Hip replacement recovery timeline, week by week.

weeks 0–2

Weeks 0-2 · standing on day one

Most patients are standing and taking a few steps with a walker on the day of surgery, per the ERAS Society consensus. Hospital discharge is typically one to three days, with some centers offering same-day discharge for selected patients. The PROMIS cohort reported day-one median NRS of 3/10 — low for a major joint operation, reflecting both modern multimodal analgesia and the fact that hip replacement immediately removes the pre-operative pain source.

Pain typically settles into 1-2/10 by the end of week one. The fast-track diary cohort measured median NRS of 2/10 at week one, dropping further over weeks 2-6.

Two posterior-approach precautions dominate the first six weeks: no bending past 90 degrees at the hip, and no crossing the operated leg over the other. Anterior approaches usually have no such restrictions.

• wk 0 ·Stand and walk with an aid (Day 0 to day 1 (ERAS: mobilize as soon as possible))
• wk 0.3 ·Hospital discharge (1-3 days; some centers same-day)

weeks 2–6

Weeks 2-6 · gait, driving, and discharge of the aid

This is where the practical milestones cluster. Driving typically resumes around week 3-4 for a left hip with an automatic transmission and around week 4-6 for a right hip — the constraint is being off narcotic pain medication and being able to apply the brake reliably. Most people are off crutches and using a single stick by week 4, and off the stick entirely by week 6.

Pain by week six is essentially negligible for most people: median NRS 0/10 in the fast-track cohort with the upper range at 3/10. The remaining work is gait normalization and confidence, not analgesia.

Some patients report a transient day 9-12 rebound in pain — a small uptick that resolves within a week. The fast-track diary picked it up clearly in the cohort means. It is not a sign of complication; it is the typical response to increased activity in the second week.

• wk 4 ·Return to driving (Left hip ~3-4 weeks, right hip ~4-6 weeks; off narcotics)
• wk 6 ·Off assistive devices / walking unaided (About 3-6 weeks, once gait is normal)

weeks 6–12

Weeks 6-12 · back to ordinary

Most people are walking unaided and back to office work by this point per the THA RTW meta-analysis (desk roles around week 4 in modern protocols, manual labor still pending). The PROMIS cohort's three-month median Pain Intensity T-score of 43 corresponds to roughly 2/10 on an NRS — population-normal or slightly below.

Recreational activities like swimming, cycling on a stationary bike, and walking on level ground are widely encouraged from week 6 onwards. Posterior-approach hip precautions typically end at six weeks unless the surgeon specifies otherwise.

Strength work — bridges, hip abductor strengthening, controlled step-ups — is the dominant rehab focus through this window. Single-leg balance and gait drills typically follow.

• wk 6 ·Off assistive devices / walking unaided (About 3-6 weeks, once gait is normal)
• wk 10 ·Return to work (Desk ~4 weeks; manual labor 3-6 months (wide, job-dependent))

weeks 12–26

Weeks 12-26 · return to recreation and sport

The THA return-to-sport literature is broadly permissive. Most surgeons clear low-impact activity (cycling, swimming, golf, doubles tennis, walking) by three months; recreational return-to-sport across mixed activities clusters around 16-28 weeks. High-impact sport (running, basketball, singles tennis) is generally discouraged because of implant longevity concerns, though not strictly forbidden — and the conversation has shifted over the last decade with improving bearing surfaces.

Manual labor return-to-work clusters in this window per the meta-analysis (pooled mean ~10 weeks, range 3-6 months). The spread is wide and depends heavily on job demands.

• wk 22 ·Return to sport / recreation (About 16-28 weeks, per clearance)

weeks 26–52

Weeks 26-52 · stable long-term

The PROMIS cohort's 12-month median Pain Intensity T-score of 44 — essentially the same as three months — confirms that final outcomes arrive early for most people. Registry data (AOANJRR/ACORN) shows population-level satisfaction in the high 90s.

If pain at twelve months is materially worse than 2-3/10 in daily life, the differential is leg-length discrepancy, hip flexor tendinitis (psoas impingement on the cup), or trochanteric bursitis. All are well-recognized and treatable — worth raising rather than assuming further patience will solve it.