Precautions for first 6 weeks
- NO hip flexion >70°
- NO hip abduction >neutral
- NO hip internal rotation
- Weight bearing as tolerated with assistive device
- NO sitting for long periods of time
- Use toilet with raised seat for 3 months
- Use abduction wedge while sleeping or resting, up to 12 hrs
- Transfer to sound side Hip rotation should be limited:
- AVOID excessive IR and FLEX >70°
1-4 weeks – Immediate Post-op/ Maximum Protection Phase
- Hip FLEX to 70°
- Gait training (WBAT)
- Increase hip ABD
- Strengthening hip extensors
- Isometric exercises in pain-free range (low intensity)
- Gentle massage
Home Exercise Program (post-op)
- Glute sets
- Hip abduction, lying on back
- Ankle dorsiflexion, ankle pumps
- Heel slides Quad sets
- Short arc quad sets
- Hamstring sets, digging heel in
- Straight leg raise
- Hip adduction with roll between legs, squeezing
4-5 weeks – Moderate Protection Phase:
- Weight bearing restrictions as per M.D. Progress
- AROM gradually and in protected range
- NO hip FLEX >90°
- ADD to neutral
- Open and closed chain exercises can begin
- Promote hip extension, by lying in prone if possible, to prevent a hip FLEX contracture
- 90° hip FLEX allowed
- May begin theraband strengthening
6+ Weeks – Minimum Protection Phase
- Increase hip EXT and ABD strength for ambulation
- PRE with light weight and high repititions, no stress ER
- Bicycling to increase muscular endurance and general conditioning
- Transition to cane, if necessary
- Begin stretching and strengthening the glutes
- AVIOD high-impact exercises
*Be cautious long term for combined motions of hip flexion, internal rotation, and adduction*
References:
Brotzman SB, Wilk KE. Clinical Orthopaedic Rehabilitation. 2nd ed. Philadelphia, PA: The Curtis Center; 2003.
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