Postoperative rehabilitation inprimary total hip arthroplasty

Abstract

Rehabilitation after primary total hip arthroplasty should start with a preoperative education and physical therapy session. This can facilitate early progression to functional independence.Transfers in and out of bed are initially carried out with the assistance of a physical therapist or surgical nurse. The patient should get out of bed on the operative side to minimize hip adduction. Dislocation precautions are emphasized during transfers.The hips should be maintained slightly higher than the knees at all times, which requires that bed and chair heights be adjusted for each patient.assistance devices, such as a reacher, sock aid, dressing stick, long shoe horn, and leg lifter, allow the patient to become independent in activities of daily living while avoiding excessive hip flexion and rotation.Early full weight bearing is permitted if both the acetabular and femoral components are cemented.When the femoral component is uncemented, protected weight bearing for 6 weeks is appropriate to permit the bone-implant interface to stabilize with biological tissue. after sufficient abductor strength has returned that limp is minimal, ambulatory support can be discontinued. a long-term exercise program, which avoids impact loading of the hip, should be encouraged to maintain cardiovascular fitness and health.