How to Prevent Hip Dislocation After a Total Hip Replacement

After having a total hip replacement there are strict precautions that must be followed to prevent dislocating the hip. Prior to surgery your surgeon may have discussed these with you but for the most part they will not come into discussion until you have either gone through a joint replacement pre-operative class, or have begun your physical therapy.

There are three cardinal rules that are followed in rehabilitation of your total hip replacement.

1. Do not cross your legs.

2. Do not bend at the hips past 90 degrees

3. Do not turn your affected foot inward or internally rotate your hip.

There may be several others that are mentioned during your rehabilitation, but these are the three main precautions that will always be discussed. These precautions are generally followed for the first six weeks after surgery however, you want to discuss that with your orthopedic surgeon as they may have you follow these precautions longer.

By following the above precautions you can be assured that you are reducing the chances of a dislocation. When sitting be sure that you also are sitting in a chair that does not rock or move in any way. Be sure that the seat height does not allow you to sink deep enough that your knees rest or in other words are higher then your hips. If you find your knees higher then your hips you are breaking the 90 degree plain.

Do not cross your legs when you are sitting. this something that is easy to do. Now in my estimation the leg you want to avoid crossing is the leg and hip that were operated on. Nursing or doctors will tell you to avoid crossing either leg due to the possibility of compromising blood circulation in your lower extremities however and this is a good rule to follow. If you cross the leg and hip that were operated on then dislocation is possible. Crossing the strong leg over the operated leg will not result in dislocation.

Avoid turning your operated leg inward to where your foot is turned inward as well. By internally turning your foot this movement is generated at the hip causing the possibility of dislocation.
This is easily done when you are walking for instance and when turning while using a walker or cane, you pivot on the affected leg instead of picking it up. When you pivot on the affected leg you will in turn internally rotate the hip possibility causing the head if the femur to jump out of the socket.

Now for the most part I have found it takes two of the three precautions to be broken at once before dislocation will take place but this is not a hard fast rule either. This will depend on the integrity of the surrounding soft tissue around the hip and the type of hip prosthesis used.

The first six weeks of your rehabilitation will be vital to strengthen the surrounding muscles, tendons, and ligaments so that they will do their job in supporting the hip joint and locking in the prosthesis.

There are roughly 250,000 or more hip replacements done a year in the US, the dislocation rate is somewhere between 1-3%. Dislocation is something not to be fearful of but to respect during the rehabilitation process.

Check with your surgeon for the exact time frame to follow the precautions then once that time has expired and the hip sufficiently healed, you will be back to living the life you expected and deserve pain free at last.

Richard Haynes
Punta Gorda, Florida