How long are walking aids required after hip replacement surgery?

Duration of Walking Aids After Hip Replacement

Most patients discontinue walking aids within 6 weeks after total hip arthroplasty based on their own pain levels and functional ability, and this early discontinuation does not increase dislocation risk.

Evidence-Based Timeline

Early Discontinuation is Common and Safe

• By 6 weeks postoperatively, 50% of patients have already stopped using prescribed walking aids, despite traditional recommendations to continue for longer periods 1
• Research demonstrates that 38% of patients had started walking without aids by 6 weeks, with no dislocations occurring in this group 2
• At 10 weeks post-discharge, patients typically use only 2.3 aids per person, down from 5.8 aids at 2 weeks 3

Clinical Recommendations

Walking aids should be used as tolerated and discontinued based on functional ability rather than arbitrary time frames, typically within 4-6 weeks for most patients:

• Initial postoperative period (0-2 weeks): Walking aids are essential for safety and weight-bearing as tolerated 4
• Weeks 2-6: Progressive reduction in aid use based on pain, stability, and confidence 2, 1
• Beyond 6 weeks: Most patients have discontinued aids; continued use should be based on individual functional limitations 1, 3

Important Clinical Context

Why Patients Stop Using Aids

The primary reason patients discontinue walking aids is improved functional ability and confidence that they can manage without them 3. This patient-driven timeline appears safe when:

• Posterior soft tissue repair was performed during surgery 5
• Modern surgical techniques with larger femoral head sizes (28-36mm) are used 5
• No significant complications are present 2, 1

Dislocation Risk Considerations

Shortening hip precautions and walking aid use does not increase dislocation risk when appropriate surgical technique is employed:

• Studies show 1% dislocation rate with only 4 weeks of precautions, with 75% of dislocations occurring after the precaution period ended 5
• Zero dislocations were reported among patients who discontinued aids early in multiple studies 2, 1

Special Populations Requiring Longer Duration

Certain patients may require walking aids beyond 6 weeks 3:

• Patients with rheumatoid arthritis (versus osteoarthritis alone)
• Those with bilateral hip replacements
• Patients with other orthopedic or medical comorbidities
• Individuals with balance or safety concerns

Practical Algorithm

Week 0-2: Full weight-bearing as tolerated with bilateral walking aids (crutches or walker) 4

Week 2-4: Transition to single cane or crutch if stable and pain-controlled 3

Week 4-6: Discontinue aids if patient demonstrates:

• Stable gait pattern
• Adequate pain control
• Confidence in mobility
• No significant limping 2, 1

Beyond 6 weeks: Continue aids only if functional limitations persist 1, 3

Common Pitfalls to Avoid

• Do not enforce rigid 6-12 week timelines when patients demonstrate earlier functional recovery 1
• Avoid prescribing excessive adaptive equipment that patients will not use—focus on walking aids and essential items 3
• Do not assume non-compliance indicates poor outcomes—patient-driven discontinuation based on functional ability is safe and appropriate 2, 1

The evidence strongly supports a functional, patient-driven approach to walking aid discontinuation rather than arbitrary time-based protocols, with most patients safely discontinuing aids by 6 weeks postoperatively.