After having a total hip replacement there are strict precautions that must be followed to prevent dislocating the hip. Prior to surgery your surgeon may have discussed these with you but for the most part they’ll not come into discussion until you have either gone through a joint replacement pre-operative class, or have begun your physical therapy.
There are 3 cardinal rules that are followed in rehabilitation of your total hip replacement.
1. Don’t cross your legs.
2. Don’t bend at the hips past ninety degrees
3. Don’t turn your affected foot inward or internally rotate your hip.
There may be several others that are mentioned during your rehabilitation, but these are the 3 main precautions that will always be discussed. These precautions are generally followed for the first 6 weeks after surgery however, you want to discuss that with your orthopedic surgeon as they may have you follow these precautions longer.
Another beneficial thing close to this field of study. By following the above precautions you can be assured that you’re reducing the chances of a dislocation. When sitting be sure that you also are sitting in a chair that doesn’t rock or move in any way. Be sure that the seat height doesn’t allow you to sink deep enough that your knees rest or in other words are higher then your hips. If you find your knees higher then your hips you’re breaking the ninety degree plain.
Don’t cross your legs when you’re sitting. This something that’s easy to do. Now in my estimation the leg you want to avoid crossing is the leg and hip that were operated on. Nursing or doctors will tell you to avoid crossing either leg due to the possibility of compromising blood circulation in your lower extremities however and this is a good rule to follow. If you cross the leg and hip that were operated on then dislocation is possible. Crossing the strong leg over the operated leg won’t result in dislocation.
Avoid turning your operated leg inward to where your foot is turned inward as well. By internally turning your foot this movement is generated at the hip causing the possibility of dislocation. This is easily done when you’re walking for instance and when turning while using a walker or cane, you pivot on the affected leg instead of picking it up. When you pivot on the affected leg you’ll in turn internally rotate the hip possibility causing the head if the femur to jump out of the socket.
Now for the most part I’ve found it takes 2 of the 3 precautions to be broken at once before dislocation will take place but this is not a hard fast rule either. This will depend on the integrity of the surrounding soft tissue around the hip and the type of hip prosthesis used.
The first 6 weeks of your rehabilitation will be vital to strengthen the surrounding muscles, tendons, and ligaments so that they’ll do their job in supporting the hip joint and locking in the prosthesis.
There are roughly 250,000 or more hip replacements done a year in the US, the dislocation rate is somewhere between 1-3%. Dislocation is something not to be fearful of but to respect during the rehabilitation process.
Check with your surgeon for the exact time frame to follow the precautions then once that time has expired and the hip sufficiently healed, you’ll be back to living the life you expected and deserve pain free at last.
Richard Haynes Punta Gorda, Florida
Richard Haynes is a Physical Therapist Assistant and Certified Personal Trainer and Fitness Consultant living in Punta Gorda, Florida. Owner of Total Joint Fitness he specializes in treating patients and clients that have had either a total joint replacement or other orthopedic injury. All questions are welcomed regarding joint replacement or fracture rehabilitation along with older adult fitness after injury. His websites are http://www.totaljointfitness.com and http://www.richardhaynes.com
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