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THR Anterior THR

desertrat said:
Do they always wait until it is bone on bone? Just curious if there are other circumstances.
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No. I was not bone on bone before my RTHR. But having waited far too long for my LTHR meant a longer, more complicated recovery. I had some damage in my right hip and I had just started limping when I saw the surgeon. Having that one done early resulted in a much easier recovery.
 
I was wondering if waiting too long could make a more difficult recovery. I was walking a lot at work and strangely, walking was the only thing that didn't especially hurt. Sitting and lying down, there was always a burning ache in my hip. Walking sometimes hurt a little, especially when I got up from sitting a while, but would mostly walk out after several steps. I've walked a lot on hard factory floors my whole career, which probably contributed to my hips wearing out.
 
I think the decision to move forward with surgery is based on deterioration of cartilage (as revealed by X-ray) + patient-reported pain & disability ... Some patients have greater pain and disability than others seemingly with the same level of cartilage deterioration. And even with the same person, some deterioration in cartilage on one side might cause severe pain ... and same level of deterioration on the other side might not.

I was bone on bone, but the main reason I had the surgery was so I could exercise and dance and pursue physical activity aggressively without pain.

Yes, there is an advantage to not waiting because over time. People with cartilage loss compensate more and more and muscles atrophy as people stop being active because of the pain. So following replacement these long-time inactive people have to recover from the surgery and heal from the surgery ... AND they have to recover from the years of inactivity and atrophy ... and they might have other parts worn out from compensation ... and greater adjustment after surgery as their bodies have to walk in a very different way, no longer requiring compensation.

The problem with going for surgery earlier, in my view, is more an emotional one. It's hard for people to convince themselves to go with the surgery until they hit some desperation and disability. I had a lot of mobility with my previous hip, though dancing and exercising caused severe pain. I waited until I was highly confident that the new hip would be a big improvement over my original one. I also finally just got sick of thinking about when to have the surgery--and I found surgeons who were confident I could dance and run with my new hip.
 
Yes, that makes sense, that recovery would be more difficult from lack of pre-op activity. My left knee has deteriorated really fast in the last year and I wonder if it is partly because of my right hip - I've been walking wrong - hunched forward because I couldn't hardly straighten up, also had very little lateral movement. Range of motion, more than pain, was why I had it done, though pain was becoming more of an issue. When the surgeon said it was ready and was up to me when, I went along with scheduling it but had my doubts, thought about putting it off and did I really need it. Cutting off the end of my femur really creeped me out. They said I could cancel later but I just didn't, glad I went through with it now.

I know what you mean about wanting to exercise again - I want to get back to hiking and yoga. My left knee might get in the way and I'll eventually need my left hip done, but it's not bone on bone and doesn't hurt unless I try to move it wrong. It also has greatly reduced range of motion, but I can walk/hike once my right hip heals.

Today I took it easy and puttered around the house - did some laundry. Tomorrow I plan to go to Costco - that will be something of a challenge. :dancy::fingersx:
 
Jaycey said:
At less than a month out of surgery?
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Costco went well - we didn't cover the whole store. Less than half really and I did it easily, propping myself up with the cart or using the cane. After a couple of more brief stops, my leg was getting tired but didn't hurt. Now I'm sitting on a recliner with my feet up and ice on my hip. There was a cat on my chest a few minutes ago - that always helps.
 
:kitty:Glad you were able to get out a bit...and glad you are counteracting that activity with some icing and resting.
That's the way we do it.
Hope today is a Good Day!
 
Good news! Glad you made it through the shopping experience and are doing okay.
Resting in your recliner with ice is wise after your outing.
I hope you have a great Tuesday! :)
@desertrat
 
Thanks for the well wishes. I feel fine today, I had gone shopping and out to eat a few other times but just to small stores where I didn't have to walk forever. I've been walking around my property too - 3 acres of desert. I feel like my leg is getting stronger and I'm ready to walk more. I started taking a few steps around my house without the cane but not ready for prime time yet. Also, I don't need as much sleep as I did at first.
 
@Wayfarer, you have a brand, brand new hip - 1 day! It really isn't bad - thank goodness they've gotten really good at this surgery. I didn't think about them cutting off my femur any more, right before surgery. I was supposed to have surgery at 11AM, the day before they called and said 1PM, at 1 I was ready and by the time they came to give me the spinal it was 3! By then I just wanted to get on with it! That was the only hitch with my surgery. The hospital had overbooked that day.
 
I recall they were wheeling my bed through hallways to the OR at break neck speed.
I remember thinking "Do they think I'm going to jump off this bed en route, or what?!! :heehee:

Only three days away from your one month anniversary, desert rat.
Time moves more quickly in recovery than we imagined. At least I found that to be true.
Hope you have a great day!
@desertrat
 
@Layla I don't remember anything after they gave me the spinal. They gave me a relaxant before the spinal and I guess that knocked me out, at least I don't remember. I also got general anesthesia. Don't know if the spinal is standard for this procedure but my doctor wouldn't do the surgery without it - he said it is safer and they can use less anesthesia.

Today is four weeks for me. I can finally quit wearing that stupid TED stocking! Had to wear on both legs for 2 weeks and then just the surgical leg for 2 more. :yes!:
 
I had Spinal and GA also. I balked at the General and was informed by the anesthesiologist
that it would be "light" I wasn't happy, but went with it. The combo worked well for me, I wasn't really groggy afterward, no dizziness, was up and walking within several hours, was eating with no nausea / vomiting etc.
I was pleasantly surprised.

Woohoo :yay: on losing the awful TED's. That's a great milestone...they're awful!
I hope you have a good day and a great end to the week :SUNsmile:
@desertrat
 
Layla said:
While we're on the subject...
My OS only utilizes the posterior approach, I've also heard, correct me "anyone" if I'm wrong, that if better access is needed during anterior surgery, for any number of unknown reasons, they'd close and access via posterior approach. Anyone else hear this? @Josephine can tell me if I dreamt this, or made it up :shrug: That would make me wonder if that's why some OS's stick with posterior...
@desertrat
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Layla, this is 100% correct! This is the reason my OS only uses the posterior (mini-posterior) approach. If something goes wrong during the surgery that requires more work than the standard hip replacement- (i.e. broken femur, femoral bleed, etc), it would likely require a second posterior incision to correct the problem. There isn't enough room to access everything from the anterior incision. This could not be planned prior to anesthesia, as Josephine suggested... because the event hasn't happened yet. You didn't dream it or make it up! :heehee:
 
Today is my one month anniversary. It has been pretty uneventful so far, except for the New Years Eve incident. Nothing seems to have come of that. I was good and called my doctor's office to ask if I could do some stuff like:
Inversion table? No :sad:
Chiropractor? No :sad:
Soak in bath? Yes! :happydance::beer: (that's wine in the cups)
Get a massage? Yes! So I will be doing that soon. :egypdance:
Also told them about the New Years Eve incident. They said as long as no pain it should be okay.
 
Inversion table?!!!! :holysheep:
I wouldn't do that for the rest of my life after THR. You couldn't pay me enough. :heehee:

Happy One Month Anniversary!
Maybe you can celebrate it with a glass of wine in the bath :beer:
A great Sunday to you! :SUNsmile:
@desertrat
 
desertrat, you are something else. I admire your desire to get back to your routine so early. I am only 5 days after surgery but I haven't once thought about getting back to my home gym routine or walk even a small portion of my 7 acres. Don't think I will 3 weeks from now either. Although I am moving around great with the walker, still have a fear for tripping or falling on uneven surfaces. I can only imagine your fearful thoughts after your early fall.

I do have a goal of driving in the next few weeks and hope to visit Costco or Bass Pro in the near future after the walker is ditched, but no rush to get a chiropractic adjustment or massage. I believe our Teeter inversion table will be on Craigslist. Cant imagine the risk using it would be worth it.
 
@goblue61 in 3 weeks you will see major improvement. Of course everyone needs to go at their own pace and listen to their own bodies. I'm really not pushing myself, if my leg/hip protests, I stop and take it easy. When I knelt to the floor it wasn't a fall, it was a stupid brain glitch. Realized too late it was a mistake. I got up okay but my hip popped and scared the @#$! out of me. Since then I've caught myself thinking about kneeling to do something and thought oh no, not again. Not sure when I'll try that again - not for a while!

Bass Pro shop is a fun place - also huge! And 2 levels but I'm sure they have an elevator. I read about people doing stairs pretty early and I haven't tried that yet, except for a few steps onto my sister's deck and I did those one at a time very cautiously. I hope things go well for you and you have fun when you go to Bass Pro.
 
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