This document, authored by Jared T. Lee, MD, provides a rehabilitation plan for patients following a Total Hip Arthroplasty.
The document outlines three phases:
- **Phase 1 (Weeks 0-2):** Focuses on reducing swelling and edema, minimizing pain, improving range of motion (ROM), preventing DVT, and achieving independent ambulation. It includes weight-bearing as tolerated (WBAT), the use of Ted hose, and specific restrictions such as no driving until off narcotics. Therapeutic exercises include range of motion restoration (active, active-assisted, passive), isometric quadriceps strengthening, supine and seated exercises, stationary biking without resistance, core strengthening, and gait training.
- **Phase 2 (Weeks 3-6):** Continues the goals of Phase 1 with an aim for independence in Activities of Daily Living (ADLs). Restrictions remain WBAT and no driving until off narcotics. Therapeutic exercises include progressing the exercise program, single-leg balance, step-ups, prone hamstring curls, heel raises, aquatic therapy (once the incision is healed), and progressive hip, quadriceps, hamstring, and gluteal strengthening, and a pelvic floor program.
- **Phase 3 (Weeks 7-12):** Aims for full range of motion, minimal pain, increased resistance exercises, and normalizing postural/pelvic and lower extremity control. Strengthening and functional tasks are progressed as tolerated. Exercises include wall squats, mini lunges, step-ups (progressing to single-leg), 4-way hip exercises, leg press, open-chain knee exercises, and advanced balance progressions. Discharge criteria include surgeon clearance, specific strength indices for hamstrings and quadriceps, Y-Balance anterior reach measurement, and no complaints of pain or instability.
The protocol provides details about restrictions, goals, and therapeutic exercises for each phase, with a progression from initial post-operative care to full return to activity and sports-specific tasks as appropriate.
