Movements prohibited with a hip prosthesis: a guide to avoid dislocation

After the installation of a total hip replacement, The body needs six to twelve weeks for the tissues to heal. During this time, the stability of the joint depends on how you move. The goal is to prevent dislocation, which is when the head of the femur comes out of its socket. The precautions to take differ depending on whether the surgeon accessed the front or back of the leg.

Situation	This action is not recommended.	Secure solution
Sit	Use a deep sofa or cross your legs	Choose a high chair with armrests.
Pick up an object from the ground	Lean forward with both feet together.	Move the operated leg back while keeping your back straight
Put on your shoes	Pull your foot towards you while bending your hip	Use a long-handled shoehorn
Change direction while standing	Pivot abruptly on the operated foot	Turn your whole body while taking several small steps

The risk of dislocation and tissue fragility

Dislocation occurs when the artificial ball slips out of the socket fixed in the pelvis. This often happens during a movement that is too wide or too rapid. The neck of the prosthesis then hits the edge of the socket and acts as a lever, expelling the implant. This is a painful incident that requires a visit to the emergency room to reposition the joint under anesthesia. In some cases, further surgery is necessary to stabilize the joint.

To implant the prosthesis, the surgeon must separate or incise the capsule and ligaments surrounding the joint. These structures normally act as natural brakes. Until they have regained their strength, they cannot properly hold the prosthesis in place. This healing phase lasts approximately six weeks. During this time, following the movement guidelines will protect the hip while the scar tissue closes.

The three movements to watch out for daily

Bending your hip too far means bringing your knee closer to your chest. The angle between your stomach and thigh should not exceed 90 degrees. To avoid this, avoid low chairs that are difficult to get up from. Using a toilet seat reducer is also helpful in the first few weeks. If you need to pick something up, let your operated leg slide back.

Bringing your leg inward or turning your foot is dangerous for the healing process. The riskiest movement is crossing your legs, whether you are sitting or lying down. This exerts direct pressure that pushes the prosthesis toward the still-fragile area. When walking, avoid sudden twists of the pelvis. Strengthening your gluteal muscles with a physiotherapist helps to better stabilize the joint in the long term.

The influence of the surgical technique

The posterior approach remains the most common method. However, it requires particular care because it weakens the back of the joint (the tendons). Conversely, the anterior approach, known as the Hueter approach, better preserves the muscles because the surgeon passes between the fibers without cutting them (neither the muscles nor the tendons). It appears to us to be less risky.

The type of implant also affects safety. Dual-mobility models have two pivot points, which greatly reduces the risk of dislocation. These prostheses are often recommended for very active people (those involved in high-risk activities), those at higher risk of falling, or those with muscle weakness.

Managing daily activities

Some guidelines for the first few weeks:

To get in the car, move the seat back as far as it will go and recline the backrest slightly. Sit first on the edge of the seat, facing away from the car's interior, then pivot as one unit with both legs together. A helpful tip is to place a plastic bag on the seat to make sliding easier. When getting dressed, always remain seated. Put the operated leg on first, but take it off last.

At night, sleeping on your back remains the safest option. A pillow placed between your knees prevents your legs from accidentally crossing during sleep. When going up stairs, remember this rule: the unaffected leg goes up first, while the operated leg goes down first, using a cane. Always use the handrail to maintain your balance.

Resuming sexual intercourse is possible after six weeks, once the deeper tissues have healed. It's best to choose stable positions that don't involve extreme twisting or bending. This is a normal stage of recovery and simply requires a little gentleness at first.

Sports activities and warning signs

A prosthesis allows you to resume an active life, but it is not designed for repeated impacts. Running, jumping, and combat sports accelerate wear and tear on the materials. Walking, cycling on flat roads, and swimming, on the other hand, are beneficial for bone health. For swimming, wait two months before practicing breaststroke. Most patients return to their usual leisure activities between the third and sixth months after the operation.

If you experience sudden, sharp pain in your groin, or if your leg feels shorter and locked, your hip is probably dislocated. In this case, do not try to move or put any strain on the limb. Call emergency services immediately. Prompt intervention can put the joint back in place without causing further damage to the surrounding tissues.