Hip replacement surgery (total hip arthroplasty) is a common and effective procedure to alleviate pain and restore mobility in the hip joint. Following this operation, careful recovery is necessary to protect the newly implanted joint. A primary goal of rehabilitation is safely regaining independence in daily tasks, including learning how to dress without risking injury. Specific, temporary rules must be followed to prevent the most common complication: dislocation of the new hip joint.
Dressing: Affected Side First
When putting on lower body clothing, such as underwear or pants, you must always dress the affected (surgical) leg first. This instructional technique is designed to minimize the potentially harmful movements of the recovering hip. To begin, sit on a stable surface, such as a chair with arms, and gather your clothing and any adaptive aids nearby.
Use a long-handled reacher or dressing stick to guide the garment’s leg opening over your foot and up the calf of the surgical leg. By inserting the affected leg first, you avoid having to bend excessively or twist the hip. Once the garment is on the affected leg, you can then safely slide your unaffected (non-surgical) leg into the other opening. Pull the clothing up as high as possible while seated, and use your walker or other support to stand before pulling the garment completely over your hips.
Undressing: Unaffected Side First
The process for removing lower body clothing is the exact reverse of dressing; you must undress the unaffected leg first. This technique maintains the protective principle of keeping the surgical hip in a stable, neutral position for as long as possible. When ready to undress, start by lowering the garment as far as you can while standing, using your walker for balance.
Once seated, use a reacher or dressing stick to push the garment down and off the unaffected leg. Removing the clothing from the non-surgical side first allows the surgical leg to remain relatively still and straight. The affected leg is then removed last, minimizing the time and effort needed to maneuver the garment over the foot.
Understanding Movement Restrictions
The reason for the affected-side-first rule is to prevent the hip from moving into positions that could cause the new ball-and-socket joint to dislocate. These specific post-surgical movement limitations are known as hip precautions, and they are dependent on the type of surgical approach used (anterior or posterior). A common precaution, often associated with a posterior approach, is avoiding excessive hip flexion, which means the hip should not bend more than 90 degrees. Bending over to reach the feet to put on socks or pants is a classic way to violate this restriction.
Other precautions include avoiding adduction (crossing the surgical leg past the midline of the body) and internal rotation (turning the toes inward). By putting the garment on the affected leg first, you are moving the limb the least amount necessary, effectively keeping the hip joint within its safe range of motion. These precautions are typically followed for about six weeks, allowing the joint capsule and surrounding soft tissues time to heal securely.
Adaptive Aids for Easier Dressing
Adaptive equipment plays a major role in achieving independent and safe dressing by extending your reach and preventing you from bending past the 90-degree limit. A long-handled reacher (or grabber) is one of the most versatile tools, allowing you to pick up dropped items or manipulate clothing without leaning forward. This aid is especially useful for guiding undergarments and pants down to the feet and then pulling them back up to hip level.
For socks, a sock aid is a simple device that holds the sock open, allowing you to lower it to the floor and slip your foot inside using long straps. A long-handled shoehorn prevents bending over while putting on supportive shoes, which should be slip-on or feature elastic shoelaces. Using these specialized tools, along with choosing loose-fitting, comfortable clothing with elastic waistbands, ensures that you can dress safely and maintain the necessary hip precautions throughout your recovery.