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When Can You Use A Regular Toilet Seat After A Hip Replacement ?

After a hip replacement, there are going to be a number of precautions you are going to have to follow, regardless of which type of hip replacement you have. And it is going to get pretty tedious. At first, the pain and all the warnings you were given, will probably keep you in check, but after a while, just like my mom, you will be wanting to get back to doing things the usual way.

For those individuals who have been told to use a raised toilet seat after hip surgery by their surgeon, the precaution will usually be taken for up to 6 to 10 weeks following your surgery.

The exact when you will be given the all clear to start sitting on the toilet again, can only be determined by your surgeon.

The surgeon may let you know when you have your 6-week post operation assessment, or at a later date.

The speed at which you recover from surgery will determine when you no longer need raised seating, and it will depend on your age, state of health, and your type of surgery.

Whether you require using a raised toilet seat is generally determined by, whether you had a posterior, lateral or anterior approach hip replacement.

Do you need a raised toilet seat after hip surgery ?

The use of a raised toilet seat, chairs and precautions about bending forwards and reaching when leaning over, are typically only advised for those individuals who have had either a posterior, or a lateral, approach hip replacement.

After posterior, or lateral, hip replacement surgery, the muscles around the hip, are in a weakened state, as some larger muscles have been cut through for these types of approach.

Situations where greater stress is placed on the joint, should be avoided for a number of weeks, because of a minor risk of dislocations.

Sitting, sitting down, and standing up, will all put more stress on the hip, and can lead to a dislocation, if they are not performed in particular ways.

One of the measures taken to reduce the stress on the joint is to raise the level of all the seats you are using to a height where the hip is at a lesser angle.

The precautions for sitting, sitting down, standing up and bending down are often referred to as  the 90 Degree Rule.

If you wish to find out about the precautions you will have to follow after a posterior, or lateral hip replacement surgery, when sitting and bending, you can read about them in this article – “Do You Need A Raised Toilet Seat After Hip Surgery” in which I discuss and illustrate them.

In this article “How To Sit On A Toilet After Hip Surgery: A Detailed Illustrated Guide”, you can see how to sit on a raised toilet seat, with or without armrests, using a walker, and which is fully illustrated.

For those individuals who have had an anterior approach hip replacement, there are typically very few precautions advised for how you sit, other than don’t cross your legs or sit in extremely low seats. There are other precautions, but they are not all the same as those for the other two approaches.

If you are very tall, it may be the case that your toilet is going to be a bit too low, but your surgeon will most likely tell you this.

The anterior hip replacement surgery is performed at the front of the hip, and the muscles are separated for the surgery, not cut through, and as such the joint’s stability is not so affected, as in a posterior or lateral approach hip replacement.

 

How high should a raised toilet seat be after a hip replacement

 

If you have been advised that you need to sit on a raised toilet, you will want to sit in a position where your hip is higher than your knees.

To work out what height your raised toilet seat should be, you need to measure from the floor to the back of your knee, and then make sure that the height of your toilet seat + your raised toilet seat, is higher than this, and your hip will then be higher than your knee when you are sitting on the seat.

 

If you want to see more about how to measure a toilet for a raised toilet seat, you can read my article explaining  –

  • how to check and measure the toilet to see if you have an elongated or a standard toilet bowl
  • how to measure yourself to find out how much of a lift your seat needs

That article is here – “How To Measure For A Raised Toilet Seat”.

 

Sitting on a toilet seat after a hip replacement

Both the patient and the carer need to know how the patient is going to sit and stand up after a hip replacement.

In most cases, if it was a posterior or lateral hip replacement, you are going to want to raise the height of your toilet seat.

For this, you will need some form of raised toilet seat or a toilet plinth.

If you don’t know anything about raised toilet seats, you can look at my article, “Types Of Raised Toilet Seats: All You Should Know Before You Buy”. In all, I discuss 13 different types of seats which you can use, and which are best models for which situations.

 

How to sit down on a raised toilet seat with armrests

 

In this section I’ll look at – how to sit down on a raised toilet seat with armrests, how to stand back up, and how to use a walker to assist with balance and stability.

If you want a fully illustrated guide I have an article all about this, which I mentioned in an earlier section of this article, which you can find here  – “How To Sit On A Toilet After Hip Surgery: A Detailed Illustrated Guide” 

To sit down

 

Step 1

Using the walker for support, slowly back up to the toilet

 

Step 2

Stop when you feel the seat against the back of your legs.

 

Step 3

Lower any clothes you need to, with the hand holding on to the walker on the side of the operated leg.

Place the hand back on the walker once you have lowered your clothes.

Now extend the leg with the hi replacement slightly out in front of you.

 

Step 4

With your hand on the same side as the operated leg, reach back for the armrest of the raised toilet seat.

With the armrest in your grip, you can let go of the walker on the side of the non-operated leg, and take hold of the other armrest on the raised toilet seat.

Using your arms and your good leg to take your weight, start to lower yourself onto the seat.

Do not bend forwards as you lower yourself, just take your weight straight down through your arms, keeping a straight back.

 

Step 5

Sit down on the front of the raised toilet seat, do not attempt to sit down as far as you can at first.

 

Step 6

Now with your arms lift your self slightly to scoot back from the front edge of the seat, so you are sitting on it properly – don’t lean forwards to do this, just take your weight with your arms, and if you need to, use your good leg to help a little. Don’t wiggle your hips to move back, it is all in the arms and the good leg, otherwise you may twist your hip.

To stand up

 

Step 1

Extend your operated leg slightly out in front of you.

Take hold of both armrests, and scoot yourself to the front edge of the seat using your arms to lift you slightly, and your good leg if need be – keep your back straight, do not lean forwards.

Don’t wiggle your hips, this can twist the hip joint.

Step 2

Before you stand, make sure that your good leg is bent back slightly under you, your foot should be tucked slightly further back than usual, and not in front of you at all – in this position your good leg will be able to provide more force, without causing you to lean forwards .

 

Step 3

Now, use your arms and good leg to push up vertically, keeping your back straight, and trying not to lean forwards.

Your operated leg should be extended out in front of you, and not load bearing as you stand up.

 

Step 4

As you stand, when your arms are fully up, take hold of the walker with your hand on the hip replacement side, while you are still holding the armrest of the raised toilet seat with the other hand.

 

Step 5

Now take hold of the walker with your hand on the other side.

 

Step 6

Now you have both hands on the walker, and your weight is on your good leg, you can bring the leg with the hip replacement back into a normal position, but take care to not put much weight on the operated leg at first.

I, of course, cannot tell how far into your recovery you are when you read this, so I am assuming that you are not yet load bearing when walking.

Sitting on a toilet seat or raised toilet seat without armrests

 

To sit down

 

Step 1

Back up to the toilet with the walker until you feel the seat against the back of your legs.

 

Step 2

Extend your leg with the hip replacement slightly in front of you.

 

Step 3

Reach back to the raised toilet seat with your other hand on the side of your non-operated hip, while keeping hold of the walker with the hand on the side of your operated hip.

 

Step 4

Sit back down on the raised toilet seat once you have your hand on it, using your hand to help lower yourself to the seat.

You can let go of the walker once you are seated.

 

Step 5

With both hands on either side of the raised toilet seat, push up to lift yourself slightly and scoot back further on to the seat.

 

 

To stand up

 

Step 1

Put your on hand on your hip replacement side, on the walker, and scoot forwards on the seat towards the edge. Due to the fact that this seat has no armrests you will have to scoot forwards the best you can, but try not to twist your hip as you do so – if you need to use your other hand, on the non-operated side, it is best to place it on the toilet seat slightly behind you, and to push up a little and forwards. The reason for placing this hand a little towards the rear of the seat is to avoid it tipping as you push down.

 

Step 2

Extend the operated hip leg hip slightly out in front of you, tuck your good leg in under you, close to the toilet.

Meanwhile, the hand on the side of your operated hip, is still holding on to the walker.

 

Step 3

Now with your hand, on the side of your operated hip, is holding the walker, you can use your other hand to push up from the raised toilet seat. Again, have the hand on the raised toilet seat as far back as you can as you push up. If you place it too far to the front of the seat and push up, this is where you can make the seat tip.

Step 4

When you stand up, you are using your good leg, and your arm pushing up from the raised toilet seat to give you all the power – you should not be load bearing on your hip replacement when standing.

Step 5

Now you are standing, take hold of the walker with the hand that you used to push up from the toilet, and stand using the walker.

Step 6

Bring your extended hip replacement leg in to a normal standing position next to your good leg.

Toileting after a hip replacement

 

Typically, these methods of toileting are really only going to be necessary really for individuals who have had a posterior, or lateral hip replacement.

Using a walker to sit down, and to stand up

Immediately after your hip replacement surgery, you will learn how to sit on a raised toilet seat using a walker.

You may also be shown how to use a walker to transfer to a bath board for bathing.

Personal Cleaning

My mom, after her posterior hip replacement, sitting on her bedside commode, never had any problem performing any personal care, but this may be because she is very small and slight.

I have read that it is larger individuals who have the most trouble reaching to clean themselves.

Certain devices, and also particular models of raised toilet seat, will make it easier to wipe yourself on the toilet, without leaning forwards and risking issues with your new hip –

 

Open Front Seats

You can find these on certain safety frames with raised toilet seats, and some bedside commodes.

The seats are open at the front, to give you greater access for personal care.

 

Toilet Aids for wiping

The “Freedom Wand” is a long-handled device which has a little gripper on the end for toilet paper or wipes.

“Comfort Wipe”, is another similar long handled device, with a different type of gripping system for the toilet paper, or moist wet wipes.

 

Handheld bidet sprayer

The handheld bidet sprayer unit is a great device.

The unit to your toilet water inlet valve without too much fuss, and can be used to clean you without any mess.

An open front toilet seat, will facilitate cleaning with lots of room to slip the sprayer in under the raised toilet seat from the front, and then to direct the spray.

Best raised toilet seats after a hip replacement

This topic is rather too broad to be dealt with properly here, but if you want to read it, I have an article which goes into a lot of detail about why these are the best raised toilet seats for after a hip replacement,  here – “Best Raised Toilet Seats After A Hip Replacement”

For now, here’s the list of what I think are the best models of raised toilet seats, depending on the user’s age and weight –

 

Best raised toilet seat for the elderly after a hip replacement

 

1) OasisSpace Stand Alone Safety Frame and Raised Toilet Seat – with a hard seat

2) OasisSpace Stand Alone Safety Frame and Raised Toilet Seat – with a padded seat

3) PlatinumHealth Ultimate Raised Toilet Seat (safety frames with raised toilet seat)

4) Medline – basic 3-in-1 Bedside Commode

5) Nova Drop-Arm Padded Commode

6) PlatinumHealth GentleBoost Uplift 3-in-1 Commode and Shower Chair

 

Best raised toilet seat for larger elderly seniors (over 350 lb) –

 

1) Nova Heavy Duty Drop-Arm Commode 8583

2) Drive Deluxe Bariatric Drop-Arm Commode 11135-1

Best raised toilet seat after a hip replacement for a younger senior in good shape

 

Risers with armrests –

 

1) Nova 3.5″ raised toilet seat riser with arms  (standard), Model No. 8344-R

2) Nova 3.5″ raised toilet seat riser with arms  (elongated), Model No. 8343-R

3) Vive 3.5″ toilet seat riser with handles  (standard), Model No. LVA1071S

4) Vive 3.5″toilet seat riser with handles  (elongated), Model No. LVA1071E

Front locking raised toilet seat with armrests

  1) Vive raised toilet seat with detachable handles, Model No. LVA10011 2) Drive Medical Premium plastic raised toilet seat with armrests, Model No. 12013 3) Nova raised toilet seat with detachable arms, Model No. 8351-R  

Best raised toilet seats after a hip replacement, for larger, younger seniors (over 300 lb)

 

1) Nova Heavy Duty Drop-Arm Commode, Model No. 8583 – 500 lb weight capacity

2) Drive Deluxe Bariatric Drop-Arm Commode, Model No. LVA1071S – 1000 lb weight capacity

How soon can I take a bath after a hip replacement ?

You will have to get a more precise answer from your surgeon, about this. This question could be asking a number of things –

  • how soon after surgery can I get water on my stitches or staples
  • how long is it before I can sit on the bottom of a bath tub
  • how long is it before I can wash myself in general

 

I’m going to start with getting the wound or dressing wet – usually, you  will be asked not to get your stitches wet for at least 48 hours, but only your surgeon or nurses, are familiar with the type of dressing that you have.

There is one rule though – typically you can immerse your hip in a bath, hot tub or swimming pool, only after 6 weeks, so whatever you do, don’t submerge your hip wound underwater, until your surgeon, or nurses, have said that it is okay to do so.

If you have had an anterior hip replacement you will need to consult with your surgeon, except for the guidelines about submerging a surgical wound underwater, which do not change according to which kind of hip replacement you may have had.

Bathing in a bathtub after a hip replacement

 

Typically, after a posterior or lateral hip replacement, patients are advised not to sit in the bottom of a bath tub after a hip replacement for approximately 12 weeks, plus as I just noted, you cannot submerge your hip underwater for at least 6 weeks after surgery.

To wash yourself, sitting above the water of the bath tub

If you have a bath transfer bench, or a bath board, you can use that to transfer to a seated position over the water of a bath tub – you should be able to do this after a couple of days.

You can’t get in the water, and you have to not break the 90 degree rule of no bending, or leaning forwards, so you’ll need to have a handheld shower head on a long hose, and a long handled sponge for washing.

Ask your nurses or doctor, whether you are able to get your dressing wet, and if you need to take any precautions.

 

Taking a shower after a hip replacement

 

Most people are allowed to shower quite soon after your operation, and you will typically do that seated on a shower chair.

To make washing easier, you can use a long handled sponge and a handheld shower head, but more about that in a minute.

Once again, you will need to ask your surgeon or nurses about what type of dressing you have, and what measures, if any, you need to take when showering.

 

How long after a hip replacement can I tie my shoes ?

 After a posterior, or lateral approach hip replacement, the typical wait before being able to tie shoe laces by bending over is up to 6 to 8 weeks after surgery.

If you have had an anterior hip replacement surgery, there are not normally any precautions of this type, unless your surgeon has indicated otherwise. Although, you may want to use the tips I am giving you here for a week or so if you are experiencing pain when bending over. You shouldn’t force it, if it hurts.

There are a number of solutions for those who cannot bend down to tie their shoes.

Elastic shoe laces – you can replace your normal shoe laces with elastic shoe laces, and then lace them up on your foot, and make sure they are staying on properly – you may need to tighten or loosen to find the right grip. (You probably want to do this before your surgery).

After your hip replacement, to put your shoes on you –

  • use a reacher, or grabber, to position the shoes  on the floor in front of you
  • without bending forwards, slip your toes into the shoe
  • slip a long-handled shoe horn in the shoe behind your heel
  • slide your foot completely into the shoe

The elastic shoe laces will stretch enough to allow to you to slide your foot into the shoe, and then they will constrict to hold the shoe snugly on your foot.

 

Slip-on shoes – to put these on

  • put the shoe in position with the reacher
  • using the reacher, hold the shoe in place while you slip your toes in the shoe
  • take the log-handled shoe horn and slip it in behind your heel in the shoe
  • slide your foot on into the shoe

 

Remember, you must stay sitting upright and not to bend forwards, or you’ll break the 90 degree rule !!

As well as the elastic shoe laces, there are a number of other assistive devices which are going to be helpful to you during the precautionary period after your surgery, if you have had a posterior or lateral approach hip replacement, so let’s briefly take a look at those now.

Helpful items for after a hip replacement

This mainly applies to individuals who have had a posterior, or a lateral hip replacement, who will have to be careful to not lean or bend forwards, to protect their hip.

 

Devices with multiple uses-

 

– Reacher/ grabber – a basic lightweight, long handled, reaching aid  to pick up items and hold them in place, without reaching down and bending.

– a leg lifter – this is used to lift your leg on to, and off, a bed, or over the edge of the bathtub if you are using a bath transfer bench, or bath board.

The device also stops the user from bending their leg while moving it.

Walking Aids –

 

– A walker – you will be using a walker to help to maintain your balance, and to keep your weight off your new hip while walking, sitting down, and standing up.

– Walker pouches – you can attach these to your walker to carry a few lightweight items around with you.

– Canes – after surgery, at first you will walk with the walker, progressing to walking with several canes, or crutches, and finally to one cane (some hospitals prefer crutches, some prefer canes, but eventually you will use one cane for a period of time).

The time you spend using each aid, will depend on your age, how strong you are, and also how well the surgery went.

 Toileting Aids –

  – A raised toilet seat – this raise the height of your toilet seat. – A bedside commode – this can be used as a toilet in a bedroom, which is especially handy for when you first come home from the hospital, and even more so at night, and as a raised toilet seat over the toilet. – Toilet wands – aids for comfortable wiping without bending. – Handheld bidets – the most hygienic way of cleaning yourself after going to the toilet, and which also eliminate any bending down, or over reaching.  

Dressing Aids –

  – Elastic shoes laces – replace your shoe laces with these and tie them before surgery, and your shoes become like slip-on shoes – Slip on Shoes not a device, I know, but they make life easier – Long handled shoe horn – this is really a giant shoe horn to help you avoid bending down – Sock Aid – a simple frame you slip your sock over, and then slip your foot into – Dressing stick – a long-handled stick with a hook on the end which helps you dress  

Bathing aids

 

– Bath transfer bench or Bath board – placed across the bath, allows you to sit over your bathtub and wash

– Shower chair – makes showering much safer as you are seated

– Long handled sponge – a long plastic handle with a sponge on the end to help you wash without bending

– Hand-held shower head – avoids moving around to get wet, and allows you to rinse yourself all over without any twisting or bending.

– Non-slip rubber mat – wherever you are standing in water, you should have a non-slip mat, so definitely the shower

– Grab bars – on the walls of the shower and above the bathtub, grab bars are a great way to avoid having falls on slippery surfaces –  rough engraved grips are best as your hands don’t slip when they are wet.

I know it is extra work, but we only use the grab bars for my mom, which we screw on to the wall – it isn’t that hard to do.

– Toilet safety frame – big armrests which fits onto your toilet or over it, to give you proper support when you are sitting down or standing up.

There are various types of models, but the main types are –

 

 

  • models are without legs which attach to the toilet
  • models which stand over the toilet on have four legs

Lifetime Precautions after a hip replacement

The temporary precautions that hip replacements patients are advised to take, relate mainly to the surgical procedure that was used.

Posterior, and lateral, approach hip replacement patients having far more short-term precautions advised, than an anterior approach hip replacement patients.

Once your hip replacement recovery period is over – the muscles and other soft tissues been given the time to heal – and you have done your strengthening work, you will be able to return to activities such as exercise and sports

What activities you can do, once you have been through the recovery period, does not appear to depend on which method was used to implant your hip replacement. Just that, with an anterior approach hip replacement, you may return to these activities within a shorter timeframe.

Most surgeons recommend that patients could return to sports activities 3 to 6 months after surgery.

Lifetime precautions after a hip replacement, are more related to materials that make up your hip replacement.

Depending on the type of materials – metal, ceramic, polyurethane – you will be advised on what types of activities and sports, you can take part in.

Typically, you will be advised that swimming, bowling, stationary biking, dancing and walking are allowed. These are referred to as low-impact activities.

Some surgeons may say those patients with “experience”, can do downhill skiing, cross-country skiing, weightlifting, ice-skating and Pilates.

High-Impact sports (I can’t see how downhill skiing is not high impact), such as racquet ball, squash, football, soccer, rugby, baseball, softball, jogging and sprinting, are totally advised against.

The recommendations came from a study in 2005, where data from 614 surgeons were collected, to find out what was “allowed”, “allowed with experience” and “not allowed” after a hip replacement.

“The current recommendations of allowable or recommended activities are derived from surveys of hip and knee surgeons based on clinical experience and preference, not prospective and retrospective analyses.”

These results are not based on actual statistics of accidents from taking parts in activities, but are derived from what surgeons thought was good for their patients. This may be just as good, but I though that was interesting to note.

Depending on which type of material your hip replacement is made of, you will be advised to on which activities you can take part in safely.

“Polyethylene wear and the associated prosthetic loosening are the most common causes of post‐operative failure and the need for revision surgery. Therefore, activities that potentially expedite the wear through increased frequency or magnitude of loading (such as high impact sports) is a primary concern. To date there is limited information on the specific relationship between wear and sporting activities.”

The particular quotes above, and much of the information, come from the –  IJSPT – International Of Sports Journal Physical Therapy – Nov 2014 –

“Sports Participation Following Total Hip Arthroplasty”

 – by Erik P. Meira, PT, DPT, SCS, CSCS and Joseph Zeni Jr, PT PhD

You can read the article on the US National Library of Medicine National Institutes of Health website here –

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4223292/

 

If you read the article I have linked to above, you will see that there are also risks from wear down different parts of the hip and small particulates being ground off and getting into the tissues, which can lead to pain and other complications, and that there is an assumption that less vigorous, and a more low-impact activities may lead to fewer particulates coming off the implant and into the soft tissues.

Finally, there is the lifetime of your hip replacement – (according to webmd.com)

“95% of hip replacements last at least 10 years, about 75% last 15 to 20 years, and just over half last 25 years or more.”

If you treat it well, it may last longer, and if you take part in regular low-impact activities it is assumed that it will last longer !

I’m Gareth and I’m the owner of Looking After Mom and Dad.com

I have been a caregiver for over 10 yrs and share all my tips here.

Gareth Williams

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