The best sitting position after hip replacement is in a firm chair with arms, where your hips sit level with or ABOVE your knees. Keep your feet flat and apart, toes pointing forward, and don’t cross your legs.
That height rule stops your hip bending past 90 degrees, a right angle, which is the main limit after the posterior approach. Low sofas, soft armchairs and low toilets break the rule, so avoid them for the first few weeks.
Get up and move every 30 to 45 minutes. These rules usually apply for about SIX weeks, and your surgeon decides when they stop.
Your surgeon’s instructions come first. If they differ from anything here, use theirs.
Sitting at a 90-degree angle
When your hips and knees are at the same height, your hip is bent to about 90 degrees. If your knees end up higher than your hips, the hip bends further, and after the posterior approach that is the position most linked with dislocation, where the ball of the new hip slips out of its socket.
- Hips level or higher: Your thighs should be flat or slope slightly down toward your knees.
- Don’t lean far forward: Reaching for your feet or the floor while seated bends the hip past 90 degrees even in a good chair. Use a long-handled reacher instead.
- Don’t cross your legs: This applies at the knees and the ankles.
- Feet apart, toes forward: Keep your knees in line with your hips and don’t let the operated knee roll inward. See hip replacement precautions
- Anterior approach: If your surgeon went in from the front, you often have fewer sitting rules, and some surgeons drop the 90-degree limit altogether. Surgeons differ on this, so follow the rules you were given. See anterior vs posterior hip replacement
Choosing a chair after hip replacement
- A firm seat: Soft cushions sink under you and lift your knees above your hips.
- Armrests on both sides: You need them to lower yourself down and push yourself back up.
- The right height: If a chair is too low, add a firm cushion or a folded blanket until your hips sit above your knees.
- An upright or slightly reclined back: Leaning back a little opens the hip angle. Slumping forward closes it.
- What to avoid: Low sofas, deep armchairs, bean bags, rocking chairs and chairs on wheels.
The OrthoInfo guide to activities after total hip replacement gives the same advice: a firm chair with a higher than average seat.
How to sit down and stand up
- Back up to the chair: Walk backward until you feel the seat touch the back of your legs.
- Slide the operated leg forward: This keeps the hip from bending as far as you lower yourself.
- Reach back for both armrests: Lower yourself slowly, taking your weight through your arms.
- To stand up: Shuffle to the front edge of the seat, slide the operated leg forward first, then push up through the armrests. Don’t pull yourself up on your walker or crutches.
Keep your hips higher than your knees, and you have kept most of the rules.
Sofas, toilets and the car
- Sofas: Most are too low and too soft. Skip them for the first six weeks, or sit at one end on a firm cushion and use the armrest to get up.
- Toilets: A standard toilet is usually too low. Use a raised toilet seat, or a firm cushion if your team agrees, and set it up before surgery.
- Getting into the car: Push the seat all the way back and recline it a little. Stand with your back to the car, sit down on the seat first, then swing both legs in together, turning your whole body rather than twisting at the hip. Add a firm cushion if the seat is low.
- Getting out: Do the same in reverse: swing both legs out together, then stand using the door frame and seat.
- Long drives: Stop regularly to get out and walk. See driving after surgery
How long can you sit?
- Every 30 to 45 minutes: Stand up and walk for a few minutes. Long spells of sitting make the hip stiff, increase swelling and raise your risk of a blood clot. See blood clot after surgery
- At a desk or the table: Use your best chair, not a low dining or office chair, and keep the things you need within reach.
- Lying down is different: Sleeping has its own rules about pillows and sides. See sleeping after hip replacement
When do the sitting rules stop?
- Weeks 0 to 6: Follow the sitting rules every time, including at night when you get up for the toilet.
- Around week 6: Your surgeon usually reviews you and often relaxes or lifts the precautions.
- After that: Return to lower seats gradually. Some surgeons advise care with very low seats for up to three months.
Go to the emergency department if
- You hear or feel a clunk or pop in the hip, followed by severe pain.
- You suddenly cannot put any weight on the leg.
- Your leg suddenly looks shorter or is turned in or out. These are signs of a possible dislocation.
- You become short of breath or have chest pain, which can mean a blood clot has reached the lung.
Call your surgeon today if
- You have new pain, swelling, warmth or tenderness in your calf.
- Your wound becomes red, hot or starts leaking fluid, or you develop a fever.
Mention it at your next review if
- At six weeks, sitting for 30 minutes is still painful.
- You get groin pain every time you stand up from a chair.
- You notice a numb patch on the outer thigh. This is common after the anterior approach and usually shrinks over months, but your surgeon will want to know.
A deep, soft sofa looks like the comfortable choice, but a firm, high chair is the one your new hip needs.