Bilateral THR Done

[MissMoo]

Hi @Birdie53 and sorry briefly hijack your post @rob3dr.

My surgeon told me I can return to running on a treadmill or soft surface (grass, sand etc) after 3 months but "in moderation". He told me no more road running and no more trail running. The wear is really the main factor I believe, however, I've read many other articles/stories of people who've gone right back to running with no apparent impact on the longevity of the implant. I'm also a forefoot striker, so less concussive on the joints which should be in my favour. When I go for my 3 month check I'm going to discuss the situation with him in more detail.

Maybe chat again to your surgeon (is it the same one who did your original surgery?) and see how the land lies

 

[Birdie53]

Yes thanks @rob3dr -- I just jump in when it strikes me-- need to work on that!
Thanks @MissMoo for your note. Makes perfect sense to me. I used to be a road runner.
I have also read many accounts of people who picked up and ran as well. My surgeon -- yes the same one-- would just say " Well, you can run--- BUT you will be back sooner" so I just have learned to fill my work outs with other things-- but I do miss the marathon running as my husband and I used to do that together. Back to my point-- after having the revision I think I will just stay away from it. This hasn't been fun. I have made it the last 7 years although I do get jealous of others! I hope you do continue to run and it is successful. Running is such a great thing isn't it?!
Heal well!
Birdie

 

[tandmcox88]

@rob3dr So glad you are doing so well. I can not even imagine having both hips done at once. I am so in awr of you and others that have done this. Your recovery is what I imagined. I will get there eventually. It seems you are almost back to normal and that is wonderful to hear.

 

[rob3dr]

@Birdie53 and @MissMoo no worries on the 'hijack'... the point is to help others out so hijack away, please!

@tandmcox88 Thank you, Ma'am! I'm sure that you'll get there soon! Just do as you can and before you know it, you'll be doing more than you ever did!

 

[rob3dr]

OK... so just a few days beyond 4 months. To all the folks who said 'take it easy'... you were right. About 3 weeks ago I was in class.... I had been sparring and stretching pretty aggressively. I noted 'something' clicked and went wrong in my left hip. I dealt with it for a couple weeks, but it seemed as though my recovery had taken about a month backward turn. My kicks that had started to climb near head level was back at low chest level... I found myself limping on my left... and I was sore and a bit swollen. In addition, I have some kind of a depression just below the surgery site on the left.
Long story short, I knocked my left hip crooked and loose. By the time I went back to the doctor, I was told it was best for now to leave it be and allow the bone to re-calcifiy (is that even a word?) around my implant. I was told no running, no jumping, no sparring, no contact kicking.... and only 'light' stretching. I suppose now I shall take up Bingo. on a good note, I go back for an eval in 3 months and hopefully will be given the green light to start doing the things I want to. I realize it's just a setback, but it's an annoying setback.
So, kiddos.... to those of you who have recently done surgery... be very clear with the doc about your post surgery plans. I thought I was clear with my doc... he said at my last (before this mishap) appt that I could 'do anything I want as long as it dont hurt'. That's all well and good, but after 24 years or so of martial arts, my definition of 'hurt' might be different from someone elses. So lesson learned.... I'll take it easy for a bit.

 

[Jamie]

Rob.....I'm so sorry to hear about your hip, but glad you've realized that it's important to heal completely before moving on to vigorous activity. Here's hoping everything levels out. Please continue to let us know how you're getting along.

 

[bsilvers]

@rob3dr ,
Rob, dude, such terrible news to hear and what a set back! I am so sorry to hear this. I really tried to stress to you how important it was just to chill out , not go Gung Ho for a while as you let your body heal. 4 months is nothing in terms of the healing process. If my memory serves me correctly I was still just going very light gradual workouts in BJJ even still at this time. The thought of doing too much too early was always on my mind. I hope that this doesn't affect your ability to fully return to the martial arts.

 

[rob3dr]

Yeah, @bsilvers and @Jamie ...it was my own fault. True... the doc said I could go back if it didnt hurt, but I know my own thresholds and I exceeded them. I was doing well and thought I would do better quicker. Ah well. Will get through this setback and keep at it. Dropped to going to class only once a week now and no sparring...which sucks.

 

[Josephine]

allow the bone to re-calcifiy (is that even a word?) around my implant

Yes it's a word in the medical world. I hate to poor boiling oil on your distress but it's most unlikely that it will recalcify because you only really get one shot at bony ingrowth. if the early, immature bone is disturbed, that's it. At five weeks you might have had a chance but not at five months. I fear you may be looking at a revision in the not too distant future. Sad thing is, had your hip been cemented, you might just have got away with it.

 

[rob3dr]

.....great. Sigh. Ah well. Going to still try to rest up and then hit it hard again and hope to get back to my old self.
...and to anyone reading, dont get discouraged by my setback. I was perfectly fine for normal day to day activities... just not the activities that I had been used to.
3 months. Just a setback. Going to remain positive.

 

[Josephine]

Going to still try to rest up and then hit it hard again and hope to get back to my old self.

I hope this doesn't mean what I fear it means. You have to give your hip lots of TLC now and NOT do any martial arts AT ALL. It's far too risky. A loose stem can fracture the bone. Trust me, you don't want that! Just be patient until you get the revision.

 

[MissMoo]

Hey Rob @rob3dr. Was it the stem or the acetabular cup that moved - I don't think you said? I was curious that your doc seemed to think that re-calcification process would still continue when Josephine is pessimistic about this.

@Josephine - I was wondering, are you advising Rob no martial arts again, ever, in this situation, or only for a specified period of time? I'm rather thinking you're suggesting this is an 'always' thing, given that you don't think the bone regrowth will now occur; presumably that means the stem would always be loose and hence always be a risk. I'm trying to clarify both for Rob and for my own personal knowledge, as another martial artist.

Just trying to weigh up what my thoughts would be and I suspect I'd already be contemplating the possibility of a revision. If you're going to have to rest up for a few more months anyway, at least it would be with more chance of a successful outcome if you had further surgery. I couldn't comprehend the idea of

and NOT do any martial arts AT ALL. It's far too risky.

for ever any more, I think, than you could.

I'm not being a ray of sunshine, I know, but I thought maybe it would be helpful to get another perspective.

 

[Josephine]

In this case, not until he gets his revision. I should have said that - I'll edit my post.
Thanks for the heads up!

 

[rob3dr]

@MissMoo It was the stem in my femur that moved. ...and thanks for asking on the clarification... I had not seen @Josephine post until just now...
@Josephine ... I have another appt in about 2 months with my doc. He only said at the last one that I needed to 'really' take it easy and explained that I could split the femur. I was given orders for no sparring, no contact kicking, only very slow kicking at waist level or below, and only 'light' stretching. I would hate to think that I should stop even doing that. I'm hopeful that my next appt will show that all is well....and I can return to what I do.
Not saying I hope you're wrong....but... well... I hope you're wrong. I think deep down, if I think logically through it, I think what you are recommending is more logical... but I'm trying to remain optimistic about my chances here.
I went to class tonight and was very easy on everything. I noted driving home that when I pushed in the clutch with my left, I had a little bit of a click or pop in my left hip, but it seems to have gone away now.
I dont know if I'm being overly cautious and attentive now or what. I've cut going to class to only one time a week... down from 3-4... and my activity level has decreased dramatically. I hope I dont have to cut out this last class. I think I'll be extra careful.. like minimal everything, until my appointment and then will bring all this up to my doc and see what he says.
I appreciate your chiming in, even if it's not the news I want to hear.

 

[Josephine]

Well, you've been told the dangers so if you're not prepared to take good advice until you get that second opinion, then on your own head be it. You ARE going to get a second opinion, aren't you? Because I think his 'wait and see' policy is, to put it mildly, questionable. But again, that's just my opinion.

 

[rob3dr]

Not to be 'snarky' but this is what is upsetting for us non-clinical types. We are asked to put our trust in a doctor and then we find that we need to get a second opinion. Understand I am not lashing out at you in the least. I know you are being helpful, so please dont take it as such. It's just frustrating for us who dont know when we do what is asked of our doctor and then find that we may need to check with another doc.

I realize they are human. I worked in a healthcare facility (In IT) for 14 years before my current assignment at a revenue facility, and I've seen docs at the other facility I wouldnt trust to pull out a splinter...and some who were quite brilliant.

I checked with other doctors I knew from my previous job and they all told me this guy I went to is the best in the area.

In a manner of speaking this 'is' my second opinion. Let me explain.

The original ortho doc I went to referred me to my current surgeon. Both are in the same facility, by my original doc said 'If I were in your shoes, this is who I would want doing my surgery'. So I did. I tried to explain to this doc (my surgeon) about my activity level and my desires. He seemed to think that I would be able to go back to full swing, in time. My original doc was less optimistic. I followed up with this surgeon about every few weeks until I was given the 'go ahead'. About a week later, he moved to another practice out of state.

The facility changed my primary doc back to my original ortho guy (who is a surgeon as well). He told me "I dont think the other doc realized fully the level you want to go back to" and told me quite simply that I will never get there. I would be able to be better than I am now, but never to where I was.
He then laid out a much stricter set of 'dont's' for me to follow, which I have been.

So it's not exactly a wait and see. One doc said I could do x,y,z... the other says no... basically dont do anything other than a,b,c.

Should I now get another opinion?

 

[Jamie]

Sorry.....your explanation confused me just a bit. But I think you're saying that the surgeon who did your THR has now moved to another state and you are back with a different doctor that you saw prior to your replacement. Do I have that right?

The problem is you have differing opinions by two different doctors. I know you want to return to your pre-surgery activity. One is saying you can; one is saying you can't. Who you believe is one issue.

But an even more important matter is that you have a loose stem. It is very unlikely that you will suddenly have bone growth into the prosthesis even with full rest for months. This is why Jo is recommending you see someone who can take an honest look at your implant. If it's loose, it's going to need to be revised. I know this is not what you want to hear, but I think you're going to find it's the truth. If neither of these surgeons are willing to talk to you about a revision, then....yes, I do think you need to see another doctor - a revision specialist. This is a bit different surgeon than the ones you may have talked to. They work with problem cases.

I don't know where you are in North Carolina, but here is one such surgeon in Hendersonville:

Dr. Amal K. Das
2315 Asheville Highway
Hendersonville, NC
828-684-8501

Primary and revision hip and knee replacements. broken link removed: https://www.hendersonvilleorthopedics.com/physicians/dr-amal-das/

The problem as I see it is that you went back to very rigorous activity too soon. I think you may be able to go back to all or most of your activity after a reasonable healing period of say 6 months or so. That may seem like a long time to take things easy, but in the scheme of your whole life, it's really just a minor blip. Of course the choices of what you do or don't do are really up to you. You are the one who knows how you feel. But I certainly think you should consider seeing a revision specialist who might be able to get you on your way to being healed a little faster. Right now, you're in a waiting pattern.

 

[rob3dr]

@Jamie You are correct. My current surgeon left and I'm back to my original one.
I'm not being headstrong about the whole thing. It just took me a bit off guard. I need to let all this soak in a day or so and then see what I need to do. I remember reading on Dr. Das somewhere in my research earlier so I may seek his advice.
I just need to let all this soak in and come to terms with things before I do anything. I'm the type who has to think my way through logically. ...and as I mentioned to Josephine, logically what she says makes sense.
Appreciate everyones input.

 

[Jamie]

That sounds like a very good approach. You have time to do just that. At some point, the way forward will become clear to you.

 

[bsilvers]

@rob3dr Rob,

Please listen to what @Jamie and @Josephine have to say , I honestly do not think you will get better advice than what you will get here at bonesmart because of that wide variety of people's surgery outcomes are shared here. Question, did you ever watch a hip replacement surgery video on youtube,etc, or anywhere to put it into perspective? Reason I'm asking is that it gave me a better idea of what type of trauma your body goes thru during the procedure and how important it is to allow your body to heal. We all heal at different rates and I'm sure it's a balancing act for Surgeons to say when you are ready to go back, especially to contact sports such as martial arts. Only you really know your body and how you feel. I was very surprised you were sparring at 4 months to be brutally honest.