Do I need a hip replacement?
A total hip replacement swaps the worn ball-and-socket joint for a smooth implant and relieves the deep groin pain of bone-on-bone arthritis. Serious complications occur in fewer than 2% of patients (AAOS OrthoInfo). It comes after simpler treatments have been tried.
The path most hips take
- Symptoms
Groin pain that spreads
Deep ache in the groin or outer hip, stiffness after sitting, pain that interrupts sleep.
- Diagnosis
An X-ray shows the wear
Standing X-rays show the cartilage space. "Bone-on-bone" means the cushion is gone.
- First moves
Everything short of surgery
Activity changes, in-house physical therapy, anti-inflammatories, injections when they fit.
- The line
When surgery makes sense
Night pain, a shrinking life despite conservative care, bone-on-bone X-rays, and your own decision.
- The surgery
What happens
Robotic assistance helps your surgeon place the implant to a CT-based plan. Many patients go home the same day.
- Recovery
Often faster than a knee
You walk on day one; many drop the walker within a week or two. Light activity returns at 3–6 weeks and most hip precautions lift around 6–8 weeks (OrthoInfo).
Week by week: our hip replacement recovery timeline and how to sleep after hip replacement.
Who performs hip replacement at Sterling Ridge
Two surgeons, with every case planned and rehabbed in-house:
- Dr. N. Brian Flowers, MD, MPT, FAAOS — primary hip and knee replacement, anterior approach. Fellowship at the Hospital for Special Surgery, Fellow of the American Association of Hip and Knee Surgeons, Mako certified, and a physical therapist before he was a surgeon.
- Dr. Rohan A. Gheewala, MD — primary, complex and revision hip and knee replacement. Adult reconstruction fellowship at Baylor College of Medicine. Second opinions welcome.
Sterling Ridge is one of the leading joint replacement practices in the Houston area. Qualified patients have same-day surgery at the Sterling Ridge / Woodforest Ambulatory Surgical Center, built with Memorial Hermann, with physical and aquatic therapy on the same campus. Our surgeons also hold privileges at several area hospitals for patients whose insurance or health history calls for one. Consults are at The Woodlands, Spring and Woodforest, Monday–Friday 8:00 AM–5:00 PM. No referral needed.
Anterior vs. posterior: the short version
Neither approach is better for everyone. Across 24 randomized trials, the anterior approach scored about 8 points higher on hip function at 6 weeks and shortened the hospital stay by 0.33 days, with roughly 17 extra minutes in the operating room and no difference in dislocation, fracture or blood clots (Ang et al., 2023). Registry data on 122,345 hips showed no difference in early revision overall; posterior hips were revised more for dislocation, anterior hips more for fracture and loosening (Hoskins et al., 2020).
Same-day hip replacement at our surgery center
The American Association of Hip and Knee Surgeons, Hip Society, Knee Society and AAOS call outpatient joint replacement safe and effective for properly selected patients. Medicare removed hip replacement from its inpatient-only list in 2020. A review of 41 studies found no difference in complications, readmissions or outcomes between outpatient and inpatient surgery, at roughly $6,800 lower cost (Bemelmans et al., 2022). The average U.S. stay after joint replacement fell from 2.9 days in 2012 to 1.1 days in 2023 (AJRR 2024 Annual Report). More in Is outpatient joint replacement safe?
Why patients choose Sterling Ridge for this
- Fellowship-trained hip surgeons who use robotic-assisted planning.
- Surgery at a center built for this operation, with our rehab team down the hall.
- If you are not ready for surgery, we will say so.
What does it cost?
National Medicare averages, facility charges only, with surgeon and anesthesia billed separately: for an inpatient hip or knee replacement without major complications (DRG 470) in 2024, the average hospital charge was $93,184 and the average total payment $17,364, of which Medicare paid $14,322 (CMS Medicare Inpatient Hospitals, 2024). For an outpatient total hip replacement (CPT 27130), the Medicare allowed amount averaged $12,476 and Medicare paid $10,847 (CMS Medicare Outpatient Hospitals, 2024). Your plan, deductible and setting change the number. We are in-network with Aetna, Blue Cross Blue Shield, Cigna, Medicare and United Healthcare, and we verify your benefits and give you an estimate before you decide. More on Cost & Insurance.
Common questions
How long does a hip replacement last?
For most patients, the first hip is the last. Across 215,676 registry hips, about 58% were still in place at 25 years (Evans et al., 2019), and those were older designs. A 2026 analysis of 1.9 million hips found modern bearing surfaces at 93.6% survivorship at 20 years (Pentland et al., 2026). Younger patients wear implants harder, but "too young" is a smaller category than it used to be.
Anterior or posterior approach?
Both work well in experienced hands, and the surgeon's experience with their approach matters more than the approach itself. Dr. Flowers uses the anterior approach, which enters from the front of the hip. The full comparison, including who is not a good anterior candidate, is on our anterior vs. posterior page.
Do I have to stay in a hospital?
Not necessarily. Qualified patients have surgery at the Sterling Ridge / Woodforest Ambulatory Surgical Center and sleep in their own bed that night. Patients with significant heart or lung disease, poorly controlled diabetes, or no one at home the first nights do better in a hospital, and we schedule surgery there.
When can I drive and go back to work?
Driving came back at about 33 days on average, with brake reaction time normal by 6 weeks (Patel et al., 2023). Across 57 studies, return to work averaged 11.2 weeks, desk work often at 4–6 weeks, and 85% returned to sport, mostly low-impact, at a mean of 16 weeks (Pasqualini et al., 2023). 87.9% of people working before surgery went back (Soleimani et al., 2023). Your surgeon clears you individually.
Will my legs be the same length afterward?
Leg length and cup position are planned from your CT scan before surgery, and robotic assistance helps carry out that plan. A 2025 meta-analysis found robotic hip replacement puts more cups in the target zone, with no difference in patient-reported scores and somewhat longer operating time (robotic vs. manual THA meta-analysis, 2025). We use the robot as a measuring tool, not a promise.
I had my knee replaced by Dr. Flowers and I would like to thank the whole team at the Spring office.— Larry (Frank) Thomas · Google review
We serve Conroe/Lake Conroe, Willis and Magnolia from the Woodforest campus, minutes away.
The surgeons who replace hips here
Read each profile for training, areas of care and office locations.
Brian Flowers, MD, FAAOS
Rohan Gheewala, MDSources
- Ang JJM et al. Anterior versus posterior approach total hip arthroplasty: meta-analysis of 24 RCTs. 2023.
- Hoskins W et al. Early revision by surgical approach, Australian registry, 122,345 THAs. JBJS 2020.
- AAHKS, Hip Society, Knee Society, AAOS. Position Statement on Outpatient Joint Replacement (2024 update).
- CMS. CY 2020 OPPS/ASC final rule fact sheet (THA removed from inpatient-only list).
- Bemelmans YFL et al. Safety and efficacy of outpatient hip and knee arthroplasty: systematic review of 41 studies. 2022.
- American Joint Replacement Registry. 2024 Annual Report highlights.
- Patel A et al. Driving after total hip arthroplasty. 2023.
- Pasqualini I et al. Return to work and sport after total hip arthroplasty: 57 studies. 2023.
- Soleimani M et al. Return to work after total hip arthroplasty. 2023.
- Evans JT et al. How long does a hip replacement last? Lancet 2019.
- Pentland D et al. Long-term survivorship of modern hip bearings, 1.9 million THAs. Lancet 2026.
- Robotic versus manual total hip arthroplasty: meta-analysis. 2025.
- CMS. Medicare Inpatient Hospitals by Geography and Service, 2024 (DRG 470).
- CMS. Medicare Outpatient Hospitals by Geography and Service, 2024 (CPT 27130).
- AAOS OrthoInfo. Total Hip Replacement.
Medically reviewed by Keith W.V. Johnson, MD, FAAOS · Updated October 21, 2026