Total Hip Replacement

A total hip replacement can be life-changing, offering relief from pain and restoring mobility. However, the journey doesn’t end with surgery. A structured rehabilitation program is essential for regaining strength, function, and confidence in movement.

Understanding Surgical Approaches: Anterior vs. Posterior

Surgeons typically use one of two main approaches for hip replacement

Anterior Approach:

The incision is made at the front of the hip, allowing access to the joint without cutting through major muscles. This often leads to a faster recovery and fewer post-operative restrictions.

Posterior Approach:

The incision is placed at the back of the hip. While this is a more traditional method, it requires precautions to prevent dislocation during recovery due to the involvement of muscles that stabilize the hip.

Immediate Post-Surgical Symptoms

It’s normal to experience a range of symptoms right after surgery, including:

• Pain and swelling around the surgical site
• Loss of range of motion and joint stiffness
• Difficulty walking, standing, or getting up from a chair
• Generalized weakness and fatigue
• Limited ability to perform daily activities.

Understanding these challenges can help set realistic expectations for recovery and highlight the importance of a structured rehabilitation plan.

Post-Operative Precautions:

To protect the new hip and prevent complications, patients must follow specific precautions depending on the surgical approach:

For Posterior Approach Patients:

• Avoid bending the hip beyond 90 degrees (no deep bending or low chairs).
• No crossing legs or twisting the hip inward.
• Sleep with a pillow between the knees to prevent inward rotation.

For Anterior Approach Patients:

• Avoid extending the leg too far behind the body
• No excessive external rotation of the hip
• Be mindful of sudden, forceful movements

Physical Therapy for Return to Function
Rehabilitation focuses on gradually restoring mobility, strength, and balance. A skilled physical therapist will guide you through different treatment approaches tailored to your recovery stage.

Early Rehabilitation (Weeks 1-4)

• Pain Management & Swelling Control: Gentle movements, ice therapy, and elevation to reduce inflammation.
• Gait Training: Learning to walk with an assistive device to prevent compensation patterns.
• Gentle Range of Motion Exercises: Early mobility exercises help prevent stiffness while staying within post-surgical precautions.

Strength & Functional Training (Weeks 4-8):

• Lower Body Strengthening: Targeting key muscle groups like the glutes, quadriceps, and core to support the hip joint.
• Balance & Stability Exercises: Improving single-leg stance and weight-shifting to restore confidence in movement.
• Functional Mobility Training: Practicing sit-to-stand transitions, stair climbing, and getting in and out of bed safely.

Advanced Recovery (Weeks 8-12+):

• Gait Training Progression: Weaning off assistive devices and improving walking mechanics.
• Higher-Level Strength Training: Resistance exercises to enhance endurance and prevent future injuries.
• Return to Daily Activities & Hobbies: Customized exercises to help patients return to gardening, golfing, or other personal goals.