If you have had a total hip replacement surgery, there are certain precautions you need to take while you are recovering. This is especially true if your surgery was done via a posterior approach (at the back of the hip, near the buttocks).
These precautions are important in order to avoid a hip replacement dislocation. When this happens, the artificial ball of the upper leg (femur) slips out of the artificial hip socket.
This article will explain the three precautions you need to take after your surgery and for how long.
:max_bytes(150000):strip_icc()/hip-prosthesis-x-ray-758293341-5c17c737c9e77c000145673e.jpg "Exercises and Activities to Avoid After Hip Replacement (1)")
According to research from the University Hospital of Cologne, around 2% of people with a total hip replacement will experience a dislocation within a year, while 28% of those with a second hip replacement will experience the same.
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This video has been medically reviewed by Oluseun Olufade, MD.
Precautions After Hip Replacement
For at least the six weeks after surgery, and sometimes up to six months, you'll need to take extra precautions as your mobility returns. For example:
- Avoid bending your hip past 90 degrees
- Don't cross your leg on the side with the new hip over your other leg
- Keep your toes straight when you walk
Recommendations
After a total hip replacement with a posterior incision, three movements should be avoided to prevent the dislocation of your artificial hip. Until you are fully recovered and your mobility and range of motion have been fully evaluated by your orthopedic surgeon, you should avoid:
- Hip flexion past 90 degrees: This means that you should not bend your hip up too far or lift your knee too high. When you are sitting in a chair, for example, your thigh should be parallel to the floor. Sitting in a low chair or bending your knee and hip up to put on a sock may break this 90-degree rule and put you atrisk for hip dislocation.
- Crossing your operated leg over the other one: You should not cross your leg with the new hip over the other one. You may be required to use a special wedge called an abduction pillow when sleeping to help keep your legs separated.
- Walking pigeon-toed (internal rotation of the hip): After a posterior approach total hip replacement, you should not rotate your hip inward. This means that your toes should be kept straight ahead or slightly rotated outwards when walking, sitting, standing, or lying down.
Sometimes the very exercises you may do as part of a physical therapy program after hip surgery can be risky. Your physical therapist can show you how to do them so they don't result in a dislocation.
When to Call Your Healthcare Provider
Call your healthcare provider if you experience signs of hip replacement dislocation, including:
- Intensepain in the hip andgroin
- A popping sound when you move
- Difficulty walking or an inability to walk
- Feeling like the hip joint "catches" with movement
- Inability to move the hip joint
- Noticing that the leg with the prosthetic hip is suddenly shorter than the other
Duration of Precautions
Most people need to follow the precautions for approximately 90 days after surgery. Some healthcare providers may want you to follow the precautions for about six months. Others may only have you follow them for 60 days.It all depends on your health and mobility level before the surgery and how complex the surgery was. It will also depend on the intensity of your post-operative rehabilitation and recovery.
Your healthcare provider will tell you when you no longer need to follow your total hip precautions.
A 2011 study in the Journal of Orthopaedic & Sports Physical Therapy reported that most people experience rapid recovery in the first three to four months following a total hip replacement. After that, improvements continue at a slower rate for up to a year.
How Long Do Hip Replacements Last?
Lifetime Precautions
Depending on your age and physical condition, you may also need to adopt some lifetime precautions after hip surgery, including:
- Avoid bending the hip too far: Older adults in particular should continue to avoid flexing the hip past 90 degrees or lifting the knee above hip level. Don't sit in deep or low chairs if they will result in a high knee position.
- Avoid twisting motions: Certain movements can increase the risk of dislocation. Examples include crossing your legs, pivoting, or walking with your toes turned in.
- Sleep with a pillow between your legs: If you are a side sleeper, it's a good idea to keep a pillow between your legs to help your hip and leg stay aligned.
- Avoid high-impact, repetitive activities: Running, jumping, and high-impact sports that involve a lot of twisting like basketball and racquetball may cause wear and increase the risk of dislocation.
Talk to your healthcare provider about whether these precautions are necessary in your situation.
Summary
After a total hip replacement surgery, you will do rehab with a physical therapist. You will also need to avoid certain movements in your everyday life to avoid the possibility of dislocating your new hip ball and socket.
Remember that each person heals differently after total hip replacement surgery. Working with your physical therapist is the best way to ensure a safe and rapid recovery.
Frequently Asked Questions
How can you avoid dislocating a replacement hip?
Many of the risk factors are beyond your control. Underlying neuromuscular disorders, for instance, play a role. Surgical mistakes such as the protheses being placed incorrectly can also lead to displacement. However, you can lower the risk by not pushing your range of motion: Don’t bend far forward from a standing position and avoid making an internal rotation of the flexed hip.
Learn More:Managing Hip Ailments
(Video) What Activities should I avoid after HIP Replacement Surgery?Does a replacement hip that’s dislocated need to be fixed right away?
Yes. The hip should be treated with a technique called reduction within 6 hours of the displacement to avoid permanent complications or the need for additional surgeries or invasive procedures.
Learn More:What Is Hip Range of Motion?
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ärzteblatt DÄG Redaktion Deutsches. Dislocation following total hip replacement. Deutsches Arzteblatt. 2014;111(51-52):884-890. doi:10.3238%2Farztebl.2014.0884
Dargel J, Oppermann J, Bruggermann G, et al. Dislocation following total hip replacement. Dtsch Arztebl Int. 2014;111(51-52):884-90. doi:10.3238/arztebl.2014.0884
Zahar A, Rastogi A, Kendoff D. Dislocation after total hip arthroplasty.Curr Rev Musculoskelet Med. 2013;6(4):350–356. doi:10.1007/s12178-013-9187-6
Peters A, Tijink M, Veldhuijzen A, Huis in 't Veld R. Reduced patient restrictions following total hip arthroplasty: study protocol for a randomized controlled trial.Trials. 2015;16:360. doi:10.1186/s13063-015-0901-0
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Barnsley L, Barnsley L, Page R. Are hip precautions necessary post total hip arthroplasty? A systematic review.Geriatr Orthop Surg Rehabil. 2015;6(3):230–235. doi:10.1177/2151458515584640
Eannucci EF, Barlow BT, Carroll KM, Sculco PK, Jerabek SA, Mayman DJ. A Protocol of Pose Avoidance in Place of Hip Precautions After Posterior-Approach Total Hip Arthroplasty May Not Increase Risk of Post-operative Dislocation.HSS J. 2019;15(3):247–253. doi:10.1007/s11420-019-09708-9
Madara KC, Marmon A, Aljehani M, Hunter-Giordano A, Zeni J Jr, Raisis L. PROGRESSIVE REHABILITATION AFTER TOTAL HIP ARTHROPLASTY: A PILOT AND FEASIBILITY STUDY.Int J Sports Phys Ther. 2019;14(4):564–581.
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By Laura Inverarity, DO
Laura Inverarity, PT, DO, is a current board-certified anesthesiologist and former physical therapist.
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FAQs
What 3 things should be avoided after hip replacement surgery? ›
Hip replacement patients are given a long list of things not to do—do not bend the hips or knees further than 90 degrees, do not cross the legs, do not lift the leg to put on socks, and much more. These movement restrictions protect the new hip from dislocation.
What happens if you exercise too much after hip replacement? ›Activity. It is important to gradually increase your out-of-home activity during the first few weeks after surgery. If you do too much activity, your hip may become more swollen and painful.
Can I do squats with a hip replacement? ›Can you do squats with a hip replacement? Yes and no. Squat exercises can be done after a hip replacement but not without the permission from your doctor. Squats should not be attempted until a few months after your operation.
Can you ride a stationary bike after hip replacement? ›Using a stationary bike
Biking can improve leg and hip muscle strength and increase the new hip's range of motion. Biking on a stationary bike eliminates the risk of falling and injuring the new hip. Adjusting the bike seat higher than usual can help avoid uncomfortable, excessive bending at the hip.
“On average, hip replacement recovery can take around two to four weeks, but everyone is different,” says Thakkar. It depends on a few factors, including how active you were before your surgery, your age, nutrition, preexisting conditions, and other health and lifestyle factors.
Are there any lifelong restrictions after hip replacement? ›That's right, no restrictions. After an anterior hip replacement you can do anything you want to.
Which movements cause dislocation after hip replacement? ›Patients should scrupulously avoid hip movements such as bending far forward from a standing position, or internal rotation of the flexed hip. Operation-specific risk factors include suboptimal implant position, insufficient soft-tissue tension, and inadequate experience of the surgeon.
How long after hip replacement is there a risk of dislocation? ›The risk for dislocation is greatest in the first few months after surgery while the tissues are healing. If the ball does come out of the socket, your doctor can perform a procedure (called a closed reduction) that can usually put it back into place without the need for more surgery.
What is the best exercise after hip surgery? ›Walking is the best exercise for a healthy recovery, because walking will help you recover hip movement. Initially, the use of a walker or crutches will help to prevent blood clots and strengthen your muscles which will improve hip movement.
Can I do downward dog after hip replacement? ›For example, if you have a posterior hip replacement, avoid poses that stress hip flexion, like downward dog, seated twist, or any motions that involve crossing your legs.
What is the most important thing to do after hip replacement surgery? ›
Balance rest and recovery with gentle exercise
While it's important to rest to allow yourself time to recover, it's also important to get moving too. This is because if you stay still for too long, you can become stiff which could hinder your recovery (and it could take longer).