One hip replacement raises the chance of surgery on the other side, but many people never need a second hip replaced.
One hip replacement does not automatically cause the other hip to fail. Artificial parts on one side do not damage the opposite joint. The main driver is the arthritis pattern you already have, plus the way your muscles, bones, and daily habits load both hips over many years.
Does One Hip Replacement Lead To Another On The Other Side? Big Picture
Surgeons call a second operation on the opposite side a contralateral total hip replacement. Studies of people with one replaced hip show mixed results: some groups see roughly half having the other hip replaced within ten to fifteen years, while others with a healthy opposite hip rarely need a second operation.
To turn those broad figures into something more personal, it helps to review the main factors that drive risk on the other side: the state of the joint on X-ray, overall load from weight and activity, and other medical conditions that affect bone and cartilage. The table below gathers those threads.
| Factor | Effect On The Other Hip | Practical Takeaway |
|---|---|---|
| Arthritis On Both Sides At Baseline | Higher chance that the opposite hip will progress and need surgery over time. | Ask your surgeon how worn the other hip already looks and what that may mean. |
| Healthy Or Mild Changes On The Other Side | Lower short-term risk; many people never move on to contralateral replacement. | Track symptoms, but do not assume surgery is inevitable. |
| Body Weight And Body Mass Index | Extra load across both hips can speed cartilage wear, especially on a joint that is already arthritic. | Gentle weight management, guided by your health team, may ease pressure on the other hip. |
| Activity Level | Very high impact sport can irritate a fragile joint; no movement at all weakens muscles and can worsen pain. | Aim for regular low impact activity such as walking, cycling, or swimming once cleared. |
| Alignment And Leg Length Difference | Marked tilt or length difference can change how weight passes through the opposite hip. | Your team may use shoe inserts or therapy to help balance your posture. |
| Previous Injury Or Childhood Hip Disease | Old damage on the opposite side can combine with arthritis and raise the chance of a second replacement. | Share any old injuries or childhood diagnoses with your surgeon and therapist. |
| Inflammatory Arthritis Or Metabolic Disease | Conditions such as rheumatoid arthritis or poorly controlled diabetes can affect several joints at once. | Skilled medical management of these conditions can help protect joint surfaces. |
| Smoking History | Linked with slower healing and bone quality issues, which can affect both implants and natural joints. | Stopping smoking brings benefits for bones, heart health, and wound healing. |
A person with mild wear on the other hip, a healthy weight, and strong muscles may stay on one artificial hip for life. Someone with severe arthritis on both sides, higher body weight, and long spells of sitting might reach a second hip replacement much sooner.
One Hip Replacement And The Chance Of Surgery On The Other Side
Research teams who follow people after unilateral hip replacement often split them into two broad groups. The first group already has clear arthritis in both hips at the time of the first operation. The second group has one badly worn hip and another joint that still looks fairly normal on X-ray.
When both hips already show arthritis, many people do go on to a second operation, with several studies reporting roughly four to five out of ten needing a contralateral replacement over ten or more years. Those who start with one worn hip and one healthy joint have much lower long-term rates of second surgery.
What Makes The Other Hip More Likely To Wear Out?
Existing Arthritis On The X-Ray
If X-rays taken before your operation already show joint space loss, bone spurs, or cysts on the opposite side, the groundwork for a later replacement is already present. The American Academy of Orthopaedic Surgeons describes hip osteoarthritis as a condition that often affects both sides, especially in older adults with long-standing cartilage wear.
Age, Weight, And Activity Level
Younger patients with one hip replacement often ask more of their joints through work, sport, or caring duties. Years of repeated load can stress cartilage on the other side, especially when extra body weight is present. Low impact activity still helps by keeping muscles strong and balance steady.
Joint Alignment And Leg Length
Hip replacement surgery tries to restore a smooth, stable joint and a comfortable leg length. In some cases a small difference in length remains. Even a few millimetres can change how the pelvis tilts and how weight passes across the spine, knees, and the other hip. Therapists often use strengthening exercises, gait training, and sometimes shoe inserts so that both hips share the load as evenly as possible.
One Hip Replacement And The Chance Of Surgery On The Other Side: How To Tilt The Odds
This heading uses a close variation of the question “Does One Hip Replacement Lead To Another On The Other Side?” because the underlying worry is the same: can anything you do now change the picture later on? You cannot rewrite your joint shape or childhood health, yet you can influence strength, weight, and daily habits.
Strengthen Muscles Around Both Hips
Targeted exercises for the gluteal muscles, thighs, and core improve joint control on both sides. Your physiotherapist can build a programme that respects your current pain, balance, and any other medical conditions. Regular practice makes everyday tasks such as standing from a chair, climbing stairs, and walking longer distances feel easier.
Keep A Joint-Friendly Body Weight
Extra body weight increases load through both hips with every step. Gentle weight loss, when safe for you, can reduce pressure on cartilage and nearby tissues. A registered dietitian or your primary care doctor can help you set realistic goals and choose eating patterns that suit your health history.
Choose Activities That Are Kind To Your Hips
Many people do well with regular walking, cycling, swimming, or low impact fitness classes once their surgeon clears them. These activities keep the heart, lungs, and muscles active without heavy impact on the joints.
Stay On Top Of Other Health Conditions
Inflammatory arthritis, diabetes, and osteoporosis can all influence how joints wear and how bone responds to load. Careful medical management of these conditions helps bone and cartilage health. Regular blood tests, medication review, and clinic visits give your team a clear picture of how your body is coping.
Guides from the American Academy of Orthopaedic Surgeons and the NHS hip replacement overview describe symptoms, lifestyle steps, and treatment choices in more detail, giving you a reliable place to read further between appointments or when questions crop up later.
Warning Signs Your Other Hip Needs A Check
Even with good habits, the other hip can start to change with time. Early review often makes treatment easier, whether that means adjusting activity, changing medication, or planning surgery at the right moment.
Common Early Warning Signs
| Sign Or Symptom | What You Might Notice | Suggested Next Step |
|---|---|---|
| Deep Groin Or Buttock Pain | Aching with walking or standing that eases with rest, often felt in the front of the hip. | Book a review with your general practitioner or orthopaedic clinic. |
| Stiffness After Sitting | Difficulty taking the first few steps after a car ride or time on the sofa. | Mention this at your next routine appointment; early therapy may help. |
| Night Pain | Pain that wakes you or stops you lying on the affected side. | Seek assessment, especially if pain worsens week by week. |
| Reduced Walking Distance | You find yourself cutting walks short or needing more rest breaks. | Track this change and share it with your surgeon or therapist. |
| Clicking, Catching, Or Giving Way | Sensations of the hip catching or feeling unreliable when you turn. | Arrange a check, particularly if movement feels unsafe. |
| New Limp Or Worsening Limp | Friends or family notice a limp, or you rely more on a stick. | Ask for a gait assessment and updated X-rays. |
| Low Back Or Knee Pain On The Same Side | Pain in nearby areas that flares with hip use can reflect altered mechanics. | Thorough assessment helps separate spinal, knee, and hip causes. |
Severe, sudden pain, fever, or an inability to bear weight needs urgent medical care. These red flag symptoms can indicate infection, fracture, or other issues that need rapid attention, regardless of whether you have one or two replaced hips.
Talking With Your Surgical Team About Your Long-Term Plan
When you meet your surgeon, treat “Does One Hip Replacement Lead To Another On The Other Side?” as part of a shared plan. Ask how the opposite hip looks now, how likely it is to change over the next five to ten years, and what signs should trigger a fresh review.
Clear communication across the team makes life easier. Surgeons, physiotherapists, nurses, and primary care doctors all see different slices of your recovery. Sharing concerns allows small adjustments in exercise plans, medication, or walking aids, which can reduce stress on both hips and help you stay active and independent whether you live with one hip replacement or two.
Mo Maruf
I created WellFizz to bridge the gap between vague wellness advice and actionable solutions. My mission is simple: to decode the research and give you practical tools you can actually use.
Beyond the data, I am a passionate traveler. I believe that stepping away from the screen to explore new environments is essential for mental clarity and physical vitality.