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JOI Birmingham Hip Resurfacing Protocol

By Brett P. Frykberg, MD

BIrmingham Hip Resurfacing

Phase I – Acute Post-Operative Phase

Goals: Normalize Gait, Decrease Pain, Prevent Stiffness

Post-Op Weeks 1-2

  • Weight Bearing: PWB with Crutches for 2-3 weeks
  • ROM: Speak with MD office regarding PROM restrictions
  • Modalities: RICE
  • Exercises: Ankle Pumps
  • Quad Sets
    • Gluteal Squeezes
    • Active Heel Slides (careful to not cause psoas tendonitis)
    • Recumbent Bike without resistance as ROM allows
    • Seated “Dangle” Stretch (See Attached Picture)

Post-Op Weeks 3-4

  • Weight Bearing: Progress to FWB. (If bilateral resurfacing was performed this may be delayed by 2 weeks)
  • Modalities: RICE
    • Scar Massage as needed
  • Exercises:
    • SLR Hip Abduction (Progress from Standing to Side-lying)
    • SLR Hip Extension
    • SLR Hip Flexion (careful not to cause psoas tendonitis)
    • Walking is to tolerance
    • Stationary Bike
    • “Figure 4 crossing of legs stretch”(See Attached Picture)
    • Can begin a pool program if the wound is well healed

Phase II – Intermediate Phase

Goals: Regain Hip Mobility, Gentle Strengthening, Normal Basic Activity

Post-Op Weeks 4-6

  • Weight Bearing: Should be FWB without assistive device
  • Modalities: RICE as needed
    • Massage and Scar Massage as Needed
  • Exercises:
    • Initiate hip flexor stretching edge of bed
    • Add leg press light weight
    • Add double leg bridges
    • Clams
    • Resisted ER and IR of Hip in Standing
    • Single Leg Balance and Proprioception work
    • Add resistance to bike
    • Childs Pose for Hip Flexion

Post-Op Week 6-12

  • Modalities: PRN
  • Exercises:
    • Tall kneeling or stool hip flexor stretching
    • Elliptical and stairmaster progression
    • Advanced bridging exercises (single, unsteady surface, resistance)
    • Initiate mid-range multidirectional lunges
    • Closed chain exercise progression

Phase III – Return to Function Phase

Goals: Restore Normal Strength, Return to Prior Level of Function

  • Exercises:
    • Begin gentle return to activity under the direction of MD and Therapist

Specific Exercises:
“Seated “Dangle” Stretch: This is a simple exercise to help increase flexion. Find a stool or lower chair. Place your knees at shoulder width. Bring your hands down towards your ankles and hold when you feel the stretch. Don’t bounce or continue if you have a lot of pain.  Repeat for a set of 10

Dangle Stretch | JOI Birmingham Hip Rehabilitation

“Figure 4 crossing of legs”: This exercise is designed to increase the rotation in your hip joint, particularly so that you can put on your own shoes and socks. In a sitting position, gently grab your operated foot and bring it to rest on your un-operated knee. This will bring you into a sitting, cross-legged position.  It will be difficult at first, and you may feel some pain around the incision site.  If it is too stiff to accomplish this early on, you may turn your body at an angle to the chair/bed, and bring the foot onto the chair/bed instead of your opposite knee.  Gently press on your operated leg to flatten it.

Supine Stretch | JOI Birmingham Hip RehabilitationSeated Stretch | JOI Birmingham Hip Rehabilitation

Begin this exercise in supine and progress to seated 


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