THR Should full ROM ever be expected?

[chialiyu]

@Horse Chick Comparing my right hip (THR in July 2020) and my left one (THR in Jan 2021), I can tell a big difference 6 months could make. I did both with anterior approach. I can see the muscle and tendon around my surgical site much smoother on the right and still lumpy and fibrous on the left. I think it affects the ROM. (I have better ROM on the right.)

 

[Jockette]

I find it very interesting that you kept noticing improvements into the 2 year.

I didn’t have a hip replaced, but I had a partial knee replacement, and I also noticed improved ROM in both my second (and third) year post op, after poor ROM my whole first year. In the second year my whole leg continued to relax and heal, giving me better ROM.

 

[Eman85]

I know you're probably going to say I'm only 6 weeks out, but with how well everything has been going I wonder why my ROM isn't better than it is and if I need to stretch more, or relax, or forget it.

With months of healing to go, you may need to re-adjust your expectations. I will also add something my surgeon’s PA shared with me early on - A prosthetic hip will never match your natural hip (before it deteriorated) but it can get pretty close. Patience is key and you should notice steady progress, feeling stronger month by month, if you don’t over do it.
Good luck as you continue the journey!

Finally someone says it! The replacement will never be as good as the design of original equipment.
I saw improved ROM right away but I knew I had lost a lot of ROM. Pushing to gain ROM early on wasn't something I wanted to do, to me that was like trying to dislocate. I just went with the gentle stretch theory and I can pull my knee to my chest. I can cross my legs with my ankle on my knee but I still have a limit on how far it will go from the tightness of the muscles. Over 3 years on my left and I still see improvements and have setbacks.

 

[Celle]

Finally someone says it! The replacement will never be as good as the design of original equipment.

It is true, of course, that a replacement hip won't be as good as the original issue, when it was young and new, and working perfectly.
But a replacement hip will be much, much better than than a poor old hip that is arthritic and giving you lots of pain.

I'd trade any day a little loss of ROM for a huge loss of continual pain.

 

[Eman85]

@Celle I agree with your post but there seems to be this myth that these pieces of man made joints will perfectly and exactly replace the joint and it will be just like a perfect natural hip. This seems to add to many people's frustration over their recovery. It seems to be fueled by many OS that don't communicate well with their patients also. In 1985 I met with an OS and we had a good discussion about the real world results of a THR. I know technology has advanced quite a bit since then but everything he told me was true and much of it applies today.

 

[Celle]

I agree that some surgeons don't make a good job of explaining fully. It would help if they did, but they're busy and they're human.

In their professional life, they see daily how much better a replacement hip or knee is than the painful, arthritic joint their patient had before surgery.

Of course the patient expects perfection from the artificial joint. Who wouldn't?
Many of us have watched the "6 Million Dollar Man", whose artificial joints were a huge improvement on his original joints, but we tend to forget what happens in reality.

there seems to be this myth that these pieces of man made joints will perfectly and exactly replace the joint and it will be just like a perfect natural hip.

But our brand-new, artificial joint Isn't replacing a perfect, natural joint. It's replacing a severely compromised joint that is accompanied by stretched, shrunken or weakened muscles and ligaments. It can't give us back the joint we had as a child or a young adult - but it's normal to hope for something like that, and so we get worried and frustrated..

 

[FCBayern]

One more thing I would add. Even though none of my three replacement joints has as good a range of motion as their 61 year old counterparts, The ROM I have allows me to do everything I want without giving a thought to it, and pain free for the first time in 20 years.

 

[Horse Chick]

@Eman85 I like your "gentle stretch theory" and I plan to do the same. To everyone that has responded, thank you so much for sharing your stories of continued improvement, it really helps. I honestly can't remember what my hip ROM was like before it went bad, its been bad for so long. I also have no idea where I got the idea my hip was going to be flopping all over the place after surgery, but it wasn't from my surgeon. Maybe it was the 6 million dollar man, LOL.

 

[Horse Chick]

The ROM I have allows me to do everything I want without giving a thought to it, and pain free for the first time in 20 years.

I know I already have better ROM than before. I think once I'm cleared to ride horses again I will really notice the change. Riding horses is what I do and for years it has been the most painful thing I do. Not only was riding painful, but I couldn't do it correctly because my ROM was so bad. Some days I thought I would just fall off because I couldn't move. I bet when I ride again I will be singing a completely different song.

 

[Eman85]

I was never much of a horse rider but when I did it was very painful as my ROM was at it's limit trying to sit on a horse so it was constantly up against the limit. I did ride motorcycles and long trips were rough. Pre-op I laid on the floor and noted my ROM sliding my legs to the side like making a snow angel. Tremendous difference when I did this post op with each leg. I was to the point where riding the lawnmower was painful, now it's no problem.

 

[Horse Chick]

Pre-op I laid on the floor and noted my ROM sliding my legs to the side like making a snow angel.

Funny. I actually made a pre-op video of all the ways I couldn't move to demonstrate my terrible ROM. I made it because I figured a year after surgery I might forget how bad I was. Already there are a few things in the video I can do. I look forward to re-visiting my video next year to see what more has changed. Almost every time I got in the saddle I cried. The saddle slipped to the left because my right hip wouldn't flex enough to sit straight. I bet my horses will be as happy as me next time I ride.

 

[Layla]

I actually made a pre-op video of all the ways I couldn't move to demonstrate my terrible ROM. I made it because I figured a year after surgery I might forget how bad I was. Already there are a few things in the video I can do. I look forward to re-visiting my video next year to see what more has changed.

What a wonderful idea. How gratifying it will be to look at it on your one year anniversary and realize the progress you’ve made.

Almost every time I got in the saddle I cried

And you may do it again, but only this time cry happy tears with your ability to do it without pain. You’ll have to share with us how your first ride goes when the time comes.
Have a great rest of the week!