Approach: anterior, cementless fixation, unless otherwise indicated.
Weight bearing status:
- Most hip replacements are weight bearing as tolerated, unless otherwise indicated. Progression to cane and then to unassisted ambulation at therapist’s discretion.
Exercises:
- Active/Active Assisted/Passive range of motion: yes, avoid hip extension behind torso, and external rotation of hip beyond 45 degrees.
- Hip abduction: yes, to 45 degrees.
- Isometric: yes, hip abductors, quadriceps, and hamstrings.
- Resistive: yes, beginning at 2 weeks. 15 pound weight limit, work on hip abductors, quadriceps, and hamstrings.
- Stationary Bike: yes.
- Prone lying to promote hip flexion: as indicated.
- Standing hip range of motion activities: yes.
Additional information:
- Rolling: as tolerated to operative and non-operative side.
- Pillow between legs: as indicated.
- Shower: OK to wash incision at 2 weeks, no tub or pool until 6 weeks.
- Pool therapy: OK to begin at 6 – 8 weeks.
- E-stim: yes, at 3 – 4 weeks, as needed.
- Scar massage and desensitization: yes, beginning at 4 weeks.
- Anterior hip precautions: apply for 3 months from surgery.
- No abduction pillow.
Recreational activities:
- Swimming: 6 – 8 weeks, provided scab is gone and scar has developed.
- Golf: 3 – 4 weeks (chip/putt/short irons), 6 – 8 weeks (long irons/woods).
- Bicycling: 8 weeks.
- Bowling: 12 weeks.
- Driving: 3 – 4 weeks, discuss in clinic.
Total Hip Replacement Therapy Guidelines
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