Part of Total hip replacement rehab
Problems after a hip replacement: what is urgent and who to call
Warning signs, and when to get help
What problems can happen after a hip replacement?
If something is happening right now, do not read this page in order. Go straight to the warning signs at the foot of it. Every line there sits under one of three headings, "Get emergency help now", "Get help today" and "Book an appointment", and each line names its own symptoms and its own route, so find the one that matches what you have, do what it says, and read the rest of this page afterward.
You have had the operation, and this page is about everything that comes after it. Problems after a hip replacement are not all the same size, and the name of the problem is rarely what decides how it turns out. Speed does. So the first job on this page is not to work out what you have; it is to work out how fast it needs looking at, and the published sources are clearer about that than they usually get credit for.
The published lists are short. The NHS names blood clots, wound infection, a difference in leg length, damage to nerves or tissue, and dislocation and wear, and it adds that people with a metal-on-metal replacement should have regular check-ups. OrthoInfo, from the American Academy of Orthopaedic Surgeons, approaches it the other way round and gives the reader a list of things to report: a persistent fever, chills, increasing redness, tenderness or swelling of the hip wound, drainage from the wound, and increasing hip pain with both activity and rest, alongside its separate sets of leg and chest signs for a blood clot.
Everything on this page falls into one of three speeds, and the full warning list at the foot of the page is sorted that way instead of by subject.
Emergency, meaning call emergency services or go to an emergency department now. A hip that has come out of its socket, a leg that has suddenly gone short or turned, severe pain or an inability to put weight on the leg after a fall, a fall you cannot get up from, and sudden breathlessness or chest pain since the operation.
Same day, meaning today rather than at your next appointment. A newly swollen or tender calf, a wound that is leaking or going backwards, a temperature, a hip that is getting more painful rather than less, a clunk that felt like a slip, new numbness or a dragging foot, bleeding on clot medicine, dizziness on standing, and tiredness or breathlessness that has been building for days.
A review, meaning ring and ask for one. Pain in a new hip that had settled and has come back, pain that is worsening month by month, a leg that feels slightly long or short with nothing else changing, and a recovery that has simply stopped moving.
One thing to settle before the detail. Your surgical team knows which operation you had, what they found while they were doing it, and what else you live with, so where their instructions and this page differ, theirs are the ones to follow. This is general education about an operation, not advice about your hip.
The way the hip was reached does not change this page much. The restrictions differ by approach, and hip precautions and how long they last is the page for that, but the signs of trouble are the same whichever way the surgeon went in. That needs saying plainly to anyone who had an anterior approach and came away with the impression that dislocation is not something they need to know about. It is less talked about with a front approach, and the restrictions given are often different, but the signs are the same and still need recognizing.
Signs your new hip has dislocated, and what not to do
Dislocation is the one people are most afraid of, and the one most often pictured wrongly. The dramatic version is real: sudden severe pain in the hip or groin, sometimes with a clunk or a pop, and a leg that will not move or take weight. OrthoInfo notes that the risk of dislocation is greatest in the first few months after surgery, while the tissues are healing. That is the window the precautions are built around, but it is not the end of the subject, and this is worth being plain about on a page people come back to years later. The NHS says a hip replacement can dislocate soon after surgery before the joint is fully healed, and that it can also happen many years after surgery. The emergency lines below hold for the life of the joint, not for the first six weeks of it.
The version that gets missed is quieter. A leg that looks shorter than it did yesterday, or a foot that now turns in or out more than it used to, or a hip that moves in an odd way, with pain that is nothing like severe. The Plymouth leaflet has unusual hip movement or deformity on its list of things to seek immediate medical attention for, and says it could mean the hip has dislocated again. Both versions are at the emergency tier in the list below, and the quieter one has its own line precisely because people talk themselves out of acting on it.
Two things not to do while you wait, both of which are in the warning lines themselves. Do not try to walk on it, and do not try to push it back into place. A hip that is out needs putting back by a team who can give you something for the pain first, and the Plymouth leaflet describes that reduction as the first step, with an X-ray often taken afterward. OrthoInfo says that a new hip which has come out of its socket can usually be put back without further surgery, in what is called a closed reduction, and that a hip which keeps dislocating may need more than that. Those are the reasons for keeping still and keeping your weight off it rather than testing it.
A near miss counts too. A hip that clunks and feels as though it slipped out and went back, even if it settles immediately and the leg looks entirely normal, is a same-day call. That line asks you to stop the exercises, go back to your crutches, frame or walker, and stay away from deep bending, crossing your legs and twisting on that leg until someone has looked at it. The same positions come up in bed, where the hospitals differ most openly about what they ask for, and sleeping positions after a hip replacement lines up what each of them publishes.
Blood clots: the leg signs and the chest signs
Clots come in two forms with two different speeds, and knowing which is which is the whole point of this section. The parent program, total hip replacement rehab, covers why clot prevention is offered after this operation. What belongs here is what it looks like when something has happened.
In the leg, OrthoInfo asks you to tell your doctor immediately about pain in your calf and leg that is unrelated to your incision, tenderness or redness of the calf, and new or increasing swelling of the thigh, calf, ankle or foot. The NHS describes throbbing pain in one leg, usually the calf or thigh, swelling in one leg, skin that is red, blue or darkened around the sore area, which it notes can be harder to see on brown or black skin, and swollen veins.
The difficulty is obvious once you see it stated: a sore, swollen leg is also what an ordinary recovery looks like in the early weeks. The NHS says you will probably have some pain and swelling in your legs and feet and that these usually get better in a few weeks. So the signs that matter are the ones about change and asymmetry. Swelling that is heading the wrong way instead of slowly settling, pain in the calf and not around the wound, and a calf that is warm and tender to touch. If you are not sure, that is what the same-day route exists for.
In the chest it is faster and it is an emergency. OrthoInfo lists sudden shortness of breath, sudden onset of chest pain, and localized chest pain with coughing. The NHS pulmonary embolism page asks for emergency help for severe difficulty breathing, pain in the chest or upper back, a heart beating very fast, or someone passing out. The NHS hip replacement page joins the two together: hip or leg pain and swelling with difficulty breathing or chest pain is the combination it sends to the emergency services, because a clot that has traveled to the lungs needs treating immediately. The line below says to call even if your leg looks completely normal, and it says that because the chest signs can arrive without any warning from the leg at all.
The medicine side has its own line. If you are on tablets or injections to lower your clot risk, the NHS is direct that the main side effect is bleeding too easily, and it lists blood in your urine, blood in your poo or black poo, severe bruising, prolonged nosebleeds, bleeding gums, and vomiting or coughing up blood. That is a same-day conversation about the dose or the type, not a reason to stop. Never stop or change a prescribed medicine on your own.
The wound, infection and the signs of sepsis
Wounds are the thing people inspect most and judge least reliably, mostly because nobody showed them what the first few days are supposed to look like. The signs the sources name are all about direction and discharge. The NHS asks for urgent advice if you have recently had a hip replacement and have oozing or pus from the wound, a high temperature or feel hot, cold or shivery, or redness, tenderness, swelling or pain in the hip or leg that is not improving or is getting worse, and says these could be signs of an infection or a blood clot. OrthoInfo's list for the same thing is a persistent fever, which it puts at higher than 100 degrees Fahrenheit, about 37.8 Celsius, taken by mouth, chills, increasing redness, tenderness or swelling of the hip wound, drainage from the wound, and increasing hip pain with both activity and rest.
One qualification belongs with those two lists, and it is the part a surgeon would want said first. OrthoInfo's page on infection after a joint replacement says the symptoms vary widely, from mild redness and swelling up to life threatening septic shock, that sometimes there are no symptoms at all, and that fever is no longer considered a sign of an infection after a joint replacement. The same page names wound drainage, usually more than ten days after surgery, and increased pain or stiffness in a joint that had been working well. So a normal temperature is not an all clear, and neither is a hip that has never gone red. Each sign on the lists above stands on its own, and none of them needs a temperature beside it.
Note what is not on either list. A wound that is a bit pink at the edges and getting less so, a small amount of clear ooze in the first days, and bruising that spreads down the thigh and changes color are not what these lines are about. Redness that is spreading, heat, a wound that starts leaking having stopped, edges coming apart, and a temperature are. So is a wound that has never stopped, and that one needs saying separately, because the warning line below is worded around a wound that starts to leak and a reader whose wound has been damp since the day of the operation can read straight past it. Neither source puts a clock on this. OrthoInfo lists drainage from the hip wound with no qualifier about when it began, and the NHS asks for urgent advice for oozing or pus from the wound in the same unqualified way. A hip wound still wetting a dressing in the second week is on both of those lists, whether or not anything about it has changed, and it is a reason to contact the surgical team rather than to keep changing the dressing and watching. Redness is also harder to see on brown or black skin, which is why the line below says so and why the other signs carry more weight there.
The reason the wound line below runs on into a long second half is sepsis, and that half is not padding. A very high or very low temperature, shivering you cannot control, breathing very fast or struggling to breathe, confusion or slurred speech, skin, lips or tongue that look blue, gray, pale or blotchy, which on brown or black skin can be easier to see on the palms or the soles, and a rash that does not fade when pressed are all on the NHS emergency list for sepsis. Those signs move the whole thing from a phone call to an ambulance. Read that part of the line now, not when you need it.
Being generally unwell has its own route, and it is the one people sit on longest. Tiredness and breathlessness that build up over days after the operation, with a racing heart, dizziness or skin paler than usual, are not the usual recovery. The Royal Orthopaedic Hospital says blood loss is common during surgery, that anemia, meaning a shortage of red blood cells or hemoglobin, is common among people having major planned surgery, that it may slow healing and raise infection risk, and that it is treatable. The NHS lists tiredness and lack of energy, shortness of breath, noticeable heartbeats and paler than usual skin among the symptoms of iron deficiency anemia. A slow bleed and an infection can present the same way, which is why that line is same-day and not something to mention at the six week check.
Can a hip replacement get infected months or years later?
Yes, and anyone years past their operation should read this section before the others. An artificial joint can become infected long after the wound has healed and been forgotten about, and the symptoms arrive without a wound to point at. New pain in a new hip together with a high temperature or feeling hot, cold or shivery, or a hip that turns hot, red or swollen, is a same-day matter whether you are three weeks or nine years out.
What earns this a section instead of a footnote is how easily it gets filed as something else. Pain that comes back in a hip that had been fine for years reads like wear, like arthritis somewhere else, or like having overdone it in the garden. The NHS says a wound infection is usually treated with antibiotics and that if it spreads deep into the hip joint, further surgery may be needed, so the cost of waiting is real and the cost of ringing is an afternoon. OrthoInfo puts the same thing in starker terms: infection can be superficial in the wound or deep around the prosthesis, minor wound infections are generally treated with antibiotics, and major or deep infections may require more surgery and removal of the prosthesis. That is the reason this line has no end date and no benefit of the doubt. If there is a temperature alongside the pain, treat it as the same-day line and not the routine one. If there is no temperature, the routine review line is still the answer rather than nothing at all. OrthoInfo names increased pain or stiffness in a joint that had been working well among the signs of an infection around a new joint, says the signs can be as little as mild redness and swelling, and says fever is no longer considered a sign of one.
Where the bacteria come from is worth knowing, because it is the part of this you can do something about. OrthoInfo says that any infection in your body can spread to your joint replacement, and names bacteria entering the bloodstream during dental procedures, urinary tract infections or skin infections as a common cause of infection after hip replacement surgery. So an infection somewhere else entirely, a tooth, a water infection, a cut or a patch of skin that is not healing, is a reason to get seen and treated rather than to wait out, and it is worth saying that you have a hip replacement when you are seen for it, because it changes what the person in front of you is weighing up. OrthoInfo asks you to make sure your dentist knows you have a hip replacement, and says that after surgery some people with certain risk factors need antibiotics before dental work, including dental cleaning, or before any procedure that could let bacteria into the bloodstream. Whether you are one of those people is a question for your own surgeon and not a rule that applies to everybody, which is exactly how OrthoInfo frames it.
One more thing about antibiotics, from the surgical side. If a clinician who has not seen your hip before offers antibiotics for pain, heat or swelling in or around the replaced joint, tell them it is a replacement and ask whether your surgical team should look at it first. Deciding whether a hot, painful replacement needs a sample taken from the joint before treatment starts is a surgical decision, and it belongs to the team that put the joint in.
The routine review line at the end of the list carries this escalation inside it, which is deliberate. Pain that is worsening month by month is a review. The same pain with heat, redness, swelling, a temperature, or a week-by-week rather than month-by-month build is not.
Nerve symptoms, weakness and a foot that drags
Some numbness is ordinary and some is not, and the dividing line is specific enough to be useful. A patch of skin around the scar that feels numb or odd is expected and often stays that way. New numbness, tingling or burning beyond that patch, down the leg or into the foot, is a same-day call.
Weakness is the version to take most seriously, because of what it does to your footing. A foot that drags, catches on the ground or slaps down when you walk is the pattern described as foot drop, and it is below at the same-day tier with a faster route if it is worsening by the hour. The NHS says a blood vessel, nerve or ligament around the hip joint can be damaged during surgery, that this is not common, and that it can either be repaired during the surgery or will heal afterward. The blood vessel half of that sentence is why the numbness line below carries a separate emergency route. The Plymouth leaflet asks people to seek immediate attention for pins and needles, numbness or weakness in the leg, knee or foot, and separately for toes that go cold, pale or blue, which is a different problem and a faster one: a foot losing its blood supply does not wait for an appointment, and that is the one symptom on this page where minutes rather than hours are the unit.
There is a practical reason this section matters more after a hip replacement than it would otherwise. A foot that catches trips you, and a fall in the early weeks is the thing everyone is trying to avoid. Keep your stick or cane and use the handrail until somebody has looked at it, whatever stage you had reached, since when the stick or cane comes away is your physio's decision and not a question of how steady you feel. Read balance and falls prevention alongside your program and not after it.
After a fall or a knock, even a small one
Falls split into three lines below, and the ones that save people trouble are not the first.
The first is the obvious emergency. A fall or injury followed by severe hip pain, or being unable to walk or put weight on the leg, goes to the emergency services or an emergency department, because it can be a broken hip. Hip fracture rehab covers that recovery if it happens.
The second is written for the moment itself rather than for afterward, and it is the one to read before you need it. If you have fallen and cannot get up, or you think you may have hurt your head, neck, back or hip, that is an emergency call. The NHS asks for an ambulance for anyone who has fallen and may have injured the head, back, neck or hip, or cannot get up, and it tells anyone helping not to try to lift them. Stay where you are and keep warm rather than struggling up or letting somebody haul you. If you cannot get up, use your phone or personal alarm, or shout or bang on the wall or floor to get someone's attention. Cover yourself with anything you can reach, such as a coat, towel or blanket. Roll gently from side to side or move your arms and legs, and change position about every 30 minutes to help protect your skin. If you were on the floor for an hour or more, get medical advice the same day, even if you then managed to get up: the World Falls Guidelines link a long time on the floor with dehydration, disturbed body chemistry, kidney failure, getting too cold, pneumonia, urine infections, damage to the skin and pain, and count it as a sign of high falls risk (Montero-Odasso and colleagues, 2022).
Two things make that possible rather than theoretical, and both are worth arranging in the first week home rather than after the first fall. Keep your phone in a pocket rather than on a table in another room, so you can reach it from the floor, and ask your doctor or your team about an alarm you wear, which the NHS lists among the things to do if you are at risk of falling. If you live alone, say so while you are still being discharged, because it changes what help is worth asking for and who checks on you in the weeks when a fall matters most.
The third line covers the knock that did not look like much. Your hip, groin or thigh is newly painful, bruised or swollen after a fall or a bump, and you can still walk on it, and the leg looks normal. That is still a same-day call to your surgical team, and the line asks you to stop the exercises and keep your full weight off that leg in the meantime. The reason is in the line: 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. In practice this is the warning people most often talk themselves out of, and the reason is understandable, because being able to walk on it feels like proof that nothing is broken. It is not. OrthoInfo's own long-term advice is to take special care to avoid falls and injuries, and it gives the reason in one line: if you break a bone in your leg, you may require more surgery. Bone that has a stem or a socket inside it does not behave like ordinary bone when it cracks, and a crack that is left to be walked on can turn into an operation that a phone call on the day might have avoided.
There is a third thing about falls that is not a warning sign at all, and it belongs here because people leave it out. In the early weeks, tell your surgical team that you fell even if nothing hurts afterward and you got straight back up. They will want it on the record, it changes what they look for if something does start to ache a fortnight later, and the fall and knock lines below are what you use in the meantime if pain, bruising or swelling appears or the leg stops taking your weight. The falls assessment line at the end of the list is a separate and slower route, and it is about stopping the next fall rather than checking this one.
Bone strength is part of the same picture, and osteoporosis is the page for that if you have been told you have thin bones or have broken something after a minor fall before.
Pain that has come back, or is getting worse month by month
This is the late question, and it has a route of its own that is neither urgent nor nothing. Pain in a new hip that had settled and has returned, or that is slowly getting worse, typically felt in the groin or thigh as you first stand up and start walking, is a reason to ask your surgical team for a review. The NHS says hip replacements are designed to last at least 15 years and that they can wear over time, and that if the hip dislocates or wears out, another operation may be needed. OrthoInfo describes revision surgery as what may become necessary where loosening causes pain, and says that over a period of years the prosthesis may wear out or loosen, most often from everyday activity, and that it can also result from a thinning of the bone around the implant called osteolysis. Neither of those is a prediction about your hip, and neither is a reason to wait and see.
There is also a check that does not wait for symptoms at all, and no page can stand in for it. OrthoInfo asks you to keep seeing your orthopedic surgeon at intervals for examination and X-rays, even when the new hip seems to be doing fine. The reason is that wear and loosening can be well under way on an X-ray before they are doing anything you would notice, so feeling well is not the same as being checked. Keep going to the follow-up appointments you are offered, and if nobody has given you one and you are some years out, ask your surgeon's service what their interval is. Reading this page is not a substitute for being examined.
If your replacement was a metal-on-metal one, the NHS asks for regular check-ups and names new hip pain, feeling less mobile than usual, and a popping or clicking sound from the joint as reasons to contact your GP, meaning your family doctor or primary care physician, or your care team. Worth knowing which type you have, and the discharge paperwork or your surgeon will tell you.
Groin pain is the one that most often gets attributed to something else, since it can come from the back, from a tendon or from the hip itself. Groin pain covers the alternatives, though in a replaced hip the review comes first.
What is ordinary in this recovery, and what is not?
Most of what frightens people in the first weeks is ordinary. The NHS says you will probably have some pain and swelling in your legs and feet and that these symptoms usually get better in a few weeks. OrthoInfo's activities page puts a longer frame on the swelling specifically: moderate to severe in the first few weeks, and mild to moderate for 3 to 6 months after surgery. So a leg that is still a little puffy by evening some months on is not in itself the sign the lines below are about; swelling that is increasing, one sided, warm or tender is. Soreness after a day of more walking, stiffness first thing, a numb patch by the scar, bruising that tracks down the thigh, and stamina that lags well behind the pain are all part of it. The hip replacement recovery timeline is the page for what each window usually looks like, and the exercises for weeks 0 to 6 covers what the early work involves, including the ankle pumps that are given from the hospital bed onward.
One more thing earns a call rather than a wait, and it is not on the NHS list. The Plymouth leaflet puts increased or severe pain that is not relieved by the prescribed medication on its list of reasons to seek immediate medical attention, and Newcastle tells its own patients to contact their GP surgery for further help if pain is not well managed at home or they are still struggling with high levels of it. So pain your painkillers are no longer touching is a reason to get advice today, from your surgical team or your doctor, rather than something to get through until the next appointment. If it came on suddenly and severely, or the leg will not take your weight, use the emergency lines below instead. Never stop or change a prescribed medicine on your own.
The distinction that actually does the work is settling against building, not ordinary against abnormal. A hip that is sore but gradually less sore week on week is doing what the sources describe. A hip that hurts more this week than last, or that hurts at rest as well as on moving, which is the pattern OrthoInfo singles out, has crossed into the list below. The same test applies to a wound, to swelling and to tiredness.
One more practical point, because people often do not think of it. Your physio, or your physical therapist if you are in the United States or Canada, usually sees you more often in these weeks than anyone else does, which makes them the quickest route to a second look at something you are unsure about. Describing it to them is not going over anyone's head, and they will send you on if it needs a surgical opinion.
And one group of symptoms does not belong on any recovery curve at all. Breathlessness, chest pain, a leg that has changed shape, a temperature with a hot hip: none of these is a stage of anything. They are their own event, with their own speed, and the list below carries them in the words of the sources they came from.
Who to call, when, and what to have ready
Each line below names its own route, and the night does not change the route. The emergency lines say to call emergency services or go to an emergency department, and that stands at three in the morning. The same-day lines say to contact your surgical team or get medical advice the same day, which means an urgent route today rather than your next routine appointment. In the first weeks that is usually the ward or the surgical team directly, and your discharge paperwork is where the number and the out-of-hours arrangement for your own service are written. Find that sheet now and put it somewhere you could direct someone else to over the phone. The service that answers an urgent call differs from country to country, so the route that applies to you is on that sheet and not on this page.
Here is what to have ready when you ring. It is practice experience, nothing published, and it shortens the call considerably. The date of your operation and which hip; the name of your surgeon or the hospital, if you are away from home; your temperature if you have taken it; the medicines you are on, especially the clot medicine and the dose; when the symptom started and whether it is better, worse or the same since; and whether you can put weight on the leg. If someone else is making the call for you, that list is what they need.
People hesitate over two things here, so to be plain about both. A call that turns out to be nothing is the system working, not a waste. And if you have already been seen for this and it has got worse since, ring again; do not assume you were given the answer the first time. Red flags in physiotherapy sets out how clinicians think about this kind of sorting, if you want the reasoning behind it.
Things to avoid day to day, as opposed to things to report, are a separate question, and things to avoid after a hip replacement covers those.
What happens next if you do call
Knowing roughly what a team does with each of these makes the call easier to make, and none of what follows is a promise about your own appointment. The decisions belong to the clinicians who see you.
For a suspected dislocation, the Plymouth leaflet describes the first step as a reduction, moving the top of the thigh bone back into the socket with pain relief, with the doctor possibly wanting an X-ray of the hip afterward, and physiotherapy where it is needed to help the recovery along. That is why the instruction is to keep still and wait for them, and not to try to deal with it yourself.
For a suspected clot, the NHS describes anticoagulant medicines being prescribed where a clot is causing pain or swelling, and compression stockings being used to lower the risk in the first place. For a wound infection, it says antibiotics are the usual treatment, and that where infection spreads deep into the joint, further surgery may be needed. For late or unexplained pain in a replacement, expect questions and tests aimed at telling infection, loosening and wear apart, because treatment differs depending on which it is.
What none of the sources promises, and neither does this page, is a particular scan or a particular answer on the day. What they are consistent about is the asking. OrthoInfo says to notify your doctor immediately, the Plymouth leaflet says to seek immediate medical attention, and the NHS says a clot that has reached the lungs needs treating immediately. That is the whole shape of this page, and it is why the sorting is by speed and not by subject.
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: since your operation, the pain, redness, warmth, tenderness or swelling in your hip or leg is not getting better or is getting worse, for example the hip pain keeps building both when you move and when you rest, or you have a new throbbing or cramping pain in your hip or leg. Contact your surgical team or get medical advice the same day, as this can be a sign of infection around the new joint or a blood clot. If you feel very unwell, go to an emergency department.
- Same day: at any time after your operation, even years later, new pain in your new hip along with a high temperature or feeling hot, cold or shivery, or a hip that becomes hot, red or swollen, which counts on its own, with or without pain and with or without a temperature. Contact your surgical team or get medical advice the same day. A new joint can become infected long after the operation, and that needs treating quickly. A normal temperature is not an all clear: OrthoInfo says fever is no longer considered a sign of an infection after a joint replacement, that the signs can be as little as mild redness and swelling and sometimes there are none at all, and that increased pain or stiffness in a joint that had been working well is one of them. So do not wait for a temperature before you report new or increasing pain in your new hip to your surgical team.
- 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.
- Routine: since the operation your leg has felt a little longer or shorter than the other one, with no sudden change and no new pain. This is not unusual after a hip replacement. Mention it to your physio or at your follow-up appointment, as some people are more comfortable with a shoe raise.
- Routine: pain in your new hip that had settled and has come back, or pain that is getting worse month by month, for example in the groin or thigh when you first stand up and start to walk. This is not an emergency, but ask your surgical team for a review, as the parts of a new joint can loosen or wear over the years. Get medical advice the same day instead, not a routine appointment, if the hip also becomes hot, red or swollen, or you have a high temperature or feel hot, cold or shivery, or the pain is building week by week rather than month by month. A new joint can become infected years after the operation, and the two can feel similar at first.
- Routine: your walking or movement has stopped improving over a week or two, you still limp badly, or you cannot manage the exercises your team gave you, but your pain, redness and swelling are not getting worse. This is not an emergency, but ask your physio or surgical team for a review in the next week or two.
Common questions
What problems can happen after a hip replacement?
The NHS names blood clots, wound infection, a difference in leg length, damage to nerves or tissue, and dislocation and wear of the joint, and it adds that people with a metal-on-metal replacement should have regular check-ups. OrthoInfo, from the American Academy of Orthopaedic Surgeons, asks you to notify your doctor immediately about a persistent fever, chills, increasing redness, tenderness or swelling of the hip wound, drainage from the wound, and increasing hip pain with both activity and rest. The useful question is not which of these is most likely but how fast each one needs attention, which is how the warning signs below are sorted.
What are the signs my new hip has dislocated?
The sign people expect is sudden severe pain in the hip or groin, sometimes with a clunk or pop, with the leg unable to take weight. The sign people miss is the quieter one: a leg that looks shorter than it did, or a foot that turns in or out more than it used to, or a hip that moves oddly, with pain that is not severe. The Plymouth leaflet treats unusual hip movement or deformity as a reason to seek immediate medical attention. Both versions are in the warning signs below at the emergency tier, and both say the same two things: do not try to walk on it and do not try to push it back. The NHS adds that a hip replacement can dislocate soon after surgery, before the joint is fully healed, and also many years later, so these signs are worth knowing for as long as you have the joint.
Can a hip replacement get infected months or years later?
Yes, and that is the reason one of the lines below has no end date on it. New pain in a new hip together with a high temperature or feeling hot, cold or shivery, or a hip that becomes hot, red or swollen, is a same-day matter at any distance from the operation. A normal temperature does not rule it out, because OrthoInfo says fever is no longer considered a sign of an infection after a joint replacement. If there is no temperature, the routine review line is still the answer rather than nothing at all. The NHS says a wound infection is usually treated with antibiotics and that if it spreads deep into the hip joint, further surgery may be needed, which is why speed is worth more here than certainty, and OrthoInfo adds that major or deep infections may require more surgery and removal of the prosthesis. OrthoInfo also says any infection in your body can spread to your joint replacement, naming dental procedures, urinary tract infections and skin infections as common routes, which is why an infection elsewhere is worth treating promptly and why your dentist should know you have a hip replacement. You are not wasting anyone's time by ringing about a hot hip nine years on.
What does a blood clot feel like after a hip replacement?
In the leg, OrthoInfo describes pain in the calf and leg that is unrelated to your incision, tenderness or redness of the calf, and new or increasing swelling of the thigh, calf, ankle or foot. The NHS lists throbbing pain in one leg, usually in the calf or thigh, swelling in one leg, skin that is red, blue or darkened around the painful area, which it notes can be harder to see on brown or black skin, and swollen veins. In the chest it is different and faster: sudden shortness of breath, sudden chest pain, or chest pain with coughing. The chest version is an emergency, and the NHS sends hip or leg pain and swelling that come with difficulty breathing or chest pain to the emergency services or an emergency department.
Is this pain normal, or is something wrong?
Direction is the question worth asking, not amount. The NHS says you will probably have some pain and swelling in your legs and feet and that these symptoms usually get better in a few weeks, so a sore, puffy leg that is slowly improving fits what the source describes. Pain that is building rather than settling is the pattern that gets attention, and OrthoInfo picks out one version of it specifically: increasing hip pain with both activity and rest. Hot, red, swollen or feverish belongs in a different category again, and that one is below at the same-day tier.
Who do I call, and what if it is the middle of the night?
Each line below names its own route, and the night does not change it. The emergency lines say to call emergency services or go to an emergency department, and that holds at four in the morning as much as at four in the afternoon. The same-day lines say to contact your surgical team or get medical advice the same day, which means an urgent route rather than your next routine appointment, and your discharge paperwork is where the out-of-hours contact for your own service is written down. If you are away from home, the operation date, which hip, and your current medicines are what any team will ask for first.
References
- 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/
- 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/
- American Academy of Orthopaedic Surgeons. Total hip replacement. OrthoInfo. https://www.orthoinfo.org/en/treatment/total-hip-replacement/
- American Academy of Orthopaedic Surgeons. Activities after total hip replacement. OrthoInfo. https://www.orthoinfo.org/en/recovery/activities-after-hip-replacement/
- American Academy of Orthopaedic Surgeons. Infection after joint replacement. OrthoInfo. https://www.orthoinfo.org/en/diseases--conditions/joint-replacement-infection/
- University Hospitals Plymouth NHS Trust. Hip dislocation. Patient information leaflet. https://www.plymouthhospitals.nhs.uk/display-pil/pil-hip-dislocations-4038/
- NHS. DVT (deep vein thrombosis). Page last reviewed 30 April 2026. https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/
- NHS. Pulmonary embolism. Page last reviewed 25 May 2023. https://www.nhs.uk/conditions/pulmonary-embolism/
- NHS. Sepsis. Page last reviewed 14 May 2026. https://www.nhs.uk/conditions/sepsis/
- NHS. Anticoagulant medicines. Page last reviewed 9 September 2024. https://www.nhs.uk/conditions/anticoagulant-medicines/
- NHS. Iron deficiency anaemia. Page last reviewed 26 January 2024. https://www.nhs.uk/conditions/iron-deficiency-anaemia/
- NHS. Falls. https://www.nhs.uk/conditions/falls/
- NHS. Low blood pressure (hypotension). Page last reviewed 11 July 2023. https://www.nhs.uk/conditions/low-blood-pressure-hypotension/
- Montero-Odasso M, van der Velde N, Martin FC, et al. World guidelines for falls prevention and management for older adults: a global initiative. Age and Ageing. 2022;51(9):afac205. doi:10.1093/ageing/afac205
- NHS. Fainting. https://www.nhs.uk/symptoms/fainting/
- Royal Orthopaedic Hospital NHS Foundation Trust. Orthopaedic surgery and anaemia. Published 5 March 2024. https://roh.nhs.uk/news-events/orthopaedic-surgery-and-anaemia
- NHS. Head injury and concussion. Page last reviewed 29 May 2025. https://www.nhs.uk/conditions/head-injury-and-concussion/
- The Newcastle upon Tyne Hospitals NHS Foundation Trust. Total hip replacement. Patient information. https://www.newcastle-hospitals.nhs.uk/resources/total-hip-replacement/
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.