Information for patients

about precautions following

Hemiarthroplasty surgery
Delivering the best in care

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Introduction
The hip joint is a ball and socket joint between the upper end
of the femur and the pelvis. The rounded upper end of the
femur is called the head, which is connected to the main shaft
of the femur by an angulated neck, as shown in the fracture
diagram below:

Greater Head of femur

trochanter

Neck of femur
Femur

Hemiarthroplasty surgery involves replacing the fractured

head of the femur with a metal or ceramic ball. A metal stem
is attached to the shaft of the bone to add stability, as shown
below:

After Hemiarthroplasty surgery, the surrounding muscles and

tissues will take anywhere between 6 weeks and 3 months
to fully heal. During this period the joint is weaker and can
become dislocated more easily than usual.
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There are precautions you can take to minimise the risk of
your hip dislocating, until the muscles and ligaments have
healed and the joint is better supported.

Precautions
Only very light work should be undertaken with no
bending, twisting or crossing the legs at the hip joint, or at
the ankles.
Do not force movements at the hip.
Do not bend forward or to either side to reach objects on
the floor.
Do not sit on low seats.
Avoid standing for long periods of time. Stand with your
feet slightly apart and your weight evenly distributed on
both legs.
Avoid driving and gardening for 3 months.

Furniture heights
Your safe height will be measured by the occupational
Therapist. This will involve taking a measurement from
your heel to your knee joint. 1 inch will be added to this
measurement to give your identified safe height.
During your stay in hospital you will be asked to provide the
occupational therapist with heights of your bed, chair and
toilet at home. This is so that the occupational therapist can
make sure that your furniture is at a safe height for you to
transfer to and from when you are discharged from hospital.
If the heights of your bed, chair or toilet are not suitable the
occupational therapist will provide equipment to make them
safe for your return home.

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Sitting
Avoid low chairs for 3 months. If possible, sit on chairs with
arms. Your Occupational Therapist will advise you on how
high the chair needs to be.
Do not cross legs or ankles whilst sitting.
When standing up from your chair, keep the leg which has
been operated on out in front of you and rest your weight on
your strong leg. Push up out of your seat using the arms of
the chair.
When sitting down, keep your operated leg out in front of
you and gently lower yourself by bending your strong leg,
and taking your weight evenly through the arms of the chair.

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Sleeping
Your bed at home should be a safe height which you can
easily get on and off of. The occupational therapist will advise
you of your safe height.
If possible get onto the bed on the side that corresponds to the
hip which has been operated on. (left hip, left side of bed).
Do not cross your legs or hook one foot under the other. Once
you are onto the bed lift your legs into bed together next
to each other, as shown by a member of the occupational
therapy team.
Do not let the leg that has been operated on cross the midline
of your body. Either sleep on your back or if you cannot sleep
on your back, put a pillow between your legs to keep the line
of your hip steady.

Yes

No do not cross leg

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Using the toilet
If toilet equipment is issued to you by the occupational
therapist, you must use this equipment for a minimum of 3
months.
If the toilet equipment you have been issued with has arms,
you should sit and stand from the toilet using the same
technique as sitting and standing from a chair.
If no toilet equipment or a raised toilet seat has been issued
(this will not have arms) then sit and stand as you would with
a chair, but hold the rim of the toilet seat with one hand,
using your crutch or stick in the other hand to lift yourself up
with. The occupational therapist will show you how to do this.

Bathing
The use of a bath should be avoided for at least 3 months
after your operation. Using a bath during the first 3 months
after your operation, may result in hip dislocation.

Dressing
You will be issued with dressing aids by the occupational
therapist.
Use the dressing aids to help you to dress your lower half for 3
months after the operation.
Always dress the leg which has been operated on first and
make sure that you undress it last.
You should never bend down through ninety degrees to
touch below either knee. You should never bring your
operated leg up towards your chest past ninety degrees.

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 90 Degrees
Yes
Yes

More than
90 Degrees
No!
No!

Car
Very low and very small vehicles should be avoided for 3 months.
When getting into the vehicle, put the car seat as far back as
possible. If necessary place a cushion in the crease of the seat
to prevent your hip from going past 90 degress.
With your back to the side of the seat, sit down and slide
yourself across the seat.
Lift the leg which has been operated on, into the vehicle.
Keeping the knee straight, slowly turn around to face the front.
When getting out of the car lift your legs out first before
standing up, and again keep the leg which has been operated
on straight.
This will be shown to you by the occupational therapist on
request.

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General household
In order to minimise the risks of dislocating your hip:
Avoid standing for long periods of time.
Try to spread your household chores evenly through the
week and give yourself plenty of time to rest.
Try sitting on a stool or chair whilst washing, ironing and
attending to activities in your home.
Consider reorganising your kitchen so that items you use
regularly are within easy reach. This will prevent you from
stretching up high or bending down low putting further
strain on your hip.
You may want to discuss this with the occupational therapist
or a family member.

Conclusion
This booklet is intended as a guide and a reminder for you
and your family.
Your hip is always at slight increased risk of dislocating and
sensible precautions should be followed long term.
All of the above points will be covered by occupational
therapist when he or she sees you in hospital.

For further information please contact the Occupational

Therapist on 0121 371 3428.

Occupational Therapy Department

Queen Elizabeth Hospital Birmingham
Mindelsohn Way, Edgabston,
Birmingham, B15 2WB
Tel: 0121 371 3428

GD07_36790 UHB/PI/0734 (Edition 2)

Author: Ellen Ruston-Shaw
Date: October 2010 Review Date: October 2012