Total hip replacement, or total hip arthroplasty (THA), is a common and highly successful procedure. The operation involves removing the damaged bone and cartilage of the hip joint and replacing them with prosthetic components made of metal, plastic, or ceramic. The surgery itself typically takes between one and two hours to complete, but the total time a patient spends within the surgical environment is much longer than the core procedure. This timeline includes preparation before the incision, the procedure itself, and the immediate recovery phase.
Pre-Surgical Preparation and Anesthesia Time
The process begins long before the surgeon makes the first incision. Once the patient is transported to the operating room (OR) suite, the pre-surgical phase starts, often adding 30 to 60 minutes to the total time spent in the OR complex. This initial time is dedicated to the surgical team setting up the necessary monitoring equipment.
Monitoring involves placing devices to continuously track vital signs such as heart rate, blood pressure, and oxygen saturation. The anesthesiologist then administers the chosen form of anesthesia, which may be a general anesthetic or a regional block, such as a spinal anesthetic. Spinal blocks are often combined with sedation, allowing the patient to remain comfortable without being aware of the surgery’s sounds. Administering and confirming the effectiveness of the anesthesia is a necessary step before the sterile surgical draping and final preparations can begin.
The Core Surgical Procedure Duration
The core surgical procedure is the period from the initial incision to the final closing of the wound. This phase generally lasts between 60 and 120 minutes for a primary hip replacement. The surgeon starts by making an incision, which can be as small as three to five inches for a minimally invasive approach or eight to ten inches for a traditional one.
Once the hip joint is accessed, the damaged femoral head is removed, and the acetabulum, the hip socket, is resurfaced. An artificial cup component is then placed into the prepared socket. Next, the surgeon prepares the femur to accept the stem of the implant. The new ball and socket are then joined, and the surgeon tests the motion and stability of the artificial joint before closing the tissue and skin with sutures or staples.
Immediate Post-Operative Recovery Room Stay
After surgery, the patient is transferred to the Post-Anesthesia Care Unit (PACU), also known as the recovery room. This is a period of intense monitoring that typically lasts between one and three hours. During this time, the PACU nurses and anesthesia team closely watch the patient’s vital signs and level of consciousness as the effects of the anesthesia begin to wear off.
Managing initial pain and nausea is a primary focus during the PACU stay. The patient may also receive oxygen and will be encouraged to perform deep-breathing exercises to help clear the lungs of mucus that can accumulate during anesthesia. The patient is only cleared to move to a standard hospital room when they have met specific discharge criteria, including stable blood pressure, adequate pain control, and a safe level of alertness.
Factors Influencing Surgical Time Variability
Surgical time ranges are not fixed and vary based on the patient’s condition and the surgical team’s choices. Patient complexity is a major determinant, as individuals with a higher Body Mass Index (BMI) or significant pre-existing conditions often require a longer operative time. Increased soft tissue and bone density in these patients can make accessing and preparing the joint more difficult, which directly adds minutes to the procedure.
The type of surgical approach used also influences the duration (anterior, posterior, or lateral). Furthermore, a revision surgery, where a previously implanted hip replacement is replaced, is significantly more complex and takes longer than a primary replacement. The experience level of the surgical team is another factor that influences the overall operative time.