Post Surgery Video Series

HipPrecautions
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HelpfulTips2

Hip Precautions

Cindy gives an introduction to Orthopedic Hip Precautions. Hip precautions are put into place to avoid increased pressure in the area of the healing tissues and to avoid the potential of dislocating the new hip after surgery. Hip precautions are labeled for the are of incision and the surgical technique used to enter the joint during surgery.

Posterior- back of the hip
Anterior- front of the hip
Lateral- side of the hip

You may also hear Posterior Lateral or Anterior Lateral

The Hip Precaution videos have been divided up into 3 general categories:

-Posterior
-Anterior
-Lateral

with a description of the most commons precautions in each category.

Hip precautions are usually in place for at least 12 weeks, but this can vary. Hip precautions and surgical procedures can vary as well. Please consult with your surgeon and physical or occupational therapist regarding the hip precautions and any special instructions that apply to your surgery in order to make sure your are viewing the appropriate video and/or videos.

On your return home, make sure to have a good place to sit, preferably with arm rests in order to allow your arms to assist your good leg when standing. Do not sit on any surface that places your hips below your knees.

Be sure to assess the bathroom toilet height and safe areas for push off for your hands.

Avoid using toilet paper holders, towel bars, pedestal sinks or sinks mounted to the wall without a base for areas of push off.

Again, make sure to consult with your surgeon or physical therapist on what hip precautions apply to you, then get started on the appropriate video and/or videos.

Cindy is demonstrating and reviewing the most common Posterior Hip Precautions.

1. Do Not bend more than 90 degrees at the hips/waist. The 90 degree angle refers to the angle between the thigh and the trunk. Use caution not to reduce the angle either by leaning forward at the waist or by raising the knee toward the trunk. Use caution when sitting or standing from any surface, making sure to maintain this precaution.

2. Do Not turn the toes/leg on the surgical side inward. Use caution not to plant and pivot on the surgical leg when turning with the walker. Always pick up the feet and turn with the walker.

3. Do not cross the legs or cross the midline of the body with the surgical leg. Some surgeons send a foam wedge home for use to prevent crossing legs/midline. Use caution not to roll onto/sleep on the non surgical side (until released to do so by surgeon), which can allow the (top leg) surgical leg to both roll inward and cross midline due to the weight of the leg.

Most hip precautions remain in place at least 12 weeks, but that can vary depending on the surgery and surgeon. Hip precautions can vary as well, so be sure to consult with your surgeon on the hip precautions and any special or additional instructions that may apply to your surgery.

If you have questions regarding you hip precautions, please be sure to consult with your physical or occupational therapist.

Cindy is demonstrating and reviewing the most common Anterior Hip Precautions.

1. Do Not extend the surgical leg backwards (hip extension) Use caution when taking steps backward to sit down on a chair, toilet, bed etc. Lead back with the non surgical leg, bringing the surgical leg back to, not beyond, the non surgical leg. Do Not lay on your stomach in bed, which could potentially put the surgical leg into hip extension.

2. Do Not turn the toes/leg on the surgical side outward. Use caution not to plant and pivot on the surgical leg when turning with the walker. Always pick up the feet and turn with the walker.

3. Do Not cross the legs. While sitting in a chair, do not cross the legs at the knees or ankles, while lying in bed, do not cross the legs at the ankles.

Most hip precautions remain in place at least 12 weeks, but that can vary depending on the surgery and surgeon. Hip precautions can vary as well, so be sure to consult with your surgeon on the hip precautions and any special or additional instructions that may apply to your surgery.

If you have questions regarding you hip precautions, please be sure to consult with your physical or occupational therapist.

Cindy is demonstrating and reviewing the most common Lateral Hip Precautions.

1. Do Not actively move the surgical leg out away from the body. This includes sidestepping, getting in/out of the bed, shower or car. A leg lifter can be used as an option for self assist your surgical leg.

2. Do Not turn the toes/leg on the surgical side outward. Use caution not to plant and pivot on the surgical leg when turning with the walker. Always pick up the feet and turn with the walker.

3. Do Not cross the legs. While sitting in a chair, do not cross the legs at the knees or ankles, while lying in bed, do not cross the legs at the ankles.

Most hip precautions remain in place at least 12 weeks, but that can vary depending on the surgery and surgeon. Hip precautions can vary as well, so be sure to consult with your surgeon on the hip precautions and any special or additional instructions that may apply to your surgery.

If you have questions regarding you hip precautions, please be sure to consult with your physical or occupational therapist.

Bedroom Post Surgery

Cindy is discussing several adaptive equipment options for use in the bedroom after hip or knee replacement surgery. If you have had a hip replacement, be sure to consult with your physical or occupational therapist on the hip precautions that apply to you in order to maintain those when getting in and out of the bed. Please take note of the height of your bed. This can often be an area of concern if you are not able to touch the floor with your non surgical leg while sitting safely on the edge of the bed. Having to slide off the edge of the bed before one foot touches the floor poses a fall risk. When getting into the bed, if your arms are not strong enough to assist in scooting your buttock safely back onto the bed before laying down can increase fall risk as well.

Cindy is demonstrating how to get in/out of the bed post hip or knee replacement surgery using adaptive equipment including a bed rail, step stool option and leg lifter. A step stool needs to be considered if the bed is too high to safely sit down on and/or the individual does not have enough arm strength to scoot their bottom back on the bed before bringing the legs into the bed. A bed rail may be an option for those struggling to pull themselves up from a lying position to sitting on the side of the bed. The leg lifter is a good option for self assist of the surgical leg on/off of the bed. Individuals who have had a hip replacement need to use caution to maintain the appropriate hip precautions pertaining to their surgery, while bringing the surgical leg on/off of the bed.

The Step Original Aerobic Platform-Circuit Size
• Aerobic platform 28.5”L x 14.5”W x 4”H
• Includes 2 original grey risers
• 275# weight limit
• Height from 4” to 6”
• Choice of 2 or 4 risers
see product link for further product details

Medline Bed Assist Bar with Storage Pocket
• Dimensions 36”-44” H x 14” W x 28” D
• Fits most twin, full and queen sized beds
• Height adjustable legs
• 13 x 9 inch nylon pocket
see product link for further product details

Freedom Grip Plus Bed rail by MTS
• Height adjustable from 21.5” to 24.5” in one inch increments
• 250# weight limit
see product link for further product details

Leg Lifter Strap by Vive
see product link for further product details

The Step2Bed step stool is great for people having difficulty getting in or out of today’s tall beds. Getting into or out of a tall bed can be an increased fall risk, especially for those experiencing weakness, pain, decreased mobility or post surgery.

Step2Bed
-Adjusts from 2 1/2 to 7 1/2 inches in height
-Weight limit of 400#
-Non slip stepping surface
-Motion sensor light

We recommend available space for: 33in (L) x 19in (D)

see product link for further product details

Bathroom Post Surgery

Cindy is discussing several adaptive equipment options for use in the tub/shower after hip or knee replacement surgery. Be sure to consult with your surgeon as to when you can return to getting in the shower. We do not recommend the use of a shower chair in a tub shower unless you are able to safely step over the side of the tub.

Drive Medical Tub Transfer Bench
• Seat Dimensions 18.5-19.5”(D) x 26”(W) x 17.5-22.5”(H)
• Outside Legs 23”(D) x 32”(W)
• 400# weight limit
see product link for further product details

Vive Shower Chair with Back and Handles
• Seat Dimensions 15.75” x 13”
• Base 17.75” wide
• Adjustable leg height from 14” to 19.5”
• 300# weight limit
see product link for further product details

Cindy is demonstrating how to transfer in/out of a tub shower using a bathtub transfer bench and leg lifter. This tub transfer bench is a good option post hip or knee surgery in order to improve safety with bathing, not having to step over the side of the tub to enter the shower. Individuals who have had a hip replacement involving the hip precaution of not bending more than 90 degrees at the hips need to use caution when lifting the surgical leg over the tub. Make sure to lean your trunk back, watching your hip/trunk angle as you lift the surgical leg over the tub edge, in order to maintain that precaution. Those individuals under the hip precaution of no active movement of the surgical leg away from the body need to have passive assistance or use of a leg lifter, keeping the leg in line with the trunk of your body as you bring the leg over the edge of the tub.

*****Reminder***** Hip replacements can still bend at the knees, Knee replacements can still bend at the hips

Drive Medical Tub Transfer Bench
• Seat Dimensions 18.5-19.5”(D) x 26”(W) x 17.5-22.5”(H)
• Outside Legs 23”(D) x 32”(W)
• 400# weight limit
see product link for further product details

Leg Lifter Strap by Vive
see product link for further product details

Vive Shower Chair with Back and Handles
• Seat Dimensions 15.75” x 13”
• Base 17.75” wide
• Adjustable leg height from 14” to 19.5”
• 300# weight limit
see product link for further product details

See video below for How to Use a Shower Curtain with a Tub Bench to Minimize Water on the Floor

This Swivel Sliding Transfer Bench with Cut-Out from Eagle Health will come in handy for those individuals who have difficulty stepping over the side of a tub or shower threshold due to weakness/limited mobility/pain or after surgery. Learn more about this product by Eagle Health.

This Swivel Shower Chair from Eagle Health will come in handy for those individuals who have limited mobility due to weakness, pain, injury or surgery and/or are dealing with limited space in which to maneuver for bathing.

How to Use a Shower Curtain w/ a Tub Bench to Minimize Water on the Floor.

Using a bathtub transfer bench is a safe way to get in and out of the bathtub but it can make a mess and be dangerous when water from the shower splashes out on the floor.

In this quick tip video, Cindy shows how to use an inexpensive shower curtain to decrease the amount of water on the floor when using a bathtub transfer bench.

By cutting the shower curtain in a “v” it will allow the user of the tub bench to feed the flap into the slit in the seat, encourage the outer flaps to fall/hang inward around the seat, thereby keeping more of the water in the tub. The “v” cut will also allow non-transfer bench users the ability to clip the two bigger pieces of the cut together thereby keeping water inside the tub.

This of course will not prevent all water from escaping the tub.  Be sure to place a towel below the tub bench on the outside of the tub to catch any water and to prevent any safety issue arising from a wet floor.

Cindy is discussing several adaptive equipment options for improving safety when getting on/off the toilet after a hip or knee replacement surgery.

****Reminder**** Toilet paper holders, towel bars, pedestal sinks and sinks mounted to the wall without a base are not safe or appropriate areas for hand placement for assistance with push off or support when getting up or down from the toilet.

Carex E-Z Lock Raised Toilet Seat with Handles
• 5” seat height
• 17” deep, 15 1/2” wide
• 17 1/4” between the handles
• Advertised as fitting most toilets
see product link for further product details

Vive Health Toilet Seat Riser with Arms
• 3.5” seat height
• 300# weight limit
• Available for standard and elongated toilets
• Removable handles
• Use with existing toilet seat
• Handle width standard 22” elongated 21.25”
see product link for further product details

Vive Health Compact Toilet Rail
• Adjustable handles from 17” to 20” wide
• Advertised to fit any shape toilet
• 300# weight limit
see product link for further product details

Vive Health Stand Alone Toilet Rail
• Freestanding design
• 300# weight limit
• 21” width between the rails
• Dimensions 26.5” long, 19” deep and 25.5” high
see product link for further product details

Drive Medical Bedside Commode
• Arm width inside 18”, outside 22.5”
• 350# weight limit
• Seat dimensions 15” D x 13.5# W x 16.5-22.5” H
see product link for further product details

Cindy is demonstrating the Raised Toilet Seat with Handles. This raised toilet seat sits on the toilet bowl, securing with a locking mechanism to the toilet bowl. Use caution when pushing up, distributing even weight through both arms. This product is advertised as fitting most toilets. As with any product, always check the fit and stability of the product before use.

Carex E-Z Lock Raised Toilet Seat with Handles
• 5” seat height
• 17” deep, 15 1/2” wide
• 17 1/4” between the handles
• Advertised as fitting most toilets
see product link for further product details

Cindy is demonstrating a Toilet Seat Riser with Arms, which sits under the existing toilet seat and bolts to the toilet. This may be a good option to accommodate for both improving the height of the toilet as well as having handles for upper extremity assistance when getting on and off of the toilet post hip or knee replacement surgery. Always distribute even weight through both hands when getting up and down from the toilet.

Vive Health Toilet Seat Riser with Arms
• 3.5” seat height
• 300# weight limit
• Available for standard and elongated toilets
• Removable handles
• Use with existing toilet seat
• Handle width standard 22” elongated 21.25”
see product link for further product details

Cindy is demonstrating how to install and use Compact Safety Rails. If the current toilet height is appropriate, but there is not appropriate/safe areas for hand placement when getting on/off the toilet post hip or knee replacement surgery, this may be a good option for additional assistance and safety.

Vive Health Compact Toilet Rail
• Adjustable handles from 17” to 20” wide
• Advertised to fit any shape toilet
• 300# weight limit
see product link for further product details.

Cindy is demonstrating the use of the Stand Alone Safety Rail for the toilet. If the current toilet height is appropriate, but there is not appropriate/safe areas for hand placement when getting on/off the toilet post total hip or knee replacement surgery, this may be a good option for additional assistance and safety. ***When getting on/off of the toilet using the Stand Alone Safety Rail, please take note that the frame “feet” extend out approximately 5 inches past the cross bar resting against the toilet base.

Vive Health Stand Alone Toilet Rail
• Freestanding design
• 300# weight limit
• 21” width between the rails
• Dimensions 26.5” long, 19” deep and 25.5” high
see product link for further product details

Cindy is demonstrating how to install and use a bedside commode over the toilet. Some bedside commodes are advertised as 3-in-1 bedside commodes. This refers to the ways in which a bedside commode can be used: at bedside, over the toilet for a raised toilet seat and over the toilet as toilet safety rails, in which the majority of them can be used. Some individuals use a bedside commode in place of a shower chair if space in the shower allows. The back rest bar on most bedside commodes can typically be removed by wing nuts or push pins in order to position the bedside commode further back over the toilet. Be sure the bedside commode comes with a splash guard for use over the toilet. Always distribute even weight through both hands when getting up and down from the toilet.

Drive Medical Bedside Commode
• Arm width inside 18”, outside 22.5”
• 350# weight limit
• Seat dimensions 15” D x 13.5# W x 16.5-22.5” H
see product link for further product details

Stairs Post Surgery

Cindy is demonstrating the basic process of going up and down the stairs after surgery using a cane and a walker. It is important that you consult with your physical therapist on your individual situation regarding how you will enter your house on your return home after surgery. The basic principle of leading up with the “good” leg first and down with the “bad”/surgical leg first applies in each situation. Whether or not you can use a cane to assist on the stairs in place of the walker will depend on your weight bearing status and will need to be discussed with your physical therapist prior to returning home. We always recommend having a caregiver who is able to assist you in entering the home on your return from surgery. Those individuals who are under the hip precaution of no bending greater than 90 degrees at the hip need to use caution when stepping down to a wide step, placing the walker down first. Consult with your physical therapist for advise on your particular setting in order to adapt as needed to maintain your hip precautions.

Additional Helpful Equipment

Cindy reviews additional equipment which may be help after a hip or knee replacement surgery. ***Reminder*** Adaptive Equipment doesn’t work the same for everyone in every situation, so be sure to keep your receipt and make sure the equipment works for you.
***Note*** Please check for details when ordering equipment for the bathroom. Some items may not be returnable due to being used for hygiene.

RMS 5 Piece Hip/Knee Replacement Kit
• Dressing Stick
• Reacher
• Long Handle Shoe Horn
• Long Handle Bath Sponge
• Sock Aid

Vive 6 Piece Hip/Knee Replacement Kit
• Dressing Stick
• Reacher
• Long Handle Shoe Horn
• Long Handle Bath Sponge
• Leg Lifter
• Sock Aid

Initially after a hip or knee replacement surgery you will not be able to bend over to tie your shoes. Slip on shoes or adding elastic/silicone shoe strings to your regular lace up shoes will be helpful. We recommend that slip on shoes have a back to them for safety.  See the highlighted titles below for examples of no tie shoe laces.

Hickies No Tie Silicone Shoe Laces
Xpand No Tie Elastic Shoe Laces

Wheeled walkers work best with the addition of something on the back legs that will slide across the floor. Often used are walker ski glides and tennis balls. Be aware of extensive use of either item, outside on concrete, gravel, etc. can cause wear or debris collection, which may result in scratching or snagging of flooring.

Vive Walker Glide Skis with Covers

A car assist handle can be useful for hand placement to assist standing up from or sitting down onto a car seat post surgery. Please note that these do not work with all cars. See the highlighted video link below for demonstration and the highlighted product titles for further product information.

Car Assist Handle Video Demonstration

Stander Metro Car Handle Plus
Able Life Car Assist Handle

Lighting is very important, especially at night for the pathway to the bathroom. A motion sensor light is a good option, coming on only as needed. A battery operated light can increase options on placement. Click on the highlighted product title below for more details.

Mr Beams Quick Tip for Night Time Safety Video
Product Review of Z Edge and Mr Beams

Mr. Beams Portable Motion-Sensing Nightlight
Z Edge Portable Motion Sensor Nightlight

Attempting to carry items while using a walker after surgery can decrease your safety. A walker basket or walker tray are a couple of options to improve your independence and safety while on the walker. There are many types of baskets, trays and bags available for walkers, though not all fit every walker. See the highlighted links below for examples.

Yunga Tart Walker Tray
Nova Walker Tray (Folding)
Health Smart Universal Walker Basket
Vive Walker Bag

Having a good place to sit after a hip or knee replacement surgery is important.  You should not be sitting on a surface that is too low, placing your hips below your knees.  Some individuals raise the height of their existing recliner or chair by building a wooden platform for it to sit on.  Caution should be taken that the chair is secured to or within the elevated platform so that the chair cannot slide off.  There are various furniture risers/elevators on the market as well.  See highlighted product titles below for some examples.

Little Boost Platform
MSR Imports Recliner Risers

Again, there are many products on the market, please check the details and save your receipt in order to make sure the product will work for you.

Adaptive Equipment Corner wishes you a speedy recovery!!

Additional Helpful Tips

Cindy is demonstrating correct positioning of the surgical leg for elevation to help reduce swelling after knee replacement surgery.

This positioning technique can be used while in a recliner, on the bed or on the couch. Just make sure that you can safely get up from the surface you are using. For rocker recliners, add a thick book, piece of wood, hand held weight under the front edge of the recliner to prevent the downward rocking motion as you attempt to get up.

For elevation
-get the foot height above hip height height
-do not sit with a rolled pillow behind your knee allowing you knee to remain in a bent position
-take caution not to confuse stretching exercise for elevation technique
-start pillow back at mid thigh
-place second pillow under calf/lower leg
-add additional towel roll under heel to assist in getting the leg as straight as possible
-should be in a position of comfort
-should not have to work to keep leg on pillows
-should be able to relax for at least 15-20 minutes or more if possible
-use ice while elevating

Cindy is discussing the use of cold therapy after a total knee replacement to help reduce swelling and pain. It is good to combine your cold therapy with elevation of the surgical leg. See video for proper positioning for elevation.

****Always use a barrier between your skin and the cold source. Perform occasional skin checks in the area of cold use.****

Variety of Cold Therapy Sources
-Ice Pack
-Gel Pack
-Frozen bag of corn or peas
-Circulating cold water therapy systems

Apply above sources for 15-20 minutes at a time. Use a barrier between the cold source and your skin. Perform skin check after removal and prior to next application. Allow at least one hour between each application.

Polar Care Cube
-knee pad
-velcro straps for thigh and calf
-power source typically plug in on lid next to
circulating tubes
-can use frozen water bottles instead of ice
-has fill lines for water and ice
-small filter in end of “cone” can be cleaned
check if water is not circulating into pad
-check with PT and/or RN regarding how long
the knee pad can be left on at a time
-use a barrier between the knee pad and skin

DISCLAIMER: Cindy is a licensed Physical Therapist; however, this video and any related comments are for informational purposes only and should not be used to replace instruction or recommendations given to you by your physician, physical or occupational therapist. All questions or concerns regarding an individual’s situation or circumstances should be referred to your professional healthcare team.

Product details and specifications coincide with product link provided, though may not always be specific to the product demonstrated above. There are many variations of products available in each category. Adaptive Equipment Corner continues to research product quality, cost and customer service through reviews, client recommendations and first-hand assessment, when the product is available for our review.  The product links throughout this series are Amazon affiliate links specific to Adaptive Equipment Corner.