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Revision THR Dislocation 3 yrs out/Revision Plan

Thank you @Jamie. @Lupyhippie How nice of you to ask! I had my left THR on 1/28, as they moved me up. All went well, but i did have to stay overnight because the pain meds made me very sick.My new hip, now at about 5 weeks post op, is great. Instant relief from the bone pain replaced by manageable surgical pain in the soft tissues. My right hip is giving me fits, but I see my surgeon on 3/12 and am hoping he moves me up on his schedule as he did for my left side. Now that I know what to expect, and have made it through one sugery, I am not nearly as fearful as I was before having the left done. Icing frequently (still icing) has been the best pain relief for me, just like you said. Hindsight really is 20/20...I wish i had done this years ago. My fear kept me in pain for too long. Once my right hip is done and healed I will kick my own butt for waiting!
Best wishes to you on a successful TKR @Lupyhippie.
 
Wishing you an easy day tomorrow, @Lupyhippie. Look forward to hearing from you post-op, once you are feeling up to it. We'll be here to support you!
 
Hey Lupyhippie,
I read about your recent left hip dislocation, on another's thread, and wondering how you're doing?
Hopefully it's going well and you're feeling secure again :fingersx: Let us know...we're here for you!
Wishing you all things good in the new year.
@Lupyhippie
 
Hi Layla. I’m now back. Had to wait awhile to figure out plan. Meet w Revision surgeon all that jazz. I’d love to make a post but not sure where to post. I have a Revision date (subject to change but rn 4/3) but I’ve got a number of variables that might pop up. And some questions for the group.

So let me know do I start a new thread. Or drag over old info or what ?

Thanks Lisa.

I’m gonna go ahead and write it out now and you can move it around as needed
 
@Lupyhippie You can continue to post here in your LTHR recovery thread. Since it's the same hip, it will be helpful to have your entire journey in one place.

I've added your expected surgery date to your signature, If it changes, just let us know.
 
How do I change the title of my post when I reply to the old one ?
 
HERE WE GO AGAIN
My Left Hip dislocated during Thanksgiving and again 3 weeks later and both times I was doing nothing but sitting. To refresh this was the hip that was replaced 7/2023 via a posterior incision. I did have a post op complication (read this thread for explanation but that was literally all in the same week as the original sx. Now 3 years later all this occurred after having ZERO warning or problems since the initial sx.
The first time I was sitting in a window seat so my hips were a little below my knees (but I’ve literally forgotten that I even have had surgery on either). I did twist slightly to the left and my big toe way turned towards the inside and I just reached way out. Heard it pop !! Yep. Dislocated. EMTs took me w a bunch of narcotics on board. Popped back into place. My dr wasn’t sure if my now 80 pound weight loss was a root cause but doesn’t think so other than my hip flexors, quads, glutes etc being weak. So I started baby baby PT doing isometric exercises. The second dislocation was 3 weeks later and I REALLY was doing NOTHING AT ALL. literally sitting in a chair. My rt big toe was hurting. I leaned slightly and lifted my knee slightly and POP. HERE I GO AGAIN. Same as before. EMT. ER POP IN PLACE. BUT this time it came w the referral to a Revision Surgeon which Illl update what all has gone down so far. Bc it’s a lot. Surgery scheduled 4/2 . I’m in a knee immobilizer so I don’t repeat the dislocation again.

What I’m wanting to know from anyone that had had a dislocation or even an injury or another joint is DO YOU FIND THE “OPPOSITE LIMB where there have been joints replaced aching at the joint site? I’ve had the RTH 6/21 and RTK on 4/2025. And now I’m having no pain fr the LTH that dislocated but pretty significant pain in the RTK abd my RTH feels weak and unstable. Trying to figure out if this is “normal”. I mentioned to Revision surgeon but idk if I should go back to the Dr that did my original TK replacement surgery?
I think I’ll call him tomorrow. But yeah my knee hurts a lot now. And really has never not hurt since the surgery. Boo hoo.

I’ll post more on the fancy way this Revision surgeon is going to do to me later. Too tired tonight. If anyone can shed light on this art Knee pain
 
Are you asking to change the title of your thread? If so, what would you like it to be?

@Lupyhippie
 
Wow, that’s a lot you have gone through and now revision surgery. Ughhh…I feel for you. I had a friend that dislocated a couple of times doing not much. Once tying her shoes and another while working in her garden. She did end up with a revision also. This past November she had her other hip replaced and we’ve had lunch a couple of times since then and so far so good. She said it’s so painful when you dislocate, I can only imagine. And because of her experience I was so cautious after my replacement always thinking about dislocation.,
I wish you the best.
 
Oh my goodness, what an ordeal you've been through! I'm glad you have a date for your revision and would love to read more about your surgeon's plan.

Lupyhippie said:
now I’m having no pain fr the LTH that dislocated but pretty significant pain in the RTK abd my RTH feels weak and unstable. Trying to figure out if this is “normal”. I mentioned to Revision surgeon
Click to expand...
What did he say? I'm wondering if this is happening because your right side has had to compensate for the left. Any time our body gets "out of alignment", we can have pain in unexpected places. Please post more when you feel up to it.
 
REVISION PLAN . My original surgeon (Tampa Bucs team dr) referred me to the Revisionist he uses for complex cases. Dr Brian Palumbo at Florida Orthopedic in Tampa. After reviewing the films from the ER and my original operating reports he said he can fix it but he’d like to know the cause of the dislocation first. So the plan is to do a whole lower body functional study under imaging a CT scan MRI -Mars and X-rays w sitting, standing turning, every way possible. These will create precise measurements that will help him deciding if other structures need realigned etc. He said the measurements are then fed into an algorithm which will calculate what and where the fixes are going to be needed.
Then all of these measurements are sent to a company in Australia ‍ who will then download these measurements into a CAD program and that is then used to design a working model of the device that will printed using a 3D printer. The part will be specific to my anatomy and is made w ceramic and titanium materials. It’s a cup and socket and is supposed to have a longer lever so there’s more ROM for the lever to travel so it does not pop out as easily.

The imaging began last week. A fancy CT that took about a half hour. Then over to X-ray where they did squatting, tilting, stand side lie. My whole body really hurt after that and into the next day.
Fancy MRI on Tuesday

Then we meet to discuss what going to be done to fix it. I’m hoping the extensive imaging showed my right hip and knee as well so this unsteadiness can get evaluated as well.

I’ll let you know. Keep you posted.
 
Wow, that sounds very impressive. Thanks so much for making us part of your plan with your documentation of how things go.

I’ve changed your thread title for you….
 
That is certainly some comprehensive exploration and analysis into what's causing the dislocations.
If that doesn't provide useful information, I don't know what will. It sounds like you have a very competent revision specialist on your side. I hope you will continue to share your journey with us, I will be watching with interest.
Good Luck, Lupyhippie!
@Lupyhippie
 
Stopping by to say Hi, Lupyhippie and see how you're doing these days?
Fingers crossed there are no more dislocation episodes. Waiting is the hardest part. Keep us updated when you can, we're right here alongside you.
@Lupyhippie
 
Well logging back on because it’s been a really tough year. I’m one year post TKR this upcoming week. And I’ve been doing all the testing for the upcoming revision surgery scheduled for 4/2. BUT during this one year with the knee I have never gotten my full strength back due to having to slow down my rehab bc of some cardiac/pulmonary symptoms : short of breath, tachycardia, dropping blood pressure.(spells of heat intolerance and near fainting) All this was followed by the dislocations. In addition this year has been my second on GLP1 and I’ve lost 65 pounds since 2023. But these last 30 pounds have come at the expense of my muscle mass. It’s gone. Completely. My skin is wobbly and I no longer look like a normal healthy womam. I’ve got that wrinkly old lady look and it’s SO DEPRESSING. My husband said tonight he feels like I’ve given up.

All this said because it’s been 2 months since the dislocation. I wasn’t due to have another appt w the surgeon but I think I’m going to request one bc I’m getting very cold feet. I’ve begun testing the waters on this hip a bit more and I think I’m ok. I just don’t want to rush into a big surgery when I’m not sure I need it.

I have my follow up for my knee next week. So I’m going to take my images to him and see what he thinks. I’m almost thinking I need to do cardio pulmonary rehab and gets this Dysautomia thing figure out first. Gain some muscle mass. And THEN have the surgery if I need it. I don’t know if a 3rd dislocation will be any more harmful than the other 2. Plus in my heart of hearts I feel like my deconditioning and muscle mass loss contributed to the instability of my hip.

Any thoughts. ?? It’s a vicious cycle and I’ve always heard the Pats telling patients this. But maybe I need to just get motivated and make reconditioning a job for a year. Then see what’s up.
 
@Lupyhippie……you have been though so much, it’s no wonder you’re feeling a bit like you may be in the wrong body right now. A lot has taken place with your body in just one short year and I think you are wise to just stop and take account to see what is really most important to do next. It’s a good idea to put some questions down on paper and talk again with each of your specialists as well as your GP to get a plan in place that prioritizes any therapy or surgery.

It is possible that getting muscle strength back might improve your hip functions. This should be addressed with both your physical therapist (make sure the person has doctorate level training so they can help with a medical diagnosis) and your surgeon. I would guess the surgeon is planning on using an implant that will reduce the potential for future dislocations and it may be this is something that needs to be done so you can move forward with recovery.

It will be important to talk with your cardiologist to see what you should be doing in terms of exercise to regain strength and endurance. I agree that joining a cardio rehab program would be great if you are cleared for that and your doctor can order it for you. I’ve been through those programs twice and they do a great job of safely getting back to more normal activity levels.

In answer to your questions about dislocations, there is no set way they occur in terms of severity. It’s not like each one is progressively worse that those before, but continued dislocations can damage soft tissue and tend to make future dislocations more likely. It’s not something you want happening. It is possible that your muscle loss has contributed to this problem. And…although it is wonderful that you have lost such a significant amount of weight, one of the side effects of the GLP-1 meds is the potential for loss of muscle mass.
 
You seem to have so much going on right now, sorry to hear about your cardiac issues. My Mom did the pulmonary therapy many years ago & it did help. As already mentioned you need to check with each physician to see what to do next.
I don’t think you are giving up, I think you are in search of the next best step. I wish you the best & keep us posted.
 
@Lupyhippie All that you describe in your thought processes doesn’t sound like giving up to me. It sounds like a wise person recognizing where their physical challenges might be and how to wrap their heads around what the next best step is for them. So much has happened recently and so much information is coming at you right now. I think it’s hard to figure out the whole picture. I think you’re doing right by yourself to sort what the priority is and what the next action step is taking care of that priority. The rest will still be there. You can always course correct if something shifts and has to become the priority. Take a deep breath and try not to get overwhelmed. It’s so easy for us to get ahead of ourselves. You know your body. Listen to that inner guidance. Blessings going forward. Please, keep us in the loop.
 
Alrighty. Here we go again. We’ve done testing and imaging and rehashing this whole debacle. All imaging has been thoroughly evaluated by both my primary ortho and my revision ortho. Despite there being nothing glaringly wrong on my imaging (as read by radiologist) and nothing wrong with leg length or anything else as read by my primary ortho sx the Revision surgeon says there is a 50/50 chance that I’m going to dislocate in the future. He has calculated that for whatever reasons that the prosthetic is “off” and will be installing a different device (dual mobility) that will . I’ve done perfectly fine since the Dec dislocation. I’ve tested my limitations. And bent past 90 just slowly. I feel good going into the surgery except for the HUGE AMOUNT of muscle mass I’ve lost over the last two years surgeries and weight loss of 75 pounds. (I still think that this did cause this dislocation but they really don’t know).

So at this point I’m just going forward w a positive outlook determined to recover like before and then be able to start PT and the gym to rebuild muscle.
Preop 3/24
Surgery 4/2

Here we go again !!
 
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