Hip replacement surgery is a complex procedure. However, the outcomes following hip replacement are usually very successful. One of the important critical success factors for a successful outcome is following the physical rehabilitation process. In order to help achieve the goals for a successful total hip replacement, you must actively participate in the rehab process and work diligently on your own, as well as the physical therapists, to achieve optimal results.

Early Rehabilitation
Your recovery program begins immediately after surgery. The rehabilitation team will work together to provide the care and encouragement needed during the first few days after surgery.

You may be given a device called an incentive spirometer into which you inhale and exhale. It measures your lung capacity and assists you in taking deep breaths. These exercises reduce the collection of fluid in the lungs after surgery, preventing the risk of pneumonia. Coughing is an effective tool for loosening any congestion that may build in the lungs following surgery.

Your physical therapist will teach you some simple exercises to be done in bed that will strengthen the muscles in the hip and lower extremity. These exercises may include:

• Gluteal sets: Tighten and relax the buttock muscles.
• Quadricep sets: Tighten and relax the thigh muscles.
• Ankle pumps: Flex and extend the ankles.

The therapist will also teach you proper techniques to perform such simple tasks as:

• Moving up and down in bed.
• Going from lying to sitting.
• Going from sitting to standing.
• Going from standing to sitting.
• Going from sitting to lying.

Although these are simple activities, you must learn to do them safely so that the hip does not dislocate or suffer other injury.

Another important goal for early physical therapy is for you to learn to walk safely with an appropriate assistive device (usually a walker or crutches). Your surgeon will determine how much weight you can bear on your new hip, and your therapist will teach you the proper techniques for walking on level surfaces and stairs with the assistive device. Improper use of the assistive device raises the chance for accident or injury.

You will be instructed in hip precautions which are designed to protect your new hip during the first 8-12 weeks following surgery.

Precautions

• Do not bend forward to reach your feet. You must maintain a 90 degree angle between your torso and legs.
• Do not lift your knee higher than your hip on the operated side.
• Do not cross your legs.
• Do not allow your legs to internally rotate (feet turned in).
• Do not twist while lying or standing.
• Sleep on your back with a pillow between your knees to prevent crossing.
• Strictly observe your weight bearing precautions during standing or walking.

Various long-handled devices for activities of daily living are helpful. These devices may include the following:

• A reacher to dress and pick things up from the floor.
• A sock-aid that will assist in putting on socks.
• A long-handled sponge to wash your legs and feet.
• A leg-lifting device to move the operated leg in and out of the car or bed.
• An elevated toilet seat so that you don’t violate your hip precautions when using the bathroom.
• An elevated bathtub chair to fit in the shower or tub.

The precautions following a total hip replacement must be strictly adhered to in order to prevent dislocation of the hip implant and the possibility of re-operation.