Total Hip Replacement
Understanding the Procedure, Benefits, and What to Expect
Total Hip Replacement Surgery
Total hip replacement is one of the most established and effective surgical treatments for advanced hip arthritis and other conditions that cause significant joint damage, pain and loss of mobility.
For patients living with persistent hip pain or facing a prolonged public-system wait, private hip replacement can provide another pathway to orthopedic assessment and treatment.
Dr. John Antoniou provides private total hip replacement surgery in Montreal for appropriately selected patients from Quebec, elsewhere in Canada and internationally.
Private total hip replacement currently starts at $19,800 CAD.
The goal of surgery is to relieve pain, restore hip function and help patients return to an active and independent lifestyle.
At a Glance
What Is a Total Hip Replacement?
A total hip replacement, also called total hip arthroplasty, replaces the damaged surfaces of the hip with an artificial joint.
The hip is a ball-and-socket joint. During total hip replacement:
- The damaged femoral head, or “ball,” is removed
- A stem is placed inside the femur
- A new prosthetic ball is attached
- The damaged surface of the hip socket is replaced with an acetabular component
- A bearing surface allows the new joint to move smoothly
Modern hip replacement implants can use durable combinations of metal, ceramic and highly wear-resistant polyethylene.
The specific implant and bearing combination are selected according to the patient's anatomy, bone quality, age, activity level and other clinical factors.
When Is It Time to Consider Hip Replacement?
Hip replacement may be considered when hip pain and joint damage significantly affect everyday life despite appropriate non-surgical treatment.
Common signs that surgery may need to be discussed include:
- Pain that interferes with walking
- Difficulty climbing stairs
- Pain when getting in or out of a chair or vehicle
- Hip pain that disrupts sleep
- Reduced ability to work or exercise
- Progressive stiffness and loss of mobility
- Symptoms that no longer respond adequately to medication, physiotherapy, injections or activity modification
- Advanced joint damage visible on X-rays
Common conditions leading to hip replacement include:
- Osteoarthritis
- Rheumatoid arthritis
- Avascular necrosis
- Post-traumatic arthritis
- Hip dysplasia
- Other conditions causing significant deterioration of the hip joint
A consultation with Dr. Antoniou is used to determine whether total hip replacement is appropriate or whether another surgical or non-surgical option should be considered.
Who Is a Candidate for Total Hip Replacement?
There is no single age at which someone automatically becomes a candidate for hip replacement.
The decision is based on the individual patient's:
- Diagnosis
- Severity of joint damage
- Level of pain
- Loss of mobility
- Impact on quality of life
- Response to previous treatment
- Bone quality
- Anatomy
- Overall health
- Lifestyle and activity goals
Total hip replacement can be appropriate for both older and younger adults when the condition of the joint and the patient's symptoms justify surgery.
For some younger or highly active patients with suitable anatomy and bone quality, hip resurfacing may also be considered as an alternative.
What Are the Benefits of Total Hip Replacement?
The main goals of hip replacement are to reduce pain and improve function.
Patients commonly seek surgery because they want to:
- Walk with less pain
- Improve hip movement
- Sleep more comfortably
- Return to work or everyday activities
- Resume recreational exercise
- Improve independence
- Improve overall quality of life
Total hip replacement is widely regarded as one of the most successful procedures in modern orthopedic surgery.
Modern implants are also increasingly durable.
A major 2026 systematic review and analysis of contemporary total hip replacements reported approximately 93.6% implant survivorship at 20 years. The same study estimated survivorship of approximately 92.8% at 25 years and 92.1% at 30 years for contemporary implants.
Individual implant longevity still varies according to the implant, patient characteristics, activity, surgical factors and the reason for eventual revision.
Private Hip Replacement in Montreal
Some patients choose private hip replacement because they want a different access and scheduling pathway from the public health-care system.
Dr. Antoniou evaluates patients from Quebec and other provinces who are considering private hip replacement surgery in Montreal.
Canada's benchmark for planned total hip replacement in the public system is surgery within 26 weeks, or 182 days, after the patient is considered ready to be treated.
Actual waits vary substantially by province, hospital, region and surgeon.
For more information, see our updated guide: Hip Replacement Surgery Wait Times in Canada by Province .
Patients who are concerned about how a prolonged wait may affect their daily life can also review: The Hidden Cost of Waiting for Hip & Knee Replacement .
How Much Does Private Hip Replacement Cost?
Starting price
The current program is presented as an all-inclusive private care pathway covering the patient's surgical journey and early postoperative care.
The exact treatment plan, services included and final cost are confirmed after the patient's medical information, imaging and individual requirements have been reviewed.
Patients researching private surgery can also review our detailed guide: How Much Does a Private Hip Replacement Cost in Canada?
That guide explains typical Canadian private-market pricing, what may be included and what additional expenses patients should consider.
What Happens During the Private Hip Replacement Process?
Consultation
Dr. Antoniou reviews the patient's symptoms, medical history, previous treatment and goals.
Imaging Review
X-rays and any other relevant imaging are reviewed to determine the extent and pattern of joint damage.
Treatment Recommendation
Dr. Antoniou determines whether total hip replacement is appropriate or whether another option, such as hip resurfacing, should be considered.
Surgical Planning
The appropriate surgical approach, implant and bearing surfaces are selected according to the individual patient.
Preoperative Preparation
Any necessary testing and medical clearance are completed.
Surgery
The damaged hip joint is replaced with the selected prosthetic components.
Early Rehabilitation
Walking and physiotherapy begin early, followed by an individualized rehabilitation and follow-up program.
What Is the Best Surgical Approach for Hip Replacement?
There is no single surgical approach that is best for every patient.
Dr. Antoniou has extensive experience with multiple approaches to total hip replacement, including:
- Anterior approach
- SUPERPATH approach
- Mini-posterior approach
The appropriate approach is selected according to factors such as:
- Individual anatomy
- Underlying diagnosis
- Bone quality
- Previous surgery
- Implant requirements
- Complexity of the case
The goal is to choose the approach that allows the joint to be reconstructed safely and accurately for the individual patient rather than applying one technique to everyone.
During the consultation, Dr. Antoniou can explain why a particular surgical approach is recommended.
What Is the Best Type of Hip Replacement Implant?
There is no single implant that is ideal for every patient.
Implant selection can depend on:
- Bone anatomy
- Bone density and quality
- Age
- Activity level
- Diagnosis
- Previous surgery
- Surgical approach
- Long-term treatment goals
Modern total hip replacement can use bearing combinations such as:
- Ceramic on highly cross-linked polyethylene
- Metal on highly cross-linked polyethylene
- Ceramic-on-ceramic in selected implant systems
The choice of implant should be based on the patient's clinical needs rather than on one material or technology being automatically superior for everyone.
Dr. Antoniou reviews the appropriate implant options as part of the surgical planning process.
Total Hip Replacement vs Hip Resurfacing
Total hip replacement and hip resurfacing can both treat advanced hip arthritis, but they are different procedures.
With total hip replacement, the femoral head and neck are removed and replaced with a stemmed implant.
With hip resurfacing, the femoral head and neck are preserved and the femoral head is reshaped and capped.
Hip resurfacing is generally considered only in selected patients with appropriate anatomy and good bone quality.
Dr. Antoniou performs:
- Total hip replacement
- Metal hip resurfacing
- Ceramic hip resurfacing
Having access to more than one surgical option allows the treatment recommendation to be based on the patient's anatomy, bone quality, diagnosis, lifestyle and long-term goals.
For a more detailed comparison, see: Hip Resurfacing vs Total Hip Replacement: What Are the Differences?
How Should I Prepare for Hip Replacement?
Preparing physically and medically before surgery can help support recovery and reduce avoidable risks.
Patients may be advised to:
- Participate in a physiotherapist-guided preoperative exercise or “pre-hab” program
- Stop smoking
- Work toward a healthier weight when medically appropriate
- Optimize blood glucose when living with diabetes
- Maintain appropriate nutrition
- Limit excessive alcohol consumption
- Prepare the home for the early recovery period
- Arrange transportation and family or caregiver support where necessary
The clinical team provides individualized instructions before surgery.
What Medications Need to Be Stopped Before Surgery?
Medication management must be individualized.
Patients should not stop prescribed medications without medical instructions.
Before surgery, the medical team reviews medications and supplements that may affect bleeding, clotting or other surgical risks.
These may include:
- Anticoagulants and other blood-thinning medications
- Fish oil or omega-3 supplements
- Certain herbal supplements such as ginkgo, ginseng and garlic
- Hormone replacement therapy
- Oral contraceptives
- Certain immune-modulating medications
The appropriate timing for stopping or restarting any medication depends on the individual patient and should be confirmed during the preoperative process.
How Long Does It Take to Recover From Hip Replacement?
Recovery varies according to the patient's age, overall health, preoperative strength, surgical complexity and rehabilitation.
Dr. Antoniou's current pathway emphasizes early mobilization.
- Walking
- Getting in and out of bed or a chair
- Using stairs when appropriate
- Getting in and out of a vehicle safely
- Using crutches, a walker or cane
The specific instructions provided by Dr. Antoniou and the physiotherapy team should always take priority over generalized recovery timelines.
When Can I Return to Work?
Return to work depends on the patient's recovery and the physical demands of the job.
Desk-based work may sometimes resume within several weeks.
Jobs that involve prolonged standing, walking, lifting or significant physical activity generally require a longer recovery period.
A reasonable return-to-work date should consider:
- Pain control
- Walking ability
- Commuting
- Fatigue
- Physical job requirements
- Overall recovery
When Can I Drive After Hip Replacement?
There is no single driving timeline that is appropriate for every patient.
The American Association of Hip and Knee Surgeons notes that many surgeons allow driving at approximately 4 to 6 weeks, although some patients—particularly after left-sided surgery—may be ready sooner.
Before driving, patients should:
- No longer be taking narcotic or other impairing medication
- Be able to enter and exit the vehicle safely
- Have sufficient strength and control of the operated leg
- Be able to perform an emergency stop safely
- Have adequate reaction time
Patients should discuss their individual driving timeline with Dr. Antoniou rather than relying on a fixed number of days.
Can I Fly After Hip Replacement?
Patients travelling to Montreal for private surgery should discuss their return travel plans before booking flights.
Air travel involves prolonged sitting and may increase blood-clot risk during the early postoperative period.
The appropriate timing for flying depends on:
- Length of the flight
- Individual blood-clot risk
- Mobility
- Postoperative progress
- Other medical conditions
For longer flights, patients may be advised to wait several weeks and use specific blood-clot prevention measures.
Travel recommendations should be individualized by the surgical team.
Travelling to Montreal for Private Hip Replacement
Patients from Ontario, Alberta, British Columbia and other Canadian provinces—as well as patients from the United States and overseas—may be evaluated for private hip replacement in Montreal.
For patients travelling from outside Quebec, the treatment pathway may include:
- Review of existing medical information and imaging
- Orthopedic consultation
- Surgical planning
- Coordination of travel dates
- Surgery in Montreal
- Early postoperative convalescence
- Physiotherapy planning
- Follow-up arrangements after returning home
Where clinically and operationally appropriate, existing imaging and medical information may be reviewed before the patient travels.
Patients should discuss accommodation, postoperative transportation, return travel and physiotherapy before finalizing their plans.
What Rehabilitation Is Available After Hip Replacement?
Physiotherapy begins early following surgery and helps patients regain mobility, strength and independence.
The current pathway includes:
- On-site physiotherapy during the initial postoperative period
- Walking and mobility instruction before discharge from the surgical centre
- Home physiotherapy referral through the local CLSC for eligible Quebec residents
- Coordination with a local physiotherapist for out-of-province and international patients
Rehabilitation is adapted to the patient's progress rather than following exactly the same schedule for everyone.
What Are the Risks of Total Hip Replacement?
Total hip replacement is a well-established procedure, but all surgery involves potential risks.
Possible complications include:
- Infection
- Blood clots, including deep vein thrombosis or pulmonary embolism
- Hip dislocation
- Fracture
- Nerve or blood-vessel injury
- Difference in leg length
- Implant wear or loosening
- Persistent pain
- Possible revision surgery in the future
Individual risk depends on the patient's health, anatomy, diagnosis and complexity of surgery.
Dr. Antoniou reviews the relevant risks, benefits and alternatives before surgery.
What Activities Can I Do After Hip Replacement?
Many patients return to a high level of recreational activity after recovery.
Activities commonly performed after total hip replacement include:
- Walking
- Hiking
- Cycling
- Swimming
- Golf
- Skiing
- Tennis
- Strength and fitness activities
- Other recreational activities adapted to the replaced hip
The current clinic guidance allows a broad return to activity after appropriate healing.
Repetitive high-impact activities, particularly long-distance running and frequent jumping, are generally approached more cautiously because of the repetitive forces placed on the implant.
Patients interested in jogging, hockey, skiing, racquet sports or other higher-demand activities should discuss their individual goals with Dr. Antoniou.
Why Choose Dr. John Antoniou for Hip Replacement?
Dr. John Antoniou, MD, PhD, FRCSC, FAAOS is an orthopedic surgeon specializing in hip and knee reconstruction and a Professor at McGill University.
His experience and credentials include:
- More than 15,000 orthopedic procedures
- Fellowship training in hip and knee reconstruction
- Fellow of the Royal College of Physicians and Surgeons of Canada
- Fellow of the American Academy of Orthopaedic Surgeons
- Past President of the Canadian Orthopaedic Association
- Professor at McGill University
- More than 200 peer-reviewed publications
- Extensive experience in primary and complex hip reconstruction
- Experience with total hip replacement, metal hip resurfacing and ceramic hip resurfacing
Dr. Antoniou also holds membership in both the Hip Society and the International Hip Society.
His private practice at Ortho Westmount provides consultation, surgery, early postoperative care and physiotherapy within a dedicated orthopedic setting in Montreal.
Frequently Asked Questions
How long does a hip replacement last?
Modern total hip replacements are highly durable, but no implant has a guaranteed lifespan.
A major 2026 analysis of contemporary hip replacements reported approximately 93.6% survivorship at 20 years, with estimated survivorship remaining above 92% at 25 and 30 years.
Individual longevity depends on the implant, patient age, activity, anatomy and other factors.
What is the difference between total hip replacement and hip resurfacing?
Total hip replacement removes the femoral head and neck and replaces them with a stemmed implant.
Hip resurfacing preserves more of the patient's natural femoral bone and may be considered for selected patients with suitable anatomy and good bone quality.
Dr. Antoniou performs both total hip replacement and hip resurfacing and can determine which procedure is more appropriate after reviewing the individual case.
What is the success rate of total hip replacement?
Total hip replacement is one of the most successful procedures in orthopedic surgery.
Most appropriately selected patients experience substantial pain relief and improvement in mobility and daily function.
Outcomes vary according to diagnosis, health, implant selection, surgical factors and rehabilitation.
Will I need physiotherapy?
Yes.
Physiotherapy begins early and helps restore walking, strength, mobility and independence.
Can I have private hip replacement if I live outside Quebec?
Yes.
Dr. Antoniou evaluates patients from elsewhere in Canada, the United States and internationally.
The clinic can help plan the treatment pathway, including imaging review, travel, postoperative recovery and physiotherapy arrangements.
How much does private hip replacement cost?
Private total hip replacement with Dr. Antoniou currently starts at $19,800 CAD.
The exact treatment plan, services included and final cost are confirmed after the patient's medical information and imaging have been reviewed.
How long are public hip replacement wait times in Canada?
Canada's benchmark is surgery within 26 weeks after a patient is considered ready to be treated.
Actual wait times vary substantially by province, hospital, region and surgeon.
Our updated Hip Replacement Surgery Wait Times in Canada by Province guide provides current information.
When can I return to work?
Some patients return to desk-based work within several weeks, while physically demanding jobs generally require longer.
The appropriate timeline depends on the patient's recovery and job requirements.
When can I drive after hip replacement?
Many patients resume driving within several weeks, but timing depends on which hip was operated on, reaction time, strength, mobility and whether the patient is still taking medications that impair driving.
The decision should be individualized.
Will I have a scar?
Yes.
All hip replacement surgery requires an incision and therefore produces a scar.
The appearance of the scar generally becomes less noticeable over time. The size and location depend partly on the surgical approach and individual healing.
What type of anesthesia is used?
The anesthetic plan is determined according to the patient's health, surgical plan and anesthesiology assessment.
Spinal anesthesia with sedation is commonly used when appropriate, while general anesthesia may be selected in other circumstances.
Can both hips be replaced at the same time?
In selected patients, bilateral hip replacement may be considered.
This is not appropriate for everyone. Overall health, age, severity of disease in both hips, surgical risk and recovery requirements must be assessed before simultaneous surgery is recommended.
Considering Private Hip Replacement?
If hip pain is limiting your walking, sleep, work or daily activities despite appropriate non-surgical treatment, an orthopedic consultation can help determine whether total hip replacement is appropriate.
Dr. Antoniou evaluates patients from Montreal, elsewhere in Quebec, across Canada and internationally.
A consultation can help:
- Confirm the diagnosis
- Determine whether surgery is appropriate
- Compare total hip replacement with other options when relevant
- Discuss the recommended surgical approach and implant
- Review expected recovery
- Discuss current private surgery availability
- Confirm the expected cost of treatment
Have your case reviewed to determine whether total hip replacement is appropriate and discuss current private surgery availability.
Content updated: October 2026.