Having a hip replacement is a major surgery that requires extensive recovery and rehabilitation. One of the key milestones after hip replacement surgery is being able to bear full weight on the operated leg. Most patients are eager to return to normal activity levels and want to know when it will be safe to put full weight on their leg after surgery.
What is weight bearing after hip replacement?
Weight bearing refers to how much body weight a patient is allowed to place through the operated leg when standing or walking. After a hip replacement, surgeons provide specific weight bearing instructions to protect the new hip joint while the soft tissues heal and regain strength.
Here are the normal weight bearing stages after a hip replacement:
- Non-weight bearing – No weight is placed through the operated leg. The patient must use crutches or a walker at all times.
- Touch down weight bearing – The patient is allowed to rest the foot of the operated leg on the floor for balance, but cannot put weight through that leg.
- Partial/toe touch weight bearing – The patient can place only a small amount of weight through the foot of the operated leg. Up to 25% of body weight is placed through the leg when standing or walking.
- Weight bearing as tolerated – The patient can gradually increase weight placed through the operated leg as tolerated and without significant pain. May still require a cane or crutch for balance.
- Full/unrestricted weight bearing – The patient can stand and walk putting full body weight through the operated leg without support.
Timeline for weight bearing after hip replacement
The typical rehabilitation timeline and weight bearing instructions after a hip replacement are:
- Week 1: Non-weight bearing or touch down weight bearing with crutches or walker.
- Week 2: Up to 25% partial/toe touch weight bearing, weaning off crutches or walker.
- Week 3: Progress to weight bearing as tolerated without crutches or walker.
- Week 4 to 6: Gradually increase to full weight bearing on the operated leg.
- Week 6 to 12: Full weight bearing walking without any gait aid or limp.
However, this timeline serves as a general guideline only. Your surgeon will provide customized weight bearing instructions depending on your specific surgical procedure, health status, and progress with rehabilitation.
Factors that affect return to full weight bearing
Several factors can influence when you can safely begin putting your full weight through the operated leg after hip replacement surgery:
- Type of surgery: Full hip replacements allow quicker return to weight bearing than hip resurfacing procedures.
- Surgical approach: Anterior, posterior, lateral, and other approaches have different requirements for protecting hip muscles and soft tissues.
- Use of minimally invasive technique: Smaller incisions heal faster but may require more restricted weight bearing initially.
- Condition of soft tissues: Weakness or damage to muscles, tendons, and ligaments around the hip joint may require slower progression.
- Type of implant: Cemented, uncemented, hybrid implants have different healing timelines.
- Rate of healing: Overall health, nutritional status, and other factors affect wound and bone healing speed.
- Presence of complications: Infections, dislocations, or fractures influence weight bearing progression.
- Hip precautions: Avoiding certain hip movements may require restricted weight bearing.
- Rehabilitation progress: How quickly strength, balance, and mobility return impacts weight bearing capability.
Your surgeon and physical therapist will regularly assess all these factors and adjust your weight bearing status accordingly for optimal recovery.
6 Tips for safe return to full weight bearing
Follow these tips for safely progressing to normal full weight bearing on your operated leg after a hip replacement:
- Adhere to the weight bearing instructions from your surgeon and PT at all times.
- Use support devices like crutches, walker, or cane until advised you can walk without them.
- Increase the weight through your leg gradually as tolerated without pushing through pain.
- Take pain medication before therapy sessions to enable optimal performance.
- Practice proper walking, posture, and joint protection techniques.
- Ensure your hip muscles gain enough strength through exercises before progressing.
When can you walk normally after hip replacement?
Most patients are able to walk normally without any limping or compensation from the other leg by around 12 weeks after hip replacement surgery. However, complete recovery can take 3-6 months for some individuals depending on their pre-operative function.
Your physical therapist will analyze your walking pattern and measure progress through limp tests. When you can walk evenly putting equal weight through both legs consistently, it indicates you have regained normal gait function after your hip replacement.
Precautions when putting full weight on your hip
Some precautions to take when you start bearing full weight on your hip after replacement surgery include:
- Wear sturdy shoes with cushioning for shock absorption
- Use a cane or walker outdoors on uneven terrain initially
- Avoid pivoting or twisting on the operated leg
- Prevent falls by removing loose rugs and clutter at home
- Do not try to catch yourself if you begin to fall
- Take stairs slowly using handrails until you gain confidence
Discuss any hip precautions you need to follow long-term with your surgeon as they depend on factors like your age, implant type, and physical demands.
Signs you are bearing weight too early
Some warning signs that you may be progressing too quickly and putting too much weight on your new hip joint include:
- Sharp or intense pain in the hip or groin area
- Limp that persists more than 6-8 weeks after surgery
- Swelling and redness around the hip incision
- Popping, clicking, or crunching sounds from the hip
- Feelings of instability, loosening, or weakness in the hip
- Increase in pain at night or when bearing weight after being sedentary
If you experience any of these symptoms, reduce the weight you bear through the leg, use support devices, and notify your surgeon promptly in case any damages need evaluation.
Conclusion
Putting full weight on your leg is a key component of rehabilitation after hip replacement surgery. Most patients can Progress to full weight bearing between 6-12 weeks with their surgeon’s clearance. However, the timeline varies based on the type of surgery, surgical approach, and each patient’s unique healing process. Patience and appropriate precautions are essential when increasing weight placed through the operated leg to allow the hip to recover properly. Stay in close contact with your surgeon and PT to safely achieve successful outcomes.