Restrictions - is there a simple list?

[nickji]

I'm sure this has been covered many times, but I can't find the thread. Is there a simple list with timings for restrictions, from the famous 90 degree one to riding bicycles? And if there is, any chance of getting it posted here? Would be so grateful. Just to muddy the waters, here's a quote, with attribution, from broken link removed: https://www.eorthopod.com/public/patient_education/5710/precautions_after_total_hip_replacement_have_we_gone_too_far.html

After a total hip replacement (THR) patients are restricted in what they can and can't do. The idea is to prevent early hip dislocation. But do these restrictions really make a difference? That's the focus of this study.

Two groups of patients with a THR were included. Care before, during, and after surgery was the same for all patients. Both groups were asked to avoid bending the hip more than 90 degrees. Rotating the hip too far in one direction or the other was also limited.

One group (restricted group) had some extra guidelines. They had to use a special abduction pillow between the legs right after the surgery while still in the operating room. Pillows were used in bed to keep the legs apart. Raised chairs and toilet seats were also used. Patients in the restricted group were told not to sleep on their sides. They weren't allowed to drive or even ride in a car for six weeks.

After six months there was only one hip dislocation. It occurred in the restricted group when the patient was moved from the operating table to the bed. The abduction pillow was in place at the time.

Results of other measures showed greater patient satisfaction in the unrestricted group. They returned to their normal daily activities sooner. This included side sleeping at three weeks after surgery compared to almost six weeks in the restricted group. Driving or riding in a car occurred sooner and more often in the first six weeks for the unrestricted group. In the final measure of outcomes, patients in the unrestricted group went back to work three weeks sooner than the other patients.

The purpose of this study was to find out if extra hip precautions are really needed after a THR. The authors conclude that only range of motion restrictions are needed for six weeks after THR. Use of pillows and added restriction for sleeping, sitting, and driving are not necessary.

E. Louis Peak, MD, et al. The Role of Patient Restrictions in Reducing the Prevalence of Early Dislocation Following Total Hip Arthroplasty. In The Journal of Bone and Joint Surgery. February 2005. Vol. 87-A. No. 2. Pp. 247-253.

 

[hurtingbuthopeful]

Very interesting article! Can't wait for Jo's response.

 

[Josephine]

Interestingly, the notion of restricted movement after a THR was introduced by Charnley but mostly because he used an extra procdedure called a trochanteric osteotomy. In effect this left the patient with a facture which was wired and had to heal. The subsequent weakness of the abductor muscles (which are attached to the trochanter) meant dislocation was at a much higher risk. It was Charnley devised the abduction pillow.

 

[TBONE]

Nick--My OS must have read that article because I had and have no restrictions at all after BTHR on April 1, 2009. The only restriction I do have is related to blood clots--don't sleep with a pillow or rolled up towel under your knees at night--for fear of restricting blood flow, I believe. My only limitations are my own pain.
Tom

 

[YoungM]

Interesting article Nick. For myself, this recovery time is so important to me and I don't want to risk dislocating at all, so I have been following my doctor's precautions and restrictions very carefully. One nurse told me not to get in a car at all for 6 weeks, but I have done that -the doctor said you just need to be very careful that you are getting in the car properly.

 

[JudyS]

As far as restrictions a lot depends on the type of incision. The traditional posterior usually carries the most restrictions. Of course the doctor that you picked and trusted to replace your hip will give you his or her set of instructions. All differ.
I had the traditional posterior and restrictions for 3 months. After six weeks my doc said I could relax a little about them. I did not have the car , driving, or sleep restrictions. I was sent info that was waiting for me when I arrived home about restrictions. I was allowed to sleep on my side, but told it would not be comfortable.
It was easy to comply with the restrictions as my body did not want to be in the non-allowed positions anyway.

As Melissa said, it is sure worth it to get a complete recovery , hopefully without any bumps or worse in the way.
judy

 

[Judles]

Boy is ignorance bliss! In my case I never even realized our joints could evn dislocate! At that time, I was limited by my own pain/discomfort! What did I know!!!!! . I also hadn't discovered Bonesmart at that point in my recovery!

 

[PRGal]

Nick--My OS must have read that article because I had and have no restrictions at all after BTHR on April 1, 2009. The only restriction I do have is related to blood clots--don't sleep with a pillow or rolled up towel under your knees at night--for fear of restricting blood flow, I believe. My only limitations are my own pain.
Tom

TBone--no restrictions is standard for anterior approach THR, barring any other disease issues or complications. This factor, along with speedier recovery, are what led me to my choice of surgeon, who specializes in this approach.