Rehabilitation Protocol for Total Hip Replacement
This protocol supports clinicians and patients through recovery following total hip replacement. It combines time-based milestones, based on tissue healing, with criterion-based progression. Management should be individualised according to clinical findings and professional judgement. If progression is uncertain, clinicians should consult Dr John Farey.
The exercises and interventions listed are not exhaustive and should be modified as appropriate to the patient’s recovery and clinician discretion.
The exercises and interventions listed are not exhaustive and should be modified as appropriate to the patient’s recovery and clinician discretion.
Recovery outcomes may be influenced by factors such as surgical approach, weight-bearing status, and trochanteric precautions. These details are provided in the operative report and/or referral and must be followed until reviewed at the initial post-operative appointment and thereafter as directed by Dr Farey.
Contact us if patient develops any of these symptoms
- Fever
- Significant calf pain
- Persistent numbness or tingling
- Excessive wound drainage
- Uncontrolled pain
- Other concerning symptoms
Phase One
Immediate Post Op
0-3 days after surgery
Goals
- Protect healing tissue
- Minimize pain and swelling
- Increase range of motion (ROM)
- Activate lower extremity musculature
- Comply with surgical precautions
- Perform ADLs independently
Precautions
- Follow appropriate surgical and weight bearing precautions
- Encourage ROM as tolerate, unless otherwise noted by surgical team
- Avoid performing torque or twisting movements
- Avoid exercises with weights/resistance other than body weight
- Monitor for signs of pulmonary embolism, deep vein thrombosis, loss of peripheral nerve
integrity, infection, increased swelling, and delayed wound healing
Exercises
Mobility
- Supine ankle pumps •. Youtube
- Supine heel slides •. Youtube
- Seated long arc quads • Youtube
- Standing hip abduction • Youtube
Strength
- Supine ankle pumps •. Youtube
- Supine heel slides •. Youtube
- Seated long arc quads • Youtube
- Standing hip abduction • Youtube
Criteria to progress
- Minimal pain and inflammation
- Independent bed mobility
- Ability to use stairs independently
Phase Two
Early Motion Phase
1-3 weeks after surgery
Goals
- Protect healing tissue
- Minimize pain and swelling
- Increase range of motion (ROM)
- Activate lower extremity musculature
- Comply with surgical precautions
- Perform ADLs independently
Precautions
- Follow appropriate surgical and weight bearing precautions
- Encourage ROM as tolerate, unless otherwise noted by surgical team
- Avoid performing torque or twisting movements
- Avoid exercises with weights/resistance other than body weight
- Monitor for signs of pulmonary embolism, deep vein thrombosis, loss of peripheral nerve
integrity, infection, increased swelling, and delayed wound healing
Exercises
Mobility
- Supine ankle pumps •. Youtube
- Supine heel slides •. Youtube
- Seated long arc quads • Youtube
- Standing hip abduction • Youtube
Strength
- Supine ankle pumps •. Youtube
- Supine heel slides •. Youtube
- Seated long arc quads • Youtube
- Standing hip abduction • Youtube
Criteria to progress
- Minimal pain and inflammation
- Independent bed mobility
- Ability to use stairs independently