Total hip replacement guide

May 21, 2018


This guide summarizes best practices.  The best care involves a combination of best practices, and the healthcare provider’s and patient's inputs.

3 days - 3 weeks post surgery



  • Reduce swelling and pain

  • Increase range of motion within precautions

  • Increase strength

  • Increase independence with transfers and gait (follow weight bearing precautions as prescribed by surgeon)

  • Monitor wound healing for signs and symptoms of infection


Precautions vary based on the surgical approach and generally followed for six weeks post surgery.  Follow your health care provider's instructions.

  • Don't bend the operated hip more than 90 degrees - don't sit in a low chair with knee above hip and don't lean forward in sitting where your trunk goes in front of your hip.

  • Don't cross legs or bring legs together.  Keep feet in line with knees, and knees in line with hips.  Sleep with a pillow between the knees.

  • Don't turn legs in or out.  Don't pivot with your feet fixed.  Instead, move your feet.

  • Don't let your knee go behind your hip. 


  • Ice 10-15 minutes, multiple times a day to reduce swelling and pain

  • Exercises (with guidance of your therapist)

    • Ankle pumps

    • Heel slides

    • Quad sets

    • Glut sets

    • Short and long arc quads

    • Hip abduction

  • Gait:  progress from walker or crutches to cane

3 - 6 weeks post surgery



  • Reduce swelling and pain

  • Increase hip range of motion within precautions

  • Increase strength

  • Improve balance

  • Normalize functional activities

Precautions still apply until at least six weeks after surgery.  Follow your healthcare provider's instructions.



  • Ice 10-15 minutes, as needed, to reduce swelling and pain

  • Additional exercises (with guidance of your therapist)

    • ​Standing hip abduction

    • Standing knee flexion

    • Standing heel and toe raises

    • Balance exercises

    • Stationary bike within precautions (don't bend hip beyond 90 degrees)

  • Functional activities training 

    • Sit to stand within precautions (don't bend hip beyond 90 degrees) 

    • Stairs

    • Gait without assistive device, as tolerated

6 - 12 weeks post surgery


  • Normalize all functional activities

  • Begin endurance activities

Precautions lifted unless otherwise instructed by your surgeon.



  • Progress strength and balance exercises

  • Begin light recreational and endurance activities (walking, swimming, progress stationary biking)

3+ months post surgery

  • Continue walking, swimming, and stationary biking for aerobic conditioning

  • Begin other recreational activities (golf, outdoor cycling, impact sports such as tennis or jogging) with clearance from surgeon


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