Total Hip Replacement
Hip arthritis, the anterior approach, and what the operation actually does — plus how we diagnose it, how surgery is scheduled, and what recovery looks like.
Call 520-881-1394 Read the packetWho this is for
This page is for people whose hip arthritis is getting in the way of work, the things they enjoy, or sleep, especially if medications, physical therapy, bracing, or injections are no longer enough.
Surgery is not automatic. In 2025 Dr. Ward performed 143 hip replacements and 20 hip revisions. He, Olivia Sobojinski, PA, and Gabby Ventura, PA listen first and talk through options. There isn't one path that fits everyone.
Fracture care, including hemiarthroplasty, is on the hip fracture page.
What happens at your visit
You will usually have an X-ray in the office. We look at it together, talk about non-surgical options as well as surgery, and you decide on a timeline that fits your life.
If you later decide to schedule, that can happen in clinic with Dr. Ward, or you can call after you have already met.
"He was low key and told me to take my time to consider and to make an appointment for surgery when I was ready. I was given a packet of information that explained thoroughly what is involved." — Google review
Understanding arthritis
The hip is a ball-and-socket joint: two bones that need to glide on each other. On top of each bone is a thin layer of cartilage, only a few millimeters thick. Dr. Ward describes it like icing on a cake: the icing is the cartilage, the cake is the bone. That icing is exceptionally smooth, so the joint moves with very little friction.
With age or injury the icing wears away. Bone is rough, more like sandpaper. Sandpaper on sandpaper means inflammation, swelling, and pain. That is arthritis. Cartilage cannot grow back. Treatment is about calming inflammation. If non-operative care is no longer working and the hip is affecting work, leisure, or sleep, replacement may be recommended.
How we diagnose it
X-ray is the main test for osteoarthritis. Cartilage itself does not show on X-ray and is poorly seen on MRI. What we are looking for is the space between the bones.
On X-ray
Arthritis on X-ray is loss of space between the bones — the icing is gone. Extra signs can include bone spurs, sclerosis (the bone looking extra white and hard), subluxation, and deformity.
If the space is preserved, the cartilage is likely still there.
About MRI
MRI is useful for muscles and tendons. It does not show bone well, and it is a poor test for the cartilage surface itself.
For osteoarthritis, an X-ray in the office is usually enough.
What the surgery actually is
The diseased femoral head is removed and the socket (acetabulum) is reamed. Smooth new surfaces take the place of bone-on-bone.
The parts
A titanium stem goes down the femoral canal. A ceramic head sits on the stem. A titanium cup with a polyethylene liner sits in the socket. Those surfaces are smooth, which is what takes away the arthritic pain.
DePuy Actis — uncemented
Stem and cup are a titanium alloy coated with hydroxyapatite so bone can grow onto them. No cement is used. A modern hip can last 20 or more years. Revision, when needed, is more often for fracture or infection than for wear.
Anterior approach
Dr. Ward uses the anterior approach. In his view the advantages are a generally smaller incision, muscles not cut to enter the hip, a lower dislocation rate than posterior, and a quicker recovery.
X-ray and Velys
He uses X-ray throughout the case with Velys software to check position and restore leg lengths — usually within a couple of millimeters.
He trained with and without robots. He prefers X-ray plus this software so he keeps the feel of the surgery.
No activity restrictions
Anterior dislocation is less than 1%, so he does not place activity restrictions. You may return to normal activity as you are able.
The incision starts one fingerbreadth below and lateral to the hip-pointer (ASIS) and runs about 10 cm.
Scheduling and getting ready
You can schedule in clinic with Dr. Ward, or call after you have already met. Leave a message. Dr. Ward or a PA will see you before surgery for leftover questions.
Dates and hospital
Alison Guerra, surgery scheduler, calls with dates. You pick. Surgery is at Oro Valley Hospital or Northwest Medical Center. You choose.
Before the date
A preoperative visit to review labs, write down questions, go over a pain plan, and get a physical therapy referral. If you need a walker prescription, that can be written then. Most people only need a walker about 2–3 weeks, so a thrift store or Walgreens is often enough.
This page is elective replacement for arthritis. A broken hip is different. See hip fracture.
What to expect
Before
A preoperative visit to review labs, write down questions, go over a pain plan, and get a physical therapy referral. Testing can be done without an appointment at the hospital. Nothing to eat after midnight the night before.
Day of
Surgery averages 60–90 minutes. Dr. Ward generally recommends a nerve block and a spinal anesthetic, and he injects the hip. Many people go home the same day after 2–4 hours in phase-two recovery. He calls the person you designate when he is finished.
Recovery
Physical therapy about 7–10 days after surgery. Plan on about three months of PT. A walker is typically needed for 2–3 weeks. Hip-flexion weakness for about a month is common. Thigh numbness is expected.
Before surgery
Most of the work happens before the operating room. Write questions down. Bring them to the preoperative visit.
Pre-op visit
- Labs and leftover questions
- Pain plan
- Physical therapy referral
- Walker prescription if you need one — most people borrow a walker or pick one up at a thrift store or Walgreens. Typically 2–3 weeks.
Testing
No appointment is needed at Oro Valley Hospital or Northwest Hospital for:
- CBC, BMP, PT/INR
- Chest X-ray
- EKG
Medical clearance from your PCP is needed if you have lung, heart, or kidney problems. It is not needed for cholesterol or stable high blood pressure. If you see a cardiologist, anesthesia requires cardiology clearance as well.
Medications
- Stop aspirin 7 days before surgery
- Blood thinners are stopped only with guidance from your PCP or cardiologist
- Restart them the evening of the day after surgery unless you are told otherwise
Night before and morning of
- Nothing to eat after midnight. Eating means the case is canceled.
- A sip of water only for morning heart medications
- Shower the morning of surgery with regular over-the-counter soap that does not contain lotion. No special soap is needed.
- Stop lotion on the legs the day before
- Do not blade-shave the legs for 2 days. Clippers are fine the day before.
Prehab
Bike, elliptical, and water exercise are good. No impact. The goal is to build the thigh muscles before surgery.
Physical therapy starts about 7–10 days after surgery. Dr. Ward will also give you exercises to start at home before that.
Home setup
- Clear rugs, cords, and footstools so you can move with a walker
- Keep a wide path from bedroom to bathroom and kitchen
- An elevated toilet seat or shower chair is optional
- Stairs are okay if you are able; you may want help at first
- Keep frequently used items within easy reach
Day of surgery
Bring
- Comfortable clothes and shoes
- Phone, ID, and insurance card
- A ride home
- Glasses (no contacts)
- Be ready to remove dentures
Leave at home
- Walker — have it waiting at home
- Ice machine
- Jewelry and rings
- Home medications
- Makeup
Anesthesia
A loved one can be with you in pre-op. Dr. Ward and anesthesia meet you there.
Anesthesia is usually a nerve block plus a spinal (like an epidural) so you wake up with less pain and less nausea. He also injects the hip. If you have a lot of back arthritis or prior back surgery, a spinal may not be possible.
Timing
- About 15–20 minutes to go to sleep
- Surgery 60–90 minutes
- Recovery room about 30–45 minutes. He calls the person you designate right after.
- Phase two is 2–4 hours: up with the nurses and physical therapy, then home. Overnight if needed.
Incision and dressings
The incision starts one fingerbreadth below and lateral to the ASIS (hip-pointer) and runs about 10 cm. Absorbable sutures are under the skin. Nothing to remove.
- Mepilex adhesive for 7 days — keep it dry
- Prineo mesh is glued on for about 3 weeks. Showers are fine. No soaking. Trim it as it peels.
Recovery
Stay ahead of the pain for the first three days. Sharp pain eases after 1–2 weeks. A night ache like a toothache is common around six weeks.
Pain, ice, swelling
- Ice is one of the best things you can do for pain and swelling
- Ankle pumps while resting
- Bruising around the hip and buttock, and down to the ankle, is common
Blood clots
Blood clots are uncommon, but the risk is higher after hip replacement. Movement is the best prevention. You will be on a blood thinner as directed in clinic.
Thigh numbness is expected
The lateral femoral cutaneous nerve supplies skin sensation only — not muscle. Retractors can stretch it. Strength is not affected, and sensation usually returns.
Driving
Not while you are on narcotics.
- Left hip: often sooner, if you have been off narcotics for 4 hours
- Right hip: off the walker, full weight, and able to slam the brake
Work
- Desk work: minimum about 2 weeks. Most people are more comfortable at 4.
- Standing jobs: minimum about 4 weeks. Most people need 6.
The other hip or knee
If the other hip or knee also needs surgery, wait until about the 3-month mark.
Anterior dislocation is less than 1%. You may return to normal activity as you are able. Compression stockings are optional — skip them if they are too tight or hard to put on.
Common questions
These are the answers from the packet. If something still does not sit right, come in. Do not feel like you are wasting his time.
What is the implant made of?
DePuy Actis. The stem and the cup are a titanium alloy coated with hydroxyapatite so bone can grow onto them. The head is ceramic. It articulates with a highly cross-linked polyethylene liner. No cement is used.
How long does a hip replacement last?
A modern hip can last 20 or more years. Revision, when needed, is more often for fracture or infection than for wear.
Does Dr. Ward use a robot?
He trained with and without robots. He prefers X-ray plus Velys software so he gets much of the same information a robot would give, and he keeps the feel of the surgery.
Will I set off airport scanners?
Most likely. Every airport is different, but about 90% of joint implants set off the scanner. You do not need a card, and you do not have to show the scar. Plan on a little extra screening.
There is a pimple on the incision.
That is often a suture abscess. It does not usually need antibiotics. It can pop like a pimple, or you can show Dr. Ward.
I see a fishing-wire suture.
That is suture spitting. You can clip it or leave it.
It feels warm and a little red.
Extra blood flow can make the hip feel warm and look a little red for up to about three months. That can be normal healing.
It has been six weeks and it still aches.
That is common. Physical therapy stretches scar tissue, and an ache can last around three months.
When should I worry?
Infection can look like normal healing. Come in rather than wait. Do not feel like you are wasting his time.
Do I need antibiotics for the dentist?
Antibiotics before invasive dental work that may bleed. Not needed for a routine cleaning. Call the office.
Other joints hurt.
You are often favoring the surgical side. That usually settles as your gait normalizes.
My leg feels longer.
Arthritis often shortens the leg slowly, so it did not feel abnormal. Surgery restores length with X-ray and computer, usually within a couple of millimeters. A shoe lift is rarely needed. The feeling of unequal length usually settles after a couple of months.
Related resources
The packet covers the details: preparing for surgery, the day of, and recovery. This page is the short version. The PDF is the full one.
Read the packet (PDF)Schedule a visit
Call 520-881-1394 and we will find a time that works.
Call 520-881-13941521 E. Tangerine Rd, Suite 337
Oro Valley, AZ 85755 · (520) 901-6380
6130 N. La Cholla Blvd, Suite 135A
Tucson, AZ 85741 · (520) 881-1394