A successful hip replacement surgery alleviates chronic pain and restores mobility. While the procedure corrects the mechanical issue, the long-term success depends significantly on strict adherence to post-operative guidelines. Following these instructions protects the new artificial joint from damage during the initial healing phase. Patients must actively participate in their recovery by avoiding specific movements, activities, and medical oversights to ensure implant stability and prevent complications.
Movement Restrictions That Risk Joint Dislocation
Preventing the new hip joint from popping out of its socket (dislocation) requires avoiding certain physical positions called hip precautions. The specific movements to avoid depend on the surgical technique used, primarily whether the approach was posterior (from the back) or anterior (from the front). The most common restrictions, associated with the posterior approach, revolve around limiting hip flexion.
Patients must not bend their hip past 90 degrees (the angle formed when the thigh is parallel to the ground while sitting). This restriction means avoiding activities like leaning forward to pick up objects, sitting in low chairs or soft sofas, and bending down to tie shoes. Using assistive devices such as long-handled reachers and elevated toilet seats is recommended to maintain this safe angle.
Another restriction is avoiding movements that can lever the ball out of the socket. This includes not crossing the legs at the knees or ankles. The hip should also be protected from internal rotation (twisting the operated leg inward so the toes point toward the midline). When moving, the feet and body should always turn together, preventing twisting or pivoting motion at the hip joint.
If the surgeon used an anterior approach, restrictions may shift to avoiding movements like hip extension (moving the leg backward) and external rotation (turning the toes outward). Regardless of the approach, the goal is to protect the soft tissues, muscles, and joint capsule manipulated during surgery, allowing them time to heal and stabilize the implant. These precautions are typically maintained for six to twelve weeks, depending on the surgeon’s assessment.
Activities to Avoid During Early Rehabilitation
Beyond biomechanical restrictions, several everyday activities must be avoided or modified during early rehabilitation. Driving is one such activity; patients should not get behind the wheel until explicitly cleared by their surgeon. Clearance is typically given after four to eight weeks, once the patient can safely operate the pedals and react quickly without compromising hip precautions.
Avoiding heavy lifting is another restriction, as it places undue strain on the new joint and surrounding muscles. Surgeons advise against lifting anything heavier than 10 pounds (roughly equivalent to a gallon of milk) for the first four to eight weeks. Ignoring this limit can increase the risk of strain, pain, and potentially dislocation.
Patients should also refrain from high-impact activities such as running, jumping, and contact sports, which generate excessive force and lead to premature wear of the artificial joint. Strenuous activities like gardening, pushing a heavy vacuum, or excessive bending should be avoided until approved by the surgeon or physical therapist. Patients must not soak the surgical incision in a bathtub, hot tub, or swimming pool until the wound is completely closed and authorized. Submerging the incision prematurely can introduce bacteria and increase the risk of a deep joint infection.
Medical Symptoms and Errors Never to Ignore
Ensuring a complete recovery requires strict adherence to the medical plan and vigilance for warning signs, not just physical movement restrictions. Patients should never unilaterally stop taking prescribed medications, especially blood thinners (anticoagulants), which prevent blood clots. These clots, known as deep vein thrombosis (DVT), are a serious risk after major orthopedic surgery and can lead to a pulmonary embolism if they travel to the lungs.
Signs of DVT, such as sudden, severe pain, persistent cramping, unusual swelling (often in one leg), or warm or discolored skin, must be reported to a doctor immediately. Patients must also monitor the surgical site for signs of infection, including a persistent high fever, increased redness, warmth, swelling around the wound, or unusual drainage or pus. An infection can compromise the entire joint and may require further surgical intervention.
Skipping physical therapy sessions is a serious error, as the exercises are designed to strengthen the muscles that stabilize the new hip. Compliance with physical therapy is a non-negotiable part of the recovery process that directly impacts long-term mobility and joint function. Any new or severe pain that feels different from expected post-operative soreness should be brought to the surgeon’s attention instead of attempting self-diagnosis.