Direct Anterior Hip Replacement

Post-op recovery	First 2 weeks	Date
Goals	Protect the hip and surgical incision Recover from swelling and inflammation Control of post-surgical pain
Precautions	Walk short distances only Use crutches for support
Recommendations	Weight bear as tolerated using crutches for support Rest and elevate as required Ice the hipas desired – particularly in the first week Range of motion exercises of ankle Range of motion exercises of knee
Suggested exercises	Supine abduction Hip flexion standing (up to 90 degrees) Supine bed supported knee bend (up to 90 degrees) Pendulum movement of the leg when standing Static gluteal, Quads and hamstring contractions Isometric abduction, adduction Short walks with crutches

Phase 1	Week 2 to week 6
Goals	Begin training to walk normally Fully weight bear with crutches for support as required Wean off crutches as able Increase range of motion Begin strengthening
Precautions	Avoid long walks, cycles or exercise sessions that inflame the hip – shorter sessions – three times a day – is better. Allow the hip to settle and rest between sessions.
Recommendation	Hip and gluteal muscle strengthening Ankle range of motion and strengthening Knee range of motion and strengthening When stable and safe – use one crutch (opposite to operated hip) When stable and safe and gait improving, discard the use of crutches (better to walk well with crutches than lurch and limp without)
Suggested exercises	Static quads contraction Supine straight leg raise Hip flexion standing and supine (up to 90 degrees) Hip abduction standing – side and back at 45 degrees Side leg raise – leg straight and leg bent Core strengthening abdominals Single leg stance exercises for balance and neuromuscular control Double calf raise

Phase 2	Week 7 to week 12
Goals	Walk as normally as possible Strengthen knee, hip and ankle
Precautions	Avoid long walks, cycles or exercise sessions that inflame the hip. Walk and exercise as feels comfortable
Recommendations	Hip, gluteal and abductor muscle strengthening Ankle range of motion and strengthening Gain control, balance and coordination of leg
Suggested exercises	Hip abduction standing – side and back at 45 degrees (perform on both legs) Progress on to Thermaband exercises for gluteals and abductors Step up, step downs Wall slide squats (0-60) Double leg squats (0-60) Double calf raise – progress to single Single leg stance exercises Bridging Core strength training Exercycle, elliptical trainer, swimming

Phase 3	3 Months – 6 months
Goals	Gain full function and strength
Precautions	None
Recommendations	Concentrated full rehab program that includes strengthening of core, hip flexors, gluteal muscles, external rotators of the hip, quadriceps, hamstrings and calves. Gain in confidence during functional activity. Neuromuscular control and co-ordination of leg
Suggested exercises	Thermaband exercises for gluteals and abductors Step up, step downs Double leg squats (never exceed 90 degrees) Double calf raise – progress to single Single leg stance exercises Bridging Core strength training Exercycle, elliptical trainer, swimming