THR Charlie's RTHR Recovery Thread

[Freyagirl]

So I'm not 'code red' but if anyone can recommend forum members or threads, or would care to share experiences on timing of second surgery, would welcome feedback. Also in a GREAT work situation and insurance so tempting to help with recovery. Also if you prefer to message me directly cool with that too!

My surgeon suggested that I have the second hip done 3 weeks after the first. I said no. Then during the 3 months leading up to the surgery hip#2 went to pot and I was miserable. After hip#1 was replaced I found myself with very little pain in #1 and misery in #2. At 2 weeks post-op I scheduled #2 for 8 weeks after #1. 1. I like the surgeon and they all change practices so I want to get her while I can. 2. I can’t fully rehab #1 until #2 is done. 3. The still bad hip adds to back and sciatica issues I also have. 4. I know how to do this now and just want to get to the other side. Good luck with your decision. Try not to second guess yourself.

 

[Nini]

This has been a very interesting thread. I have seen myself in many of the comments! I’m close to 9 weeks PO. And 69 years old no health issues I’ve been discouraged that I’m not further healed. Everyone says give it time. I really appreciated all the insight I found in your journey Charlie! You did really good to fly when you did! No way could I even think about doing that! Thank you again for all you shared!

 

[Nini]

. The posterior muscles / glutes just never seemed to loosen up until then, which had me banging my head against wall: the darn thing just needs some time to heal before you can continue to make progress. It's everything you read here over and over but have now personally experienced.

I feel like this is where I’m at and you post is very encouraging!! Thank you for sharing!

 

[Mojo333]

Hi @Charlie33
When should I consider THR surgery? One of the most oft asked questions on the forum and I actually find myself - oddly - feeling lucky that after so many years of back pain that no-one could find root causes for... I finally had a simple Xray that confirmed Stage 4 OA...bone on bone....both hips!
So really not alot of choices and healing at the same time...though hard, got me one and done!

my other hip shows moderate degenerative change, does not give me real pain but VERY limited ROM. So the disease process in the other hip keeps your pelvis in a tilted position and your sort of fighting the other side.

The term moderate in the context of OA is a bit..... I don't know, in my opinion.... wishy-washy
especially when you are trying to decide "Is this bad enough to go through another surgery?"
So it really is stage 3 - also called moderate hip osteoarthritis.

Stage 3: The cartilage starts to erode and the gap between the hip bones narrows. Normal activities highlight decreased ROM (in hindsight, I realize this) and walking, kneeling or squatting may cause pain and swelling.


Stage 4 (the most severe stage): The cartilage is almost gone, which causes chronic inflammation. By this time there can be bone spurs formed and other nasty changes that may cause additional challenges for the Surgeon.

I guess you can guess what my thoughts are... no-one can predict how fast the stages progress....some folks, might be years and it can also get way worse in a matter of months.
We also see alot of folks on this site who feel the other "bad" hip is interfering with their 1st recovery.

I am about to be 8 years out from BTHR replaced at age 53, and still grateful.
The short term recovery went well...the adjustment of the body afterward was a bit tricky (including a tilted pelvis and PT to work on that)...but hip replacement definitely cured my back issues and chronic pain so I am a bit biased!

 

[Charlie33]

@Mojo333 and all, thanks for the kind and generous responses!

My reaction (and writing a long response as it will hopefully this aids others in their decision process) and how I think about it is as follows:

First off, I don't think my recovery was 'normal': I've had problems since I was in my 20's (at 20 fell with four bodies on top of me playing a game and leg twisted behind my back, soft cast for 12 weeks). Joint capsule and hip flexor shredded... and waited a long time to get fixed. In retrospect, if you let a bad hip stay bad for too long, the surgery may be less effective to reestablish normal muscle movement. This has been a challenge for me for sure. The average person in their 60's who had a hip go south for normal reasons over say 3-5 years, not related to an injury or chronic condition earlier in life (perthes, fai), seem to recovery very well and fast with some PT but many do nothing and are fine (from my reading and personal experience with friends). Not the case with me: left side a problem for 20 years.

Second, the other hip is clearly holding me back and has through the recovery. But I pushed and pushed and got things to work, but it seems like I have to put soooo much effort in (like taping a broken egg back together) it seems a bit odd to put the work in relative to the result I have.

My first OS (who was great) didn't think I needed a second hip now, but commented 'the range is worse than the xray indicates'. I consulted a second OS a year ago (same surgical approach but uses CT Scan for cup placement) and said get it done September 2023: the range was so bad, you are ready now. He also said your other hip is slightly raised due to OA which will continue to cause your pelvis to be out of whack until we fix it.

Also a comment on pelvic tilt (@Mojo333): this can happen at any time and what is causing me issues right now. My OS has seen people where muscle imbalances happen 10 years post Op. My knee injury from 10 weeks ago, and while healed, caused the pelvic tilt and irritation to piriformus.

I will likely change surgeons because in my view cup placement w/o CT is based on surgeons experience and snapping xrays intraop and hoping it goes right versus a detailed preoperative plan from CT that NAILS cup placement and pelvic alignment (sadly have researched extensively). As an aside, first surgeon was great and second OS loved his work (as do I).

Disclaimer: most hip replacements are done without CT and go just fine (including mine!). I have no complaints, but this technology has now been around 5-7 years old and feel will become new standard of care over time. My OS uses it for TKR and admits it will give him a better cut line than what he can do himself...

Also a comment on pelvic tilt (@Mojo333): this can happen at any time and what is causing me issues right now. My OS has seen people where muscle imbalances happen 10 years post Op.

So what is the plan? Like before THR #1 not in debilitating pain, but 'in annoying pain' and super limited range and function going sideways and trending lower...Going back to OS #2 to check in. In many ways would rather get #2 done than eek along... but we will see...

Thanks and hope this helps anyone thinking about this stuff!

 

[Eman85]

Work and life situation had a lot to do with the timing of my first THR. My second I was in a good position as I had retired. I didn't want to have it, but knew it was coming. I timed it for the winter as I do too many things in the good weather that I didn't want to miss out on, that's why I chose the later timing for my second. Probably should have been done 6 mos earlier but I was so used to living with bad hips waiting was no big deal and it didn't interfere with my life.

 

[Charlie33]

@Eman85 yeah living with bad hips is something that is normal for me. I have to say in December I had a month which I had not experienced in 20 years and felt 'normal'. I have to say the first replacement really was a miracle in terms of ROM I got back. Hopeful with second replacement can get back to December again!