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THR 1st April Surgery and doing well

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Well it's been a while so will update you on my 12 week progress!.

Had an appt today thinking it was with my OS but he was away so met with the Registrar. It was very interesting.

I learnt that that I have an Exeter cemented stem and a metal on plastic liner ( uncemented). I thought I had a ceramic head but was told that as my socket was so small they would not use ceramic as it would crack! They were even considering using an Asian Pacific head due to my small socket.

No longer have the restrictions but told to not excessively externally or internally rotate as I could dislocate my hip. The way I put my socks on causes a lot of internal rotation and he told me to stop and to try and increase my flexion. Still at 90 and not budging :hissyfit:

He said I can do everything I did before but within my comfort zone and to not excessively force anything. To not cross my legs either.

Still using one crutch but he said I was doing well and to see OS in another 3 months.

That's about it :biggrin:
 
Not bad - good progress. His further advice about restrictions is 'not yet'. Ultimately you will find yourself doing things like that anyway, just like this young professional dancer does - that's her new hip leg in the air!

[Bonesmart.org] 1st April Surgery and doing well
 
Hello Everyone,
Thought I'd resurrect my old post op thread as it has been a year since my surgery.

Overall, I'm doing well. I don't have the pain in the hip and other issues that some on this forum have stated. However, my ongoing issues are that I still use a crutch as my right leg is not strong enough to carry my weight, plus I have knee pain in both knees, mainly right and foot pain, again mainly in right.

Pe-op I never had pain in my right knee or foot. It was my left knee that took the strain.

I also notice the same issues of my left leg still taking the strain as it did pre-op. My LLD has reduced but I think I will need to get a Podiatrists opinion about whether to have a raise in my shoe. I currently use a small one in my trainers but when in boots or sandals I don't, as difficult to fit one in. I may have to have the heel raised. Unsure about this as I didn't like it previously and i had hoped I could get away with it. But I have to say I do find it beneficial when walking. As I use a crutch I can get away with it now but maybe that's part of the problem as I may get to independent walking sooner with one all the time

I do still have my trendelenburg gait which has definately improved over the past year. I have had a few Physio's which has helped but have had too many plateau's. I still do my hydrotherapy and physio exercises and started back again with my Personal Trainer. Taking it slow as last time I overdid it.

I know it's a patience thing and I will get there but at times it is upsetting/annoying/frustrating, dependent on my mood.

I'm now looking at KMI - Anatomy trains. I was recommended this by a friend. It says on the website that it is one up from Rolfing.

Didn't expect it to take this long at all. :sigh:
Have a good Easter :thumb:
Jyoti
 
Happy Anniversary and Happy Easter Jyoti! So nice to hear from you! Strangely enough, I had ongoing thigh/femur pain for two years after my THR in 2010 also.

I knew I had an LLD and the OS would not agree with me. That being said, I just had a second THR on my other leg, he evened up the legs, and my pain has totally disappeard!

I felt all along that the longer stem in my leg (I had a fracture with #1) was the cause of my pain...I was right!

Good luck with finding an answer to your pain. I also had very good luck with Glucosamine & Chondroitin for my knee pain.

Again, Happy Anniversary! We've missed you!
 
Hi Jyoti.
I think your patience is amazing! It's been a year for you, and while you aren't where you hoped you'd be, you can still see the progress you've made, and continue with further plans. You go girl!

Sharon
 
Hi Jyoti! Good to see you back here!

Please don't get discouraged. It took me over a year to recover. A lot depends on what condition you were in pre-op and how long you waited for your op. Bottom line is no two recoveries are the same.

Hope to hear more from you!
 
Hi Jyoti,

Happy Anniversary, I thought of you on April 1st as I'd remembered that was your surgery date!! One year down and the work continues, I am right there with you!!!!! :friends:

Do you think that some of the knee related issues have anything to do with the lengthening of your leg? I often feel as if there is added tension on the tendons at the top of my leg (groin/adductors) and knee. Sometimes it feels as if stretching of that leg doesn't accomplish much of a stretch of the muscles, it's more of a stretch at the tendon connections.

I definitely compensate with the good leg *still* too!! At my rolfing appointment on Friday she worked on the illiacus on my good leg and that muscle was SO tender...

Fantastic to try the KMI trains, do let us know how that goes. I find rolfing is very helpful and it's good to have a total body focus for us CDH folks since we carry and work our bodies in a different fashion. I think I saw Feldenkrais mentioned in one of the KMI websites, my rolfer has suggested that might be a good next step for me as well -- I find that I have a lot of gait-related maladaptive movements still. The whole idea of "the heel-toe mantra" doesn't work for us!

Experimenting with some lifts in your shoe is a great idea and I would think that could enable you to strengthen your muscles and get to a cane and then device free. You will get there -- crutch free, don't you let anyone tell you it won't happen. Maybe @alexthecat: would weight in on the LLD/lift/atrophy improvement for us.

I suggested to @lisanewmc: that she video herself walking since she's also working on eliminating her TD gait and she had reported that it was getting better -- maybe you could try it too. One day we'll be walking so much better that we'll be amazed when we look at our videos and truly see the progress from outside our body.

You are right, it is a "patience" thing and we have to remember not to lose our sense of enthusiasm to move forward and regain our levels of fitness, flexibility & mobility. Rest at your plateaus and ready yourself for the next level, our work continues!! :thumb:

Take care,
Cardie
 
I wouldn't recommend a shoe lift unless you are sure that you have a true difference in leg length. It's a question for your surgeon, if you have a one-year follow-up appointment ... or even if you don't. In the meantime, I'm not sure about using a shoe lift only part-time. It seems like that would be hard to adapt to.

Can you expand on the knee pain a little? Where is it located exactly and what's the sensation? Sharp? Dull? Throbbing? That sort of thing. Sorry if you already explained that and I missed it.

I agree with Cardie about making a video of your walk. They did that to me in PT and I hated it. It does help you develop a mind-body connection though, so I'm glad I did it, even though I thought it was dumb at the time.
 
Thanks Cardie and Alex,

That was lovely of you to remember my 1st year. Doesn't time fly. I can really understand why you need pain to have a THR as if I hadn't then I would not have been as positive about the surgery, despite the new pains, which are nothing compared to the hip pain previously. My ROM has improved but nothing major so the things I either found difficult or couldn't do before are still the same, except I can now get my sock on properly with a bit of a struggle :th_heehee:

Will let you know Cardie when I go to the KMI Trains. Hopefully in the next week or 2. I also read about the Feldenkrais method. However, it didn't seem as good in what I read.

Alex, I do have a LLD. Previously it was 5 cms and I was told that they lengthened by 3cms so it should be about 2cms. My Physio has said by wearing a raise it straightens my hips out and is better for me. I do wear it the majority of the time, however, recently was on holiday so didn't wear it as i wasn't wearing my trainers. I have made an appt with a Podiatrist who helped me 2 years ago prior to the surgery when I needed a heel lift. I'll ask her to measure me also so hopefully will get a better idea of the exact LLD.

My knee pain is mainly on the inside of the knee. It is difficult to describe but I would say an ache after walking or any activity where i need to stand. My Physio did acupuncture going up from the knee and it hurt like crazy. It was tender to the touch. my foot pain is on the outside of the foot. It's all a mystery to me. :scratch:

Seeing my OS for my yaear check-up on 18th April so will ask him. But normally don't see him nd se a Registrar whose sole interest is that my hip is doing fine. However, will ask and see what they say.

Will let you know how it all goes and Thanks.
Jyoti
 
I'm on my phone, so I can't give you a link, but there is an article about pes anserinus in the Library. That might relate to your knee pain, if you want to look that up.
 
Hi, I found your info regarding stiffness post excercise really interesting as that's what happened to me yesterday. I've only been weight bearing a couple of days (4 weeks post op) and last evening I was so stiff right through my thigh/buttocks that I was worried I had damaged the hip. Is this stiffness normal?
 
Very, very, very normal! In fact, it's more likely nothing more complicated than post-op pain. I will offer you more in your own thread so we don't derail Jyoti's thread. Okay?
 
Hi Jyoti,

Here's the link for pes anserinus from the library that Alex mentioned. It leads to a fantastic website that has all sorts or stretches for a variety of hip related (other body parts too) issues!!

Just wondering if you find your foot pain to be on the outter portion of your foot because you are walking on your feet differently now? For example, there was a period of time that the outside area of both my feet were very sore and I think it was because I was rotating my ankles out a bit -- supinating, which was putting more pressure on those parts of my feet.

Well, it is good that your OS has as the primary concern of whether your hip & hardware are ok -- they leave all the soft tissue issues up to us with the support of our physio folks, massage folks, accupunture & rolfing/KMI people...

On the LLD, maybe you could ask at your 1 year visit if a standing x-ray of your pelvis & lower back can be taken so that you can view whether some of the LLD issues may be related to those areas versus the actual length of your femur. I have found that no one really wants to measure my leg length b/c there are too many other factors that can give a measurement that may not at all relate to my true leg lengths -- in other words, it can be related to the way my pelvis tips or tilts and my spine twists and pulls at my pelvis. This always leads back to a discussion of trying different things and seeing how they feel & work for me.

I don't know if you corrected for your full LLD prior to surgery. My suggestion on experimenting really just meant that I try different inserts in my shoe and walk around at home to see how they feel. I have also tried my old shoe with the external lift at times -- also just around the house, to see how it feels. Thus far I haven't found anything that feels good enough to wander around outside in... I use as my gauge whether I can stride fully with my op-leg with the lift in my shoe and not feel like the ball of my appliance is creating an uncomfortable amount of pressure in my plastic socket and also limiting my leg to only going directly under my body and stopping there.

Jyoti, you have a lot of professional support and I'm sure that between your podiatrist & physio that you'll be able to craft a lift that will be helpful. Maybe it will also be something temporary allowing your leg to continue to strengthen & stretch and activate muscles and move to a different level of assistive device use.

Do let us know how you progress, please. :friends:
Take care,
Cardie
 
Thanks Alex and Cardie,
Have read about the condition and will look further into it. However, unsure if it is that as it does start in the inner part of the knee but doesn't go all the way up but maybe that doesn't count. I do need to foam roller it but so difficult with limited ROM. Will look at the tennis ball and massage myself.

I agree Cardie, I am walking differently but I don't think it's that much. I still have my knee go in and from the knee to the foot it goes out. I think it's more noticeable now as my hip is now aligned and the bones from the knee to the foot ( can't remember names of them) are slightly bent. Told by Physio this has happened from childhood to try and compensate for my gait. Won't go straight now. No-one has been able to say why i have the foot and knee pain, but will be more direct with the various professionals I see and see if they say anything.

Anyway, will keep you updated with it all.
Best wishes
Jyoti
 
ONE YEAR APPT WITH CONSULTANT

Well, I had my one year appt and was lucky that I actually saw my Surgeon as I last saw him at my 6 week appt. He asked whether I was happy about the surgery and I said yes, in that the pain has gone but still not happy that I still cannot walk without my crutch. He tested me and said I was trendelenburg positve which I knew.

He said that he understood my frustration but that due to having CDH and my history he couldn't say for sure whether I would be able to walk independently as he does not know if my hip muscles will strenghten further. He said he hoped I would improve over the next 6 to 12 months and said the 2 year mark would be the final date to know how much I could do.

I questioned him about why I was able to stand on my right leg pre-op without no support and now I find it very difficult. He said that pre-op I was not using my hip muscles to stand as my bone was literally fused so they were not being used. Now with my new hip it can move and it is the first time my muscles are being used so no-one knows whether they will be able to get back to 'normal' strength. You learn something new everyday.:sigh:

So all I can do is to keep at it and hope that my muscles get to a point where I can walk independently. Otherwise there have bene improvements, mainly that I have bettter posture and my back ache has reduced alot. Also my ROM has improved a bit which is good but I had hoped for alot more so still unable to tie shoelaces etc.

In relation to my knee and foot pain he could not answer that question either and said he doesn't know if that will improve. That was upsetting when I thought about it, as now my hip wants to do more but my knee and foot can't take it so I am walking and doing less.

My hope was for the surgery to allow me to do what I was doing before but of course I wanted more. I have to get there as I do not want a crutch for the rest of my life as that would be too depressing. But one lesson I learnt was that I can't wait to live my life, as I was saying before that 'when I'm off the crutch I'll do ....'. Now, if I want to do it I have to go for it.

He was actually more empathic then previously but I still don't understand why they can't say all this before the surgery as it has been so frustrating at times due to the many plateaus and very slow progress I have made. He even said that I look younger after the surgery :biggrin:, but then again I have just been on holiday and caught a bit of a tan :wink1:.

So he has said to come back in a year's time - that's 2013!!

Am looking at other therapies to help me get there so will let you know what happens next.
Best wishes
Jyoti :thumb:
 
Jyoti, my experience was as your surgeon is describing. You will see more improvement in the next 6 to 12 months. For some of us this recovery takes longer! Hang in there my friend. You are still making progress.

Please keep us updated!
 
Hi Jyoti,

Well, I'd say that was a pretty good visit -- even if you didn't get a lot of hard and fast answers. I got a lot of "I don't knows" at my last appointment too but it was about stuff that was going to depend upon me and how much time and effort I decided to put in to working on things like muscle strengthening and stretching to improve ROM and my own levels of activity.

The good part is your hardware is in the right place and you've healed from your surgery -- right????

Are you given the green light on KMI and when's the first appointment?

How about the shoe lifts, any suggestions from him on that item?

My PT guy told me back at 3 months out from surgery, they see continued improvement on range of motion up to 3 and sometimes 5 years after surgery!

Our work continues, but it is something to set goals for and continue to strive towards --- :thumb:

Have you looked in this thread Tie shoes??? there are some stretches included in there and I bet @alexthecat: might have some adaptive suggestions for you as well.

Take care, :flowerysmile:
Cardie
 
HI Jyoti-Things will get better but its still going to take time. IM glad your looking into therapys to help you.

I had bad knee pain pre/post op with 1st THR and some knee pain with 2nd THR(both dissipated over time) but a new thing for me was foot pain! Sometimes when I start walking on my R foot I get some popping, its slowed down a lot since the early days though.

These things take time especially since your body has been set a certain way for so long pre op.
 
I can totally relate on the patience thing AND the comparing to others thing. Everybody and every body is different going in and coming out, not to mention every doc and every PT person. You have got to trust your body. Listen to it more than you ever have before. If you rush it, it will fight back. Even when you think you are pushing it at the right pace, as someone above mentioned, it will let you know if you've done too much. I do not know what the appropriate excercises are to be doing at what time, but I do know I was not doing any leg lift things till definitely after 4 wks and if my memory serves me it was not until 5 wks, but like I said all of our instructions are different.

Hang in there and I wish you continued success -which it does seem you are having, even if you re impatient :)) -cathy
 
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