The first home visit is less about 'exercise' in the traditional sense and more about 'movement literacy' in their specific environment. It’s about teaching them the language of their new hip—how it speaks back when they stand up and how to read the signals of pain versus surgical discomfort.
The specific restrictions depend on the surgical approach used. For a posterior approach, patients must follow the "90-degree rule," which means they cannot bend their hip past 90 degrees, cross their legs at the ankles or knees, or twist the operated leg inward or outward for at least six weeks. These precautions are essential to prevent dislocation while the surrounding tissues heal.
According to the 2025 KNGF updates, therapeutic ultrasound has been downgraded to a Grade D recommendation because research indicates it provides no additional value over a placebo. The modern clinical focus has shifted entirely toward active mobilization and functional training. Passive treatments, including manual stretching by a therapist, are no longer supported as primary interventions in favor of the patient performing active movements.
Patients can typically consider returning to driving between 4 and 6 weeks post-operation, provided they meet two critical criteria. First, they must be completely off all narcotic pain medications to ensure they are not impaired. Second, they must demonstrate sufficient muscle control and reaction time to perform emergency maneuvers, such as slamming on the brakes, without hesitation or pain.
The "Golden Window" refers to the first 6 to 12 weeks following surgery, which is a critical period for regaining range of motion and establishing long-term functional habits. During this time, the focus is on "movement literacy"—teaching the patient how to navigate their home safely and rebuilding the "engines" of the hip, specifically the gluteus medius and quadriceps, to prevent long-term limping or instability.
The recommended protocol is to use ice packs for 15 to 20 minutes following any physical activity. When resting, the leg should be elevated above the heart. However, it is vital never to place a pillow directly under the knee, as this can cause a flexion contracture that prevents the leg from straightening. Instead, pillows should be placed under the calf or ankle to keep the knee joint supported but extended.
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