Total hip replacement protocol posterior lateral approach

Q: What are posterior lateral hip precautions?

Dont lean forward while you sit down or stand up, and dont bend past 90 degrees (like the angle in a letter L). This means you cant try to pick up something off the floor or bend down to tie your shoes. Dont lift your knee higher than your hip. Dont sit on low chairs, beds, or toilets.

Table of Contents Show

What are posterior lateral hip precautions?
What is posterior lateral approach to hip replacement?
What is the difference between lateral and posterior hip replacement?
What is posterior approach to total hip replacement?

Precautions for first 6 weeks

NO hip flexion >90°
NO hip abduction >neutral
NO hip internal rotation
Weight bearing as tolerated with assistive device
NO sitting for long periods of time
Use toilet with raised seat for 3 months
Use abduction wedge while sleeping or resting, up to 12 hrs
Transfer to sound side Hip rotation should be limited:
- AVOID excessive IR and FLEX >90°

1-4 weeks – Immediate Post-op/ Maximum Protection Phase

Hip FLEX to 90°
Gait training (WBAT)
Increase hip ABD
Strengthening hip extensors
Isometric exercises in pain-free range (low intensity)
Gentle massage

Home Exercise Program (post-op)

Glut strength sets
Hip abduction, lying on back
Ankle dorsiflexion, ankle pumps
Heel slides Quad sets
Short arc quad sets
Hamstring sets, digging heel in
Straight leg raise
Hip adduction with roll between legs, squeezing

4-5 weeks – Moderate Protection Phase:

Weight bearing restrictions as per M.D. Progress
AROM gradually and in protected range
- NO hip FLEX >90°
- ADD to neutral
Open and closed chain exercises can begin
Promote hip extension, by lying in prone if possible, to prevent a hip FLEX contracture
90° hip FLEX allowed
May begin theraband strengthening

6+ Weeks – Minimum Protection Phase

Increase hip EXT and ABD strength for ambulation
PRE with light weight and high repititions, no stress ER
Bicycling to increase muscular endurance and general conditioning
Transition to cane, if necessary
Begin stretching and strengthening the glutes
AVIOD high-impact exercises

*Be cautious long term for combined motions of hip flexion, internal rotation, and adduction*

What are posterior lateral hip precautions?

Don't lean forward while you sit down or stand up, and don't bend past 90 degrees (like the angle in a letter "L"). This means you can't try to pick up something off the floor or bend down to tie your shoes. Don't lift your knee higher than your hip. Don't sit on low chairs, beds, or toilets.

What is posterior lateral approach to hip replacement?

The posterior approach is traditionally the most common approach used to perform total hip replacement. In the posterior approach, the surgeon makes an incision at the back of the hip close to the buttocks. Hip replacement is indicated in patients with arthritis of the hip joint.

What is the difference between lateral and posterior hip replacement?

The posterior approach is considered to be easy to perform, however, increased rates of dislocation have been reported. The direct lateral approach facilitates cup positioning which may decrease rates of hip dislocation and diminishes the risk of injury to the sciatic nerve. However, there is an increased risk of limp.

What is posterior approach to total hip replacement?

The posterior approach to total hip replacement is a minimally invasive surgical technique where the replacement of the damaged hip joint is made through the side of the hip, along the outer buttock area, and is the most commonly used approach.

total hip replacement protocol posterior lateral approach