Hip Replacement: Post-Operative Physiotherapy Protocol

Written By Bryn Gilbertson

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PHASE I— IMMEDIATE REHABILITATION – Usually 1-2 weeks 

Goals 

  • Protect integrity of repaired tissue 

  • Restore independent mobility

  • Reduce pain and swelling 

Precautions 

  • Crutches for first 1-2 weeks – wean to 1 crutch in OPPOSITE HAND

  • No extension activities beyond neutral extension with extension

  • No crossed legs

Specific Exercises: 

  • Straight line walking

  • Clams or Side leg raises (Abductor strengthening) 

  • Supine abduction in bed 

  • Mini Squats

  • Core stabilisation

  • Calf pumps

PHASE II— INTERMEDIATE REHABILITATION – 2-6 weeks 

Goals 

  • Restore range of motion

  • Restore hip strength

  • Normalise gait without aid (crutches)

Precautions 

  • Avoid active hip extension and external rotation

  • No distance walking – aim 2-4000 steps/day

Specific Exercises 

  • Supine hip abduction

  • Clam shells

  • Dynamic gait progression – side stepping, tandem, low hurdles

  • Forward step ups/downs

  • Hydrotherapy and upper body exercises with pool buoy between legs

PHASE III— ADVANCED 6 weeks+

Goals 

  • Restoration of muscular endurance/strength 

  • Restoration of cardiovascular endurance 

  • Optimize neuromuscular control/balance/proprioception 

Precautions 

  • No precautions

Specific Exercises 

  • Treadmill – inline walking 20mins 2 x per day

  • Advanced strength training – squats/lunges as tolerated

  • Side to side lateral agilities 

  • Resume normal sports drills/training at 8-12 weeks

Bryn Gilbertson
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Anterior Hip Replacement: Post-Operative Physiotherapy Protocol