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REHAB PROTOCOL · HIP

Total Hip Replacement Rehab Protocol

By Dr. Shayne Kelly, DO — Fellowship-Trained Sports Medicine Surgeon · Tri-City Orthopedics, Kennewick, WA

The written protocol Dr. Kelly provides to his patients and their physical therapists in the Tri-Cities. Time frames are guidelines — progression is criteria-based, and your own post-op instructions always govern.

⬇  Printable protocol (PDF)Request an appointment →
Educational information, not medical advice. This is not a substitute for the specific instructions Dr. Kelly and your physical therapist give you. Your timeline depends on your surgery, your body, and your progress. Follow your own care team's directions. In an emergency, call 911.
Acute Phase (0–2 Weeks)
EARLY RECOVERY
Intermediate Phase (4–6 Weeks)
PROGRESS FUNCTION

Acute Phase (0–2 Weeks)EARLY RECOVERY

DAY 1 UNTIL HOSPITAL DISCHARGE
  • •Weight bearing as tolerated with walker or crutches; elevation for edema control.
  • •Ice 20 minutes of every hour for edema and pain control.
  • •Gait training: continue safe ambulation for 50 feet, instruct in transfers and stairs prior to discharge.
  • •Instruction in hip precautions. Avoid hip flexion beyond 90°, no internal rotation and no adduction.
HOME EXERCISES TO INCLUDE
  • •Ankle pumps with leg elevation; quad sets; gluteal sets; supine hip abduction.
  • •Outpatient physical therapy should be scheduled prior to surgery. Patients may do home PT or rehabilitation if medically necessary and physician ordered.
DAYS 3 TO 14
  • •Begin outpatient physical therapy at approximately 2 days post-op.
  • •Change bandage at 1 week post-op unless excessive drainage is evident within the bandage in which case it should be changed sooner.
  • •Staple/suture removal at 14 days post-op by PT or in office at which time shower normally without a bandage covering the incision. No submersion.
  • •Gait training with appropriate assistive device; continue elevation and ice for edema and pain control.
  • •Tubigrip stocking for edema control if needed; perform home exercise program (HEP) as issued by P.T.
  • •Instruct in all appropriate transfers for independence in home.
EXERCISES TO INCLUDE
  • •Ankle pumps with leg elevation; quad sets; gluteal sets.
  • •Flexibility: Groin, hip flexors, and hamstrings <90° with supervision of a therapist.
  • •PROM: into hip abduction, extension, and external rotation; supine hip abduction.
  • •Straight leg raises hip flexion, abduction, extension in standing; short arc quads, long arc quads, hamstring curls.
  • •Bridging; heel lifts; wall squats to 30° hip flexion; resisted terminal knee extension in standing.
GOALS  Safe transfers & gait

Intermediate Phase (4–6 Weeks)PROGRESS FUNCTION

  • •Progress all previous exercises; step-ups forward and lateral.
  • •Begin single-leg balance. Balance board bilateral lower extremities.
  • •Gait training. Wean from assistive device as able with normal gait pattern; stationary bike.
  • •Knee extension machine (avoid >90° hip flexion); hamstring curl machine.
  • •Review functional activities (laundry, vacuuming, cooking, sweeping, lifting) for safety; final phase after 6 weeks
  • •Progress all previous exercises; advance balance and proprioception exercise.
  • •Begin recreational/sports related simulation activities (ex. practice golf swings). Goals: Return to prior level of function with normal strength, range of motion within precautions, flexibility, balance, endurance, and gait.
GOALS  Independent ADLs

Discharge Criteria

  • •Independent ambulation without assistive device, including stairs
  • •Functional ROM for ADLs; independent home program
  • •Low-impact recreation per Dr. Kelly

Time frames are guidelines — progress when phase goals are met, per Dr. Kelly and the treating therapist.

When to call

Increasing pain, numbness, redness, drainage from the wound, or fever/chills — call (509) 460-5588. After hours, the answering service can reach Dr. Kelly. If your issue feels emergent, call 911 or go to the nearest emergency department.

Physical therapists

Treating one of Dr. Kelly's patients? Download the printable protocol for your clinic, and call (509) 460-5588 with questions about an individual patient's progression.

⬇  Protocol PDF

Related protocols

HIPHip Arthroscopy & Labral RepairKNEETotal Knee ReplacementSHOULDERReverse Total Shoulder Replacement

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