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Hip arthroplasty - precautions; Hip replacement - precautions

What to Expect at Home

After you have hip replacement surgery, you will need to be careful how you move your hip, especially for the first few months after surgery. In time, you should be able to return to your previous level of activity. But even when you do your everyday activities, you will need to move carefully so that you do not dislocate your hip.

You will need to learn exercises make your new hip stronger.

After you fully recover from surgery, you should not downhill ski or do contact sports, such as football and soccer. You should be able to do low impact activities, such as hiking, gardening, swimming, playing tennis, and golfing.

Self-care

Some general rules for any activity you do are:

  • Do not cross your legs or ankles when you are sitting, standing, or lying down.
  • Do not bend too far forward from your waist or pull your leg up past your waist. This bending is called hip flexion. Avoid hip flexion greater than 90 degrees (a right angle).

When you are getting dressed:

  • Do not dress standing up. Sit on a chair or the edge of your bed, if it is stable.
  • Do not bend over, raise your legs, or cross your legs while you are dressing.
  • Use helpful devices so that you do not bend too much. Use a reacher, a long-handled shoehorn, elastic shoe laces, and an aid to help you put on your socks.
  • When you are getting dressed, first put pants, socks or pantyhose on the leg that had surgery.
  • When you undress, remove clothes from your surgery side last.

When you are sitting:

  • Try not to sit in the same position for more than 30 to 40 minutes at a time
  • Keep your feet about 6 inches apart. Do not bring them all the way together.
  • Keep your feet and knees pointed straight ahead, not turned in or out.
  • Sit in a firm chair with a straight back and armrests. Avoid soft chairs, rocking chairs, stools, or sofas.
  • Avoid chairs that are too low. Your hips should be higher than your knees when you are sitting. Sit on a pillow if you have to.
  • When getting up from a chair, slide toward the edge of the chair, and use the arms of the chair or your walker or crutches for support.
  • Do not cross your legs.

When you are bathing or showering:

  • You may stand in the shower if you like. You can also use a special tub seat or a stable plastic chair for sitting in the shower.
  • Use a rubber mat on the tub or shower floor. Be sure to keep the bathroom floor dry and clean.
  • Do not bend, squat, or reach for anything while you are showering. Use a shower sponge with a long handle for washing. Have someone change the shower controls for you if they are hard to reach. Have someone wash the parts of your body that are hard for you to reach.
  • Do NOT sit down in the bottom of a regular bathtub. It will be too hard to get up safely.
  • Use an elevated toilet seat to keep your knees lower than your hips when you are using the toilet, if you need one.

When you are using stairs:

  • When you are going up, step first with your leg on the side that did not have surgery.
  • When you are going down, step first with your leg on the side that had surgery.

When you are lying in bed:

  • Do not sleep on the side of your new hip or on your stomach. If you are sleeping on your other side, place a pillow between your thighs.
  • A special abductor pillow or splint may be used to keep your hip in the proper alignment.

When you are getting into or riding in a car:

  • Get into the car from street level, not from a curb or doorstep.
  • Car seats should not be too low. Sit on a pillow if you need to. Before you get into a car, make sure you can slide easily on the seat material.
  • Break up long car rides. Stop, get out, and walk about every 2 hours.

Do NOT drive until your doctor says it is okay.

When you are walking:

  • Use your crutches or walker until your doctor tells you it is okay to stop using them.
  • Put only the amount of weight your doctor or physical therapist told you was okay to put on your hip that had surgery.
  • Take small steps when you are turning. Try not to pivot.
  • Wear shoes with nonskid soles. Avoid wearing slipplers as they can make you fall. Go slowly when you are walking on wet surfaces or uneven ground.
References

Minns Lowe CJ, Barker KL, Dewey ME, Sackley CM. Effectiveness of physiotherapy exercise following hip arthroplasty for osteoarthritis: a systematic review of clinical trials. BMC Musculoskelet Disord. 2009 Aug 4;10:98.

Ververeli PA, Lebby EB, Tyler C, Fouad C. Evaluation of reducing postoperative hip precautions in total hip replacement: a randomized prospective study. Orthopedics. 2009 Dec;32(12):889-93.

Reviewed By

Review Date: 12/20/2010

C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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Q: Taking care of your new hip joint?
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