Hip Replacement Medically reviewed by Thomas D. Ferro, M.D. in Los Angeles, CA

A personalized, 3D-planned hip replacement for Los Angeles patients, with a recovery that begins at home. From Downtown and Koreatown to Silver Lake and Echo Park, Angelenos can choose NanoHip™ for a hip replacement that doesn't require an inpatient admission. A CT scan of your hip is the raw material for a detailed 3D plan, finalized by our engineers and your surgeon before surgery. In the operating room, your surgeon uses a muscle-sparing technique, and a spinal anesthetic with sedation means no general anesthetic. Most patients are on their feet within a few hours.

A Faster Return to Your Los Angeles Life

The track record behind NanoHip™ spans more than 5,400 hip replacements, and patients commonly:

Walk on their new hip within a few hours
Make it home around two hours after surgery
Return to the sports and pastimes they enjoy, free of restrictions

Your CT scan is used to build a three-dimensional model of your hip. That model, not an X-ray on surgery day, is where your implant's size, position and alignment get decided.

Four Key Differences You Should Know

If you're comparing hip replacement options, these four differences set NanoHip™ apart. Each makes a useful question for any surgeon.

A plan drawn from your own anatomy

Every NanoHip plan is custom-built. Using a 3D model generated from your CT scan, our biomedical engineers settle the sizes of your cup and stem, map where those components will sit, and work out how to restore your leg length and offset. Final sign-off comes from your surgeon.[3]

Learn how 3D surgical planning works →

Less disruption to surrounding muscle

Instead of detaching or cutting muscle, NanoHip surgeons work through natural gaps between muscle groups to reach the hip. Because your 3D model shows your anatomy in detail, the minimally invasive approach is selected for your body, not for promotional appeal.

Same-day discharge with spinal anesthesia

Going home the same day is well supported. Researchers who pooled 20 studies, more than 580,000 operations in all, found no meaningful gap in complications or readmissions between outpatient and inpatient hip replacement.[6] On the anesthesia side, a national study of more than 380,000 joint replacements associated spinal anesthesia with fewer complications and lower 30-day mortality than general anesthesia.[5] You'll recover at home in Los Angeles that same day.

Implants with a proven history

All NanoHip™ implants are FDA-cleared, with long performance histories documented in national joint registries. Only your plan is custom; the implants are proven.

Side by Side: NanoHip™ vs. Traditional Hip Replacement

	vs	Traditional Hip Replacement
Planning Process	A 3D plan from your CT scan, built by biomedical engineers and approved by your surgeon, with implant size, cup and stem position, leg length, and offset determined in advance	Flat X-ray templating, often wrapped up during surgery, where positioning and alignment decisions come under time pressure
Approach to the Joint	A muscle-sparing technique adapted to each patient	A posterior or lateral approach going through or around the hip muscles
Anesthetic Choice	A spinal anesthetic plus sedation	General anesthesia, which many hospitals still use as their default
Post-Surgery Setting	Your own home, usually about two hours after surgery	A hospital bed, frequently for one to three days
Therapy Plan	A home program led by your surgeon, adding formal therapy only if necessary	Outpatient physical therapy across several weeks

Your Los Angeles Doctors

At NanoKnee, we pride ourselves on assembling an elite team of hand-picked surgeons recognized as leaders in joint replacement. Each of our specialists is chosen for their exceptional skill and dedication to excellence. When paired with NanoKnee's revolutionary approach to joint replacement surgery, our surgeons deliver unparalleled care. With a focus on innovative, minimally invasive techniques, our team is committed to ensuring you receive the most advanced treatment available, providing you with a superior path to recovery and a better quality of life.

Jonathan Saluta, MD

Board-certified and fellowship-trained, Dr. Saluta has extensive experience in treating a multitude of bone and joint issues, including fracture fixation and complex reconstruction of the hip, knee...

Learn More about Jonathan Saluta, MD

Meet our Surgeons

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Understanding the NanoHip™ Procedure

With NanoHip™, your hip replacement is planned in three dimensions and completed as an outpatient surgery. You'll put weight on your new hip the day of the operation and spend your recovery at home. Our surgeons treat patients who want to remain active, and they build every plan with that aim. Of the reasons a hip replacement may need revision in the U.S., instability is the most frequent.[2] That's one reason our biomedical engineers and surgeons finalize your plan well before your operation. The position of your cup and stem relative to your pelvis and femur, and the way your leg length and offset are restored, are decided on your 3D model rather than estimated from a flat X-ray during surgery. This groundwork is how your surgeon aims for a hip that's both stable and strong, with less risk of needing a revision because of instability.

01 05

What he did for me was almost like a miracle.

My knees had become so painful that I had to walk with a cane and I was on an aggressive pain medication. I was very limited in what I could do and I felt as if the pain was affecting my attitude toward everything. Dr. Ferro is marvelous! I felt relaxed and comfortable with him in the first visit. I was very confident in Dr. Ferro and ...

Sandra Wolfe

Thank you Dr. Ferro for your exceptional medical skills and abilities...

Slowly but surely the pain in your knees robs you of your quality of life. The doctor tells you, "your knees are bone on bone." He answers your questions, then says "take your time and let me know when you are ready for surgery. After surgery your response is, "oh, why didn’t I have both knees replaced years ago!" Pain free to do ...

Sandra Brown

Do your research and I know you can’t go wrong with Nano Knee there the best!!

This is my second Nano Knee Replacement, the first was three years ago, and now one just a week ago. The first one was so much better that I could dreamed it could be, the speed of recovery and much less pain than I thought I could have and when all said and done it is 100% back and there is no feelings that tell me anything was ever d...

Robert Hench

Highly recommend Dr Ferro and Nano Knee Clinic!

Received the best care and consideration from office personnel, surgical team, Janika NP and Dr Ferro from start to finish. Every faucet was organized with prompt follow up to my needs. Now pain free and straight legged after a Total knee replacement for severe knock knee. Unfortunately, a few months later another issue arose not relat...

Gina Dusi

My new knee feels great and I'm looking forward to 30 more years without pain.

The surgery went well, and I was walking without assistance in 4 days. My total recovery is ongoing, but at 3 months I'm back to walking 3 miles on the beach with no pain. My new knee feels great and I'm looking forward to 30 more years without pain.

Cynthia Clark

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How to Know You May Need Hip Replacement

Hip replacement is usually recommended once arthritis makes everyday life difficult and conservative treatments, such as activity changes, medication, physical therapy or injections, no longer provide relief. Common signs include:

Hip or groin pain that makes walking or climbing stairs difficult
Ongoing pain at night or while resting
Stiffness that limits routine motions, such as squatting or kneeling down
Imaging that shows severe arthritis in the hip joint

What Happens When You Arrive for Surgery

NanoHip™ is an outpatient procedure. With a spinal anesthetic and sedation, you'll be comfortable and unaware during the operation, without general anesthesia. Most surgeries last between 90 minutes and two hours. Within a few hours, your care team will help you walk on your new hip, and most patients return home the same day. You can put your full weight on the hip right away.

Your Recovery at Home

Most NanoHip™ patients get back to their daily routines in one to two weeks and to an active lifestyle in six to eight weeks, guided by a home exercise program from their surgeon. On average, published research shows most patients returning to sport, moderate-impact sport included, around five months after hip replacement.[8]

Staying Active for the Long Run

NanoHip™ is designed to support an active lifestyle without restrictions. The research on standard hip replacement is encouraging here: in a review of 37 studies, sports-active patients largely returned to their sport, and upward of 80% regained the level of play they had before arthritis interfered.[8]

At your consultation, your NanoHip™ surgeon will explain each stage of healing and help you set a realistic timeline for returning to your favorite activities, whether that's a round of golf or a hike in Griffith Park.

Hip Replacement Frequently Asked Questions

How long will a hip replacement serve me?

Potentially for many decades. In the largest review of national joint registry data, around 89% of hip replacements were still working 15 years after surgery, 70% at 20 years and 58% at 25 years.[1] Durability depends heavily on how well an implant is positioned, so NanoHip™ charts your anatomy before surgery and pairs individualized placement with modern implant designs, aiming for a hip that keeps pace with your life without activity restrictions.

What does careful planning do for implant durability?

It gives the surgical team control over the factors that matter most: fit and position. With NanoHip™, biomedical engineers create a CT-based 3D plan that sizes your cup and stem to your bone and maps their position, your leg length and your offset. Your surgeon approves it before surgery.

The benefits are measurable. When CT-based 3D planning was compared with X-ray templating in 200 patients, 3D planning got the stem size right 88% of the time versus 69%, and the cup size right 96% of the time versus 56%. Offset errors greater than 3 mm fell from 23% to 5% of patients and varus stem placement from 10% to 2%, and there were no early fractures or subsidence in the 3D group compared with three in the X-ray group.[3]

NanoHip™ combines that proprietary 3D modeling with FDA-cleared implants that have extensive registry histories, optimizing placement and minimizing soft tissue trauma.

Who makes a good NanoHip™ patient?

People who've been advised to have a hip replacement and who want to recover at home, stay active, and have an implant planned for their own anatomy. NanoHip™ was developed for active patients across a broad age range who want excellent function afterward. Your NanoHip™ surgeon will determine whether you're a candidate during your consultation and recommend your next step.

What conservative treatments might come first?

Depending on your condition, your surgeon may recommend activity modification, weight management, physical therapy, anti-inflammatory medication or corticosteroid injections before considering surgery. Your NanoHip™ surgeon will review your imaging and history to recommend the right approach. When arthritis has progressed past what these treatments can relieve, hip replacement offers consistent, long-lasting results.

Is leg length planned before NanoHip™ surgery?

Yes. Your leg length and offset, the distance from your hip to your body's midline, are planned on your 3D model so your surgeon begins the operation with specific targets. In a 200-patient comparison, CT-based 3D planning reduced offset errors of more than 3 mm from 23% of patients to 5%.[3]

How does NanoHip™ spare surrounding tissue?

NanoHip™ is a minimally invasive hip replacement that reaches the joint through the spaces between muscles rather than cutting through them, and randomized trials report that these muscle-sparing approaches tend to make the first few weeks easier.[7] For long-term function, though, accurate restoration of your anatomy matters more than incision size. Your implant's size and placement determine how your hip performs for years, and both are fixed in your 3D plan before surgery.[3]

Do I need to be asleep for NanoHip™?

No. NanoHip™ surgeons use spinal (regional) anesthesia with “twilight” sedation, so you're comfortable and unaware during the procedure without general anesthesia. In a national analysis of more than 380,000 joint replacements, spinal anesthesia was associated with lower 30-day mortality and fewer complications than general anesthesia.[5] General anesthesia is available if your health makes it the safer option.

Will I go home the same day as my hip replacement?

Most patients do, usually about two hours after surgery, because NanoHip™ is an outpatient procedure. Outpatient hip replacement has been studied extensively, and a meta-analysis of 20 studies found no difference in complications compared with inpatient surgery, plus the advantage of recovering at home.[6] Your surgeon will decide ahead of time whether going home the same day is appropriate for you.

How long should I expect surgery to take?

Plan for roughly 90 minutes to two hours. Your implant sizes, positions, leg length and offset are set in your 3D plan, so fewer decisions are made under time pressure in the operating room, and your surgeon has the added insights of NanoKnee's proprietary 3D Blueprinting® plan, offered nowhere else.

How long does it take to recover from NanoHip™?

Most NanoHip™ patients walk within hours of surgery and are doing light activities by the end of the first week. A general guide:

7–14 days: normal daily activities
2–6 weeks: moderate activity
6–8 weeks: an active lifestyle with no limits

Recovery varies from person to person.

What role does physical therapy play after NanoHip™?

A smaller one than you might expect. Most NanoHip™ patients recover with a home exercise program from their surgeon, and formal outpatient physical therapy is added only if their surgeon recommends it. You'll walk the day of surgery and add strengthening, cycling and low-impact activities like swimming once your incision heals, typically within two weeks. The NanoKnee app makes it easy to track progress and reach your care team.

Which activities can I get back to with a new hip?

Plenty. For most NanoHip™ patients, the list includes walking, cycling, golf, swimming, hiking, tennis, running and skiing, all without restrictions. The evidence is reassuring: of 6,485 hip replacement patients followed across 37 studies, better than eight in 10 got back to the sport level they had before symptoms, taking about five months on average and most often choosing low- to moderate-impact activities.[8]

Will I get my range of motion back?

Most patients regain the motion they need for daily life and sports, and many recover movement arthritis had taken from them. Your 3D plan positions the cup and stem to restore your hip's center of rotation and offset, helping keep the joint stable through its full range. Your mobility will continue to improve throughout the first year, and our goal is to help every patient regain what arthritis and wear took away.

What will my incision and scar look like?

You'll have a single incision, usually 4 to 6 inches long, closed with absorbable sutures and a cosmetic technique that minimizes scarring. Skin typically heals within two weeks, and you'll keep protecting the area for several weeks afterward.

What risks come with having a hip replaced?

Risks include infection, blood clots, dislocation, fracture, a difference in leg length, nerve injury, implant loosening over time, and anesthesia-related complications. NanoHip™'s standard practices address several of these: spinal anesthesia is associated with fewer perioperative complications than general anesthesia,[5] and pre-operative 3D planning targets the component position, leg length and offset problems behind instability and loosening, the two leading causes of revision.[2][3] Your surgeon will review your specific risks with you and plan to minimize them.

How well does hip replacement work for most people?

Remarkably well. Hip replacement is regarded as one of the most successful operations in medicine. The American Joint Replacement Registry has recorded more than 4.4 million hip and knee replacements since 2012,[9] and in a study of 850 hip replacement patients, only 7% were dissatisfied at one year.[4]

Serious complications are uncommon, and some risks are shaped by decisions made before surgery. A national analysis of more than 380,000 joint replacements found spinal anesthesia was associated with lower 30-day mortality and fewer in-hospital complications than general anesthesia.[5] NanoHip™ procedures are performed by board-certified orthopedic surgeons under spinal anesthesia with sedation, with our proprietary 3D modeling supporting consistent implant placement and a muscle-sparing approach tailored to your anatomy.

Is NanoHip™ appropriate for older adults?

Yes, for many. Older adults with advanced arthritis are some of the most frequent recipients of hip replacement, and the procedure can greatly improve their mobility and quality of life. Overall health, rather than age, determines candidacy, and every NanoHip™ patient is evaluated before surgery. Spinal anesthesia, a standard part of NanoHip™, is associated with fewer perioperative complications than general anesthesia.[5]

What's covered, and what's not?

When it's medically necessary, hip replacement surgery is covered by Medicare and most commercial insurance plans. The pre-operative 3D planning and engineering are not covered, and depending on your plan, that portion may cost up to $8,500. Our patient navigators will confirm your coverage and costs before you commit, and financing is available for non-covered amounts.

Is NanoHip™ performed with robotic assistance?

No. Your surgeon performs the operation without a robot. AI assists only with planning, helping our biomedical engineers build a 3D model from your CT scan, and your surgeon reviews and approves the plan. NanoHip™'s precision is established before surgery, not by technology in the operating room.

Sources

Evans JT, Evans JP, Walker RW, Blom AW, Whitehouse MR, Sayers A. How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet. 2019;393(10172):647-654. doi:10.1016/S0140-6736(18)31665-9
Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009;91(1):128-133. doi:10.2106/JBJS.H.00155
Aubert T, Galanzino G, Gerard P, Le Strat V, Rigoulot G, Lhotellier L. Accuracy of preoperative 3D vs 2D digital templating for cementless total hip arthroplasty using a direct anterior approach. Arthroplasty Today. 2023;24:101260. doi:10.1016/j.artd.2023.101260
Anakwe RE, Jenkins PJ, Moran M. Predicting dissatisfaction after total hip arthroplasty: a study of 850 patients. J Arthroplasty. 2011;26(2):209-213.
Memtsoudis SG, Sun X, Chiu YL, Stundner O, Liu SS, Banerjee S, Mazumdar M, Sharrock NE. Perioperative comparative effectiveness of anesthetic technique in orthopedic patients. Anesthesiology. 2013;118(5):1046-1058. doi:10.1097/ALN.0b013e318286061d
Gong S, Yi Y, Wang R, Han L, Gong T, Wang Y, Shao W, Feng Y, Xu W. Outpatient total knee and hip arthroplasty present comparable and even better clinical outcomes than inpatient operation. Front Surg. 2022;9:833275. doi:10.3389/fsurg.2022.833275
Ramadanov N, Bueschges S, Lazaru P, Dimitrov D. A meta-analysis on RCTs of direct anterior and conventional approaches in total hip arthroplasty. Sci Rep. 2021;11:20991. doi:10.1038/s41598-021-00405-4
Hoorntje A, Janssen KY, Bolder SBT, et al. The effect of total hip arthroplasty on sports and work participation: a systematic review and meta-analysis. Sports Med. 2018;48(7):1695-1726. doi:10.1007/s40279-018-0924-2
American Academy of Orthopaedic Surgeons. American Joint Replacement Registry (AJRR): 2025 Annual Report. Rosemont, IL: AAOS; 2025.
Chua MJ, Hart AJ, Mittal R, Harris IA, Xuan W, Naylor JM. Early mobilisation after total hip or knee arthroplasty: a multicentre prospective observational study. PLoS One. 2017;12(6):e0179820. doi:10.1371/journal.pone.0179820