Last reviewed: September 29, 2026

Some people do still have pain a year or more after a hip replacement. Usually it is mild, and most people are pleased with the result even so.

In large studies, a little over one in ten people had moderate or severe hip pain a year after surgery, yet about nine in ten were satisfied. After that, pain tends to stay where it is. In a national registry study that followed hip replacements for five years, about seven in ten people had a large improvement that lasted. The rest also kept their improvement, but at a lower level. How the hip was doing at six months predicted how it would be doing at five years. Severe pain several years out was uncommon, and less common than after a knee replacement.

Pain near a hip replacement does not always come from the implant. In a study of about 200 painful hip replacements sent for evaluation, the most common causes were irritation of the tissues around the hip, mostly a bursa on the side of the hip, and pain coming from the lower back. Wear of the plastic liner and loosening came next. Reactions to metal and infection were less common. According to a joint statement from the American Academy of Orthopaedic Surgeons and hip surgeon groups, loosening and infection should be ruled out first.

Lasting pain is more likely in people with more pain before surgery, pain in other parts of the body, burning or tingling pain before surgery, depression or anxiety, a tendency to dwell on pain, or higher body weight, and possibly in women. These are links, not proof of cause.

In general:

  • Pain on the side of the hip, or pain that seems to come from the back, is worth describing that way to your surgeon.
  • Burning or tingling pain is worth describing that way too.
  • Pain that returns or gets worse after the hip had been doing well is worth reporting.
  • Pain with fever, swelling, redness or drainage from the scar needs to be seen promptly.

Drafted with AI assistance from published sources, reviewed and edited by Babak Sheikh, MD.

Sources:

  • Laigaard J, et al. Chronic Postsurgical Pain After Primary Total Hip Arthroplasty for Osteoarthritis: A Nationwide Cross-Sectional Survey Study. J Arthroplasty. 2025. https://doi.org/10.1016/j.arth.2025.09.057
  • Cheng HY, et al. What Proportion of People Have Long-Term Pain After Total Hip or Knee Replacement? An Update of a Systematic Review and Meta-Analysis. BMJ Open. 2025. https://doi.org/10.1136/bmjopen-2024-088975
  • Dainty JR, et al. Trajectories of Pain and Function in the First Five Years After Total Hip and Knee Arthroplasty: An Analysis of Patient Reported Outcome Data From the National Joint Registry. Bone Joint J. 2021. https://doi.org/10.1302/0301-620X.103B6.BJJ-2020-1437.R1
  • Galea VP, et al. Longitudinal Changes in Patient-Reported Outcome Measures Following Total Hip Arthroplasty and Predictors of Deterioration During Follow-Up: A Seven-Year Prospective International Multicentre Study. Bone Joint J. 2019. https://doi.org/10.1302/0301-620X.101B7.BJJ-2018-1491.R1
  • Wylde V, et al. Persistent Pain After Joint Replacement: Prevalence, Sensory Qualities, and Postoperative Determinants. Pain. 2011. https://doi.org/10.1016/j.pain.2010.11.023
  • Erivan R, et al. Painful Hip Arthroplasty: What Should We Find? Diagnostic Approach and Results. J Arthroplasty. 2019. https://doi.org/10.1016/j.arth.2019.04.014
  • Kwon YM, et al. Risk Stratification Algorithm for Management of Head-Neck Taper Tribocorrosion in Patients With Metal-on-Polyethylene Total Hip Arthroplasty: Consensus Statement of the American Association of Hip and Knee Surgeons, the American Academy of Orthopaedic Surgeons, and The Hip Society. J Bone Joint Surg Am. 2021. https://doi.org/10.2106/JBJS.20.01837
  • Smits RJH, et al. Biopsychosocial Predictive Factors for Developing Chronic Postsurgical Pain After Hip Replacement Surgery: A Systematic Review. Osteoarthr Cartil Open. 2025. https://doi.org/10.1016/j.ocarto.2025.100725
  • Wieczorek M, et al. What Have We Learned About the Course of Clinical Outcomes After Total Knee or Hip Arthroplasty? Arthritis Care Res (Hoboken). 2020. https://doi.org/10.1002/acr.24045
  • Blikman T, et al. Neuropathic-Like Symptoms Have an Additional Predictive Value for Chronic Postsurgical Pain in Total Hip and Knee Arthroplasty Patients. BMC Musculoskelet Disord. 2024. https://doi.org/10.1186/s12891-024-08129-y

This is general information about what published research shows. It is not medical advice and it is not about your situation. Reading it does not create a doctor-patient relationship with me. I am a retired orthopedic surgeon and I do not see patients. Talk with your own doctor before changing anything about your care. If something feels suddenly or seriously wrong, get medical care promptly rather than waiting.

This page is provided as is. I make no guarantee that it is accurate, complete or current, and medical evidence changes. Use of it is at your own risk.

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