In our last post, we informed you about hip osteoarthritis. However, if osteoarthritis or an injury in the hip joint has progressed to the point where a pain-free life is no longer possible, a hip TEP is often recommended. The hip joint total endoprosthesis (TEP) is a widely used and therefor effective surgical solution for patients with severe hip problems. A TEP can significantly improve quality of life and typically lasts 15 to 20 years.

What is a Hip Joint TEP?

A hip joint total endoprosthesis (TEP) replaces the damaged hip joint with an artificial joint component. This procedure is often performed on patients suffering from severe hip joint pain and functional limitations due to osteoarthritis, rheumatism, hip fractures, or other degenerative joint diseases.

Types of Hip Joint TEPs

There are different types of hip joint TEPs, selected based on the patient and specific needs:

  • Cemented Prostheses: These are fixed with a special bone cement and are particularly suitable for older patients whose bone quality may not be optimal.
  • Uncemented Prostheses: These are inserted without cement, allowing the bone to grow into the surface of the prosthesis. They are ideal for younger, more active patients with good bone quality.
  • Hybrid Prostheses: A combination of cemented and uncemented components. Often, the hip socket is uncemented while the femoral component is cemented.
  • Short-Stem Protheses: These preserve more bone and are suitable for younger patients or those with less bone damage.

Why is a Hip Joint TEP Used?

A hip joint TEP is primarily used for the following reasons:

  • Pain Relief: Chronic pain caused by degenerative joint diseases can be significantly reduced or completely eliminated by replacing the damaged joint.
  • Improvement in Quality of Life: An artificial hip joint can greatly enhance mobility and the ability to participate in daily activities.
  • Prevention of Further Heath Complications: Chronic hip pain and movement restrictions can lead to additional health problems, such as muscle atrophy or postural issues.

Physiotherapy After a Hip Joint TEP

Physiotherapy plays a crucial role in recovery and rehabilitation after a hip joint TEP. Here are some important aspects of how physiotherapy contributes:

1. Pain Control and Swelling Reduction:

After the operation, it is important to alleviate pain and reduce swelling. Physiotherapy uses various methods to achieve this:

  • Cold Therapy: Application of ice Depacks to reduce swelling and relieve pain.
  • Manual Therapy: Gentle manual techniques to promote blood circulation and alleviate pain.
  • Manual Lymphatic Drainage: This technique drains lymph fluid, reduce edema, and decrease swelling.

2. Restoration of Mobility:

Restoring the mobility of the hip joint is a primary goal in the early phase of rehabilitation. This includes:

  • Passive Movement Exercises: The therapist performes these to gently mobilize the joint.
  • Active Movement Exercises:  The patient performs these exercises independently to improve mobility and build confidence in the new joint.
  • Resistance Movement Exercises: These exercises help to strengthen the muscles and enhance mobility.
  • Deep Muscle Strengthening on Uneven Surfaces: Exercises on unstable surfaces improve stability and strengthen the deep muscles.

3. **Muscle Strengthening**:

Targeted strengthening of the muscles around the hip joint is essential to support the stability of the new joint and improve overall posture. This includes:

  • Strengthening Exercises for the Hip Muscles: Exercises such as leg lifts, bridges, and targeted training of the adductors and abductors.
  • Stabilization Exercises: Exercises that strengthen the core and deep abdominal muscles to stabilize the hip.
  • Proprioception Training: Exercises to improve body awareness and balance.

4. Gait Training:

Physiotherapy also involves training the correct way to walk. This helps the patient regain a normal gait pattern and avoid incorrect loading. Measures include:

  • Gait Analysis and Correction: The therapist analyzes the gait pattern and also provides feedback for improvement.
  • Exercises for Gait Stability:  Training on various surfaces and with obstacles to enhance stability.
  • Use of Walking Sticks or Aids: Instruction on the correct use of these aids and gradual discontinuation.

5. Functional Training:

To prepare the patient for a return to daily activities, physiotherapy also includes functional training. This involves:

  • Exercises for Daily Activities: Exercises that improve the skills for tasks such as climbing stairs, getting up from a sitting position, and bending.
  • Ergonomic Training: Tips and exercises for correct posture and movement during daily tasks to avoid overstrain.
  • Sport and Leisure Activities: Advice and training for the safe return to sports and leisure activities.

6. Ergonomics and Assistive Device Counseling:

Physiotherapists also advise patients on the proper use of assistive devices and ergonomic adjustments to their living spaces:

  • Assistive Device Counseling: Selection and adjustment of walking sticks, aids, seat cushions, and other assistive devices.
  • Ergonomic Adjustments in the Home: Tips for adjusting furniture, bathrooms, and kitchens to make the postoperative phase safer and more comfortable.
  • Training for Independence: Instruction on techniques that enable the patient to perform daily activities safely and independently.


A hip joint TEP can greatly improve the lives of patients with severe hip joint problems. Selecting the right prosthesis and a successful operation are just the first steps. Postoperative physiotherapy is crucial for a full recovery and a return to an active, pain-free life. In our practice, we offer tailored physiotherapy programs that are customized to the individual needs of our patients, helping them achieve their recovery goals. Do not hesitate to contact us if you have any questions or would like personalized advice.