How can I prevent dislocation after hip replacement surgery?

After a traditional posterior approach (incision on the side) hip replacement surgery, you will have to obey “hip precautions” for four to six weeks to help prevent dislocation. You will not be permitted to bend your hip past 90 degrees, twist your foot inwards, or cross your leg past the midline of your body. Sometimes it is advised to sleep with a pillow between your legs to prevent dislocation during sleep. In an anterior approach (incision in the front of the hip), there are no precautions.

Patients can prevent dislocation after a hip replacement by toning the muscles around the joint, undergoing physical therapy and avoiding certain movements.

To prevent dislocation after hip replacement surgery, it is best to avoid extreme positions while the soft tissues heal. Depending on the surgery, whether anterior or posterior, you will be taught a different set of precautions by your surgeon and physical therapist. There are different precautions for anterior (from the front) and posterior (from the back) approaches. No approach is free from the risk of dislocation, so be sure to discuss this with your surgeon.

This depends upon the approach used. Most replacements are done through a posterior approach. For these patients we restrict movements that severely flex the hip like bending over to pick something from the floor or sit in low chairs. Today many of us do replacements from an anterior muscles sparing approach which has no restrictions.

Dr. Scott D. Martin, MD
Orthopedic Surgeon

Precautions against dislocating a new hip implant are quite limiting for about 12 weeks. It's important to follow them regardless of how well you feel, since a position can be risky without causing pain.

  • Bend over as little as possible. Your hip should flex no more than 90 degrees, meaning you should not bend over farther than your waist. This rules out bending over to tie your shoes normally or pick up something you've dropped, and it also means you'll need a raised toilet seat and a chair or bed that is high enough that your knees don't rise above your hips when you sit.
  • Be careful in bed. Lying down, you mustn't pull your knee toward your chest or reach down too far to get your covers.
  • Rely on long-handled gadgets. Four devices can be helpful: a reacher to help you pull up pants or grab items that are out of safe range; a tool to pull on socks without bending over; a shoehorn to put on sturdy non-tying shoes; and a sponge to help you wash below your knees.
  • Avoid movements that turn the operated leg in or out. Keep your feet pointed straight ahead when you sit and stand. Don't cross your legs, even at the ankle. Sleep on your back or on your side with your abduction pillow between your legs.
Dr. Jeanne Morrison, PhD
Family Practitioner

Dislocation (where the femoral component becomes separated from the acetabular component) is a complication of a total hip replacement. It can be avoided usually by not flexing (bending) the hip more than 90 degrees. One should avoid bending over (either while sitting or standing) to prevent flexing more than 90 degrees. Avoid sitting in a chair that is low to the ground or a couch in which a person "sinks into" because this could cause the hip to flex more than 90 degrees. Adduction of the hip where the effected leg is brought across the midline of the body such as crossing one's legs should be avoided. Abnormal rotation of the hip (especially internal rotation) can lead to dislocation.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.