The first week after an anterior hip replacement — what actually gets you through it

Post-Surgery Recovery · An honest first-week guide

The first week after an anterior hip replacement — what actually gets you through it

An anterior approach means fewer movement precautions — but the first week is still a real climb. Here is what days zero to fourteen actually look like, and what makes them easier.

By the Inspired Comforts editorial team · Last updated May 20, 2026 · 11 minute read

Most of what you read before an anterior hip replacement is either a clinical pamphlet or a highlight reel. The pamphlet tells you the steps; the highlight reel tells you someone was golfing in six weeks. Neither tells you what Tuesday afternoon of week one actually feels like — the stiffness that creeps in by 5 p.m., the walker you were sure you would not need, the small humbling negotiations with your own body.

This guide is the in-between version: honest, practical, and specific to the anterior approach. Patients in communities like r/TotalHipReplacement describe the same first week again and again, and the pattern is clear enough to plan around. Here is that pattern — and the handful of decisions that make it easier.

The simple answer

The first week after an anterior hip replacement is mostly about controlling pain and swelling and slowly trading the walker for a cane. Most people walk the same day and go home within a day or two. The anterior approach usually comes with fewer movement precautions than posterior surgery — but you will still be exhausted, stiff by evening, and dependent on help. Set up one floor of your home, ice often, take pain medication on schedule, dress sitting down, and pace harder than you think you need to.

Anterior or posterior? It changes your whole first week

If you are reading this before surgery, the single most useful thing to confirm with your surgeon is which approach they are using — because it shapes what you can and cannot do at home.

Same day

Most patients take their first steps with a walker the day of surgery

Source: AAOS & hospital guidance

6–12 wks

How long posterior hip precautions typically last — anterior often has far fewer

Source: orthopedic surgery guidance

90°

The hip-bend limit most precautions set: do not fold past a right angle

Source: AAOS OrthoInfo

With a posterior approach, the surgeon works through muscles at the back of the hip, so the classic hip precautions apply — typically for six to twelve weeks: do not bend the hip past 90 degrees, do not cross your legs, and do not rotate the operated leg inward. With an anterior approach, the surgeon works between muscles at the front rather than cutting through them, so dislocation risk is lower and most surgeons prescribe far fewer formal restrictions. That is why an anterior patient can often sleep on their side with a pillow between the knees within the first week, while a posterior patient is told to wait.

“Not all surgeons recommend the same precautions.”
— American Academy of Orthopaedic Surgeons, Activities After Total Hip Replacement

That quote matters. “Anterior has fewer precautions” is true as a general rule, but your surgeon’s specific instructions override every guide on the internet, this one included. Get your precautions in writing before discharge and tape them to the fridge.

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The first two weeks, stage by stage

Recovery is not linear. It tends to move in stages, and naming them helps — because the worst day is usually not the day you expect.

Stage 0 · Before surgery

The prep that pays off in week one

Three things matter more than anything you can buy. First, arm and shoulder strength — your operated leg will be near-deadweight for repositioning, and you will push yourself up and around with your arms. Practice rising from a chair using only your arms. Second, set up one floor: a sleeping spot, the bathroom, and the kitchen on the same level, because stairs are a project in week one. Third, a recliner — many patients find an electric recliner is the easiest place to sleep, ice, and do early exercises. For the full home checklist, see our guide on what to install at home before a hip replacement.

Stage 1 · Day 0 — surgery day

You will probably walk the same day

This surprises people: a physical therapist will usually have you up on a walker within hours, taking a few steps and trying a single stair. Many anterior patients now go home the same day or the next morning. The first night is often steadier than expected — a dull discomfort around a 4 or 5 — but sleep is broken. Have your meds, water, and a phone charger within arm’s reach so nothing requires a midnight expedition.

Stage 2 · Days 1–3

The hard stretch — and day two is often the worst

The anesthetic and nerve block fully wear off, and pain frequently peaks around day one or two before it improves. Swelling builds. Moving from sitting to standing is the hardest motion. This is the stretch to take pain medication on schedule rather than chasing pain — many patients stagger acetaminophen and a stronger medication so something is always working. If your team offers a telehealth or home PT visit in these days, take it; being able to ask “is this pain normal?” is worth a great deal.

Stage 3 · Days 4–7

Finding a rhythm — the cane starts to tempt you

Sleep usually improves. Walking in the walker smooths out from a shuffle into something closer to steps. The cane will start to feel tempting around now — but most people genuinely still need the walker for stability through the first week. Use what your PT tells you to use; a fall in week one undoes weeks of progress. Short, frequent walks beat one long one.

Stage 4 · Days 8–14

Re-entry — and the temptation to do too much

By the second week many people are mostly independent for self-care and starting to think about work. A desk job from home is often manageable in short blocks; sitting longer than about 45 minutes gets stiff, and you will still tire suddenly. Stairs, laundry, and anything that involves carrying something still need help. The most common week-two mistake is simply doing too much because you finally feel able.

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What actually gets you through the days

Beyond the medical plan, recovery in week one is a series of small logistics. These are the ones patients mention most.

Ice, relentlessly. Swelling is the enemy of comfort and movement. Cold-therapy machines that hold temperature for hours spare you and your caregiver from swapping ice packs all night. A flat ice pack positioned right on the joint beats a bulky one nearby.
Take the meds while you need them. There is no medal for suffering through the first three or four days. Step down on your own timeline, with your team’s guidance — not your pride’s.
Mornings are your good window. Most people move best in the morning and stiffen through the afternoon. Schedule PT, walks, and showering early; leave the evening for rest.
Protect your sleep. A pillow between the knees helps, and propping slightly onto your side may be allowed sooner with an anterior approach — confirm with your PT. A bedside urine container can save several painful trips and is worth the small dignity cost.
Do your PT, but do not freelance it. The exercises are the recovery. Overdoing them, though, brings the stiffness and pain roaring back the next day. Match effort to what your PT prescribed.
Plan for boredom. You will be too tired for much but too restless to do nothing. Line up easy, low-focus things in advance.

Getting dressed when you cannot bend

Even with the anterior approach’s lighter precautions, the early days make dressing genuinely hard: there is pain, real swelling, a healing incision, and an operated leg that does not want to lift or thread through a narrow pant leg. Standard guidance from the AAOS is consistent: do not dress standing up, sit down to do it, do not bend over or hike your knee up to reach, and put the operated leg in first. A reacher, a sock aid, and a long-handled shoehorn remove most of the bending.

The bottom half is the hard part. Pull-on pants still demand that you bend and feed a stiff, heavy leg through a closed tube. Side-snap — or “tearaway” — pants solve that geometry: the leg opens fully along the seam, so you lay the pants flat, set your leg down, and snap them closed without bending, lifting, or threading anything. (For the wider picture of which surgeries need them, see our explainer on when tearaway pants actually earn their place.)

Bottoms that go on without bending

Our Easy Day line opens fully down the side with snaps, so getting dressed never asks your new hip to fold or your operated leg to thread a pant leg. The Easy Day Flannel Pants ($36.99) are the cozy choice for week-one rest, the Easy Day Pajama Pants for women ($32.99) add pockets, and the Easy Day Pants ($34.99) are the day-clothes version once you are up and moving. Browse them all in Post-Surgery Bottoms.

A quick, honest word on shortcuts

Recovery forums often surface talk of supplements and peptides — BPC-157 and similar blends — promising faster healing. We will be straight with you: the human evidence for these is thin to nonexistent, many are not regulated as medicines, and some carry real risks, including interactions with the blood thinners you are likely taking after surgery. There is no shortcut worth a complication in week one. If you are curious about anything you can take, ask your surgeon first — the people who know your incision, your medications, and your clotting risk.

When to call your surgeon

Most of week one is uncomfortable but normal. A few things are not, and they are worth knowing cold. Contact your surgical team promptly — or seek emergency care — if you notice any of the following.

Signs of a blood clot (DVT): calf or leg pain, warmth, redness, or swelling that does not ease when you elevate the leg. Sudden chest pain, shortness of breath, or a racing heartbeat is an emergency — call your local emergency number immediately.
Signs of infection: a fever, spreading redness or warmth around the incision, increasing drainage, or a foul smell from the wound.
Signs of a dislocation: a sudden pop or click followed by severe pain, a leg that suddenly looks shorter or turned, or a new inability to bear weight.
Pain that is escalating rather than slowly improving after the first few days, or pain your medication no longer touches.

This list is for awareness, not alarm. Clots and infections are uncommon, and your team would always rather get a “probably nothing” phone call than a late one.

Common questions about the first week

Is recovery from an anterior hip replacement faster than posterior?

Often, in the early going. Because the anterior approach goes between muscles rather than cutting through them, many patients have fewer movement precautions and an easier first few weeks. Long-term results of the two approaches are broadly similar — the difference patients feel most is in the early recovery, and even that varies by surgeon and by person.

When can I stop using the walker after hip replacement?

Most people rely on a walker through roughly the first one to two weeks, then transition to a cane as balance and strength return. It is tempting to switch early because the cane is easier — but your physical therapist’s timing exists to prevent a fall. Follow their call, not your confidence.

Can I sleep on my side after an anterior hip replacement?

Many anterior patients are cleared to sleep slightly propped onto their side with a pillow between the knees within the first week, since dislocation risk is lower. Posterior patients are usually told to wait longer. Confirm your own timeline with your surgeon or PT before you try it.

How do I get dressed without bending after hip surgery?

Sit down to dress, put the operated leg in first, and use a reacher, sock aid, and long-handled shoehorn so you never bend past about 90 degrees. Side-snap (tearaway) pants make the bottom half easiest — they open fully so you can lay them flat and snap them closed without lifting or threading the leg.

When can I go back to work after a hip replacement?

A desk job from home is often manageable in short stretches by the second week, though you will tire quickly and sitting beyond about 45 minutes gets stiff. A job on your feet, or a commute, usually takes considerably longer. Ease in, and clear your timeline with your surgeon.

When can I drive again?

It depends on which hip, whether the car is automatic, and whether you are still taking opioid pain medication — you should not drive on it. Many people resume driving a few weeks out; your surgeon makes the call. Our guide on driving again after surgery covers the mental side of it too.

The honest summary

The first week after an anterior hip replacement is not the highlight reel and not the worst-case pamphlet. It is a steady, unglamorous climb: walk on day zero, get through the day-two pain, find a rhythm by the weekend, and resist the urge to sprint in week two. Set up one floor, ice constantly, dress sitting down, lean on your walker and your people, and let the mornings carry the hard work. The new hip is the easy part — it is already done. The first week is just giving it room to settle in.

Sources & further reading

AAOS OrthoInfo — Activities After Total Hip Replacement
AAOS OrthoInfo — Total Hip Replacement
Hospital for Special Surgery — Anterior vs. Posterior Hip Replacement
Johns Hopkins Medicine — Hip Replacement Recovery Q&A
NHS — Complications of a Hip Replacement
National Blood Clot Alliance — Blood Clots After Hip and Knee Replacement
Community — r/TotalHipReplacement on Reddit

By the Inspired Comforts editorial team. Inspired Comforts exists because people we love went through some of these conditions, and the recovery clothing they needed did not exist the way it should have. We are not nurses or doctors — we are people who care obsessively about recovery clothing and the small things that make recovery a little easier to get through. On medical questions we cite real published practitioners and link to their work in full; if anything here does not match what your surgeon or physical therapist tells you, trust them. Everything we make and write serves one idea: that getting through surgery should not cost you yourself — that you get to retain as much of who you are as possible. Read more about us.

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