A total hip replacement (THR) is a common procedure that relieves pain and restores mobility. Success relies heavily on protecting the new joint during initial recovery. This involves strict adherence to safety precautions concerning movement and environmental setup. Among the most important home modifications is ensuring the bed and surrounding bedroom environment are configured to prevent movements that could compromise the healing hip. Getting in and out of bed requires careful attention to joint positioning.
Why Specific Bed Height is Essential for Recovery
The requirement for specific bed height is rooted in Hip Precautions. These are temporary restrictions on movement designed to reduce the risk of the new joint dislocating. The primary concern is avoiding excessive hip flexion, which is the bending of the hip joint that occurs when the knee is brought toward the chest.
A low bed forces the hip to bend past a 90-degree angle when the patient sits down or stands up. This deep angle significantly increases stress on the joint capsule and surrounding tissues. This is particularly relevant for patients who have undergone a posterior or posterolateral surgical approach, as these techniques temporarily weaken the structures at the back of the hip. Dislocation, a painful complication, occurs when the ball component of the artificial joint pops out of the socket.
Maintaining a safe bed height ensures that the angle between the torso and the thigh remains greater than 90 degrees during the transfer. This minimizes the risk of dislocation while also making the transition from sitting to standing easier and safer. The correct height promotes a stable position that requires less effort and muscle strain from the recovering patient.
Calculating and Achieving the Optimal Bed Height
The ideal height for the sleeping surface is customized to the patient’s body size. The proper height is achieved when the patient is sitting on the edge of the mattress with their feet flat on the floor and their knees level with or slightly below their hips. This position ensures the hip joint does not flex beyond the safe 90-degree angle, allowing the knees to be positioned lower than the hips when seated.
To determine the measurement, the patient should stand next to the bed with their mobility aid. The correct height is approximately the distance from the floor to the crease behind the knee, plus one or two inches. This measurement should be taken while the patient is wearing the shoes they will use at home, and checked while seated on the mattress to account for compression.
If the existing bed is too low, several methods can be used to temporarily raise the height. Simple, sturdy bed risers, often called “elephant feet,” can be placed under the bedposts. Alternatively, a second box spring, a firm mattress topper, or a rental hospital bed can be used. The raised height must be firm and stable, as any instability could pose a fall risk.
Essential Bedroom Safety Adaptations
Beyond the height of the bed, the entire bedroom environment requires modification to support safe movement. Removing throw rugs, loose cords, and clutter from the walking path prevents tripping hazards. The path from the bed to the bathroom must be clear and wide enough to accommodate the patient’s walker or crutches.
Adequate lighting is necessary, especially for nighttime trips; nightlights are recommended to illuminate the floor. The bedside table should be positioned within easy reach, allowing the patient to access essential items like a phone, water, and medication without twisting or leaning. Any item requiring a deep bend, such as shoes or dropped objects, should be managed with assistive devices.
Assistive Tools
Assistive tools are often required to maintain hip precautions throughout daily activities. These adaptations minimize the need for dangerous movements within the room:
- A long-handled reacher or grabber allows the patient to pick up items from the floor without bending over.
- Sock aids are necessary for putting on socks without excessive bending.
- Long-handled shoehorns assist with putting on shoes.
- An elevated toilet seat or commode is needed in the bathroom to maintain the required hip angle.
Timeline for Resuming Normal Sleeping Arrangements
The period during which hip precautions must be followed is temporary. In most cases, patients adhere to these restrictions for approximately six to twelve weeks after surgery. This timeframe allows sufficient time for the surrounding muscles, tendons, and joint capsule to heal and regain stability.
The duration of precautions varies depending on the surgical approach (anterior versus posterior) and the surgeon’s protocol. An anterior approach often involves fewer restrictions, while a posterior approach requires longer adherence to the 90-degree rule. Clearance to return to a normal bed height and eliminate assistive devices must be explicitly given by the orthopedic surgeon or a physical therapist.
Until medical clearance is granted, maintaining the elevated bed and using all safety adaptations is necessary to ensure the long-term success of the hip replacement. Patients should avoid discontinuing precautions prematurely, as doing so can place the new joint at risk of dislocation. The transition back to normal activities should be gradual and guided by the recovery team.