Hip replacement surgery is a common and effective procedure that can dramatically improve a patient’s quality of life by reducing pain and restoring function. The success and long-term health of the new joint depend heavily on adhering to specific activity restrictions and precautions, both in the initial recovery phase and for many years afterward.
Early Post-Surgery Limitations
In the weeks following hip replacement surgery, strict limitations on hip movement are in place to allow for healing and prevent complications. Patients are advised to avoid bending the operated hip past 90 degrees, such as deep squatting or reaching for objects on the floor. Movements such as internal rotation (turning the toes inward) and crossing the legs at the knees or ankles are also restricted. These specific motions can put undue stress on the surgical site and increase the risk of the new joint dislocating.
Weight-bearing restrictions can vary, but many patients are encouraged to begin walking with assistance soon after surgery to promote circulation and healing. Driving is typically prohibited for several weeks, particularly if the right hip was operated on, as the ability to safely control pedals may be impaired. Lifting heavy objects is restricted; patients are advised to lift no more than 5 to 10 pounds in the initial recovery period.
Specific sleeping positions are recommended to maintain hip alignment and prevent twisting. Patients are advised to sleep on their back with a pillow between their legs or on their non-operated side with two pillows between the legs. Avoiding sleeping on the stomach is recommended. When sitting, use chairs with armrests and avoid low seating, ensuring hips remain higher than knees. Techniques for getting in and out of bed or chairs are taught to prevent excessive hip flexion or twisting.
Ongoing Activity Adjustments
Beyond the initial recovery phase, certain activities require long-term adjustment or avoidance to protect the hip replacement and extend its lifespan. High-impact activities that place repetitive stress on the joint are discouraged. This includes running, jumping, contact sports like football or basketball, and aggressive aerobics, as these can accelerate wear and tear on the prosthetic components and increase the risk for revision surgery.
Recreational activities such as downhill skiing, horseback riding, or gardening that involves deep squats also require caution. Moderate activities like walking, swimming, and cycling are encouraged, but specific movements may need modification. For example, using a stationary bike can help maintain muscle tone and hip flexibility.
Resuming sexual activity is safe once discomfort subsides, but patients should avoid positions involving extreme hip bending, crossing the legs, or internal rotation. Using pillows for support can help maintain hip alignment. Preventing falls is an ongoing precaution, as a fall could cause significant damage or dislocation. This involves removing household hazards and using assistive devices. While early lifting restrictions ease, avoid repetitive heavy lifting long-term to prevent excessive strain on the joint.
Understanding the Need for Precautions
These precautions are necessary to safeguard the newly implanted hip joint and maximize its functional life. A primary concern is preventing hip dislocation, which occurs when the prosthetic joint comes out of its socket. The risk of dislocation is highest in the first few months after surgery while the surrounding tissues heal, though it can occur later. Movements that involve extreme hip flexion, adduction, or rotation can cause dislocation. While surgical approach and implant design influence dislocation risk, patient adherence to precautions contributes to stability.
Beyond dislocation, adhering to restrictions helps ensure the longevity of the implant. Artificial hip components are subject to wear over time. High-impact activities and excessive mechanical stress can accelerate this wear, potentially leading to the need for revision surgery. Most hip implants are designed to last 15 to 25 years, but this can be influenced by activity levels and body weight.
Physical therapy plays a fundamental role in reinforcing safe movement patterns and strengthening the muscles supporting the hip. Therapists guide patients through exercises that improve mobility, balance, and strength while teaching techniques to avoid movements that could compromise the joint. This structured rehabilitation helps patients regain function and confidence, contributing to the long-term health and stability of the hip replacement.