Hip replacement surgeryis a treatment for severe arthritis of the hip joint. People 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 is that they will likely have a significant decrease in hip pain and disability.
After hip replacement surgery, you may have to restrict certain activities to prevent problems with the hip replacement implant. The concern is that in some cases, the replaced hip is 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 a hip replacement, includinganterior hip replacement, as well as some newer styles of implants that may lower the chance of dislocation.Your healthcare provider can let you know what type of precautions are needed to prevent hip dislocation after your specific type of surgery.
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Three Positions to Avoid
Most hip replacements are performed with what is called a posterior approach. In order to prevent the chance of ahip replacement dislocationafter a posterior approach, certain positions should be avoided. These positions place the hip in a position where dislocation is more likely after surgery. These restrictions are known as posterior hip precautions.
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.
To keep the legs from crossing, you should avoid sleeping on your side until your surgeon tells you that it’s OK. Even then, some surgeons will recommend that you sleep with a pillow between your legs to keep your hips level.
Forward Bending
It is important not to bend your hip up more than 90 degrees while recovering from a total hip replacement.In general, if your knee is below your hip joint, you are in a safe position. Problems can occur with deep-cushioned seats or low seats such as a toilet.
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 while adhering to these precautions.
Pivoting
You should do absolutely no pivoting (twisting your leg in or out) on your operated leg.To prevent pivoting, don’t reach across your body to pick up objects. When walking, take small steps and pick up your feet, preventing your leg from turning inward. Use care when getting into or out of bed or a vehicle.
Considerations
A hip with a replacement implant may not be 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, as they are tailored to the specific techniques that they use.
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 can occur, and a dislocation is one of the most concerning complications. There are often steps that can be taken to prevent these from occurring. Typically, a hip is more likely to dislocate in certain positions. Learning to avoid these positions can help to prevent complications.
Fortunately, surgeons today are able to minimize this risk, but it can’t be eliminated. Every patient should discuss precautions with their surgeon after having a hip replacement.
Physical Therapy After a Total Hip Replacement
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Tsukada S, Wakui M.Lower dislocation rate following total hip arthroplasty via direct anterior approach than via posterior approach: five-year-average follow-up results.Open Orthop J.2015;9:157-62. doi:10.2174/1874325001509010157Barnsley 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:10.1177/2151458515584640Indiana University Health.Precautions for total hip replacement patients only.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. doi:10.5435/JAAOS-D-15-00044
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Tsukada S, Wakui M.Lower dislocation rate following total hip arthroplasty via direct anterior approach than via posterior approach: five-year-average follow-up results.Open Orthop J.2015;9:157-62. doi:10.2174/1874325001509010157Barnsley 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:10.1177/2151458515584640Indiana University Health.Precautions for total hip replacement patients only.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. doi:10.5435/JAAOS-D-15-00044
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Tsukada S, Wakui M.Lower dislocation rate following total hip arthroplasty via direct anterior approach than via posterior approach: five-year-average follow-up results.Open Orthop J.2015;9:157-62. doi:10.2174/1874325001509010157Barnsley 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:10.1177/2151458515584640Indiana University Health.Precautions for total hip replacement patients only.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. doi:10.5435/JAAOS-D-15-00044
Tsukada S, Wakui M.Lower dislocation rate following total hip arthroplasty via direct anterior approach than via posterior approach: five-year-average follow-up results.Open Orthop J.2015;9:157-62. doi:10.2174/1874325001509010157
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
Indiana University Health.Precautions for total hip replacement patients only.
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. doi:10.5435/JAAOS-D-15-00044
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