Hip replacements are the second most common joint replacement surgery that I see in the clinic.
This is known to be the replacement surgery that is the easiest to rehab from. This is because the hip is a more stable joint due to the bony structures. In my experience, patients are usually better within 8 weeks of the anterior approach and 10-12 weeks with the posterior.
Types of Replacements
Anterior approach: the incision is made on the front of the thigh. This approach is less invasive because less muscles and soft tissue structures are cut during the surgery.
Posterior approach: incision is made in the back, gluteal region. This approach does take a little longer to heal from, however sometimes this is the best option for the amount of damage done prior to surgery.
Find out more about these techniques here.
Precautions
The posterior approach has universal precautions, which are motions the patient should not complete in the first 6-8 weeks following surgery:
- No bending the hip more than 90 degrees
- No bringing the leg across the other leg.
- No internal rotation of the hip.
These precautions are there because the combination of these motions is how the hip dislocates! So, stay away as much as possible.
With the anterior approach, there are no universal precautions because of the less cutting to tissues.
Exercises at Week 1-2
- Mini Squats
- SLR
- 3 way hip
- Bike or Nustep
- heel raises
Manual therapy during this time will include Passive Range of Motion of the hip. We may also start gait training with a cane instead of a walker.
Exercises at Week 2-6
Continue with the previous exercises and add:
- Bike
- Sit to stand
- step ups
- bridges
- clamshells
Manual therapy will include Passive Range of Motion again and increased stretching of the muscles surrounding the hip.
Exercises Week 6 and Beyond
At this point exercises will include further strengthening activities and focusing on any other activities that the patient cannot complete. Most of the time working on gait is the most important for the patient.
- Lunges
- Hip hiking
- heel taps
- other strengthening of the quads, hamstrings, and gluts
Hip replacements are the second most common joint replacement surgery that I see in the clinic and are easier to rehabilitate than a knee or shoulder.
Like with any type of surgery, please do not compare yourself to other people. Work at your own pace and towards your own goals.
Also, if you are on the fence about getting a hip replacement, try exercising regularly first. Sometimes, exercises and the right kind of exercises can help reduce pain and put off a surgery. Check out my blog post about exercises for Osteoarthritis here.