I had a hip replacement January 2012 using the posterior approach by a very experienced hip specialist–that’s all he does–hips. Titanium shell and femur stem, ceramic femur head, and highly crosslinked poly shell liner. I was in pretty bad shape going into the surgery --was in a lot of pain, using a cane and walking like a 100 year old, rather than a 51 year old. Muscles on that leg had atrophied–it wasn’t pretty. I had spinal anesthesia and it was great. I woke up quietly, no pain because I was numb from the waist down. Spinal wore off slowly so I had lots of time to get adequate pain meds in me before it wore off totally. Much easier to keep up with the pain that way.
Non-cemented and I was full weight bearing from get go. I came along with recovery pretty quickly. I was originally told 12 weeks before riding, but at 7 weeks, I was given the OK to ride if I could comfortably do so. Unfortunately I couldn’t do it because of arthritis pain in the other hip. The new one felt fine at that point, though.
I know the anterior approach is all the rage now, but personally, I would rather the surgeon be able to physically see what they are doing in there, rather than rely on radiologic equipment and to check the hardware placement. Yes, a few more muscles are traumatised with the posterior approach, but with an experienced surgeon, recovery can still go pretty quickly. I belong to an online support group for hip replacement patients and I’ve found reports of nerve injuries and dislocations to the front with anteriors, more so than the posterior. Seems like the posteriors come out of surgery with everything working OK and just start their healing without much drama. There is a period of restriction for things like bending more than 90 degrees and crossing your legs, but that period goes fast (mine was for 6 weeks) and it didn’t seem that inconvenient after the first week or so.
I sometimes wonder if some surgeons are jumping on the anterior bandwagon because they can draw in patients who want the anterior … but they might not be that well trained in the procedure. I was just looking at a rthopedic group’s owebsite the other day where the primary focus of the ortho surgeons seemed to be complex fractures and pelvis reconstruction. But, then I saw a section about their doing anterior hip replacements too. Seemed odd to me because it was like it was an extra thing they added into their practice and that was the only type of hip replacement they did. There is a lot of competition in the joint replacement world these days … Stuff like this concerns me. Just my 2 cents.
I had the second hip replaced by the same surgeon but had to go to a different hospital. That was in June 2012. The surgery went fine and I felt even better and had better post op mobility than after the first one–I got out of bed the next morning with very little help and walked in the hall for more than 50 feet without batting an eye! I thought recovery was going to go at lightening speed–it had been so much more difficult with the first hip at that point because I had been so weak prior to having the surgery. The problem that occurred, though, is that I had to go to a different hospital for hip number 2, and their physical therapy was much more aggressive. I don’t know why I didn’t refuse some of the more painful exercises … but I didn’t. I gritted my teeth, cried, and just forced my way through them. I ended up getting a hip flexor tear and although the hip itself is fine and healing great, the tear is delaying my overall recovery. My surgeon thinks that it may be up to 6 months before the groin pain is gone and the tear is healed. That is such a bummer because I started out SO well.
Advice for anyone undergoing a hip replacement, or… really any ortho surgery like it: Although PT immediately post op is not easy and it does involve some pain, it shouldn’t be severe pain–if it is severe STOP and refuse to do it. You don’t need to go great guns on PT in the beginning to recover just fine. Starting with some basic exercises and walking is all you need during those early post op days; you can advance to more intensive exercises as time goes by. You may need a friend or family member to attend the first couple of PT sessions, just to watch out for you because I know my judgment was clouded between the stress of the surgery and the meds, and I tended to just do anything they wanted me to do, even though it hurt like “you know what” and I told them so. They just pleasantly said “Oh you are doing fine; keep going.” Well, “keep going” ended up with an injury I didn’t have going in. So, just be on the lookout for overly aggressive (yet usually well meaning) physical therapists and stand up for yourself if necessary.
My riding will probably be delayed until spring of 2013–I’m a wuss and don’t tend to ride in the winter. But, I wasn’t able to ride for more than 2 years prior to surgery, so I guess waiting a few more months won’t kill me.
Good luck to anyone considering this surgery. It’s not a walk in the park (it’s a major surgery), but it’s very doable and it’s absolutely life changing to go from feeling that awful arthritis pain to having a joint that moves fluidly and feels great. The joint prostheses they are using now are lasting a lot longer too, so it’s nothing to be able to get 20+ years out of your first replacement.
