Total Hip Replacement Protocol (cementless)
Goals: Safe and independent use of crutches or walker. Independent with knowledge and maintenance of hip precautions. Daily performance of home exercise program. All exercises to be repeated 25x, 2-3 x/day. When wound completely healed, begin scar tissue massage. Exercises:
- 1. Quad sets- tighten knee muscles of outstretched leg by pushing the back of the knee into the bed, hold 5 seconds.
- 2. Gluteal sets- squeeze buttocks together, hold 5 seconds.
- 3. Heel slides- bend knee sliding knee towards buttocks, then slide heel back away from body.
- 4. Hip abduction & adduction- lay on back, slide straight leg out to side and back in, careful not to cross midline.
- 5. Short arc quads- put 6 inch towel roll under knee. Straighten lower leg until knee is fully extended and hold for 5 seconds. Then relax and slowly bend knee back to original position.
- 6. Long arc quads- seated, let legs bend to 90°, straighten lower leg until knee fully extended. Then relax and slowly bend knee down to original position.
Goals: With physician approval, increase weight bearing by 25%/week until 100% weight bearing. Utilize cane as soon as able and safe. Maintain general hip precautions. Exercises:
- 1. Stationary bike adjusted to not exceed 90° hip flexion. (When approved by MD)
- 2. Prone hip extension.
- 3. Mini squats.
- 4. Bridges.
- 5. SLR. (flexion & abduction)
- 6. Hip rotation (NO IR, ER to 30°)
- 7. Calf raises.
- 8. Standing hip abduction.
- 9. Standing hip extension.
- 10. Marching.
Goals: Ambulation without device. Ascend and descend stairs in a step over step fashion. Exercises:
- 1. Shallow water walking waist deep.
- 2. SLR in waist deep water (buoyancy assisted and resisted).
- 3. Hip abduction.
- 4. Hip extension.
- 5. Hip flexion to 90°.
- 6. Knee flexion & extension.
- 7. Deep well exercises (bicycle, cross country ski)
- Golf when off 2 crutches and steady, approximately 3-4 months.
- ρ chip and putt approx. 3 months.
- ρ driving approx. 4 months.
- ρ cart recommended for first 6 months