HIP REPLACEMENT
Treatment for joint pain may include activity modification, weight loss, strength training, oral anti-inflammatory medications, or cortisone injections. However, joint replacement surgery may also be considered for more severe osteoarthritis or joint deterioration.
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Hip Replacement at Proliance Orthopedic Associates
Proliance Orthopedic Associates is a leading provider of hip replacement surgery in the Pacific Northwest, performing over 2,000 joint replacements per year across our fellowship-trained surgical team. Our hip replacement program features direct anterior approach surgery, robotic-assisted technology, and a same-day discharge model at our award-winning outpatient surgery center in Renton, Washington.
Hip replacement surgery at Proliance Orthopedic Associates is performed at the Proliance Surgery Center at Valley, which has been named a 2025 Best Ambulatory Surgery Center for orthopedic and spine care by U.S. News & World Report. The surgery center is also recognized as one of the Top 20 ambulatory surgery centers in the United States for joint replacement volume. Proliance Orthopedic Associates has been named a Top Orthopedic and Surgical Care Provider in Washington by Castle Connolly for 2025.
Our hip replacement surgeons are Dr. Timothy Alton, Dr. Prash Bremjit, Dr. Andrew Merritt, and Dr. Fred Huang. Our surgeons offer the direct anterior approach, robotic-assisted hip replacement, and muscle-sparing techniques designed to minimize tissue disruption and accelerate recovery.
PATIENT EDUCATION
Hip arthritis develops when the smooth cartilage that covers the ball-and-socket joint of the hip gradually wears away. The hip joint consists of the femoral head, which is the ball at the top of the thighbone, and the acetabulum, which is the rounded socket in the pelvis. In a healthy hip, these surfaces are lined with cartilage that allows smooth, pain-free motion. When arthritis develops, this cartilage thins and eventually wears through, resulting in bone rubbing against bone.
The most common form of hip arthritis is osteoarthritis, which is a degenerative condition that progresses over time. Inflammatory arthritis such as rheumatoid arthritis and post-traumatic arthritis from a previous injury can also damage the hip joint. Avascular necrosis, a condition where the blood supply to the femoral head is disrupted, is another cause of hip joint deterioration that may eventually require replacement.
Symptoms of hip arthritis typically include pain in the groin, thigh, or buttock that worsens with activity. Stiffness and reduced range of motion make it difficult to put on shoes and socks, get in and out of a car, or walk comfortably. Many patients notice a limp that worsens as the arthritis progresses. Rest pain and night pain often develop in the later stages of the disease.
Before considering hip replacement, our surgeons work with each patient to explore conservative treatment options. These may include physical therapy to strengthen the muscles supporting the hip, oral anti-inflammatory medications, activity modification, the use of a cane or walking aid, cortisone injections to reduce inflammation and pain, and weight management. When conservative treatments no longer provide adequate relief and hip pain is limiting daily activities, work, or the ability to stay active, hip replacement becomes the most effective long-term solution.
Total hip replacement, also called total hip arthroplasty, is a surgical procedure in which the damaged ball and socket of the hip joint are removed and replaced with artificial components. The worn femoral head is replaced with ceramic ball attached to a stem that fits into the thighbone. The damaged socket is replaced with a metal cup lined with a durable bearing surface. Together, these components recreate the natural movement of the hip and eliminate the bone-on-bone contact that causes pain.
The surgery typically takes about one hour. With anesthesia preparation, total operating room time is approximately 90 minutes. Hip replacement at Proliance Orthopedic Associates is performed under spinal anesthesia combined with long-acting local anesthesia, which avoids general anesthesia and its associated side effects in most patients.
- Valley Medical Center Total Joint Replacement Guide
- Proliance Surgery Center at Valley Total Hip Replacement Guide
- Valley Medical Center Joint Replacement Seminar
- Risk Assessment for Surgery [PDF]
To read a section of the guide, click on a topic below:
Our hip replacement surgeons utilize the direct anterior approach for total hip replacement. This technique accesses the hip joint from the front of the body, working between the muscles rather than cutting through them. The muscle-sparing nature of the anterior approach typically results in less post-operative pain, faster recovery, fewer restrictions after surgery, and a lower risk of hip dislocation compared to traditional posterior approaches.
Patients who undergo anterior approach hip replacement at Proliance Orthopedic Associates generally have very minimal precautions after surgery, meaning there are no restrictions on bending, crossing legs, or sitting in low chairs. This is a significant quality-of-life advantage during the recovery period and reflects the stability of the anterior approach.
The majority of hip replacement patients at Proliance Orthopedic Associates go home the same day as surgery. Same-day discharge is supported by thorough pre-operative preparation, spinal anesthesia, multi-modal pain management including an intra-articular injection during surgery, and a structured recovery plan that begins before the patient leaves the surgery center. Patients walk with a rolling walker within hours of surgery.
Research demonstrates that patients who recover at home after hip replacement do at least as well as those who stay in a hospital setting. Patients are more comfortable in their own environment, sleep better, and avoid the infection risks associated with inpatient facilities. For patients with significant medical complexity or limited home support, an overnight stay at Valley Medical Center can be arranged.
Recovery from anterior approach hip replacement is typically faster than traditional approaches because the muscles are not cut during surgery. Most patients walk with a rolling walker from the day of surgery, transition to a cane within one to two weeks, and are walking without any assistive device by three to four weeks. Physical therapy begins within the first week and focuses on restoring hip range of motion, rebuilding strength, and normalizing gait.
Return to low-impact activities such as walking for exercise, cycling, swimming, and golf typically occurs within four to six weeks. Hiking, doubles tennis, and other recreational activities are generally resumed by two to three months. Most patients report significant improvement in pain and function within the first six weeks and continue to improve for up to a year after surgery.
FREQUENTLY ASKED QUESTIONS
Q When is hip replacement surgery recommended?
Hip replacement is recommended when hip arthritis is causing significant pain and functional limitation that is no longer adequately managed with conservative treatments such as physical therapy, medications, and injections. The decision is based on the severity of the arthritis, the impact on daily life, and whether the patient is healthy enough for surgery.
Q What is the direct anterior approach and why does it matter?
The direct anterior approach accesses the hip joint from the front, working between the muscles instead of cutting through them. This muscle-sparing technique typically results in less pain, faster recovery, and fewer post-operative restrictions. Most patients have no hip precautions after surgery, meaning no restrictions on bending, crossing legs, or sitting in low chairs.
Q How long does a hip replacement last?
Modern hip replacements are designed for long-term durability. With current implants and surgical techniques, approximately 90 to 95 percent of hip replacements are functioning well at 15 to 20 years, and many last significantly longer. Advanced bearing surfaces and cementless fixation continue to improve implant longevity.
Q Can I return to sports and exercise after hip replacement?
Q Does insurance cover hip replacement?
Q What anesthesia is used?
Q Will I need to go to a rehabilitation facility?
Almost always the answer is no. The majority of our hip replacement patients go home the same day as surgery. Recovery takes place at home with outpatient physical therapy starting within the first week.
SCHEDULE A CONSULTATION
If you are experiencing hip pain and would like to learn whether hip replacement is right for you, contact Proliance Orthopedic Associates to schedule an appointment with one of our fellowship-trained hip replacement surgeons. We see patients at clinic locations in Renton, Covington, Maple Valley, and Auburn in the greater Seattle area. Call 425-656-5060 or book an appointment online through our website.
