A Posterior Hip Replacement is commonly performed in people who have chronic hip pain. This hip pain may be from a prior injury, wear and tear over time, and several types of arthritis including Rheumatoid Arthritis and Osteoarthritis. With any of these conditions, the structures of the hip may become damaged and prevent normal movement of the hip joint. A healthy hip joint should move and glide freely without painful motion.
If Posterior Hip Replacement is recommended, the surgeon will perform surgery to replace the ball and socket joint of the hip with prosthesis. In order to fit the new parts, the bones are shaped and cleaned in order to join the new parts together. This creates a brand new hip joint from synthetic parts.
After surgery you will most likely be using an assistive device to help you walk. It is important to know how to properly use and size these items in order to be safe. Check our Walking Assistance page in order to learn about this.
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Post Surgery Precautions
Due to the location of the surgical procedure, a number of precautions need to be followed after surgery to avoid hip dislocation. These Posterior Total Hip Replacement Precautions should strictly be followed for 3 months after surgery and you should check with you physician before forgoing them. There are three precautions that should be obeyed. They are:
1) Never bend your hip past 90 degrees.
2) Never cross your hip past midline.
3) Never perform internal rotation at the hip.
The first precaution is to never have your hip angle go past 90 degrees.
Hip Angle at 90 Degrees
If the knee is lower than the hip this is still a safe position.
Hip Angle Greater than 90 Degrees
Lying on your back is safe. Even bending your hip a little is okay. Here the hip angle is past 90 degrees so this is wrong.
Lying on Back Hip Angle Past 90 Degrees
Bending forward at your waist while sitting can also make the angle past 90 degrees and should be avoided.
Sitting Hip Angle Past 90 Degrees
If you are sitting and raise your hip upwards this also causes the hip to go past 90 degrees and should be avoided.
Sitting Raising Hip Angle Past 90 Degrees
Sitting in a higher chair can help keep you in a safe position. Keeping your knee lower than your hip means your joint is not past 90 degrees and you are in a safe position.
Sitting in a High Chair Hip Angle Not Past 90 Degrees
Now the knee is higher than the hip so your joint is past 90 degrees and you are not in a safe position.
Sitting in a High Chair Hip Angle Past 90 Degrees
The second hip precaution is the hip joint angle should never cross the midline. The best way to avoid this is to never cross the legs.
Lying Hip Angle Past Midline
While seated at a chair, it is also important to never cross the hip angle past midline.
Seated Hip Angle Past Midline
While standing at your walker, the hip angle should also never cross midline.
Seated Hip Angle Past Midline
The third and final precaution is to avoid internal rotation of the hip. This inward rotation is often mistakenly done during sit to stand.
Sit to Stand Hip Internal Rotation
It can also be mistakenly done while lying down. A simple way to remember is to not turn your toes in.
Lying Hip Internal Rotation
Placing a pillow between your knees can help you to avoid this.
Lying with Pillow Between Knees
While walking, the safest way to turn is to turn away from the involved hip.
Turning Away from Involved Hip
You may turn towards the involved hip, but must pick your foot up to AVOID PIVOTING. A simple way to way to avoid pivoting is to pick the foot up then turn the body.
Turning Toward Involved Hip
This is pivoting and has broken the third hip precaution of avoiding internal rotation of the hip.
Standing and Pivoting on Involved Hip
To maintain these precautions, it is VERY IMPORTANT that you also sit correctly in a chair.
Square up to the chair by taking baby steps around, do not pivot. Back up to the chair and feel the chair with the back of your legs.
Touch Chair with Back of Legs
Put the involved leg out slightly and reach back for the chair. Always sit in a chair that has armrests.
Putting Involved Leg Out and Reaching for Chair
Sit on the front edge of the chair then scoot back. Again, do not bend your hip past 90 degrees when sitting so it is very important to keep your back straight and not lean forward.
To go to standing, reverse the process. This same process can be performed with a 4-wheeled walker. Be sure to remember to always avoid chairs without armrests and stools.
These precautions also should be obeyed when riding in a car.
Traveling in an SUV is easier to navigating than a small car. First, move the seat back as far as it will go.
Move Seat Back
Next, recline the seat about half way back.
Recline Seat Halfway
Square up to the seat, you should now feel the seat with the back of your legs or backside.
Square Up to the Seat
You should hold onto the dash with your left hand and the seat with your right. DO NOT hold onto the door. It is not a stable object. Place your involved hip out slightly and sit on the edge of the seat.
Hold Onto the Dashboard and Seat
While you scoot back, make sure to bend your neck or you could hit your head. Use your uninvolved side to push yourself back.
Bend Neck and Move Back
Remember, one of your hip precautions is to not have your hip joint past 90 degrees, so you will need to extend your torso back as you slide into the seat. Once you are in, you may un recline your seat a little, but do not move it forward. To get out, reverse the process.
If you are traveling in a low car use some pillows to raise the seat up.
Pillows Added to Low Car
Repeat the same steps above and follow your hip precautions! Of course, it is always a good idea to have someone help you.
