After a transtrochanteric surgical approach for total hip arthroplasty, which statement about abduction precautions is MOST accurate?

• A. Active Hip Abduction to 40 degrees in Sidelying Is Allowed
• B. No Resisted Abduction and No Active Isotonic Hip Abduction Against Gravity Until the Osteotomy Has Healed
• C. Abduction to Neutral Is Prohibited
• D. Hip Abduction to 60 Degrees Is Allowed Immediately

Answer: (B)

After a transtrochanteric approach, the greater trochanter is temporarily detached to access the hip, and the abductor muscles attach there. Healing the trochanteric osteotomy depends on protecting those attachments from stress. Abduction forces—especially when resisted or performed actively against gravity—place tension on the osteotomy site and can disrupt healing or cause displacement. So the safest, most accurate precaution is to avoid any resisted abduction and any active hip abduction against gravity until the osteotomy has healed.

Other options misstate the restriction by implying either early active movement is allowed or by prohibiting abduction entirely, which isn’t consistent with typical healing guidelines.