Hip replacement surgery: the good, the bad, and the ugly - personal experiences appreciated!

[iberianfan]

I really don’t have a lot to add here. So much good advice and information. I have had both hips replaced: right one over 10 years ago anterior; left one this past October posterior.

For me,anterior was much easier to recover from. But I was 10 years younger. They kept me one night, but had me up walking same day and doing stairs on day two. Never used crutches or a walker. Used a cane briefly. Started PT on Monday after surgery on Friday. Had to have a driver for a couple of weeks.

Now I am 70 and th is last one was more difficult. It was done outpatient. A lot more pain at the incision site and restrictions on movement. But stopped pain meds by Saturday following Monday surgery. Beginning week 2, things improved a little each day.

Both times, resumed riding 6-7 weeks out. Resumed Pilates too. I have arthritis in virtually every joint. Having a knee injected tomorrow. Have severe scoliosis with major pinched nerve in my spine but injections help. also had a right shoulder replacement.

So I can understand your urgency to keep moving. PT helps a lot to get you started and it gets progressively more challenging in the exercises. Ice is your friend. Pretty much constant icing. If you don’t have one of those little machines that pumps ice water through a poultice type wrap, get one. I am sure you can find a used one. Looks like a small ice chest.

With the posterior incision, I couldn’t sleep on either side. But the couch worked for sleeping on my back (better than my bed). Recliner was not comfortable, although it saved my life after shoulder replacement.

Well, for someone who didn’t have much to say, I certainly blathered on. You will do great!!!

[Dr_Doolittle]

Thank you, @iberianfan - you are an inspiration!

I SO appreciate all the incredibly helpful information from everyone, thank you all again!!

[iberianfan]

Oh, and I have stairs literally everywhere. It’s even one step down to my living room. I never found them to be too much of a problem.

[paintedpony]

Although our surgical experiences are at least somewhat similar, and chances are yours will be “average” everyone’s recovery is unique. Please do not measure yourself and your progress/success based upon the experience of another. You are unique. One person will have no post op pain, immediately walk with ease or be back to work in 2 weeks. That might not be your experience. Accept that you may progress at a slower pace, experience more pain, or have different challenges. That could be you. Formulate a return to home plan that will position you for success regardless of your rate of progress.

Knowing I would be home alone for very long periods (12-14 hrs) beginning the day after discharge, I purchased a lift chair (our furniture was low and I was afraid I would have difficulty rising without assistance. I was very fearful of falling. Lol, you will understand that fear). Being able to raise your seat height even slightly makes standing so much easier and the ability to ever so slightly alter my position was a godsend! This purchase was the best decision ever! During the first weeks I spent a great deal of time in this chair. It was so comfortable. (In hospital I spent my two nights sleeping in a geri chair as it was way more comfortable than bed). I loaned the chair out twice to other post op hip recipients, and eventually gave it away to an elderly relative.

Set up a recovery corner. Table, light, reading material a few water bottles, computer, remote control, light blanket, charging wires etc. Have some form of containment for the bits and bobs. A small basket or bag.

I recommend you purchase a “reacher”. Somehow, having your hip replaced causes you to drop almost everything. Nothing worse than the TV stuck on the weather channel for hours because you dropped the remote or your pain pills are on the floor.

Do you have clothing that will work? You will want to be dressed, but struggling into leggings or jeans will not happen. I bought two soft open leg track suits. Lol, yes the little old lady leisure suit. My feet were cold. Hubby bought me loose fleecy booties with nonskid bottoms.

Figure out how you will transport food and fluids. Do you have a travel mug/water bottle that does not leak? Do you have a hands free way to carry it. I used tote bag tied to my walker.

After proving to myself that I was one of the people who would fall using crutches, I stuck to a walker. My strength was good, but balance sucked. Do whatever you need to be safe. Do not fall. Bath transfer bench was very helpful.

If you are in pain deal with it. Tylenol, prescription pain meds whatever it takes to allow you to do the physio required.

Physio is essential, DO IT.

You will have limit energy, spend it wisely. Establish a routine that works for you and stick to it. Plan your day to alternate work and rest. Focus on doing the essentials such as physio and showering in the morning. If you find you are fatigued and need to nap, do so without shame.

Everyone recovers, we just do it at our own pace. Please do not be disappointed if you progress at a slower rate than some, or require a few more aids.

[Zu_Zu]

Returning to read any updates Dr. ~ hoping the process is moving smoothly and your questions are being answered by your “hip” team ~ Jingles & AO ~ extra carrots for Ella !

[Zu_Zu]

@Dr_Doolittle ~ ^ that was a rhetorical? btw no need to reply as it may trigger too much feedback for your brain cell to ‘process’ during this anxious time ~ just know the Z-gang is thinking of you ~

[Dr_Doolittle]

As always, you are too kind

Had an appt. with the surgeon - surgery is scheduled for May 4th (May the Fourth be with you! I am choosing to consider this a “lucky” date.)

He was very matter of fact - seems to think my recovery (considering my general health and fitness, how my x-rays looked - though the arthritis is significantly worse since my last x-ray in July '22, and it’s now bone on bone) will be unremarkable - and said that his patients go home the same day. He does the anterior approach, and the sedation is twilight sleep and an epidural. Thank heavens for this because when I got breast reduction surgery, I went under a general and it took TWO HOURS longer than expected for me to wake up. Of course they told my husband and daughter nothing while they were waiting and waiting - and when they finally got me “ready for discharge”, I was barely conscious. They hurried me through changing (had to help me because I could barely speak, couldn’t walk, and couldn’t move my arms), and husband and daughter had to half carry my “carcass” to the car and then up the stairs to the house. It was awful.

I did mention this to the surgeon, but he doesn’t use a general - to my great relief! He said that unless I had issues I would be able to do PT at home (since I will have DH’s help), and start going to a PT center after 2 weeks. Obviously no driving for awhile since it’s my right hip, so will have to enlist DH - but if all goes well I can probably be driven to my horse and to the barns where I teach - the more “moving around” the better but obviously first using a walker and then a cane.

He said that I would be sent a detailed list of instructions, and that I would need to schedule a physical with bloodwork and an EKG within a month of surgery. No restrictions on riding between now and then (other than pain, though the injection seems to be working pretty well and I’ve ridden 3 horses in the past two days; my students’ and my own) - and I’ve only had twinges. I’m sure I’ll be a hurtin’ puppy by the time I’m ready to go under the knife, but in the meantime I’m doing what I can do! This thread has been SO helpful, though; it’s great to hear peoples’ personal stories and insights into what to expect, and I’m optimistic - though of course everyone’s experience is different and I’m also prepared for that. A friend’s father went through it twice (older than I am), and his advice was to work on upper body strength before surgery because you will need it!, so back to the pushups. I can add some MORE strengthening exercises to my schedule between now and then to make sure I’m as strong as possible before surgery. We will obviously have to prepare the house, but I have almost two months. DH will be taking some time off to help so that’s all set - and DD will come over and help me with the dogs. Must keep a positive attitude, and I’m not afraid of the work!

[Zu_Zu]

Canter on !

[beau159]

@Dr_Doolittle

Thanks so much, I am very grateful for you taking the time to explain everything so thoroughly! I’ll have a list of questions at the consultation, there is so much to ask (and prepare for), but the contributions of posters in this thread have really helped guide me in the right direction.

Might you have a link to the Facebook group you mentioned?

I don’t know that I am allowed to post it here (can’t remember COTH rules) so I will try to PM it to you.

Glad you are on the schedule for surgery!!

@Dr_Doolittle

Sleeping in a recliner; that would be a good idea (I sit in one in the living room), but trying to sleep in it may KILL my low back. My QLs are very tight and I have to use lumbar support, heat, TENS unit, regular bodywork, trigger point injections, stretching, inversion table etc. to keep them from seizing up. DH said he can bring our daughter’s single bed downstairs and see if he can “make it fit” in the living room. (This should be an interesting experiment! Ha! Yoiks.)

Just want to say that I’ve struggled with lower back pain for a long time too … and now that I’ve had my hip fixed, I’ve realized my lower back pain has been because of my hip!!! So, maybe, maybe could yours loosen up after having your hip done? Just a thought!! It’s amazing how much of the rest of your body can be affected by one thing.

[Dr_Doolittle]

Thanks for the link! Will check it out today

Re: the low back thing - it would sure be nice if I got some relief, but the low back thing has been going on for 20+ years and the hip has only been bothering me for a year, so…

It might help with the tight muscles on the right side, though - the ortho said my right leg was a little shorter as a result of the arthritis. Since I only started having pain about a year ago, the arthritic changes have accelerated quickly!; it’s much worse than it was only 7 months ago.

Anyway, I guess I’ll find out - and will cross fingers!

[Simkie]

@Dr_Doolittle

Re: the low back thing - it would sure be nice if I got some relief, but the low back thing has been going on for 20+ years and the hip has only been bothering me for a year, so…

Hip stuff can totally present as low back. Did anyone ever actually look at your hip with anything but a radiograph?

Hip instability or impingement can cause damage to the labrum, which is a cartilage cuff on the rim of the acetabulum that serves as a gasket in the joint. Hip instability is also painful in it’s own right, because the muscles surrounding the hip–which includes things like the psoas, which originates at the lumbar spine–work overtime to keep you together, when it’s really the bony structure that’s supposed to be doing the bulk of that work.

Hopefully you find even more relief than you expect with this surgery!

[Dr_Doolittle]

That would be nice! But interestingly, this arthritis came on pretty suddenly and progressed quickly. I’ve had rads and MRIs of my low back and pelvis over the years (between my osteopaths, orthopedists, and chiropractors), nothing remarkable ever showed up until last year; around this time I started to have pain in my right hip and at first thought (assumed) it was soft tissue until I went in and got an x-ray last July.

Left hip is fine (a little arthritis but to be expected for a 66-year-old), and my two hips look like they belong to different people.

I will definitely be excited for some relief if this was indeed contributory!

[beau159]

@Dr_Doolittle

I’ve had rads and MRIs of my low back and pelvis over the years (between my osteopaths, orthopedists, and chiropractors), nothing remarkable ever showed up until last year;

Curious - did they tell you or suspect if you had a labral cartilage tear? It’s my understanding that that can make things progress pretty rapidly. (it did for me) And a cartilage tear doesn’t actually show up on any imaging and can only be assumed with contrast dye during MRI.

Not that the cause really matters as you need the replacement regardless, but curious!

And now I am just reading @Simkie response above. Guess we think alike!!

[Simkie]

@beau159

And a cartilage tear doesn’t actually show up on any imaging and can only be assumed with contrast dye during MRI.

A non contrasted MRI at 3 tesla does a fine job showing a labral tear, but it does need to be a hip series, and the radiologist does need to be looking for that. So often they’re not!

So much of this hip stuff is new enough that if you’re not seeing exactly the right specialist, no one is going to pick it up. Without a dedicated hip MR, and a careful look by a pretty specific doctor, who knows what’s in there.

[Dr_Doolittle]

Well, I do have a hip MRI scheduled for April - doc didn’t seem to feel it was necessary, but might be good to have anyway…

Would the results have any impact on surgery, or no?

[beau159]

@Dr_Doolittle

Well, I do have a hip MRI scheduled for April - doc didn’t seem to feel it was necessary, but might be good to have anyway…

Would the results have any impact on surgery, or no?

Not really.

The total hip replacement is going to take out all the bad cartilage too, if you have one. You already have the arthritis, so as far as the surgeon is concerned, it’s not going to change how he is going to do the THR.

[Dr_Doolittle]

That’s kind of what I figured, thanks! Let me see if I can attach a picture of the hip in question:

(There’s really no cartilage left, and there are two bone cysts as well – the black dots on the x-ray)

[Simkie]

@Dr_Doolittle

Would the results have any impact on surgery, or no?

Hmmm, probably not? The labrum is removed in hip replacement, so it doesn’t matter if it’s toast. Something like a hip capsule tear or high grade abductor tendon tear might change the approach? (Or add a procedure…) If they find something like ischiofemoral impingement, the surgeon can be careful to not overmedialize the cup. For most facing hip replacement, MRI isn’t really worth the effort, since you know the problem is trashed articular cartilage. With your complex & long standing pain pattern, it’s probably a good box to check, just to make sure the picture is clear. (That you’re complex is another reason to get another opinion or two, more eyeballs is better! All of your imaging is portable.)

Did your surgeon mention a 3D CT? That’s important for planning prothesis type & size. That’s also the best way to evaluate things like acetabular undercoverage or version weirdness, which shouldn’t derail replacement but might up the difficulty a little. You want to know going in if there’s really the room to seat the cup you want to use, ykwim?

[Simkie]

I’m reaching back a bit here, but IIRC that tear drop sign is a signal of acetabular retroversion. There’s also very clear cam FAI. It’s a bit hard to tell with no joint space (ouch) but the acetabular index also looks low. Yes, there’s been a problem here before you lost all the cartilage

[Dr_Doolittle]

That’s really interesting, could you elaborate?