Part of Total hip replacement rehab
Driving after hip replacement: the two questions behind the date
Warning signs, and when to get help
When can you drive after a hip replacement?
Driving after a hip replacement raises two questions, and most of the confusion comes from answering them together. Can you control the car? And are you allowed to drive it? Your surgical team settles the first, by watching what you can actually do. The licensing authority where you live and your insurer settle the second, and that is the half that sends people round in circles.
You will not find a date here in our own voice. What you will find is a handful of sourced positions, and they make a good deal more sense read together than one at a time.
If you came here wanting to know whether you can drive on Tuesday, here is the order to work through, because that is the part most pages leave out. First, find the date or the condition your own surgical team set. It is usually in your discharge paperwork or your clinic letter, and if nobody gave you one, that is the question for your next appointment rather than something to work out for yourself. Second, go and sit in your own car, parked, and work through the readiness checks in the next section, because a date is worth nothing if you cannot get into the seat or stop hard. Third, make two phone calls, one to your insurer and, in the UK, one to DVLA if anything in your own situation might be notifiable. Fourth, make the first drive a short one, in daylight, on a quiet road, with somebody beside you if that can be arranged. Tuesday is all right when those four are done and your team has said yes. It is not all right because a particular number of weeks has gone by.
The NHS, writing for people recovering from a hip replacement, advises waiting at least 6 weeks to drive, and to check with your doctor that you are fit to drive. That is a floor with a condition attached, not a release date. Six weeks and no check is not what it says. OrthoInfo, from the American Academy of Orthopaedic Surgeons, lists driving among the activities people get back to after this operation and attaches no date to it at all. What it attaches instead is a condition, and it is the firmest thing any of these sources says about the medicine half of the question: on its activities page, OrthoInfo's position is that most people are safe to drive again once they have stopped taking opioid pain medication and once strength and reflexes have returned toward normal, with your doctor helping you decide when. Read that as a gate rather than a date. It can fall before six weeks or well after it, depending on how long you need the strong painkillers.
Gateshead Health goes further in its physiotherapy leaflet for hip replacement patients and ties the answer to function. Its position is that you will not be able to drive for at least 6 weeks, that walking without any mobility aids comes first, and that you then drive when you feel safe to do an emergency stop and to control the car safely. That is a test, not a date. For somebody sitting at home with the car keys on the table, it is the more useful of the two.
Two more NHS trusts set the same six weeks and add the detail. Leeds puts it at approximately six weeks, providing an emergency stop can be performed without hesitation or discomfort, and tells you to test that while the car is stationary. Newcastle recommends not driving for six weeks, says your consultant can advise you on it, and gives a sequence for the first attempt: check you can reach and use the pedals without discomfort, have a trial run with the engine off, try out all the controls, go through the emergency stop procedure, then start with short journeys and stop regularly on a long one to get out and stand up. Four services, one number, and three of the four will not hand it to you without a test attached.
The research measures one narrow slice of all this, which is how fast you can get on the brake pedal in a driving simulator. A systematic review and meta-analysis of 14 studies, 7 of which could be pooled, reported that brake reaction time after a hip replacement was around or above its pre-operative level at 1, 2 and 3 weeks, and below it at 6, 12, 32 and 52 weeks, with the differences at 6, 32 and 52 weeks reaching statistical significance. Self-reported returns to driving in the same review ranged from 6 days to over a year, or in rare cases never, and most of the 960 people who reported one came back within about 6 weeks, pooling to a mean of 32.9 days. The mean recommendation in the published literature was 4.5 weeks, while individual surgeons advise anywhere from 4 to 8 weeks (Patel and colleagues, 2023). An earlier meta-analysis of 19 studies, covering planned first-time hip and knee replacements for osteoarthritis, concluded that total brake response time was back to pre-operative values two weeks after a right hip replacement, although its margin of error was wide enough to include no change at all (van der Velden and colleagues, 2017).
Hold on to one thing about the word baseline, because it does a lot of quiet work in those two papers. Baseline there means how you braked before the operation, with the hip that needed replacing. The simulator study that compared two surgical approaches measured against healthy people instead, and it found that patients braked more slowly than that control group before surgery and only came up to the control group's level at six weeks (Jo and colleagues, 2022). So a return to baseline at two weeks is a return to the braking of somebody with an arthritic hip, which is not the same thing as a return to normal.
Put those side by side and you have the honest picture: two careful pooled analyses of the same kind of data, one landing on two weeks and one on six. Neither is permission to drive. Neither measured crashes either, and a simulator pedal is not a wet road with a child on it. What they give your surgeon is a rough idea of when the physical side comes back in general. When yours has come back is a different question, and they cannot answer it.
The guidelines are quieter on this than you would expect. NICE NG157, the UK guideline on primary hip, knee and shoulder replacement, puts no date on driving anywhere. It mentions driving once, and it is worth knowing about: the information you are given about the operation is meant to cover returning to usual activities, playing sports, driving and sexual activity among them, from the first appointment onward. So a conversation about driving is something the guideline expects you to have been offered, not a favor to ask for. What else it asks for is useful to you here: rehabilitation starting on the day of surgery where possible and within 24 hours of it, and clear goals plus a point of contact for the rehabilitation you do yourself. That point of contact is who the driving question belongs to. NG157 also asks for supervised outpatient rehabilitation, in a group or one to one, for people who are having difficulty with daily activities, who have ongoing problems with specific needs, or who are not meeting their goals on their own. Getting back behind the wheel is a specific need. If you are stuck on it, say so at your appointment; waiting it out quietly is not the only option open to you.
The surgical approach your surgeon used changes which movements you are restricted from and therefore how you get into a car at all, so if you do not know whether your hip was reached from the back, the front or the side, hip precautions and how long they last explains how to find out and what each list covers. For where driving sits among everything else that comes back, see the hip replacement recovery timeline, and the exercises that build the leg doing the braking are staged on the total hip replacement rehab program. If you are still weighing up the operation itself, why a hip replacement is needed is the page before this one.
Being physically ready: the checks that apply wherever you live
The permission half changes from country to country. This half does not, because a car is the same shape everywhere. Here is what a physiotherapist looks for before backing somebody's return to driving. Four of the items come straight out of the hospital leaflets, the walking aids from Gateshead, the pedals and the stationary emergency stop from Leeds and Newcastle, and the rest is practice experience rather than a validated test. The whole list sits behind your own team's instruction, never in place of it.
- You are walking without your walking frame or walker and without your stick or cane, which is where Gateshead Health starts.
- You can get into the driver's seat and out again on your own, without help and without twisting on the operated leg.
- You can hold the driving position for as long as the journey will take, with the hip comfortable rather than merely tolerable.
- Any restriction your surgeon put on how much weight you may put through the operated leg has been lifted, because a hard stop needs close to full force through that leg. A revision, a fracture fixed at the same operation and a repaired muscle at the side of the hip are the usual reasons for one, and the date it lifts belongs to your surgeon, not to a week number.
- You can move the right foot from accelerator to brake quickly and firmly, and repeat that two or three times, without the hip or thigh slowing it down.
- You can turn your head and shoulders to check both blind spots and to reverse, which asks more of a new hip than people expect.
- The rest of you is up to its share of the job. The left leg works the clutch in a manual or stick shift car, both arms turn the wheel, and a painful other hip or knee, a stiff shoulder or a neck that will not turn makes the same drive harder than the new hip alone would. If you are waiting for the second hip to be done, or the other knee, say so when you ask, because it changes the answer and often changes the car you borrow.
- You are off the opioid painkillers, which is where OrthoInfo sets its own condition, and you are not taking anything else that makes you drowsy, slow or lightheaded.
- You are not dizzy when you stand up or when you get out of the car.
- Your team has said yes.
Read it as all ten, not a pick of ten. One no is the answer, however good the other nine look.
Do the first run of these on the driveway with the engine off. Sitting in your own car and finding out what the hip makes of it costs nothing and tells you more than any week number does. A seat too low to get out of, or a driving position that pulls at the front of the hip, is better discovered there than three miles from home. Sit to stand using armrests is the exercise that most directly builds the getting-out-of-a-car movement, and walking without a stick or cane covers the aid question that Gateshead puts first.
Can you do an emergency stop?
The emergency stop decides the physical half, and strength is not really what it measures. It means getting on the brake hard, fast and without warning, at a moment when you were thinking about something else entirely. Pressing a pedal is not the hard part. Pressing it at full force, straight away, without bracing or flinching because you half expect the hip to complain, is.
One thing before you try it. The practice is itself a hard load through a new hip, so it waits until your team has cleared you to put full weight through the operated leg, and if a restriction on that is still in place there is nothing to test yet.
Practice it parked, which is what Leeds and Newcastle both ask for: Leeds says to test the emergency stop while the car is stationary, and Newcastle asks for a trial run with the engine off and a run through all the controls. Set it up properly first. Level ground, engine off, handbrake or parking brake on, in park if the car is an automatic and in neutral if it is a manual or stick shift.
Then press the brake down hard and fast, as if something had run into the road, and let the pedal come all the way back up. Three of those, with a pause between each one, tell you what you came to find out, and five is the most this is worth. Stop at the first one that is sharply painful rather than pushing on to a number. Then try two or three with the other leg, which is your built-in reference for what normal feels like. Two things about doing it parked. With the engine off the pedal is heavier than it will be when you are driving, because the power assistance is not running, so what you are judging is how fast and how willingly the leg goes, not how much force it can make. And this is a test, not an exercise: a handful of hard efforts tells you where you are, and repeating it daily is loading a new hip for no information. If it was not a clear yes, leave it a week, carry on with the program, and try again.
Leeds sets the bar as an emergency stop performed without hesitation or discomfort, so slower, weaker, painful or hesitant on the operated side all mean the same thing: not yet.
The braking leg is the right one in the UK, the USA, Canada, Australia and New Zealand, whichever side of the car the steering wheel is on. So a right hip replacement is the one sitting directly on top of this job. That does not make a left one irrelevant, as the sections below explain.
Tell your physiotherapist or physical therapist what happened when you tried it. A slow, weak brake is usually thigh strength, fear of the movement or stiffness at the front of the hip, and all three are things they can work on with you. It is a training problem far more often than it is a reason to wait another month and hope.
Who decides whether you are allowed: your licensing authority and your insurer
This is the half readers cannot find, and it is hard to find because it genuinely differs by country, by state and by insurance company. What this section can do is name the body that decides where you live. It does not invent a waiting period for any country whose own rules we have not read.
In the UK, the licensing authority is the DVLA. Gov.uk states that you must tell DVLA if you develop a notifiable medical condition or disability, or if a condition has got worse since you got your licence, and that failing to tell DVLA about a condition that might affect your safe driving can bring a fine of up to 1,000 pounds, with prosecution on top of that if you have an accident. The DVLA page we read defines a notifiable condition as anything that could affect your ability to drive safely, and the examples it lists do not name surgery or hip replacement anywhere. So whether anything in your own situation is notifiable is a question for DVLA, not for a website.
One rule on that page does carry a number, and it is worth knowing before you are in it rather than after. You must surrender your licence to DVLA if your doctor tells you to stop driving for 3 months or more, if your condition "affects your ability to drive safely" and that lasts 3 months or more, or if you do not meet the required standards for driving because of your condition. You can apply to get the licence back when you meet the medical standards again. Most recoveries from a hip replacement never come near that, since the usual advice is six weeks. A complication that keeps you off the road for months does come near it, so put the question to your surgeon rather than letting the date go by.
In the USA, driver licensing is run state by state, so there is no single national waiting period to quote you. Your surgeon and your own insurer are the two answers you need. In Canada it is handled by each province and territory. In Australia it is each state and territory: Transport for NSW, for example, says that to get, keep or renew a licence in New South Wales you may need to arrange a medical assessment, and that some medical conditions may result in a licence being changed or removed. In New Zealand licensing sits with the NZ Transport Agency. We have not read a hip replacement waiting period in any of those authorities' own documents, so this page does not state one, and you should not accept one from any page that has not read it either.
Then there is your insurer, which is a separate conversation from the licensing one, and three NHS trusts tell their own patients to have it. Gateshead Health tells patients to let their insurance company know about the operation. Leeds asks you to inform your insurance company that you have had a joint replacement procedure, and gives the reason in one line: to make sure your insurance stays valid. Newcastle is the blunt one, and it is the version worth hearing: drive this soon after the operation, have a crash, and your insurer may hold you liable for the damage, so check with the company before you drive. Beyond that, whether and how cover is affected is a matter for the company you are insured with, and nobody can state their position on your behalf, so ask them directly, ask early, not on the night before, and keep the reply. It costs you one phone call and removes the one worry on this page that nothing clinical can settle.
Make both calls in the week before you expect to be cleared. People spend six weeks concentrating on the hip, then meet the paperwork half on the morning they wanted to drive.
Does the side you had done, or an automatic gearbox, change it?
Both are real variables and neither is fussing, and the review that pooled this research says so directly: it concludes that driving advice should be individualized according to transmission type, the surgical technique used, the side operated on, the medicines you are taking and your other conditions (Patel and colleagues, 2023).
Take the side first. The right leg brakes in all five of our markets, so a right hip replacement is squarely in the way of the most important thing a leg does in a car. A left hip replacement spares the braking, but it still has to get you in and out, hold a position for the journey, and press the clutch in a manual or stick shift. The 2017 meta-analysis that reported a two week return to baseline measured right hip replacements specifically. These findings are side-specific, and they do not read across (van der Velden and colleagues, 2017).
On gearboxes, an automatic removes the clutch work and nothing else. It does not remove the hard brake, the twist to look over your shoulder, or the climb in and out. For readers in the UK, Australia and New Zealand, where manual cars are still common, borrowing or hiring an automatic for the first weeks back is a sensible thing to raise with your surgeon.
The surgical approach deserves one honest paragraph, because you will certainly meet claims about it. A simulator study of 90 right hip replacements compared the direct anterior approach with the posterolateral approach and found that the anterior group recovered faster on some braking measures at 2 and 4 weeks, while both groups were back to baseline at 6 weeks. The authors concluded that braking normalizes at 6 weeks after a hip replacement regardless of the approach, and their words for the group they studied were young active patients, so the finding does not read straight across to an older reader (Jo and colleagues, 2022). You may also come across much earlier figures from a single surgeon's series of 212 anterior hip replacements, in which most patients reported driving within three weeks and the authors suggested that selected, medically fit patients might drive within a week (Batra and colleagues, 2018). That is one surgeon's practice in one clinic, reported by questionnaire, and it is not a general recommendation. Neither paper is your surgeon, and neither of them knows how you get out of your car.
Both of those papers also looked at hips reached from the front or the back, and neither of them included one reached from the side. If yours was a side approach, the front part of the muscles at the side of the hip was lifted off the bone and stitched back, and that repair has a healing timetable of its own that no driving study has measured. Standing on that leg asks the repaired muscle to hold your pelvis level, and swinging the leg into and out of a footwell asks it to control the leg on the way, so the timing goes to the surgeon who did the stitching (Agarwala and Jagani, 2018).
Driving while you are still taking painkillers
People decide this part for themselves more than any other part of the question, and it is the one with legal teeth in it.
OrthoInfo's condition, quoted further up this page, is the simplest version of it: off the opioid painkillers, strength and reflexes back toward normal, your doctor helping you decide when. If you are still on the strong stuff at six weeks, that is the sentence to take to your appointment, because the week number and the medicine do not have to arrive together.
Gov.uk puts it in law, not in advice: in England, Scotland and Wales, driving with legal drugs in your system is an offense if they impair your driving. It names the prescribed medicines to talk to your doctor about before you drive, and the list reads like a hip replacement discharge bag: morphine and the opiate and opioid drugs, with codeine, tramadol and fentanyl given as the examples, plus diazepam and several other benzodiazepines. Newcastle routinely sends patients home with a short course of morphine, so this is not a hypothetical.
Read the two halves of the law separately, because people mix them up. Having the prescription, and taking the medicine as a healthcare professional told you to, is what protects you from the offense of being over a specified blood limit. It does not protect you from the separate offense of driving while the medicine impairs you. So a prescription is not a reason to drive, and gov.uk tells anyone in doubt to talk to a doctor, pharmacist or healthcare professional.
Drowsiness is not the only way a painkiller makes you a worse driver, and the rest of the list is harder to spot. Slower reactions. A flat feeling. A moment of confusion at a junction you have driven through a thousand times, or misreading how fast the car coming toward you is moving. None of those announces itself, and the person taking the medicine is the worst placed of anyone to judge it. That is why the question goes to the prescriber or the pharmacist and not to your own sense of feeling fine.
There is an error in the other direction, and it is the commoner one. Do not skip or reduce your pain relief so that you can drive. That buys you a legal drive and a painful, distracted, stiff one, and it undoes the pain control the early exercises depend on. Never stop or change a prescribed medicine on your own. Ask your prescriber how your medicines and driving fit together and whether the timing can be arranged around a journey, and ask them before the day you want to go out.
Being a passenger, and getting into the car
Being a passenger comes first, usually on the day you go home, and it is a different question from driving.
As a passenger, all that is asked of you is getting in, sitting, and getting out. As a driver, you are responsible for stopping a heavy vehicle in an emergency. People run the two together and conclude that a comfortable ride home means they could have driven it, and it does not follow. The method for getting in and out, the seat height and what to do about a low car are covered on stairs, car transfers and the toilet, so they are not repeated here.
What does belong here is the seat and the stops. If your team gave you precautions, they apply to a car seat as much as to an armchair, and the reclined seat everybody remembers is for getting in rather than for the journey: Leeds slides the seat right back and reclines the backrest to get you in, then has you bring it more upright once you are sitting, with the knee no higher than the hip. Which position you have to keep away from depends on how the hip was reached, so a seat position copied from a leaflet written for somebody else's operation is not safe by default. After a back approach the risk is deep bending combined with the leg crossing the middle of your body and turning inward, the combination rather than any one of the three on its own. After a front or a side approach the cautions often point the other way, toward the leg going back behind you and turning outward, which is nearer to what a far back, reclined seat asks of a leg stretching for the pedals, and your own list is on hip precautions.
On a long journey, stop and move. Being much less mobile than usual is one of the situations the clot warnings below name, and ankle pumps are the thing to do in the seat between stops, with a short walk whenever you break the trip.
The first drive: how to make it short and safe
Treat the first one as a test, not a trip, and set it up so that going wrong costs you nothing.
Daylight, dry weather, a quiet road you know well, and short. Somebody with you if that can be arranged. No motorway, freeway or highway, no multistory parking, no appointment at the other end that you must get to. Have the licensing and insurance half settled already, and make sure your crutches or stick are not loose in the footwell where they can slide under a pedal.
Then build it up the way you built up walking. Being able to drive for ten minutes does not mean an hour, and a new hip that has been fine in a chair all week can stiffen badly after forty minutes in a fixed driving position. Add distance in small steps and keep stopping to get out and move.
Stop and rethink if the hip aches enough to pull your attention off the road, if you find yourself bracing against the brake, or if you cannot do the mirror and blind spot checks without thinking about your hip. A distracted driver is the hazard here, not the implant.
When to wait longer, and when to get advice
Wait longer, without feeling that you have failed anything, if you still need a stick or cane to walk, if any limit on weight through the operated leg is still in place, if the parked braking practice was slow, weak or painful, if you are taking something that slows you down, if you feel lightheaded on standing, if you cannot get in and out unaided, or if your own team gave you a later date or a different instruction. Their instruction wins over everything on this page.
A fall, a knock or anything that felt like the hip slipping or giving way under you needs checking before you drive again, not after. If your hip has clunked and felt as though it partly came out, if a small knock has left it newly sore or swollen, or if it will no longer lift the leg out to the side or hold you up when you stand on it, that is a same-day call to your surgical team, and the lines below say exactly what to do. If you are older, have fallen in the past year or feel unsteady, treat the whole return to driving as part of a wider steadiness question and work through balance and falls prevention alongside it.
Some symptoms mean you do not drive at all, including driving yourself to be seen. Sudden severe hip pain with a leg that looks shorter or turned, sudden breathlessness or chest pain, new numbness in the leg or foot after a fall, or a foot that has turned cold or pale are all in the warning signs below, and more than one of them ends with the instruction not to drive yourself. Call for help or get someone else to take you. The warning signs after a hip replacement sets the whole set out with the urgency each one needs, and if what is stopping you driving is nerve pain down the leg rather than the new hip, driving with sciatica is a different subject with its own page.
It helps to know what you are actually asking them for, because it is not a calendar check. Your team is the only one that knows how your hip was reached, what muscle, tendon or capsule was repaired on the way in, whether any precaution or weight limit still stands, and whether anything particular to your operation makes them want longer. A sign-off is them saying the hip can take a hard load and an awkward climb in and out, which is a different judgment from counting weeks.
The question to put at your six week check is a specific one, and specific questions get answers: am I fit to drive, is there anything about my operation that makes you want me to wait longer, and is there anything I should tell DVLA or my insurer. Those three take a minute to ask and they settle a question that no amount of reading will.
Related exercise programs
Warning signs
Get emergency help now
- Emergency: sudden severe pain in your hip or groin, sometimes with a clunk or pop, and you cannot move the leg or put weight on it, or the leg suddenly looks shorter or turned in or out. Do not try to walk on it or push it back into place. Keep still and call emergency services or go to an emergency department, and do not drive yourself. Your new hip may have come out of its socket (dislocated), and a medical team needs to put it back.
- Emergency: your operated leg looks shorter than it did, or its foot turns in or out more than before, or the hip moves in an unusual way, even if the pain is not severe. Keep your weight off it and go to an emergency department straight away, and do not drive yourself. If you are in severe pain or cannot move the leg, call emergency services.
- Emergency: you have just fallen and cannot get up, or you think you may have hurt your head, neck, back or hip. Stay where you are, keep warm and call emergency services, or get someone to call for you. If you got up and walked without trouble and only notice pain later, use the same-day lines in this list instead.
- Emergency: you have had a fall or an injury and now have severe hip pain, or you cannot walk or put weight on the leg. Call emergency services or go to an emergency department. This can be a sign of a broken hip (hip fracture).
- Emergency: since your operation, you suddenly become short of breath, you get chest pain or pain in your upper back that may be worse when you breathe in, you cough up blood, your heart is beating very fast, or you faint. Call emergency services straight away, even if your leg looks normal. These can be signs of a blood clot in the lungs (pulmonary embolism).
Get help today
- Same day: after a fall or a knock, even a small one, your hip, groin or thigh is newly painful, bruised or swollen, even if you can still walk and your leg looks normal. Stop the exercises, go back to your crutches or frame and keep your full weight off that leg, and contact your surgical team or get medical advice the same day. A break in the bone around a new hip is not always obvious at first, and walking normally on one can move the broken ends apart.
- Same day: a calf or thigh that is newly swollen or getting more swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services.
- Same day: you are taking tablets or having injections to lower your risk of a blood clot and you notice blood in your urine, black or bloody stools, bleeding gums, a nosebleed that goes on and on, bruising far beyond what the knock would explain, or you are being sick or coughing up blood. Get medical advice the same day, and do not stop the medicine on your own. Bleeding more easily is the known trade-off of these medicines (NHS), and the dose or the type may need looking at. Go to an emergency department if the bleeding will not stop, you feel faint, or you bang your head while you are taking it, even if you feel fine, because the NHS advises getting urgent advice after a head injury on medicine that thins your blood and only a hospital can scan for a bleed inside the head.
- Same day: your wound becomes more red, hot, swollen or painful, starts to leak or ooze, is still leaking in the second week or has never stopped, has pus coming out of it or its edges start to come apart, or you have a high temperature or feel hot, cold or shivery. Contact your surgical team or get medical advice the same day. Redness can be harder to see on brown or black skin. If you feel very unwell, go to an emergency department. If you have a very high or very low temperature, shivering you cannot control, you are breathing very fast or finding it hard to breathe, you are confused or your speech is slurred, your skin, lips or tongue look blue, gray, pale or blotchy (on brown or black skin this can be easier to see on the palms of the hands or soles of the feet), or you have a rash that does not fade when you press it, call emergency services, as this can be sepsis.
- Same day: in the days or weeks after your operation you are getting more and more tired, breathless doing everyday things such as walking to the toilet or getting dressed, dizzy or lightheaded, your heart is racing, or your skin looks paler than usual. Contact your surgical team or get medical advice the same day. Tiredness and breathlessness that build up like this are not part of the usual recovery. Blood loss during and after a hip replacement can leave you short of red blood cells (anemia), which is treatable, and a slow bleed or an infection can show up the same way. If breathlessness comes on suddenly, or you get chest pain, call emergency services, as the emergency line above explains.
- Same day: dizziness, lightheadedness, blurred vision or feeling faint when you stand up that is new for you, does not pass within a minute or two, keeps happening, or has made you fall. Sit or lie down, and get medical advice the same day. This can be a drop in blood pressure on standing (postural hypotension), a type of low blood pressure, which the NHS lists among the causes of falls, and your doctor can check it. Tell them about your medicines, because some can cause it. If it does not settle within a few minutes of sitting or lying still, call emergency services. If you faint, call emergency services, even if you come round quickly, because the NHS says to call them when someone faints while exercising or is badly hurt, and a faint onto a new hip can dislocate it or break the bone around it.
- Same day: dizziness or feeling faint during or after exercise, other than the brief lightheadedness as you stand up covered in the line above, without any of the emergency signs above. Stop the exercises and get medical advice the same day. If you faint, it does not settle within a few minutes of sitting still, or you cannot stand or walk steadily, call emergency services.
- Same day: your hip clunks and feels as if it partly slipped out of place and went back, even if it settles straight away and your leg looks normal. Stop the exercises, avoid the movement that brought it on, go back to your crutches or frame, and keep away from deep bending, crossing your legs and twisting on that leg until you have been seen. Contact your surgical team or get medical advice the same day. If the leg then looks shorter or turned, or you cannot move it or put weight on it, call emergency services.
- Same day: you felt a pop, a snap or a sudden tearing pain over the side or the back of your hip, or your hip will not lift the leg out to the side any more, or it will not hold you up when you stand on that leg, so your hip drops or you lurch to one side. Stop the exercises, go back to your crutches or frame, and contact your surgical team or get medical advice the same day. Muscle and tendon are cut and stitched back during a hip replacement, and a repair that has given way needs assessing rather than exercising. If you cannot put weight on the leg at all, or the leg looks shorter or turned, call emergency services.
- Same day: a leg or foot that is getting weaker, for example your foot drags, catches on the ground or slaps down when you walk (foot drop). Get medical advice the same day. If the weakness is getting worse by the hour, go to an emergency department.
- Same day: new numbness, tingling or burning in your operated leg or foot, beyond the numb patch of skin around your scar. Contact your surgical team or get medical advice the same day. If it started after a fall or an injury, or your foot or toes turn cold, pale, blue or gray, call emergency services or go to an emergency department straight away, and do not drive yourself.
Book an appointment
- Within a few days: you have had a fall, even if you were not hurt, or you keep tripping, stumbling or feeling that your legs might give way. Book an appointment with your doctor within a few days and ask about a falls assessment. Tell them about every fall, even the ones where you were not hurt.
Common questions
When can I drive after a hip replacement?
When your surgical team says you are ready and you can control the car, including stopping hard without warning. Four NHS services land on the same six weeks and three of them attach a test to it. The NHS gives the floor: wait at least 6 weeks, and check with your doctor that you are fit to drive. Gateshead Health asks you to be walking without any mobility aids first and then to drive when you feel safe to do an emergency stop and control the car. Leeds puts it at approximately six weeks providing an emergency stop can be performed without hesitation or discomfort, tested while the car is stationary. Newcastle says six weeks with your consultant's advice, after a trial run with the engine off and a check that you can reach and use the pedals without discomfort. A systematic review of simulator studies found the advice surgeons give ranges from 4 to 8 weeks and that the published mean recommendation was 4.5 weeks (Patel and colleagues, 2023). None of that is permission. Ask your surgeon for your date, and check separately with your licensing authority and your insurer.
Does it matter which hip was replaced?
It may, and the review that pooled this research says the operated side is one of the things driving advice should be individualized on (Patel and colleagues, 2023). In the UK, the USA, Canada, Australia and New Zealand the brake is worked with the right foot whichever side of the car you sit in, so a right hip replacement is the one sitting directly on top of the braking job. A left hip replacement is less involved in braking, but it still has to get you into the seat, hold a driving position for the length of the journey, and work the clutch in a manual or stick shift car. Neither side comes with a shorter wait that we can source, so take the date from your team, not from the side.
Is an automatic different from a manual?
The same review names transmission type among the factors advice should be tailored to, so it is a fair question to put to your surgeon and not one to settle yourself. An automatic takes the clutch out of the job, which matters most to someone whose left hip was operated on. It does not remove the hard braking, the twisting to look over your shoulder, or the business of getting in and out. In the UK, Australia and New Zealand, where manual cars are common, borrowing an automatic for the first few weeks back is a reasonable thing to ask your team about.
Do I have to tell my insurer or the licensing authority?
Ask both, and do not take the answer from a page like this one. In the UK, gov.uk says you must tell DVLA if you develop a notifiable medical condition or if a condition has got worse since you got your licence, and that failing to tell DVLA about a condition that might affect your safe driving can bring a fine of up to 1,000 pounds, with prosecution on top if you have an accident. It defines a notifiable condition as anything that could affect your ability to drive safely, and the examples it lists do not name surgery or hip replacement, so whether anything in your own situation is notifiable is a question for DVLA. The same page says you must surrender your licence if a doctor tells you to stop driving for 3 months or more, or if your condition affects safe driving for 3 months or more, which a long complication could reach even though the usual advice is six weeks. On the insurance side, Gateshead Health, Leeds and Newcastle all tell patients to contact their insurer, Leeds to keep the policy valid and Newcastle because insurers may consider you liable for damage if you drive soon after surgery and have an accident. What your insurer does with that is between you and them, so ask them directly and keep the answer.
Can I drive while I am taking the painkillers?
Not if they are affecting you, and for some of our readers that is law and not only common sense. OrthoInfo puts it as a condition rather than as advice: in most cases it is safe to start driving again once you are no longer taking opioid pain medication and your strength and reflexes have come back toward normal. In England, Scotland and Wales, gov.uk says driving is an offense if a legal drug in your system impairs your driving, and it tells you to talk to your doctor, pharmacist or healthcare professional if you have been prescribed something and are not sure whether to drive. The medicines it names to ask about include morphine and the opiate and opioid drugs, with codeine, tramadol and fentanyl as its examples, and diazepam, which covers most of what people are sent home on after this operation. Having the prescription and taking it as advised protects you from the separate offense of being over a specified blood limit. It does not make you safe to drive, and it does not help you afterward if you were impaired. The trap is the other direction: do not skip your pain relief so you can drive. Never stop or change a prescribed medicine on your own. Ask your prescriber or pharmacist instead, and plan the drive around the medicine rather than the medicine around the drive.
How do I know I can do an emergency stop?
Test it parked before you test it moving, which is what Leeds and Newcastle both ask for. Leeds says to test the emergency stop while the car is stationary and sets the bar at one performed without hesitation or discomfort. Newcastle asks for a trial run with the engine off and a run through all the controls. So sit in the driving seat on level ground with the engine off and the handbrake or parking brake on, in park if it is an automatic and in neutral if it is a manual, and press the brake pedal down hard and fast, as though something had run out in front of you. Three times, with a pause between each, and five at the very most. Stop at the first one that is sharply painful. What you are looking for is whether the operated leg can move quickly from the accelerator, hit the pedal hard, and do it again without the hip stopping you or making you flinch. Compare it with two or three on the other leg, which gives you a useful reference, remembering that with the engine off the pedal is heavier for both legs than it will be on the road. If it hurts, if it is slow, if you have to think about it, or if you cannot make the same force on both sides, you are not ready, and that is information to take to your physiotherapist or physical therapist, not a reason to give up.
Can I be a passenger before I can drive?
Yes, and almost everyone is, because most people go home from hospital in a car. Being a passenger and driving are different questions: one is about getting in and out and sitting comfortably, the other is about controlling a heavy car in an emergency. Our page on stairs, car transfers and the toilet covers the method for getting in and out. On a longer trip, break the journey up so you are not sitting still for hours, because being much less mobile than usual is one of the things that raises clot risk after surgery, and the warning signs below say what to watch for.
References
- NHS. Recovering from a hip replacement. Page last reviewed 6 March 2024. https://www.nhs.uk/tests-and-treatments/hip-replacement/recovering-from-a-hip-replacement/
- NHS. Complications of a hip replacement. Page last reviewed 6 March 2024. https://www.nhs.uk/tests-and-treatments/hip-replacement/complications-of-a-hip-replacement/
- Gateshead Health NHS Foundation Trust. Physiotherapy following hip replacement surgery. Patient information. https://www.gatesheadhealth.nhs.uk/resources/physiotherapy-following-hip-replacement-surgery/
- Leeds Teaching Hospitals NHS Trust. Total hip replacement: a guide to your rehabilitation. Patient information. https://www.leedsth.nhs.uk/patients/resources/total-hip-replacement-a-guide-to-your-rehabilitation/
- The Newcastle upon Tyne Hospitals NHS Foundation Trust. Total hip replacement. Patient information. https://www.newcastle-hospitals.nhs.uk/resources/total-hip-replacement/
- GOV.UK. Driving with a medical condition or disability. Driver and Vehicle Licensing Agency. https://www.gov.uk/driving-medical-conditions
- GOV.UK. Drugs and driving: the law. https://www.gov.uk/drug-driving-law
- NSW Government. Fitness to drive. Transport for NSW. https://www.nsw.gov.au/driving-boating-and-transport/driver-and-rider-licences/health-conditions-and-disability/fitness-to-drive
- National Institute for Health and Care Excellence. Joint replacement (primary): hip, knee and shoulder. NICE guideline NG157. Published 4 June 2020. https://www.nice.org.uk/guidance/ng157
- American Academy of Orthopaedic Surgeons. Total hip replacement. OrthoInfo. https://www.orthoinfo.org/en/treatment/total-hip-replacement/
- Patel PV, Giannoudis VP, Palma S, Guy SP, Palan J, Pandit H, Van Duren BH. Doctor when can I drive? A systematic review and meta-analysis of return to driving after total hip arthroplasty. Hip International. 2023;33(1):17-27. https://doi.org/10.1177/1120700021998028
- van der Velden CA, Tolk JJ, Janssen RPA, Reijman M. When is it safe to resume driving after total hip and total knee arthroplasty? A meta-analysis of literature on post-operative brake reaction times. The Bone and Joint Journal. 2017;99-B(5):566-576. https://doi.org/10.1302/0301-620X.99B5.BJJ-2016-1064.R1
- Jo S, Lee HJ, Lim WB, Lee HJ, Choi SK. Driving simulator brake reaction parameters after total hip arthroplasty according to different surgical approaches. The Journal of Arthroplasty. 2022;37(9):1809-1815. https://doi.org/10.1016/j.arth.2022.04.001
- Agarwala S, Jagani N. Osteotendinous suturing for anchorage of hip abductor mechanism in total hip arthroplasty through a lateral approach: a technical note. Journal of Orthopaedic Case Reports. 2018;8(2):26-29. https://pubmed.ncbi.nlm.nih.gov/30167407/
- Batra A, Gogos S, Nizam I. When do patients drive after minimally invasive anterior hip replacements? A single surgeon experience of 212 hip arthroplasties. SICOT-J. 2018;4:51. https://doi.org/10.1051/sicotj/2018045
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- American Academy of Orthopaedic Surgeons. Activities after total hip replacement. OrthoInfo. https://www.orthoinfo.org/en/recovery/activities-after-hip-replacement/
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Written and checked by the PocketPhysio editorial team. Last updated 2026-10-17.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.