| Every year, nearly 200,000 Americans undergo hip | | | | of this equipment along with equipment to aid you in |
| replacement surgery, mostly due to arthritis. The | | | | putting on your socks, shoes, and pants. |
| vast majority of those surgeries are done with the | | | | If you have low chairs at home, use pillows to add |
| traditional method, using a posterior or lateral (side) | | | | height. Chairs with arm rests make it easier to sit |
| approach to gain access to the hip joint. With the | | | | down and stand up. Don't sit on a low couch. The top |
| traditional lateral method, the chance of dislocating | | | | of your bed mattress should be 27" from the floor. |
| your new hip is greater than with the minimally | | | | Getting on and off your toilet seat can be difficult |
| invasive anterior approach. | | | | and hazardous if it's too low. While in the hospital, |
| Hip dislocation after hip replacement surgery rarely | | | | you'll be using a raised toilet seat. You'll also need one |
| occurs, but to reduce the risk even further it's | | | | at home until your hip has healed. Your therapist or |
| essential to strictly follow your hip precautions | | | | case manager will order one for home use before |
| (restrictions of certain hip positions/movements) | | | | you get discharged from the hospital. |
| taught to you by your physical/occupational | | | | If you dislocate your hip, call 911. You want to get to |
| therapists. Your new hip needs time to heal in place, | | | | the hospital as quickly as possible so your surgeon |
| particularly during the first 6 weeks following surgery. | | | | can put your hip back in place. This may require |
| During this period, your hip muscles and bones are | | | | another surgery and rehab. If your surgeon is |
| healing up around your new hip joint to keep it | | | | concerned about another dislocation, he can fit you |
| securely in place. | | | | with a hip brace. Once the hip completely heals, the |
| There are usually three main total hip precautions. 1) | | | | brace may no longer be needed. |
| Don't turn your toes inward, 2) don't cross your legs, | | | | After your hip replacement, your doctor will let you |
| 3) and don't bend your new hip more than 60-90 | | | | know how much weight you can safely place on |
| degrees. Your surgeon will also instruct you on how | | | | your leg while walking. This is known as your "weight |
| much weight he wants you to place on your surgery | | | | bearing status". It should be strictly followed, as |
| leg while walking. | | | | putting too much weight on the leg can damage your |
| 1) Don't turn your toes inward. Where your toes go, | | | | new hip. Your doctor will allow you to increase your |
| your hip follows. If you turn your toes in on your | | | | weight bearing as the hip heals. The following are |
| surgery leg (pigeon-toed), your hip will internally | | | | some common "Weight bearing" terms: |
| rotate. This motion can pop your hip out of its new | | | | - non-weight bearing- no weight at all on the leg |
| joint. Internal rotation can also occur while standing in | | | | - toe touch or toe down weight bearing- only your |
| place and twisting toward the direction of your new | | | | toes touch the floor, usually about 10% of your |
| hip. Let's say your right hip was just replaced. If you | | | | weight through your surgery leg |
| reach across your body with your left arm, maybe | | | | - partial weight bearing- toes and front part of your |
| to answer the telephone or lay an object down on | | | | foot down, about 25-50% of your weight through |
| the table, you're at risk of dislocating your new hip | | | | your surgery leg |
| due to internal rotation. | | | | - weight bearing as tolerated- you're allowed to put |
| 2) Don't cross your legs. Moving your surgery leg | | | | as much weight on your surgery leg as your pain |
| across your body's midline can cause your new hip to | | | | level allows, heel down when walking/standing (heel |
| dislocate. This includes sitting in a chair with your | | | | toe gait pattern) |
| ankles crossed or reclining in bed with your legs | | | | - full weight bearing- no weight bearing restrictions, |
| crossed. | | | | heel down when walking/standing (heel/toe gait |
| 3) Don't bend your hip beyond a 60-90 degree angle. | | | | pattern) |
| The best way to know if you're complying with this | | | | Your surgeon will discuss your hip precautions with |
| precaution is to take a look at your surgery leg when | | | | you before and after your surgery. Your physical |
| you're sitting down. Your knee should be lower than | | | | therapist will teach you how to safely get in/out of |
| your hip. If your knee and hip are level with each | | | | bed, transfer, walk, sit, climb stairs, and get in/out of |
| other, your hip is at a 90 degree angle. The closer | | | | your car while maintaining your hip precautions. Your |
| you move your knee to your chest, the greater your | | | | occupational therapist plays a similarly important role |
| risk of dislocating your new hip. And reaching down | | | | in your rehab. As well as teaching you how to safely |
| toward your shoes or the floor also creates this | | | | dress, the occupational therapist will also train you in |
| same risk of dislocation. One way to reduce the | | | | bed mobility, walking, and safe toilet and shower/tub |
| chance of hip dislocation is to straighten your leg out | | | | transfers. Following your hip precautions in the |
| in front of you when you're sitting. This reduces the | | | | hospital and at home is an important part of your |
| bend of your hip. | | | | rehab and will greatly reduce your risk of hip |
| While you're in a standing position, don't bend down | | | | dislocation. |
| to retrieve something from the floor or a low | | | | Some of the above information may vary from |
| cupboard. There are devices, called "reachers", that | | | | patient to patient. Your doctor and physical |
| aid you in picking things up from the floor or getting | | | | occupational therapists will instruct you in all total hip |
| objects from high cupboard shelves. Your | | | | replacement precautions. |
| occupational therapist will train you in the proper use | | | | |