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life time precautions

Discussion in 'Hip Replacement Recovery Area' started by hipper, Dec 18, 2010.

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  1. hipper

    hipper New Member

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    I had a LTHR on November 3rd. I had developmental dysplasia and a lot of damage to the hip. I had my 6 week check-up yesterday and the surgeon was very pleased with his work and felt I was doing well. He told me that I would need to follow the 3 precautions for life (don't bend more than 90 degrees, no twisting, and don't cross the leg over the mid-line). He told me that as long as I keep my knees apart I will be okay. Has anyone else been told that they will have precautions for life?

    Thanks!

    Hipper
    LTHR 11/3/10
     
  2. Jamie

    Jamie Administrator

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    Hi, Hipper....welcome to BoneSmart!

    Your surgeon has a very conservative approach that is not usually echoed in the advice given to most of our members. In the end, you'll have to decide for yourself if you are comfortable living with that kind of restriction. We have many, many hip replacement patients who do not and do just fine.

    What I'm betting will happen as you get farther and farther out from surgery is that you will just find yourself doing things and only realize you are beyond the restriction once you've already done it. As long as you're not having pain, you are fine.
     
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    • JuliaB

      JuliaB New Member

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      I also had congenital displasia, and at my 6-month checkup my surgeon advised me to observe indefinitely the "don't twist" precaution and to always have my feet pointing outwards when I rise from a chair. I realize it's not the typical advice, but I don't think those of us with significant displasia issues necessarily warrant the typical advice.
       
    • Josephine

      Josephine NURSE DIRECTOR, BONESMART Administrator

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      Well, you might think that but it's not so! Your damaged hip has been replaced, that makes the 'typical advice' entirely appropriate.

      hipper, it's not at all usual to have that imposed upon you. I think he's being over-cautious as a legal get out clause - so if anything happens he can just sit back and say 'I told you so' and avoid responsibility.

      Fact is, if the implants are put in with the correct alignment, there is absolutely no reason for you not to be able to do those things. After about 3-4 months, the muscles will have regained their strength and tone and a new 'pseudo' capsule have formed around the joint, keeping it stable. Once that has happened, the joint will be as secure as a normal one and you can do anything you want to.

      Have a look at these pics and this pic - this young lady had developmental dysplasia and was only 26 when she had her hip done! Let her be your inspiration!

      In fact, do yourself a favour and read the entire thread 4 months pics

      .
       
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      • KristinL

        KristinL Member

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        "After about 3-4 months, the muscles will have regained their strength and tone and a new 'pseudo' capsule have formed around the joint, keeping it stable" - Hi Josephine I dont quite understand what this means. I'm a visual learner so if you could direct me I sure would appreciate it.

        I'm taking it that it is all the side exercises that I am told will keep the joint in place. Those stinkers that are currently triggering my thigh muscle spasms. Sigh. 3-4 months. 3-4 months. I knew February was the estimation. I think it's the getting there day by day that is dragging a bit. Thank you in advance, Kristin
         
      • Josephine

        Josephine NURSE DIRECTOR, BONESMART Administrator

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        Pseudo just means false. It means that fibrous tissue develops around the hip joint and replaces the original capsule that has been excised. Once it is grown and healed, along with the muscles that were split apart, then things return to normal.

        It's called healing!View attachment ai54.tinypic.com_2hmhs2s.jpg

        And the exercises will help the muscles gain strength and tone, of course. Never forget the tone!
         
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        • hipper

          hipper New Member

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          Thank you. Those pictures certainly are inspiring. I've never had good rom in that hip but it got much worse over the last few years and I can already tell it is much improved. Thanks for the info.

          Hipper
           
        • Jaycey

          Jaycey Moderator

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          Hi hipper, I had developmental dysplasia as well and my only restrictions after my 6 weeks follow up were no bungee jumping and no parachuting. I have to agree with Jo and Jamie - sounds like your OS is ultra conservative.

          Ultimately you will discover your own limitations. I don't cross my legs anymore - I think partly because I got out of the habit. Twisting isn't a problem for me and I don't worry at all about the 90 degree rule.

          Your new hip is very strong. Enjoy it!
           
        • Jyoti

          Jyoti Senior

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          I also have congenital dysplasia so reading this thread is very interesting for me. Still waiting for an op date but when I next see my consultant I will check what he thinks about these precautions. I hope he says different.
          Jyoti
           
        • silviapapp2003

          silviapapp2003 New Member

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          I have those precaution. I had a partial HR in July after falling and breaking teh head of my femur. Hang in there....You are not alone...
           
        • Jamie

          Jamie Administrator

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          Hi, Sylviaapp2003....welcome to BoneSmart! I'm glad you joined our forum and look forward to learning more about you.

          If you haven't started your own thread in the Hip Recovery forum, it would be great for you to do that and tell us more about your surgery and recovery.
           
        • hipper

          hipper New Member

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          I spoke to a friend who had her hip replaced by the same surgeon and he didn't give her life time precautions so I guess I'm special ;)

          Hipper
          Lthr 11/3/10
           
        • Jaycey

          Jaycey Moderator

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          Hipper, be sure and ask for clarification on your restrictions when you next see your OS. And let us know what he says. Seems every OS has a different view on this.
           
        • Jamie

          Jamie Administrator

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          Yes, and I would also ask why he gave different instructions to the person you talked to than he gave to you. This is one time a frank conversation with the surgeon is really called for.
           
        • Josephine

          Josephine NURSE DIRECTOR, BONESMART Administrator

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          I just found a snippet from a surgeon's conference the report of which I posted in the Library The Great Debate 2009 - Hip and Knee Controversies

          Nuff said, I think! :wink:
          .
           
        • grateful

          grateful Senior

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          Jo,
          The notes from that conference are fascinating. I am very surprised to see that only 4% of knee patients and 55% of hip patients were very happy with their replacements. Was that just patients of that one doctor? If so, maybe he needs some technique improvement! I don't know as many people with knee replacements, but I've never personally met anyone who wasn't thrilled they'd had a hip replacement. I know things do go wrong, that's just my own anecdote.
          But I do love the goal of a "forgotten hip"! I can almost envision it!
           
        • alexthecat

          alexthecat Forum Advisor

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          Perhaps that number includes people who had joint replacement after a hip fracture. From my own experience, emergency hip surgery is very different and, for a variety of reasons, much less pleasant than planned THR. It's a rare patient who would be "thrilled" to suffer a traumatic injury, regardless of the quality of their surgical outcome.
           
        • Josephine

          Josephine NURSE DIRECTOR, BONESMART Administrator

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          I have no idea, grateful. I wasn't at that conference so if you read the article, you know as much about it as I do.
           
        • KayS

          KayS Junior Member

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          hipper, I also have lifetime precautions. My first THR was 7 years ago, and I can tell you that I mostly forget I have had a hip replacement. I still cannot sit cross legged, and I try not to twist, but otherwise, I'm pretty flexible. I agree with the others, that your surgeon is being ultra cautious and that can only be a good thing. One day, you will just make those moves and realize you are fine. Building those hip and buttocks muscles will make all the difference. So glad to hear you are doing well, and your 6 week check up went so well.
           
        • hipper

          hipper New Member

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          Thanks Kay. I've already found myself bending more than 90• without or problem. I was never able to cross my leg so I didn't expect to be able to do that. Those hip and buttocks muscles do let me know they need to be built up but I trust with time and persistence they will get stronger. Thanks again!
           
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