Surgical Explanations
Rehabilitation Protocols
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Total Hip Replacement
GUIDELINES:
No flexion should exceed 90°
No crossing knees for at least 3 months
Abductor pillow should be used for 3 months
Patient should use an elevated commode seat
When sitting, patients should keep their knees lower than their hips (Use a pillow if necessary)
Patient should avoid sitting in soft couches
Phase 1: Day of Discharge - Day 3
This part of the rehab process is more patient dependent than other rehab programs. However, if any of the following conditions persist, the patient should see the physical therapist:
Abductor weakness
Arthrofibrosis
Severe function limiting pain
GOALS:
Regain reductor and gluteal strength
Regain normal gait
Minimize effective immobility including reducing the chance of DVT and atrophy
Phase 2: Day 4-Day 12
Seated ankle pumps - up to 500 repetitions daily
Quad sets at high repetitions and sub-maximum weight
Strengthen gluteals and hamstrings
Windshield wipers (abduct and adduct the leg)
Begin supine hip flexion
Gait training to teach proper use of walker and/or crutches
Phase 3: Day 12-Day 21
Standing hip flexion (maximum of 90 degrees)
Abduction
Hip extensions while laying prone over a table
Mini-squats and ball squats (0°-45°)
Heel raises
Gait training
Patient should be shown how to ambulate up and down stairs
Patient should be instructed on scar massage
Phase 4: Day 22-Day 42
Flexor and abductor stretching
Flexion contracture
limit on abduction or hip extension
Single-leg balance
Note: Be sure to avoid Trendelenberg lurch
Phase 5: 7-10 Weeks
Thera-BandŽ side-steps and back-walking
One-legged stands against wall with resistance
Patient can begin some cardiovascular work
Patient can ride bike with a high seat
Phase 6: 10-12 Weeks
Patient can begin walking and other aerobic activities
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