After Hip Replacement - Restrictions and Precautions

hip rehab
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Hip replacement surgery is a treatment for severe arthritis of the hip joint. Patients who commit to hip replacement surgery must understand that there are some changes they will have to adapt to for the rest of their life. The trade-off for the patients is that they will likely have a significant decrease in hip pain and disability.

After hip replacement surgery, patients may have to restrict certain activities to prevent problems with the hip replacement implant.

The concern is that hip replacement implants are not as stable as a normal hip joint. This means that it is possible for the ball of the ball-and-socket hip replacement to dislocate.  There are some newer methods of performing hip replacement, the so-called anterior hip replacement, as well as some newer styles of implants that may lower the chance of dislocation.  Your doctor can let you know if you need to take precautions to prevent a hip dislocation.

In order to prevent the chance of a hip replacement dislocation, certain positions should be avoided. These positions place the implant in a position where dislocation is more likely. These restrictions are known as "hip precautions."

What positions should be avoided?

  • Crossing your legs
    You should not cross your legs after hip replacement surgery. When putting on socks and shoes, you should not cross your legs to bring your foot towards your body. Your therapist will instruct you on how to safely get dressed. You should not sleep on your side until instructed by your surgeon. Some surgeons may have you sleep with a pillow between your legs to prevent them from crossing.
  • Forward bending
    It is important not to bend your hip up more than 90 degrees. In general, if your knee is below your hip joint, you are in a safe position. Problems occur with deep cushioned seats or low seats (such as toilets).

It is important to work with your physical therapist and occupational therapist to learn the proper ways to get dressed, sit down, walk, and perform other routine activities.

What is the problem with these positions?

As mentioned above, a hip replacement implant is not as stable as a normal hip joint. If a dislocation of the hip replacement occurs, the hip implant must be put back in place. This can usually be done in the emergency room, but may require additional surgery. Furthermore, hip replacement dislocations can damage the implant and decrease the chances of success after hip replacement surgery.

As hip replacement implants have changed over time, and as surgical procedures have been developed and refined, the precautions after hip replacement surgery have also changed. Not every surgeon uses the same precautions--some prefer significant restriction, while others may allow more activities. It is important that you discuss with your surgeon the specific recommendations for your situation as there may be reasons why you need more (or less) restrictive precautions.

A Word From Verywell

Complications from hip replacement surgery are unusual, and there are often steps that can be taken to prevent these from occurring. A dislocation is one of the most concerning complications. Typically, hip dislocate in certain positions, and learning to avoid these positions can help to prevent complication.

Fortunately, surgeons seem to be better able to lower this possible risk of surgery, and newer implants may lessen the chance of a hip dislocation. That said, every patient should discuss their precautions with their surgeon after having a hip replacement.

Sources:

Yu S, Garvin KL, Healy WL, Pellegrini VD Jr, Iorio R. "Preventing Hospital Readmissions and Limiting the Complications Associated With Total Joint Arthroplasty" J Am Acad Orthop Surg. 2015 Nov;23(11):e60-71.

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