Physiotherapy for Hip Replacement
Hip replacement or hip arthroplasty is a treatment for end state arthritis of the hip. There are approximately 53,000 hip replacement operations performed in Canada every year. Physiotherapy following hip replacement is important to optimize mobility, range of motion, strength, and endurance.
Objectives of Physiotherapy for Hip Replacements
In the early postoperative period, patients are asked to follow ‘hip precautions’. These involve avoiding bending the hip more than 90 degrees, rotating the leg in or out excessively and crossing one’s legs. The objective of these guidelines is to avoid dislocating the hip. For patients who have had a lateral approach to the hip, active abduction of the hip is also avoided for six weeks in order to protect the repair of the abductor tendons. Further, principles of early rehabilitation include progressing with transfers (i.e. bed to chair), as well as, ambulation with the use of walking aids such a cane or walker. Isometric strengthening of the core muscles is also initiated and the selection of exercises advances according to one’s progress.
After the first six week, patients are encouraged to ambulate further without aids. Hip precautions are lifted and core and lower extremity strengthening is also progressed. Return to most advanced daily activities and leisure activities commences after 3 months post-operatively.
Common Reason that Patients Require a Hip Replacement
After a failure of routine non-operative care, patients commonly undergo a hip replacement for the following conditions:
- End-stage primary osteoarthritis
- Avascular necrosis
- Post-traumatic osteoarthritis
- Rheumatoid arthritis
- Other causes of inflammatory arthritis
For more information, please see our video related to hip replacement surgery, where Dr. Jas Chahal outlines symptoms experienced by patients with osteoarthritis, as well as, some of the technical details involved with this surgery.