61 Year Old Male Needs Two Hip Replacements

[Van A.]

I was informed in less than a 10 minute interview/exam, including x-rays which I brought with me, that I need two hips replaced. To be fair my appointment was on Nov. 22 at 3:15pm and he probably wanted to go home for Thanksgiving. The surgeon is a highly qualified, very experienced hip replacement specialist.

All I can remember now is that he insisted that I donate my own blood (2 pints minimum) before the surgery, that he uses ceramic only, that the operation takes 1 1/2 hours and the two biggest post surgery concerns are infection and dislocation of the new hip (both very unlikely he thought). He suggested that the 2nd hip could not be replaced until at least 60 days after the 1st. All other factors were minor in his opinion.

He made no mention of MIS which I am very interested in for obvious reasons. Once my 10 minutes were over a nurse came to meet me and handed me a card for a person with the title of C.M.A. Surgery Scheduling Coordinator. I a supposed to call this person Monday morning for futher instructions.

I am Internet savvy, well insured and there are 23 certified orthopedic hip surgeons within 15 miles of my home. I am open for any suggestions as to what to do next. Thank you for any help.

 

[shanvey]

I am sure that you have read all of the posts on this web site, like I did. If I was you, I would definitely locate a physician that performs MIS. There are 30 ortho surgeons in my area. However, none of them would even suggest MIS because they do not do it. I did my research. My husband was scheduled to have a traditional hip replacement on Nov 7th, 2006. I was about to go out of mind worrying about it. We went to a OS about 100 miles away and MIS is all that he does. He does around 750 MIS hip replacements a year. The old OS told us that my husband would probably receive 2 units of blood, the surgery would take 1 1/2-3 hours, would be on coumadin, and would be able to go back to work after 3-4 MONTHS, hospital stay would be 4-5 days, walk ***isted with a walker in 2-3 days, un***isted walking in a "few weeks" The new OS said the MIS replacement would use the same hip replacement hardware, surgery would only be 30-45 minutes, he would walk with crutches the SAME day of surgery, walk the length of the hospital hall on the 1st post-op day and would go home on the 2nd day. The only blood thinner this OS uses is an aspirin.

It probably would not be a bad idea to go ahead and call the surgery scheduler on Monday like the nurse told you to. This way you can go ahead and schedule your surgery if for some reason you cannot find an OS that specializes in MIS or for some other reason.

One place to go to on the internet to find an OS that specializes in MIS is www.zimmer.com. Good luck and let me know what you find out! My husband is 44 years old and is scheduled to have MIS hip replacement on Wednesday, November 29th. I will keep you posted on how it goes. What state are you located in? We are in Alabama.

 

[Van A.]

First, good luck with your husbands surgery on the 29th and thank you very much for your reply. It looks to me like you have found a very good solution to your husband's problem. I am still looking for one for mine.

I guess I got some good fortune by having maybe the last available appointment with a hip surgeon before Thanksgiving. That has given me the entire weekend to research my problem. In addition to Zimmer I have found lots of other good sources of information on the Internet. Many of them are linked right off this site. Here is a link I found that could hold a lot of promise or it could just be marketing hype: https://www.osiosi.com/hana.cfm.

In addition to that link, I have found the names of several surgeons that apparently perform MIS surgery nearby. It may take some time to find the right one, but with some effort on my part I'm sure that a qualified, caring MIS surgeon is available in my immediate area. I live in Texas and I will post back to let you know what I find out.

 

[hvyironfr8dog]

After months and months of searching for the right surgeon, as there are many in South Florida, I finally decided to go back to a well known and trained MIS surgeon not far from home. It's not that hard to find a good surgeon who has done over 300 per year, what is difficult I had found is deciding on if the implant he is going to use is what you want. Realize, each doctor uses only one type of implant and normall believes in doing it only one way. First off...does he do MIS or traditional surgury. Go with the MIS guy.

What cut does he make....the posterior or anterior cut. One is suppose to cut less muscle, thus less time to recover. And the big question, what make implant is he using....Zimmer, Smith and Nephew, Biomet, etc.....there are too many to mention but all have there positives and negatives.

Also, does your doc believe in metal on metal design implant? How does he feel, or more importantly...how do you feel about the possibility of metal ions leacing into your blood and eventually crossing the blood-brain barrier and thus the anecdotal reports that demetia and Altzimers may be caused by metal ions in the brain!

What about Ceramic on metal, or Ceramic on ceramic, or Ceramic on highly cross-linked polyethelene. These are the questions you need to ask your doc, and more importantly yourself, as each of these combinations offer great potential for a successful and long lasting implant....but also offer there own individual risks.

After putting up with the pain for 6 fulll years, I can't take it anymore. I am scheduled for bi-lateral total hip replacement here in Coral Springs, FL tomorrow morning.

I will have the "Zimmer" Ceramic head on the highly cross-linked Poly-cup....both hips at the same time. My surgeon says I am healthy enough for it and young enough to handle the PT...that is the key. He would not do both hips on an older, more sickly patient.

Why am I using Zimmer when I my research finds other just as good, if not better designs out there...ie: the metal on metal Biomet extra large head. I guess I am tired of trying to match the right doc with the right prostetic device.

If you find the right doc, one you like and trust, who has done a bunch of these same MIS operations, then....take my advice....just go with him. Every joint implant company makes a good device at the top of there product line...just go with that one and hope for the best. If you are comfortable with your doc, and he is well experienced then that really is the key. I have been told its more important that the doc be well trained and experienced in the device he is using rather than the importance of the device itself.

Good luck my friend. I will be out of commission and off this board for a while....wish me luck... and say a prayer for me.

Chuck

 

[Van A.]

Thanks for your input. I think you are right about MIS. I think I want a surgeon that has done at least 200 MIS in the last year (obviously the more the better). Ceramic on ceramic is my 1st choice without cement. Then attitude or demeanor, hospital, cost, anterior cut (I just found out I will have to pay 10% of all costs) and whether or not the surgeon uses the hana™ HIP AND KNEE ARTHROPLASTY TABLE. I have become intrigued with the arrangement that table provides to the surgeon/patient. Finally the availability of the surgeon. I have heard that some surgeons are booked 3-4 months in advance.

Please tell me what your surgeon said about doing both hips at once. The 1st surgeon told me to get another surgeon if I wanted both done at the same time. Best of luck tomorrow!

 

[shanvey]

Update on my husband's hip replacement yesterday. His surgery went very well! He has about a 3 inch incision. The surgeon did a 1 incision posterior approach. The surgery lasted about 45 minutes. About 5 hours after surgery, he was able to get up to a chair with ***istance. What a difference overnight made! This morning he got out of bed without ***istance. By lunchtime, he was walking the halls, WITHOUT crutches, walker or a cane. At 4:00 this afternoon, we tackled the stairs. He walked up one flight of stairs, and then walked the same flight down! Totally amazing. We are scheduled to go home in the morning around 11. MIS hip replacements are truly a miracle!!

 

[Van A.]

Great to hear about your husband's result! I hope I do 1/2 as well. I have found a surgeon I like and trust. I am going back for what he calls a post-operation meeting before my surgery on Dec. 14th. I am going to post a new question to the group regarding double vs. single hip surgery. Good luck for the continued recovery.

 

[hvyironfr8dog]

Good luck my friend.

I am back home now after bi-lateral THR on 11/28.

3 days in CCU, followed by 2 more days in the Orthopedic wing of the hospital. They had me up standing on the second day with minimal walking. My blood pressure was excessively low, thus my extended stay in CCU for monitoring. The PT staff was great...had me doing light PT from the second day on, and I really felt much better each day. Walking the halls of the hospital by day four with no problems...just a walker.

I transfered to the local Health South Rehab Hospital as an in-patient to take advantage of their great reputation for intensive rehab work, as my home support is not that good and have many steps in my house. I would suggest going to a place like this for the aggressive rehab work as soon as possible. As an inpatient, I was able to do aggressive PT several times per day and made remarkable progress in a a very short time. I stayed aprox. 6 days there. I am home for my second full day now. It sure is nice to sleep in my own bed. Hospital beds suck, there is no getting around it.

I have now started in-home PT with a local PT company that will visit me 3X/week for 3 weeks. In that time I will be doing more aggressive PT, possibly utilizing our community pool for aqua-therapy, which is considered by many PT people just about the best therapy for joing replacement. Florida is a bit cool this time of year, but if the water is heated, I will try that also.

I will be re-evaluated by my OS on the 18th to see how I am doing and if some of the normal post-op. restrictions can be removed, such as, no driving a car, no crossing legs, no moving leg past mid-line of body, no bend of torso and thighs past 90 Deg., etc. You will have the same restrictions with Bi-THR.

I have been scooting around the house for two days now, and climbing 16 steps to the second floor with simple ***istance of a cane, athough I use the walker on flat surface. I am bored and looking for a new challenge. I think I may now try just using the cane only. My PT says its OK to try it, so why not? I just have to figure out which is my weaker leg as the cane will need to be in the OPPOSITE hand for balance. I think the left is weaker as I kick a ball with the right.

What I have noticed and expected from reading other reports on this site, is that I have now traded my hip joint pain for a different kind of pain. One is coming from deeply underneath the 4 inch incisions on each posterior cut hip as they heal. I ***ume this is the internal stitching I feel. BTW, my doc doesn't believe in any external stitches or staples. He used a " Surgical Crazy Glue" on me...thus no pain from ugly painful staples or external stitches....it was very clean, very neat. My sugeon is one of the best in all of South Florida. That is why I picked him. I feel lucky that he was in my HMO plan of doctors to use with AETNA.

By the way, I just checked the AETNA website. He billed them approx. $10,000 for the bi-lat THR he just did on me. They paid him only $2300. Now wonder health insurance is so messed up in this country. He deserved every bit of the $10,000 he charged in my opinion. Luckely though, my co-pay from AETNA only appears to be aprox. $238.00!

I can feel an internal healing process involving the tightend stitched muscles healing AND naturally the ligiments that where cut that hold your femor to your pelvis. My OS said that the operation requires him to cut 1/2 of the ligaments to get the femoral head out of your leg to saw off the damaged head. So that healing process is the main reason of the "no-bent leg" restrictions that naturaly must be closely followed for fear of dislocating you new joints.

The other pain I feel mostly, and this is a good pain, is the muscle soreness I am experiencing all over my legs...from my buttocks, thighs, hamstrings and abductor/adductor muscles. This reminds be of the feeling I used to get in high school football when the 3-a-day practices started at the end of summer. It's a good kind of hurt....one that reminds me of my youthful athletic days....but also a strong slap in the face as to the realization of just how atrophied, out-of-shape, and shortend, my leg muscles had become with the limited motion that 6 years of arthritis had forced on them.

It is now my job....and firm desire to whip these 51 year old legs into shape... to match the "hips joints of a 20 year old kid", (my surgeons words), that I have been blessed to be given now. I intend to do just that in the weeks and months to come!

What ever you do, do not skimp of the aggressive post-op PT. Push hard, get as much as you can, go to a rehab facility, use home PT, and get into an out-patient program as I intend to do next month when my 9 in-home visits are used up This will undoutably allow you to return to a normal, athletic lifestyle as quick a possible...with is something I used to do and want back so deparately.

I vow here and now, to never let my athletic days be taken from me again. Wish me luck.

Good luck on your surgury. Stay strong and focused. Watch the nurses and ask questions whenever they are trying to force you to swallow another pill. Ask what its for...you will be surprised of the mistakes they make and the questions that they CANNOT answer. Don't take anything for granted in a hospital setting.

Good luck and let me know how it went.

Chuck

 

[Van A.]

Hi Chuck,

I do wish you the best of luck! It sounds like the surgery went as well as possible. I am going to be operated on next Thursday morning for the right hip only. The surgeon says he will do the left 3 months later.

I worry about boredom, pain and the PT necessary to get me back to an active life again. I am sure I have a good surgeon. By the way, his bill to Aetna is only $1450. I am sure of that because I have already paid the 10% deductible. I have no idea what the total bill will be.

The surgeon tells me that 2 weeks after the surgery I should be able to do pretty much what I want. We'll see...