THR A hiker's tale (male, age 49)

pdx_hiker

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[I just discovered this forum the other day, so I didn't have a chance to post in the pre-op forum before my surgery. I'm just going to put it all in this thread.]

PRE-OP:

I'm 49 and have never had any musculoskeletal issues at all, except for a couple of twisted/sprained ankles. My main physical activities for the last 20 years have been hiking, disc golf, softball, and volleyball (listed in descending order of time spent but roughly increasing order of wear-and-tear on my hips). Three autumns ago, I had some minor pain in my left thigh but didn't think much of it, and it went away; that may or may not have been the first stirrings of my hip osteoarthritis.

Then, last year, I started to notice that my left leg would get weird AFTER hiking, in the car. If I wanted to move my foot forward or backward on the floor, sometimes I had to lift my thigh with my hands, or shuffle my ankle around. I would sometimes notice the same thing after softball. I don't hike much in the winter, but when my local volleyball game finally started up post-Covid, I started going every week, and after a few weeks I was noticing a lot of pain in my thigh during and after playing. One time I lunged after the ball and nearly fell over because something felt weak and just... off. I decided it was time to see the doctor. I figured they'd just send me to PT and give me some exercises to stretch out the muscles.

My primary care doctor seemed to know what he was doing when I described the problem; he ruled out knee issues, but referred me to an orthopedics place. In February, the orthopedist did an x-ray and said "Yup, you've got hip arthritis. You're gonna need a hip replacement." But he said it might be 10 years down the road... or 2 years. Nothing makes you feel OLD like the words "hip replacement." :sad:

Anyway, I started asking around, and everyone said "just do it, my brother/sister/aunt/friend got a hip replacement and wished they'd done it sooner." So I did some research on various procedures, and I found a different orthopedic surgeon in Portland who (a) does hip resurfacing as well as THA, and (b) specializes in younger, active patients. I went to see him in April, and he said my arthritis was pretty bad, and he recommended surgery. (But he didn't recommend resurfacing; he thinks the chances of a revision are much greater with resurfacing than full replacement.)

So I figured I'd see how the spring and summer went. I stopped playing volleyball — for good — because all the jumping and sideways movement is the last thing an arthritic hip wants. But I kept doing my other sports/activities. After hiking or softball, getting up out of the car was often a bit of an adventure; I'd have to shake my leg and twist my hips to get the bad leg to "click" into place and support my weight, and then I'd be OK. Sometimes it would happen after getting off the sofa or the toilet.

But the weird thing is, the bad hip didn't really slow me down too much WHILE I was doing stuff -- especially once I found that naproxen sodium (Aleve) worked way better for me than ibuprofen. I didn't do any 15-mile hikes this past summer, but I did a few 12-milers with 3000' of elevation gain, and I scrambled up a few semi-sketchy mountain peaks. A couple of times, I even hiked on three consecutive days. Softball turned out to be more of an problem; I asked for a pinch-runner on the bases, and I refused to play outfield, because any running was painful. Disc golf wasn't really an issue at all, because my backhand throwing motion pivots off my good leg.

Over the course of the summer, while my leg muscles were relatively strong, the getting-out-of-the-car and getting-up-off-the-sofa problems weren't getting any better. I decided to schedule my hip replacement surgery for September, for a couple reasons: (1) My legs would be in good shape for rehab, and (2) My entire recovery would be in the colder, darker, wetter part of the year when I don't really mind being inside anyway.

But I admit I was (and am) nervous about this whole thing. A lot of people who have hip replacements were in constant pain before the surgery, and for them, it's a godsend. I wasn't in constant pain, I just had my weird wobbly moments and couldn't run. I'm doing it now because I didn't want it to get worse and leave me with weak legs, messed up knees, and/or an inconvenient recovery window.
 
OP
OP
pdx_hiker

pdx_hiker

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POST-OP:

I had my left total hip replacement on September 13. The surgeon was Dr. Mark Wagner of Orthopedics Northwest (Portland, Oregon). Dr. Wagner does do Mako robot-assisted surgery, but my insurance didn't cover the robot, so he used "OrthAlign" instead. He used the mini-posterior approach; the incision is about 4-5 inches long and was closed with steri-strips and self-dissolving sutures (under an amazing flexible waterproof dressing). My installed parts are the Stryker Trident acetabular cup with X3 HXL polyethylene liner, and the Accolade II 127° femoral stem (Ti-Al-V alloy) with a Biolox Delta 36mm head (AlO-ZrO₂-SrO ceramic).

The surgery was at 7:30am, and I left the hospital around 4pm, after having brief sessions with an Occupational Therapist (who mostly wanted to see me sit on the toilet by myself) and a Physical Therapist (who made me go up and down a couple of stairs and kept telling me not to cross my ankles).

When I was discharged, I stayed at a friend's place for the first week, because she has a little studio unit in her backyard that's all one level and has a shower with no barriers. And I was able to bring my cat with me, which was nice for both me and her.

The first evening wasn't too bad; I was still half-full of anesthetics and probably in some sort of shock. The second day sucked: I would shift my weight on the sofa with my knees up, and my bad leg would just flop over sideways because my traumatized muscles had no control over it. I kind of wish someone would have warned me about the Day 2 backslide!

The next day was a little better, and things have mostly progressed forward from there, although my thigh gets a little sore and stiff after spending time on my feet. I stopped using the front-wheel walker after the second day, and switched to a cane for support -- actually a trekking pole with a rubber foot on it. I used the pole(s) for 2 or 3 more days, but now I'm walking indoors with no support and it feels fine. (I still bring the sticks if I go for an actual walk outside.)

I took oxycodone the day after surgery, but then for the next week I only took it at night to make sure I got a good night's sleep. I've stopped it now, because I want to be able to drive my car soon. I'm taking Tylenol and Aleve.

I returned home last night, 8 days post-surgery. I'm spending most of my time on the living room sofa (same level as the kitchen and bathroom), but my bedroom is upstairs. Fortunately, the stairs have not been a problem. There's a handrail if I need it, but I haven't really needed it.

So, anyway, I know it's going to be a while before I'm 100% again, but I guess... so far, so good? It's pretty cool that I had the biggest bone in my body sawed off 9 days ago and I'm walking almost like a normal person. On the other hand, like I said in my pre-op intro, I wasn't in everyday pain, so this feels more like preventative maintenance rather than a heaven-sent miracle. I'm confident that my hiking ability will be fully restored at some point in the next year, but I'm curious about things like softball: Will I be able to run short distances pain-free? If so, will I be slow as molasses? Time will tell!
 

Layla

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Welcome to BoneSmart! Thanks for joining us. I read your above posts with interest. It sounds like you made the right decision as an active 49 year old. I'm sure given time you'll get back to all you love. I will leave the BoneSmart Recovery Guidelines below. Let us know if you have any questions and we'll do our best to advise. I wish you comfort as you begin the journey. Brighter days are on the way! :SUNsmile:

HIP RECOVERY GUIDELINES

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.

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
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

5. At week 4 and after you should follow this

The recovery articles
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 that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 

Eman85

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I'm past my softball playing days, I played for years with bad hips. I can run short distances with no pain or real worry but it's not anything I want to do often. I waited to have mine done knowing that when I had them done I would do my best not to damage them like I've done to just about every other joint in my body.
 

CricketHip

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Hi and welcome to the forum. Now that I've been through a THR, I wouldn't ever advise anyone to wait until they are in excruciating pain. So I think you made a good decision. It sounds like it was a well thought out one, too.

Re:Softball, there's a good chance you will be back on the ball field, especially if you take your time in resuming the game.
If you search around and read other recovery stories, I think you will be inspired by them.

Will I be able to run short distances pain-free? If so, will I be slow as molasses? Time will tell!
Well, part of this depends on whether you were slow as molasses prior to the THR. :rotfl:

Seriously though, I wish for you an easy recovery and hope you update and keep us posted on your progress.
 

cold_brew

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I hope you get back to softball! Sleepless nights with achy hips after softball about 3 years ago were my body’s first hint that I’d be spending this summer bouncing back from a bilateral THR.

My volleyball days are probably over too? Especially the way I used to play - not indestructible anymore! Maybe I can still practice with my son who’s 13 and just getting interested. He’ll just have to take my word for it on how awesome I used to be :)

But here I am, feeling way better at op+10 weeks than preop. There’s still hiking and biking and swimming ahead and - maybe - some non extreme snow sports out there still.

So good luck and ever upwards in your recovery!
 
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pdx_hiker

pdx_hiker

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Well, part of this depends on whether you were slow as molasses prior to the THR. :rotfl:
Maybe not as fast as 10 years ago, but until 2022, I was speedy enough to beat out most ground balls to the left side! I know running of any kind isn't good for a hip replacement, but I'll be willing to risk a few short sprints every now and then.

My volleyball days are probably over too? Especially the way I used to play - not indestructible anymore! Maybe I can still practice with my son who’s 13 and just getting interested. He’ll just have to take my word for it on how awesome I used to be
You should definitely practice with your son... there aren't many g-forces involved in passing it back and forth, and it's a great way to sharpen skills. And I know I could go ahead and play in my local pickup game, with severely reduced skills (and expectations), but I refuse to be That Guy... the one who kills every rally because he never moves. I'm not hyper-competitive, but I'm competitive enough that playing badly would be far more stressful for me than just walking away from it.
 

Jaycey

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I know running of any kind isn't good for a hip replacement, but I'll be willing to risk a few short sprints every now and then.
We have many members who return to running. Since you will be running on a field versus on hard surface there should be less wear and tear.

For now - easy does it. This process can take up to one year or longer.
 
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Welcome and I enjoyed reading your story.
I'm much older than you and my THR was due to a fall and fracture so much different circumstances for sure, I had no issues with my hips prior to my fall.
I'm pretty much back to my everyday life, I can even wash the bathroom floor on my hands and knees, maybe not something some folks look forward to but for me it was a big accomplishment.
My suggestion would be easy does it for now. A lot of us want to push our bodies to recover sooner than they are able to and this can lead to frustration.
Many go back to skiing, hiking, running. I'm an avid walker and I'm walking 3 miles a day most days.
We are here for any type of support you may need, emotional or otherwise.
Congrats on the new hip, you have youth on your side.
Stay well and I wish you all the best.
 

HollyNY

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POST-OP:

I had my left total hip replacement on September 13. The surgeon was Dr. Mark Wagner of Orthopedics Northwest (Portland, Oregon). Dr. Wagner does do Mako robot-assisted surgery, but my insurance didn't cover the robot, so he used "OrthAlign" instead. He used the mini-posterior approach; the incision is about 4-5 inches long and was closed with steri-strips and self-dissolving sutures (under an amazing flexible waterproof dressing). My installed parts are the Stryker Trident acetabular cup with X3 HXL polyethylene liner, and the Accolade II 127° femoral stem (Ti-Al-V alloy) with a Biolox Delta 36mm head (AlO-ZrO₂-SrO ceramic).

Hi @pdx_hiker ,
I had an anterior right hip replacement on 9/12 that used the MAKO robot guided by CT scan data.

I was worried about staples but my surgeon also uses dissolvable sutures

My bionic parts are almost the same as yours.

It is amazing what these doctors are able to do and how fast our bodies can recover!

You did the right thing! A bone on bone hip can go from 'not that bad' to incapacitating quickly.

Once the cartilage is gone it is game over.
 
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OP
pdx_hiker

pdx_hiker

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Day 10: I got my car back. I'm not planning any major road trips, but it's a relief to not have to rely on others for transportation.

(When I had a bad hip, standing up after getting out of the car was sometimes a bit of an adventure. After surgery, it's sitting down that requires some choreography.)

I'm having a fair amount of stiffness/soreness around the knee of my left leg (the one with the implant). I assume that's from the knee trying to compensate for the new weirdness in my pelvis. Or maybe my femur itself is complaining, having been reamed out and invaded?
 
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