Exercises and Activities to Avoid After Hip Replacement

Recovery can take from three months to over a year

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.

Hip prosthesis, x-ray
BSIP / Getty Images

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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Click Play to Learn More About Hip Replacement Exercises to Avoid

This video has been medically reviewed by Oluseun Olufade, MD.

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 at risk 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:

  • Intense pain in the hip and groin
  • 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.

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.

  • 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.

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10 Sources
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