Precautions Flashcards
Anterior hip precautions
Anterior approach hip replacement
For an anterior approach hip replacement, the precautions are generally less restrictive compared to the posterior approach, but certain movements should still be avoided to protect the healing hip joint. The exact precautions can vary depending on the surgeon’s guidelines, but the common precautions for the anterior approach include:
Avoid Hip Extension Beyond Neutral:
Avoid extending the leg too far backward.
Be cautious with movements that require significant hip extension, such as walking backward or certain exercises.
Avoid Excessive Hip External Rotation:
Do not turn the leg outward excessively.
Be careful during activities that might cause the leg to rotate outward, such as pivoting on the operated leg.
Avoid Crossing Legs:
While this is less of a concern compared to the posterior approach, it’s still advisable to avoid crossing the legs, especially in the early postoperative period.
Additional Considerations:
Walking: Patients are generally encouraged to walk as much as possible within pain tolerance to regain strength and mobility, but should avoid overextending the hip.
Sleeping: Some surgeons recommend sleeping on the back or the non-operated side with a pillow between the legs to avoid excessive rotation or extension.
Sitting: While sitting, it’s important to ensure that the hip is not excessively extended or rotated, so avoiding low, soft chairs may still be recommended.
The anterior approach is associated with fewer restrictions because the surgical technique typically spares muscles, leading to a lower risk of dislocation. However, following the recommended precautions is crucial to ensure proper healing and avoid complications. Always follow the specific instructions provided by the healthcare provider or physical therapist, as they may tailor precautions to the individual patient’s needs.
Posterior hip precautions
Posterior approach hip replacement
For a posterior approach hip replacement, specific precautions are typically recommended during physical therapy to avoid dislocation and ensure proper healing. These precautions generally last for about 6-12 weeks after surgery but can vary based on the surgeon’s preference and the patient’s condition. The three primary hip precautions for the posterior approach are:
No Hip Flexion Beyond 90 Degrees:
Avoid bending at the hip past 90 degrees.
This means avoiding activities like sitting in low chairs, bending down to tie shoes, or leaning forward to pick up objects.
No Hip Adduction Past Midline:
Do not cross the legs or bring the operated leg across the body’s midline.
Use a pillow or abduction wedge between the legs while sleeping to prevent crossing.
No Internal Rotation of the Hip:
Avoid turning the operated leg inward, such as when twisting the body or pivoting on the operated leg.
Be cautious when turning in bed or during activities like getting into a car to avoid rotating the leg inward.
Additional Considerations:
Getting in and out of bed: Use a “log roll” technique to avoid excessive hip rotation.
Sitting: Use chairs with armrests and higher seats to avoid deep flexion of the hip.
Toileting: A raised toilet seat may be necessary to maintain hip precautions.
Walking: Use an assistive device like a walker or crutches as recommended to ensure stability and avoid violating precautions.
These precautions help protect the hip joint during the early healing phase and prevent complications like dislocation. They should be followed diligently as instructed by the healthcare provider or physical therapist.
