Depending on how long it's been since they have had their survey, they may not be able to take the leg across the midline, so single leg circles just to the midline. Keep kegs hip width apart when doing elephant. I would give them modified versions of any mat work where the legs cross. It could potentially pull the new head out of the acetabulum, placing them at great risk. Talk with them about their surgeons suggestions.
Lara, I'd strongly recommend you speak to your client's doctor about any contraindications. I'm not sure if the guidelines have been updated since they were saying don't flex at the hip beyond 90 degrees or cross the midline. If not, the sheer act of getting down on the Mat could be contraindicated. I agree with Lynn... Talk to your client about their surgeons suggestions.
Thank you!