THR Elated and apprehensive

[RhondaLee]

Hello, all! New participant here. I have perused the site a little; it looks like there is a wealth of information to be had here.

I am scheduled to meet with an orthopedic surgeon the middle of September. My right hip has been paining me for several years; given the pandemic, along with physicians moving out of the area, I am finally able to seek relief. Little did I realize that I would be looking at a THR. The x-ray revealed that it's bone on bone. Having had a complete hysterectomy at age 20, perhaps it shouldn't come as such a surprise. <<<rolling eyes>>>

I'm looking forward to gaining some awareness from this site, along with learning from those who have gone before. I am also interested in discussions re osteoarthritis and HRT.

 

[djklaugh]

@RhondaLee Welcome to BoneSmart! You have come to the right place to get accurate information ad excellent support. I am leaving you some articles that will help you prepare for hip replacement. Do feel free to read any thread here in hip pre-op and also over in hip post-op as well as any article in the library here. And ask any questions you have. When you get a date for surgery we will create a signature for you and add you to the appropriate monthly team list.

Hip: pre-surgery considerations

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:


Score Chart: How bad is my arthritic hip?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:


Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced hip, take a look at the posts and threads in stories of amazing hip recoveries

 

[Jaycey]

@RhondaLee Welcome to BoneSmart! Your thread title says it all! We were all in that space pre-op. The diagnosis can be stressful.

But it's good you found us early in this process. Stick around and let us know about any concerns or questions you might have. We will be with you all the way!

 

[RhondaLee]

Thanks so much, folks. I have some questions; hopefully, you won't have to read a novella to get to all of them!

I met with the surgeon last week for the first time. Nice guy <<<shrugging>>>.

He told me that there are ONLY two places I should be going to for information on the internet re joint replacement: the Mayo Clinic and the Board of Orthopedic Surgeons.

He also told me he ONLY does posterior. I'm a newbie to all of this. However, several friends of mine who have had THR have had it done anteriorly. And I had read (various sites, hah!) on the internet that recovery was quicker when an anterior procedure is done because muscles are not cut. He dispelled that, stating that muscles are cut in both procedures--and that the recovery is the same in both procedures. ???

I also have to have a dental clearance. They won't put me on the surgical schedule until they have it in hand. I have an appt in October but have asked to be called if there's a cancellation. I've had the labwork done and completed the interview with the nurse.

He told me that it would be in/out the same day. Yikes!!! Boy howdy, have things changed in the medical world. I have to say that made me swallow hard, it was said so matter-of-factly. Phew! And there's a sterility procedure to follow with bathing, starting a week or two prior to surgery. I guess it's putting the risk of infection onto the patient's shoulders rather than onto the hospital, where it would have been in the past?

 

[Jaycey]

He told me that there are ONLY two places I should be going to for information on the internet re joint replacement: the Mayo Clinic and the Board of Orthopedic Surgeons.

Well, as you know we will respectfully disagree. BoneSmart was created due to lack of information elsewhere.

However, several friends of mine who have had THR have had it done anteriorly. And I had read (various sites, hah!) on the internet that recovery was quicker when an anterior procedure is done because muscles are not cut.

All marketing hype. Recovery rates have nothing to do with approach. And the end result is the same - no more hip pain.

He told me that it would be in/out the same day.

Yes this is the trend. But you should not feel pressured to leave the hospital. Work with staff to get your pain managed. And if you have the slighted doubt about leaving early, advocate for yourself. We can't predict how you will react to surgery.

 

[Mojo333]

He told me that there are ONLY two places I should be going to for information on the internet re joint replacement: the Mayo Clinic and the Board of Orthopedic Surgeons

Or you could go to a working patient forum that involves information shared by Actual patients who have undergone the procedure and recovery.

He also told me he ONLY does posterior. I'm a newbie to all of this. However, several friends of mine who have had THR have had it done anteriorly.

He dispelled that, stating that muscles are cut in both procedures--and that the recovery is the same in both procedures. ???

You can go to Mayo website info that actually deems Anterior as muscle sparing and touts quicker recovery which I would probably actually take issue with this ascertation. And would not bode well for his expertise in posterior which has been equally successful. We want successful longterm vs quicker short term, ultimately.

I also have to have a dental clearance. They won't put me on the surgical schedule until they have it in hand.

I guess it's putting the risk of infection onto the patient's shoulders rather than onto the hospital, where it would have been in the past?

This is the reason, I am sure for the clearance.
There is some empirical evidence that dental infection could be a risk for
Prosthetic joint infection (PJI), hence a good reason for making sure that you don't have issues they could be held responsible for.

 

[Woodstockhip]

He told me that there are ONLY two places I should be going to for information on the internet re joint replacement: the Mayo Clinic and the Board of Orthopedic Surgeons.

Well, I'm sure you can get good information there. But there's NOTHING like picking the brains of the people who've been there. That would be us.

He also told me he ONLY does posterior. I'm a newbie to all of this. However, several friends of mine who have had THR have had it done anteriorly. And I had read (various sites, hah!) on the internet that recovery was quicker when an anterior procedure is done because muscles are not cut. He dispelled that, stating that muscles are cut in both procedures--and that the recovery is the same in both procedures. ???

This is interesting. I had what they call postero-lateral. That's basically going in through the side of your butt. Muscles were "teased apart" rather than cut. Interestingly, my surgeon was an early adapter of the anterior method but found that, for him, he got better visuals with the posterior method and he preferred the tools used in posterior. I guess he found that there was a greater likelihood (but still very low) that the special table used for anterior surgery resulted in the occasional (I think) ankle dislocation. So he's back to posterior. But his partner swears by anterior. Go figure. My understanding is that there are fewer restrictions after anterior surgery but despite my fear of breaking the "hip precautions," most of the things you aren't supposed to do after posterior you wouldn't want to do anyway 'cos they'd hurt! Bottom line, your surgeon doesn't want to screw up any more than you want him to, so if you trust him and feel confident, it's all good.

I also have to have a dental clearance. They won't put me on the surgical schedule until they have it in hand. I have an appt in October but have asked to be called if there's a cancellation. I've had the labwork done and completed the interview with the nurse.

I needed cardiac clearance, lab work and GP clearance. I guess dental clearance is pretty common.

He told me that it would be in/out the same day. Yikes!!! Boy howdy, have things changed in the medical world. I have to say that made me swallow hard, it was said so matter-of-factly. Phew! And there's a sterility procedure to follow with bathing, starting a week or two prior to surgery. I guess it's putting the risk of infection onto the patient's shoulders rather than onto the hospital, where it would have been in the past?

There appear to be a number of reasons why this same-day-surgery is preferred. First, there are sick people in the hospital and the quicker you're out of there, the less likely you are to catch some yucky bug. It's thought that people heal better in the comfort of their own surroundings, so home is good. They will schedule nursing and PT visits to your home. Also, anesthesia and surgery have improved so much that what used to mean a 5 day stay in the hospital has been cut back to less than a day. I had my first hip done in a hospital -- they called it a 23 hour stay. I got to eat a lousy dinner and spend the night, then was booted out the next morning. My next one, same doc, will be done in an outpatient surgery center. Same 23 hour stay. Hopefully the food will be better.

Lots of great information here on bonesmart and more moral support than you can imagine!

 

[RhondaLee]

He told me that there are ONLY two places I should be going to for information on the internet re joint replacement: the Mayo Clinic and the Board of Orthopedic Surgeons.

Well, as you know we will respectfully disagree. BoneSmart was created due to lack of information elsewhere.

However, several friends of mine who have had THR have had it done anteriorly. And I had read (various sites, hah!) on the internet that recovery was quicker when an anterior procedure is done because muscles are not cut.

All marketing hype. Recovery rates have nothing to do with approach. And the end result is the same - no more hip pain.

He told me that it would be in/out the same day.

Yes this is the trend. But you should not feel pressured to leave the hospital. Work with staff to get your pain managed. And if you have the slighted doubt about leaving early, advocate for yourself. We can't predict how you will react to surgery.

Jaycey, so...are muscles cut in both procedures? Enquiring minds and all that...

Thank you for the prompt response. Your thoughtful, efficient responses do much to allay fear.

 

[Eman85]

I can only speak for posterior THR as I've had 2 of them and it works. As for internet info your OS has a good reason for saying that as there is a lot of misinformation out there.
If I was to simplify the experience of having a THR I would just tell someone to understand the recovery and know that it's not a 3 week deal. No matter how they install the parts it's a major procedure and takes a while to heal internally. Go in accepting the recovery and do all you can to make it a good recovery and you'll have a good outcome.

 

[subie2021]

No matter what the approach, the surgeon has to do certain things internally to replace your old joint. Lots of separating, sawing, pounding, and cranking are involved, whether the incision is on your front or on your rear
The best approach is the one your surgeon is comfortable and competent with, that will, in his expert opinion, give *you* the best result.
Hopefully we're all doing great after all that internal mess is healed up.
Best wishes for a great outcome!

 

[CricketHip]

I have had 2 THR's, both anterior and was told that no muscles were cut. Teased apart, yes, connective tissue disrupted, yes.
Some of the best advice that I've heard on this forum is this-- you want your surgeon to use the method and approach that he is most comfortable/confident with.

I am so proud of you for making the decision to schedule your THR!!

 

[HollyNY]

Hi @RhondaLee
I had Mako robot anterior surgery 12 days ago. No muscles cut. No nerves cut. Dissolvable sutures instead of staples.

Most important to me, no movement restrictions.

The Mako robot was fed data from a CT scan of the pelvis. During the operation it then tells the surgeon when the various bionic parts are perfectly aligned.

I can't put into words how different my life is already compared to before the surgery.

If you can, find someone that uses the robot no matter what approach is used.

 

[Caison113]

All approaches work and all have pros and cons. Go with what your surgeon is good at! Better a perfect X than a shoddy Y. Hip surgery has been around a long time and is probably the "easiest" replacement joint to install (vs. knee or shoulder). The data on long-term recovery is essentially identical for all approaches.

 

[LaKarune]

Little did I realize that I would be looking at a THR. The x-ray revealed that it's bone on bone. Having had a complete hysterectomy at age 20, perhaps it shouldn't come as such a surprise.

I’m very new here and just saw this post. Is there a relationship between hysterectomy and cartilage loss? Assuming that would make it related to hormones-? (I could Ask Jeeves about this but I’m already beyond saturated with medical research as I try to figure out what procedure will be best for me for THR…)