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Aaron WeyMD, FAAOS, FACSAdult and Pediatric Spine Surgery
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Hip · Post-op rehabilitation protocol

Total Hip Arthroplasty Precautions

Patient handout for the weeks after hip replacement: what to avoid, what to do, permanent precautions, and when sports can resume.

This is the rehabilitation plan I ask your physical therapist to follow after this operation. Bring it to your first therapy visit. It is a framework, not a prescription: your therapist adjusts the pace to how you are healing, and anything we discussed in the office takes precedence over what is printed here. If something on this page does not match what we talked about, ask me.

Physical therapist: please send progress notes to the office at (201) 836-1663 and call with any question about the plan.

Precautions for up to 6–8 weeks after surgery

Do not

  • Sit in low, soft furniture because your hip will flex too much.
  • Go on prolonged car rides – do stop frequently and stretch.
  • Do not drive until cleared with your physician (usually 6 weeks post-op).
  • Pivot on your operated leg.
  • Sit too long (> ½ hour) and become overly fatigued.
  • Take chances – be careful on uneven or wet ground.
  • Squat, cross your legs or ankles – be careful when picking up objects and bending at the waist.

Do

  • Sleep on your back for 6 weeks with a pillow between your legs.
  • Use a walker or crutches bearing the amount of weight as instructed.
  • Use a raised toilet seat, reacher and shower seat.
  • Use TED hose for 6 weeks. If calf pain or swelling occurs, see your physician.
  • Sit on a stool to garden and use a long handled tool.
  • Keep housework light – no heavy lifting.
  • Take frequent, short walks and get adequate rest.
  • Continue your exercise program as directed by your physical therapist.
  • Maintain a balanced diet to avoid weight gain.

If you travel by air, tell the security guards that you had a hip replacement – you may set off the metal detectors. Pick up an "Implant Card" from the Orthopedic Clinic.

Permanent precautions

  • Avoid squatting.
  • Carry loads (such as briefcase, groceries, etc.) on side of operation.
  • Use caution when bending at the waist to pick up objects.
  • Do not play sports that involve repetitive jumping and acceleration/deceleration such as basketball, racquetball, and singles tennis. Walking, swimming, and bicycle riding are better.
  • Extended running is not advisable because of the stress on the implant-bone interface.
  • Repeated climbing or horseback riding may be harmful.

Sports after hip replacement

Sports not contraindicated

Sport Start Return to previous level
Swimming Pool aquatic activity at 6 weeks if wound healed 1 year
Bowling 3 months 6 months
Golfing Chipping and putting – 3 months; Driving – 6 months Ok to start at 6 months; Full activity at 1 year
Tennis Doubles 6 months 1 year
Snow Skiing Greens/Blues 6 months 1 year
Horseback Riding 3–6 months if experienced 1 year
Bicycling Stationary (at home) – 2 months; Outdoor – 3 months 1 year

Sports / activities not recommended

  • Jogging / Running / Jumping
  • Basketball / Football / Baseball / Soccer / Volleyball
  • Waterskiing

Abbreviations

AROM / AAROM / PROM: active / active-assisted / passive range of motion. ROM: range of motion. ER / IR: external / internal rotation. ABD / ADD: abduction / adduction. FLEX / EXT: flexion / extension. WBAT / PWB / TTWB / NWB: weight bearing as tolerated / partial / toe-touch / non-weight bearing. SLR: straight leg raise. HS: hamstrings. ITB: iliotibial band. UE / LE: upper / lower extremity. UBE: upper body ergometer (arm bike). BAPS: balance board. BFR: blood flow restriction training. PREs: progressive resistance exercises. D/C: discontinue. prn: as needed. POD: post-operative day. TENS: transcutaneous electrical nerve stimulation. ADLs: activities of daily living.

Source

Adapted from William Beaumont Army Medical Center, Physical Therapy Section, "THA precautions WB08", Revised August 2008, published by William Beaumont Army Medical Center (a work of the U.S. Government in the public domain). Original: THA precautions WB08.pdf.

This protocol is general guidance for the rehabilitation team and does not replace the specific plan, restrictions and follow-up we set together. Your own situation may differ: if anything here does not match what we talked about, what we talked about wins, so please ask me.