. In some cases, part of the clot can travel to the lungs, causing a pulmonary embolism.
To reduce this risk, patients may be given blood-thinning medication, compression measures and advice to begin moving as soon as it is medically appropriate.
Increasing leg or calf pain, swelling or tenderness should be assessed promptly. Sudden chest pain or difficulty breathing requires immediate medical attention.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
2. Infection
An infection can develop around the surgical wound or, less commonly, deeper around the artificial joint. A superficial wound infection may sometimes be treated with antibiotics.
A deep infection involving the artificial joint can be more serious and may require additional surgery and prolonged antibiotic treatment. Warning signs can include increasing redness, warmth, swelling, wound drainage, fever or pain that is worsening rather than improving.
3. Hip dislocation
A hip replacement can occasionally become dislocated, meaning the ball of the artificial joint moves out of the socket. Dislocation is more likely during the early recovery period while the tissues around the new joint are healing, although it can also occur later.
A sudden feeling that the hip has moved out of position, severe pain or an inability to bear weight requires urgent medical assessment.
4. Difference in leg length
After hip replacement, one leg may feel slightly longer or shorter than the other. Surgeons take measurements and make adjustments during the operation to achieve appropriate leg length, but a small difference can sometimes remain.
Many minor differences become less noticeable as the muscles and surrounding tissues adapt. In some cases, a shoe insert or other treatment may be considered.
5. Nerve or blood vessel injury
Nerves and blood vessels are located around the hip, so there is a small risk of injury during surgery. Nerve injury can cause numbness, altered sensation, weakness or, rarely, more significant functional problems. Blood vessel injury is uncommon but can require additional treatment.
6. Fracture around the artificial joint
A fracture can occasionally occur in the bone around the hip replacement, either during the operation or later following a fall or significant injury. Treatment depends on the location and severity of the fracture and may sometimes require additional surgery.
7. Persistent pain or stiffness
Hip replacement is designed to reduce pain and improve function, but some people may continue to experience discomfort or stiffness after surgery.
Persistent symptoms may have several possible causes, including muscle weakness, stiffness, implant-related problems, infection, instability or another condition affecting the hip or surrounding area. Ongoing or worsening symptoms should be evaluated rather than assumed to be a normal part of recovery.
8. Implant wear or loosening
Artificial hip components are designed to function for many years, but they can gradually wear or become loose over time. Wear or loosening may cause pain, reduced function or instability and, in some cases, may eventually require revision surgery to replace or repair the components.
Can hip replacement cause numbness?
Some numbness around the surgical scar can occur because small skin nerves may be affected during the incision. This can persist for some time and may not completely disappear. However, significant new numbness, weakness or difficulty moving the leg should be reported to the medical team, particularly if it is worsening.
What increases the risk of complications?
The likelihood of complications varies from person to person. Factors that can influence surgical risk include overall health, age, existing medical conditions, previous surgery, mobility and certain lifestyle factors.
Conditions such as diabetes, cardiovascular disease, obesity, smoking and a previous history of blood clots may affect risk and recovery in some patients.
This is one reason pre-operative assessment is important. Medical conditions can often be reviewed and optimized before surgery when appropriate.
Which symptoms require emergency attention?
Some complications can become serious quickly. Seek emergency medical attention for sudden chest pain, severe difficulty breathing or other symptoms suggesting that a blood clot may have travelled to the lungs.
A sudden severe hip pain accompanied by an inability to move or bear weight can also require urgent assessment because it may indicate dislocation or another mechanical problem.
Do side effects mean hip replacement has failed?
No. Experiencing pain, swelling, stiffness or tiredness during recovery does not automatically mean that the replacement has failed. Recovery after hip replacement takes time, and many early symptoms gradually improve as the tissues heal and strength returns.
The concern is when symptoms are unexpectedly severe, become progressively worse, fail to improve as expected or are accompanied by signs of infection, blood clots, dislocation or another complication.
The Bottom Line
Hip replacement surgery can provide substantial relief from pain and improve mobility, but it is still a major operation and some side effects or complications are possible.
Pain, swelling, bruising, stiffness and temporary weakness are often part of normal recovery. More concerning symptoms include worsening pain, persistent wound drainage, fever, significant calf swelling or pain, sudden inability to bear weight, or symptoms of a blood clot or dislocation.
Most people recover without a major complication, but recognizing warning signs early is important. Following the rehabilitation plan, taking prescribed medicines correctly and keeping scheduled follow-up appointments can help support a safe recovery and allow problems to be identified promptly.
