Physical Therapy Protocol

Posterior Total Hip Replacement

A week-by-week recovery guide for patients following posterior total hip replacement with Dr. Kee, including hip precautions for the first 6 weeks.

Hip Precautions
First 6 weeks
Typical Duration
6–12 weeks to full activity

Hip Precautions — First 6 Weeks

Because the posterior approach passes through muscle near the back of the hip, standard hip precautions apply for the first 6 weeks to protect the repair while it heals. During this time, avoid:

A raised toilet seat, a firm chair with arms, and a reacher/grabber tool can make these precautions easier to follow at home. Your surgical team will confirm when precautions can be relaxed, typically around 6 weeks.

Days 0–7 Goal: Manage swelling, regain basic mobility within precautions
  • Walk with a walker for balance and support
  • Follow hip precautions closely — no bending past 90°, no crossing legs, no internal rotation
  • Ice and elevate to manage swelling, which typically peaks around day 3
  • Begin gentle home exercises for ankle pumps and short walks as tolerated
  • Use a raised toilet seat and a firm chair to stay within precautions
Weeks 1–3 Goal: Progress mobility while maintaining precautions
  • Progress from walker to cane as strength and confidence allow, guided by your surgical team
  • Continue hip precautions throughout this phase
  • Gradually increase walking distance day by day
  • Formal outpatient physical therapy typically begins during this window to guide safe progression within precautions
  • Light daily activities resume as tolerated, staying within precautions
Weeks 3–6 Goal: Build strength while precautions remain in effect
  • Many patients are walking with a cane or without an assistive device, per their surgical team's guidance
  • Hip precautions remain in effect until cleared by your surgical team, usually around 6 weeks
  • Light exercise such as stationary biking is often introduced under PT guidance
  • Driving typically resumes once off narcotic pain medication, reaction time feels normal, and precautions allow it
6+ Weeks Goal: Lift precautions, return to full activity
  • Hip precautions are typically lifted around 6 weeks, once confirmed by your surgical team
  • Continued strengthening and range-of-motion work with physical therapy
  • Higher-impact activity (golf, tennis, hiking) is reintroduced gradually based on comfort and strength
  • Continued improvement in strength and endurance is normal for several months
Note for physical therapists: This protocol reflects standard posterior-approach hip precautions (avoid flexion >90°, adduction past midline, and internal rotation) for the first 6 weeks. Please individualize progression based on the patient's strength, balance, and surgical findings, and contact our office with any questions about a specific patient.

Questions About Your Recovery?

Our care team is available to answer questions about your protocol or recovery progress.