Total Hip Replacement Protocol

The Total Hip Arthroplasty (THA) anterior approach post-operative protocol is designed to guide rehabilitation and ensure optimal recovery following surgery. This protocol typically spans several weeks and is divided into phases, each with specific goals and exercises.

Important General Considerations 

• Begin outpatient physical therapy within the first week after surgery
• Driving is typically allowed around 6 weeks post-operatively
• High-impact activities such as prolonged running, jumping, and heavy manual labor should be avoided long-term to maximize the longevity of the arthroplasty
• Obtain an appointment with your GP between 14-17 days after the surgery to have the wound checked and stitches removed.
• We will schedule a video meeting with you approximately 6 weeks after the surgery.
• Contact your GP if you experience the following issues: Increasing pain in the surgical area combined with redness and fever.A swollen, shiny, and painful lower leg.

 

This protocol is a guideline and may be modified based on individual patient needs

 

General Precautions

For the first 6 weeks post-surgery adhere to the following precautions:

• No hip extension past 20 degrees
• No hip external rotation past 50 degrees
• Avoid lunges for 6 weeks to prevent dislocation
• Weight-bearing as tolerated (WBAT) with use of assistive devices as needed
• No crossing legs (crossing ankles is okay)

 

Phase I: Initial Recovery (0-2 weeks)

Goals

• Minimize pain and swelling
• Protect the surgical site
• Initiate early range of motion (ROM) within restrictions
• Begin basic strengthening exercises

 

Interventions

• Use of assistive devices for ambulation
• Soft tissue mobilization as needed
• Early ROM exercises within restricted range
• Basic strengthening exercises focusing on gluteal muscles and hip rotators

 

Phase II: Motion and Strengthening (2-6 weeks)

Goals

• Progress ROM to patient tolerance
• Improve gait pattern
• Advance strengthening exercises

 

Interventions

• Continue previous exercises with progression
• Initiate closed-chain functional exercises
• Begin balance and proprioceptive activities
• Gait training to normalize walking pattern

 

Phase III: Advanced Strengthening (6-12 weeks)

Goals

• Achieve full hip ROM
• Normalize gait without assistive devices
• Improve functional strength and endurance

 

Interventions

• Progress to more challenging strengthening exercises
• Introduce cardiovascular activities like elliptical and stair stepper (after 6 weeks)
• Focus on sport-specific or work-specific activities as appropriate

 

Phase IV: Return to Function (12+ weeks)

Goals

• Return to work and recreational activities
• Achieve normal gait on all surfaces
• Maximize strength and endurance

 

Interventions

• Advanced strengthening exercises
• Sport-specific training (if approved by physician)
• Functional task training for work or daily activities

For information: call us at +31202090332 or by email: doctors@dhkc.nl