[DISLOCATION] ponymad recovery thread

[Hipmumma44]

I don't have much to add on to what everyone else has said....Just wanted to send lots of love and strength your way! It sounds as though you are doing well to stay calm during a very difficult situation. I hope things get worked out quickly for you and you manage to get some answers

 

[Delphi]

Good morning Pony,
Hope you managed to get some rest last night after such an emotional day. Hope also that a clearer picture emerges when you meet physio and surgeon to enable you to take decisions going forward. If you are anything like me, I would need comprehensive answers as to the cause of this problem if at all possible, in order to get my head around it.
Keep your chin up, this too will pass eventually. Big hug, Diane xxx

 

[ponymad]

Update - I had a comfortable night, have been up, showered and dressed. Lots of thoughts going around my head last night...My surgeon came to see me and thankfully he thinks the reason for dislocation was possibly sat with my legs too close together and the lack of scar tissue forming around my implant. Opening up my scar and carrying out some exploratory checks may cause more issues than it solves - my wound is very good, no bruising, Leaking or swelling at all and I would to keep it that way! I'm waiting to see the Physio and I will have to adhere to more strict restrictions and wear the brace around my hip - but not the one I was given yesterday that resembles a torture tool! I'm just using a wrap that fits tightly around my hip and thigh. This will remind me to not bend and twist whilst the implant beds in. I'm doing so well with other aspects of my recovery. I do plan to take a second opinion from another orthopaedic surgeon for my own peace of mind.


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[sammylou99]

Morning Pony,
Well that was a better update. Still awful that it happened but I'm glad they are not going back in - would be my worst nightmare at this point!! And glad you are not going to have to wear that torture device!!! I could do with something to remind me lol! It's easy to forget when you seem to be going well as I found out on Saturday. I'm interested that it could have dislocated from your feet too close together though - I have not been aware of that being an issue (I will now!!). I too would want a second opinion for peace of mind. So unlucky. But look at it as a hitch as you are doing so well in every other way and I'm sure with the brace you will continue to recover well. Small steps for us all is I think the answer! Sending you big hugs and hope you are back home soon.
Sam xxx


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[ponymad]

Delphi, good morning! Slept last night and so feeling refreshed! Going home today and no surgery for the next 4 weeks at least....i will be getting a second opinion but need to understand exactly what they can check at this stage without actually "going in" to physically look. Pain is very manageable now - paracetamol only, it is about the same as pre-dislocation. Positive thoughts! And happy birthday!


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[ponymad]

Right.... just had the senior Director of Physio come and see me. My surgery was anterior lateral incision with the Exeter hip and I have had the first dislocation by not only my surgeon, but all the other surgeons in this hospital and the NHS hospital across the road who use this approach. This approach usually means lower restrictions (which I was following) but for the next 6 weeks, I have to go "old school" with the restrictions and wear the brace (not the metal one). That is 6 weeks from now and not from my surgery as the dislocation probably disrupted the tissues in the area. I'm happy with that at the moment but will be having a consultation with another surgeon to get a second opinion. Onwards and upwards!


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[Jaycey]

My surgeon came to see me and thankfully he thinks the reason for dislocation was possibly sat with my legs too close together and the lack of scar tissue forming around my implant.

As Josephine said previously:

Hips do not dislocate that easily! I think it much more likely that there was something amiss with the way the implants were inserted. I think this because it is very often the case.

Just sitting with your legs too close will not make you dislocate. I would seek a second opinion if I were you! I know you want to get on with all this but if they leave it you may risk further dislocation. Just my two pence.

 

[ponymad]

As Josephine said previously:
Just sitting with your legs too close will not make you dislocate. I would seek a second opinion if I were you! I know you want to get on with all this but if they leave it you may risk further dislocation. Just my two pence.

Most definitely will be... without having to open me up, what questions do I ask and how can they check the implant?


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[Delphi]

That sounds more positive,Pony. It may not seem so to you as you are the very unlucky exception to their successful record, but let's hope this is just a ( rather large) bump in the road to a successful recovery. I also went privately to guarantee surgery by a surgeon with an excellent reputation and a history of no dislocations. However I had posterior approach, so 'old school' restrictions as you say. Even with those restrictions, nobody had told me not to sit in a chair with my legs together. I have been told no chairs less than minimum 2 inches higher than my back of knee height when seated - 19 inches in my case.
Glad to hear that the brace is more like a wrap and that you won't be in more discomfort with it. After your experience, I am sure we will all be more mindful of our body positions . Look after yourself and take it very easy. Do you have anybody at home with you during the day? Will be thinking about you and wishing you well, Diane xx

 

[Irish Joe]

Ponymad.
Keep calm. All seems to be progressing.
Without wanting to panic you sometimes the things you are told aren't worth the paper they are written on if you know what I mean.
I hope you do seek out that second opinion so that you can be satisfied that your on the right course of action.
The moderators and advisers on this forum should be able to help you with the question to ask.
Dislocation with your knees touching each other while sitting down just doesn't sound right to me.
Quite a few questions need answering I think.
Best Wishes.
Joe..........

 

[ponymad]

Hi Diane - I do feel reassured but still have questions for my surgeon and for another consultant to give me a second opinion once I get through the restricted period.

I think describing the dislocation as being caused by my legs being together is probably not the full view. I was sat at my dressing table on a chair which was probably slightly lower than my dining chairs. I'm going to measure it when I get home - and use some cushions to sit higher. The height probably added to the risk - not sure until I check it.

My legs were in the narrow space between drawers, I can't remember what position my legs or feet were in but likely to be close together. whatever position, it was enough when combined with the chair height, to dislocate. Of course the position after dislocation was quite odd with my foot completely turned in on itself and my left knee digging in to my right knee. I was also "perched" on the edge of the chair by this point and slightly turned to the left . Very uncomfortable and my right foot started slipping whilst waiting for the ambulance!

Physio and surgeon have said if my feet were together or crossed, and I twisted, it may have been enough to dislocate because the scar tissue has not healed to a point that it would anchor the implant. If I was sat with my feet facing forward or slightly pointed out, and with my legs set apart, it would be unlikely to have a dislocation risk as the head of the implant would be directed inwards. The opposite would mean the head was moving in the opposite direction.

My X-rays pre and post relocation, been reviewed by various doctors in A&E snd the NHS orthopaedic hospital, and all are happy with the relocation and felt no revision required but restrictions advised. That has reassured me as I don't want a further procedure 2 weeks after - my scar is really small and healing well.

I want more information on the surgical approach used. This is not the "old" approach but has been pioneered by Exeter Hip Group and Queen Elizabeth Orthopaedic Hospital in the past 18 months, and as the first dislocation, there is quite a lot of interest.

I've also been told that horse riding would be most unlikely to cause a dislocation - although it will be a while before I can do that.

So I'm back to 2 crutches, plenty of rest and religiously keeping to the 90 degree rule plus many others - for 6 weeks - Sia total of8 weeks from Op.

Waiting to go home! My husband has taken a few days off so will be well looked after. Will keep you posted... xxx


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[ponymad]

Thanks Joe - just did a lengthy reply to Delphi...waiting to go home and going to be very very careful. Whilst worried, I'm feeling much more confident I can avoid this happening again - unless the actual implant is faulty of course. I have an Exeter Hip which I think has a good record. Fingers (not legs) crossed!


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[Jaycey]

@ponymad if you were sitting on a lower chair and did any twisting that could cause a dislocation. However as you pointed out - you were not under any restrictions. I would ask the surgeon to confirm why this happened given you had no restrictions.

Meanwhile please take things very easy. I am glad your husband can help for a few days. The restrictions are no hard to follow - just a bit frustrating at times. Do you have grabbers at home?

 

[ponymad]

I have grabbers - unused, but will be using them now. I did have restrictions, but not to the extent that I have now.

X-ray shows no movement of the cup and the relocation was successful. Of course the implant could be faulty but without opening up my hip and looking, they can only go by the X-ray . I've been told that the surrounding scar tissue is not sufficiently repaired at 12 days post op so rather than any investigations, I feel comfortable with reviewing once I've had more recovery time, albeit with a much more conservative approach.

I've already spoken to my insurance company who have agreed to pay for a 2nd opinion:review with an alternative OS after my next meeting with my surgeon. If I want one - I will definitely be taking it up!




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[Delphi]

Good news news about the x Ray, Pony.

A couple of things occurred to me. Have you looked at the National Joint Register to check out the records of possible alternative surgeons for your second opinion? I started the process of injections etc with one surgeon close to home, but got a second opinion when it became clear that a THR would be required. I was very lucky in that I had a school friend plus neighbours who were all medics, whose opinion I asked, plus a friend who was back playing competitive tennis within 6 months or so of the op, and unbelievably, they all recommended the same guy / same hospital. The fact that he turned out to be a lovely person, down to earth and empathetic, was the icing on the cake. Whatever approach he had recommended, I would have gone with, given that he inspired such confidence in his expertise. Whoever you decide upon, make sure that you are comfortable with their record and level of experience .

The second question ( as I don't know the answer ) is, can't they get more detail now from an MRI than just an X ray? The reason I ask is my first x Ray showed OA damage to both hips and spine, but I only found out about the labral tears and degree of damage after the MRI scan.

Well, hopefully you will be home by now, and relaxing with a good cup of tea. These stressful times really take it out of you physically and mentally, so you will definitely appreciate having your husband around for a while.
Hope that is the last of the trauma for you, and that you can now take it easy and recover fully, albeit at a gentler pace!
Diane xxx

 

[Krista]

@ponymad, glad you are feeling so much better!

Just FYI, I had the antero-lateral approach for my THR. My surgeon (here in the U.S.) requires all of the usual restrictions for 6 weeks after this approach, including no bending past 90 degrees for any reason (necessitating sitting on higher chairs and the use of grabbers), no crossing of the legs (including no turning inwards or outwards of the surgical leg at all), and a requirement of sleeping only on the back.

I hope that with your new regimen of restrictions and the wrap that you continue to recover well. I agree with the recommendation that for your second opinion you find someone who is experienced with revisions. Regarding the MRI suggestion, yes, generally MRIs show lots of details, including of soft tissues. However, if there is any metal in the prostheses, that will make for wavy, indistinct areas where the prostheses are in the images. Even with MARS MRIs (metal artifact reduction series), the areas are still wavy, just a bit less so. They can be very useful for people who are further on in recovery and are having soft tissue problems. X-rays from different angles usually will tell the tale better for the prostheses and bones at any time during recovery.

 

[ponymad]

Back home and feeling so much more relaxed! I'm quite pleased with the response from my surgeon, he was at my bedside within 2 hours of being notified on a Sunday afternoon and visited me at 7.30 this morning. I also have his personal mobile number - I discussed a second opinion with him today and he suggested one of the surgeons that Josephine recommended to me - who is recognised as a top 10 of OS's and a pioneer of the minimal approach used. I couldn't use him as not on my insurance. I don't think a revision is on the cards from what I've discussed so far. I'm resting up and being ultra careful. Frustrating, but if it means I don't risk another dislocation, then that is worth it. On a positive (always got to find them) my dressing comes off tomorrow, I have zero pain from the wound, no swelling and no bruising. Looking forward to seeing my scar! Thanks everyone [emoji4]


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[Josephine]

My surgery was anterior lateral incision with the Exeter hip and I have had the first dislocation by not only my surgeon, but all the other surgeons in this hospital and the NHS hospital across the road who use this approach.

It was an anterior? Even more concern about the replacement.

without having to open me up, what questions do I ask and how can they check the implant?

That's why you are having a second opinion.

 

[Jaycey]

I discussed a second opinion with him today and he suggested one of the surgeons that Josephine recommended to me

Can you just see him privately for a check? It might be well worth whatever you have to pay to have peace of mind.

 

[ponymad]

That's my plan - not a chance on the NHS as not an emergency. I spoke to my GP this morning who reiterated that the X-rays following the relocation don't show concern and were reviewed in A&E, in the orthopaedic hospital and by my surgeon. her recommendation is that I follow the restrictions in full and wait for the 6 week check before getting a 2nd opinion as I will be X-rayed once more. I called my insurers and they confirmed that without evidence from my current X-rays of any issue with the surgery or implant, they won't pay for an MRI. No extra pain, just taking paracetamol, feel perfectly capable of walking for 15 minutes, dressing off and incision looks great. If the damn dislocation hadn't happened, I would be in a very good place 14 days from surgery! My nervousness of it happening again is less following my phone calls this morning so not going to let the positives outweigh the negatives.


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