THR 1mo Post-op Posterior Left THR with Major Bone Graft

[Meastleamy]

Thought I’d post an update now that I’m almost 1 month post op.

First of all, I cannot say enough good things about my experience at HSS!!! Every single person with whom I interacted was kind and patient, and I felt as though I received the very best quality of care.

As for my surgeon, Dr. Nawabi, I have only awe. I have advanced OA and was in continual excruciating pain before surgery, and had a pretty substantial leg length difference. I have quite literally felt NO pain since I emerged from surgery. Maybe some muscle tightness here and there, but that’s it. I got quite nauseous on the oxy and the tramadol, and very quickly realized all I needed, or wanted, was Tylenol and ice. The Game Ready machine is my only addiction. I was taking meloxicam for the first 2+ weeks, but no longer.

My legs are perfectly aligned now. I forgot the joys of standing and walking barefoot. Oh, and my incision is a thing a beauty! Dr. Nawabi says that the pre surgical imaging did not convey the quality of the bone. Once he got in there, he said it just basically disintegrated. He used the word “mush” which isn’t exactly what you want to hear. The pre and post X-rays say it all.

I should add that Dr. Nawabi has a very conservative approach to recovery. Slow and steady. His main focus is on the patient’s overall health and the quality of recovery and long term viability of the replacement. So, you won’t be running a marathon in three weeks, or even be walking without crutches, walker or cane right away. But the return on your patience and diligence is a really excellent and consistent improvement in mobility, strength and confidence.

I have a lot of thoughts about why I chose this particular surgeon. I won’t go into it here, but if anyone has questions, please reach out.

 

[Layla]

Following are the Recovery Guidelines, I will type more in a post below -
As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.

4. PT or exercise can be useful BUT take note of these

BoneSmart philosophy for sensible post op therapy​

5. Here is a week-by-week guide

Activity progression for THRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications​

Wound Closure​

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Layla]

Hello,
Thanks for joining us on the healing side to share your recovery this far. What you've experienced to this point sounds wonderful and your surgeon is a gem. You're lucky you found him. I like his conservative approach to recovery and how it's benefitting you. Hopefully you'll continue to update with progress reports. I wish you all the best on your journey!

 

[BellaMac]

Great news and gratitude for sharing your positive experiences.

 

[Going4fun]

Great update. Is this the Dr. Nawabi from the Hospital for Special Surgery? I've heard great things about him, and what's amazing is that he's not a joint replacement specialist and still he apparently is amazing at joint replacement.

Great to hear about the low level pain.

 

[Meastleamy]

Great update. Is this the Dr. Nawabi from the Hospital for Special Surgery? I've heard great things about him, and what's amazing is that he's not a joint replacement specialist and still he apparently is amazing at joint replacement.

Great to hear about the low level pain.

Yes, the very same Dr. Nawabi. He is a joint replacement specialist, in that he does hundreds of them. He is, however, also seen as somewhat of a generalist because he does hips, knees and shoulders. I am so happy I found him. I cannot recommend him enough. I spent a lot of time doing my research and feel duly rewarded for that effort.

 

[Meastleamy]

Great news and gratitude for sharing your positive experiences.

I was so afraid to have surgery, especially after reading too many stories of bad outcomes. I will say that I agree with people who say to find the right surgeon. Quite honestly, I think that’s the hardest part.

 

[Meastleamy]

Hello,
Thanks for joining us on the healing side to share your recovery this far. What you've experienced to this point sounds wonderful and your surgeon is a gem. You're lucky you found him. I like his conservative approach to recovery and how it's benefitting you. Hopefully you'll continue to update with progress reports. I wish you all the best on your journey!

It is far better than I expected!!! I’d never had surgery beyond having my wisdom teeth extracted, and was very apprehensive. But I was in so much pain and could barely walk, so I really had few options. I wanted my life back!! I feel extremely grateful to have access to such incredible medical care.

 

[Going4fun]

He's not listed as a joint replacement specialist on HSS' website. But no matter, I know that he's highly respected there for his joint replacements. And other docs there will recommend patients to him for joint replacement. He is apparently just a fantastic thinker-communicator as well.

I'll be having my surgery in five weeks with a colleague of Dr. Nawabi, Dr. Alexander McLawhorn.

I'm so happy to hear that you are thrilled with your surgery with Dr. Nawabi and HSS. Congrats.

 

[Meastleamy]

He's not listed as a joint replacement specialist on HSS' website. But no matter, I know that he's highly respected there for his joint replacements. And other docs there will recommend patients to him for joint replacement. He is apparently just a fantastic thinker-communicator as well.

I'll be having my surgery in five weeks with a colleague of Dr. Nawabi, Dr. Alexander McLawhorn.

I'm so happy to hear that you are thrilled with your surgery with Dr. Nawabi and HSS. Congrats.

It’s very weird how HSS categorizes the surgeons. Can’t always figure it out. Nawabi is part of the Sports Medicine dept, the Orthopedic dept and the Hip Preservation dept. McLawhorn was going to be my next choice. I know two people who had their hips replaced by him and both are very very happy!!!

I will add that after watching videos of both Nawabi and McLawhorn, among many others, I was deeply impressed by their ability to describe three dimensional anatomical details, abnormalities or procedures in clear and highly visual terms. I wouldn’t be surprised if precise language belies someone’s surgical skill.

Best of luck to you!!!

 

[Going4fun]

Yeah, I saw a video of McLawhorn, and there was not one extra movement through the whole thing ... so efficient. Thanks for passing on the good news from other patients about him.

I get what you're saying about precise verbal and spatial-description skills about surgery. Pretty interesting idea.

How did you find Dr. Nawabi?

 

[Meastleamy]

Right, I thought the same thing: Economy of words, clear formulation of ideas, and the ability to render multiple facets of information into a single lucid response.
I think both McLawhorn and Nawabi share that trait. I’m sure many other surgeons do as well. Add in some excellent bedside manner, and voila.

I researched the heck out of every surgeon at HSS who participated in my insurance, watched all the videos I could find, read every review and testimonial, looked at published papers and was impressed by his education, training and broader cultural experience. And, just by chance, a friend of a friend turned out to have had her hip replaced by him and her review was a deep and thoughtful one. And a glowing one. Plus, I’d had a very unpleasant experience with a different surgeon the week earlier, and the contrast could not have been more stark. There are other reasons too: the fact that he was part of the sports medicine dept was important to me. I was a previously active person, and I wanted that to factor into my goals for surgery. One of the first things they asked me was what kind of activities did I want to return to post hip replacement. I also liked that he is part of the hip preservation team there. I appreciate and value that it is a collaborative group of doctors working to solve challenging cases. My hip was a mess.

Apologies for the very long response.

 

[Going4fun]

No apologies. I wanted the full response! GREAT ... thanks .... I am a fellow traveler who reads like heck about surgeons. I surely did, the first time, a little less this time.

 

[Meastleamy]

No apologies. I wanted the full response! GREAT ... thanks .... I have a fellow traveler who reads like heck about surgeons. I surely did, the first time, a little less this time.

Glad I could be of service!
Who was your surgeon for the first hip?

 

[Going4fun]

My first surgeon was Dr. Matthew Austin of the Rothman Institute. Great guy and a good ultimate result. But my recovery was longer and more frustrating than I wanted. I'm happy now, though I have some aches and pings. Interestingly, when I went to HSS for X-rays to see Alexander McLawhorn, they took the X-rays of course.

A week after meeting Dr. McLawhorn, I get a note from a radiologist who had done a close viewing of my good hip in addition to the arthritic untreated hip. And the radiologist seemed to notice some problems with my bone on that operated side ... Nothing coming lose, but somewhere in there something going on with the bone. Not an emergency, but the radiologist seemed to say there were some issues that need monitoring.

I was blown away impressed (as well as a little scared) that the radiologist would give my artificial hip (and surrounding bone) such a close viewing. I'll be contacting Dr. McLawhorn's office this week for a translation of what the radiologist found. HSS just seems to have that little bit extra in its treatment, which I really appreciate.

 

[Meastleamy]

Ah, the Rothman Institute! My step mother had both her hips replaced there. The first of which was an anterior approach done almost 20 years ago, the second about 10 years ago. Both are still going strong. Another friend, just this past year, had outpatient hip replacement there and was so pleased with the outcome. That said, I think it bodes well that the HSS radiologist is looking at the overall picture presented by your X-rays. I’m sure it’s a bit distressing to hear that they see something going on with your operated hip but, I’m guessing whatever it is, it’s something which can be addressed. Better to know early on. I do believe you are in the best of hands with McLawhorn! Wishing you a good outcome!!

 

[Going4fun]

Thanks. Eager to hear more as you recovery continues. Do update us. Great to connect.

 

[Meastleamy]

Yes, you too!!! Take good care. And definitely keep us all updated on your pre and post op status.

 

[PBhips]

Please, @Meastleamy and @Going4fun, I’ve been researching HSS surgeons like crazy, and it all gets so confusing. Neither McLawhorn nor Nawabi take Medicare any longer, and I’ve just turned to 65. Do you have any other suggestions since you’ve done so much research? I need 2 THRs and am freaking out with stress, trying to decide on a surgeon.

 

[djklaugh]

@PBhips Welcome to BoneSmart! Please look at the date the original poster of this thread last made an entry ... September of 2022! Please start your own thread -- you will get much more support and useful information than posting on a very old, inactive thread.

To start your own thread go to the main listing for pre op hips - at the top of the list on the right is an orange button "Post Thread" - click that to start your own thread.