Restrictions after a Total Hip Replacement & the Logic Behind Them

After having a total hip replacement, your doctor might recommend that you avoid certain movements for the first 6-10 weeks of recovery. These restrictions are given as precautions in order to prevent dislocation of the new joint.
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Restrictions for the posterior/lateral approach include:
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• Avoid flexing the operated hip over 90 degrees.
• Avoid crossing the legs at your knees and ankles.
• Avoid Internally rotating (pivoting on your leg so that your foot points inwards) your operated leg.
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Examples of certain daily activities that are affected by these restrictions include:
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• Bending down to tie shoes.
• Sitting on a low toilet seat.
• Sitting with your legs crossed.

Restrictions for Anterior approach include:

• Avoid active extension at the hip.
• Avoid external rotation (figure 4 position) at the hip.
• In some cases, don’t actively move the operated leg laterally or away from your midline.
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Examples of certain daily activities that are affected by these restrictions include:
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• Don’t lie on your stomach.
• Don't back up by leading with the operated leg.

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These restrictions vary depending on your doctor. Some surgeons give precautions to everyone, and some surgeons only to a few. Sometimes the surgeons want you to adhere to the restrictions for  six weeks and some for ten. It often depends on several factors including the type of implant and the health of the surrounding tissue.

To help you adhere to your restrictions, It is strongly recommended to use a raised toilet seat after the operation and place a pillow between your legs when going to sleep in order to help maintain these precautions. Other helpful equipment is a sock aid and reacher or grabber to pick up light items from the floor.

As long as you follow your doctor's restrictions, you should be safe. The risk of dislocation is small, especially when following the guidelines. Need for revision of your new hip is also low. Statistics show that approximately 2% of patients over 90 years old will require revision, while only 1.2% of patients under 69 will require revision during this time frame.

During recovery, it's recommended to walk and maintain movement throughout the day in order to avoid blood clots and regain strength and control over your new joint. Remember to practice moderation and find the right balance between exercise and rest that works best for you.

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