After a total hip replacement, the surgeon's job is over, but the patient's work is just beginning. Man-made hip joints are smaller than natural joints, so hip dislocation is always a concern, notes physical therapist Sarah B. Briley, adding that careful observance of certain precautions is critical to proper healing. These precaution should be observed from six to 12 weeks after surgery, depending on surgeon recommendations and surgery type.
No Hip Flexion Beyond 90 Degrees
Perhaps the toughest precaution to follow, no hip flexion beyond 90 degrees, affects nearly every movement people make. The California Pacific Medical Center's patient guide to hip replacement illustrates how everyday activities such as sitting and dressing are affected by this precaution because it prevents people from reaching their feet. Special care must be taken so that the knee never rises above the hip when sitting or getting in and out bed. Rehabilitation professionals can provide education on assistive devices that help with dressing and other activities of daily living.
Avoid Hip Internal Rotation
No internal rotation means the patient should not allow the toes of the affected leg to rotate inward toward the other leg. Briley says that physical therapists often advise using the toes and the knee as checkpoints because some people have naturally internally rotated feet, sometimes called "pigeon-toed."
Avoid Hip Adduction
Patients should not cross the affected leg over the other leg. When the legs are crossed, the bones of the lower leg, the tibia and fibula, move over the other leg, forcing the head of the femur, the bone of the upper leg, to move in the opposite direction, thus promoting hip dislocation. Briley cites that this precaution is often neglected because so many people have the habit of crossing their legs and find it a more comfortable position.
References
- Sarah B. Briley, P.T.; Regional Rehabilitation Center; Greenville, North Carolina
- California Pacific Medical Center: Learning About Your Health: Total Hip Replacement: Caring for Yourself at Home
