During transfer after hip arthroplasty, which position helps protect the joint?

• A. Neutral alignment with no adduction or internal rotation
• B. Flexed and adducted
• C. Flexed and externally rotated
• D. Extended and adducted

Answer: (A)

The key idea here is protecting the hip prosthesis by avoiding movements that can destabilize the joint. After a hip arthroplasty, keeping the leg in neutral alignment with no adduction or internal rotation minimizes stress on the joint and reduces the risk of dislocation during transfers. When the hip is neutral and not crossing the midline, the femoral head stays centered in the socket and the posterior structures aren’t put on a risky stretch.

Positions that involve flexion with adduction place the leg across the midline and bend the hip, which increases the chance of the ball slipping out of the socket. Flexion with external rotation, while less risky than internal rotation in some planes, still involves bending the hip and can approach unsafe ranges depending on the surgical approach. Extension with adduction also crosses into adduction during a position that can strain the joint and surrounding tissues. So, the neutral position with no adduction or internal rotation best protects the joint during transfers.