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Total Hip Replacement Rehabilitation Protocol

Rehabilitation following Total hip replacement tends to be less intense compared to total knee replacement. A home exercise regimen can accomplish most of the goals with periodic physiotherapist supervision and input.

Goals of rehabilitation following THR

  • Observe hip precautions for 12 weeks (for posterior approach THR).
  • Control pain and swelling.
  • Regain normal gait and muscle control / strength.
  • Restore proprioception, balance and coordination.

Day 1

  • Sit at edge of bed and out in chair.
  • Begin transfers and short walks with walker for 5-10 minutes twice during the day.
  • In bed static quadriceps, ankle pumps, hip abduction and gentle SLR as able.

Day 2-3

  • Progress with mobility. Aim for 50 m walk with walker by day 3.
  • Progress with exercises in bed and in chair as advised by therapist.
  • Sit out in chair most of the day by day 3. Aim for a single sitting session of 45-60 minutes. All meals sitting in a chair.
  • Use toilet / bathroom with assistance for all toileting needs.

Days 3 to 14: After discharge home or rehabilitation centre

  • Continue exercises as advised by therapist.
  • Progress with walking distance with walker. Aim for 100 m.
  • Sit out in chair for all meals and most of the day.
  • Independent transfers into and out of bed.
  • Perform HEP with assistance.
  • Negotiate 4-6 stairs with assistance.

Weeks 2 to 6

  • Continue home exercises. These aim to improve lower limb strength, proprioception and balance.
  • Progress with walking distance
  • Can start hydrotherapy if available
  • Transition to straight cane or walking stick indoors as able.

Week 6 onwards

  • Wean off stick indoors. Gradually progress to unaided ambulation as able and if safe.
  • Progress with functional tasks within home environment and then in external environments.