THR Few questions about hip replacement

[mariustpz]

Hello,

I am 25 years old and I got on 10th this month my right hip replacement.
Long story short, I had tuberculosis and I did not know so my hip was affected until I needed a replacement. First I had a arthroscopy because nobody knew I had tuberculosis and after that failed arthroscopy I had a spacer for 6 months and this month I got my hip replaced.

My surgeon used a BIOLOX Delta with ceramic head. And I know is uncemented.

After the surgery at three hours they took me out of bed to walk, and after 1 day the doctor said I can walk using only 1 crutch.

I am feeling good, I did take for 3 days pain meds but because I had no pain I didn't took them anymore, as my doctor said.

The thing is I am a little paranoic, after I read all the stuff on the internet I have a curiosity.

It is ok that I walked in only one crutch since first day after surgery since is uncemented? Is there any chance that i can move the acetabular cup without knowing it? Or make any harm to the prosthetis? I'm worried because I want that this surgery to be the last one.

Also, does anyone had this type of prosthetis? Is it good?

Sorry for my bad english and thank you.

 

[Andyinhull]

Hi there! I have uncemented hip replacements, I have had to have both mine done, I thought I was young at 51 to have to have this procedure. Try not to worry too much about your situation, the acetabular cups are fixed in pretty tight and won't be a problem. I was walking same day as both my hip replacements. Just take things easy and you'll be fine and don't over do it on the PT. I'm just over 3 weeks from my RTHR and have walked 4K today without a stick. Good luck on your recovery and healing thoughts are with you.

 

[Mojo333]

@mariustpz and

I'm sorry you have had to get a hip replaced at your young age but having a good new hip to get back to your life after healing from surgery will be Awesome.

Bearing weight using a crutch for stability soon after surgery is perfectly fine and expected for most new hippys.
I had double so obviously I had to walk on my new hips soon.

Your implants are fixed in place and you want to be mindful in your movements as the soft tissue heals, if you listen to your body...you are unlikely to cause any damage.

I let my surgeon decide what kind of implant, and I don't have specific knowledge of yours..but it sounds like the makeup of the components are very similar.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Hip Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary​

2. Control discomfort​

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT​

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this ​

Activity progression for THRs​

6. Access to these pages on the website​

Oral And Intravenous Pain Medications​

Wound Closure​

​

Pain management and the pain chart​

Healing: how long does it take?​

Chart representation of THR recovery​

​

Dislocation risk and 90 degree rule​

Energy drain for THRs​

Pain and swelling control: elevation is the key​

Post op blues is a reality - be prepared for it​

Myth busting: on getting addicted to pain meds​

Sleep deprivation is pretty much inevitable - but what causes it?​

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[subie2021]

No worries, your English is great
Cups and femoral stems can both be installed with or without screws (cups) or cement (stems) It's your surgeon's choice and dependent on his assessment of your particular situation.
If your surgeon cleared you for use of one crutch, and if you manage well with it, it's fine. If you find you need two crutches in certain circumstances there is no rule that says you can't use them.
I don't think you need to be overly concerned about harming your implants. Remember, they are there to enable you to move and carry on with life. You will want to obey any restrictions the surgeon has imposed until he has determined that you are well healed.
Remember when you read about other peoples' problems with hip replacement, that they are a small minority. Most patients heal well and go happily onward with their lives.
Take care and give your hip time to heal properly.
Best wishes for happy healing and good luck with your new hip.

 

[mariustpz]

Thank you all very much for your answers! I have read a lot of topics here since I had the spacer on august last year. I'm glad I posted here, talking with other people about this helps, I never thought I will have a hip replacement so it is something new for me. I also forgot to mention that I wear a hip brace, more or less, because in bed the hip brace moves around.

In my head "uncemented" sounded like nothing holds it, because I don't have a screw either, so in my head I think that the acetabular can move in my hip and I was worried that in my sleep or when I walk I can move it. I sleep on my left side with a pillow and on my back.
Also when I searched and saw that many of people have weight restrictions I got panicked because I walk every day since surgery to get my muscle strength back.

I have no pain, and it's weird because when I got the spacer the pain was so bad for weeks, and the surgery is the same, posterior approach, same cut.

Today is the 17th day post op and I still need a crutch to walk, when I try without it I have a limp. I can feel that the muscle where I had the surgery is not healed.

Next week I will go to see my surgeon, I hope it's all good with my new hip and I hope soon I will make my "new first steps" without the crutch. I can't walk from June last year when I had the arthroscopy.

Thank you again.

 

[Andyinhull]

Your bone will grow into your uncemented implants and will become very stable over time, the implant is covered with a surge that attracts and encourages bone to bind to it.

 

[Andyinhull]

*surface

 

[Eman85]

Sounds like you're doing fine. Most of us used a walker for the first steps the day of surgery and progressed to a cane or crutch slowly after that. I don't have cement but my cups have screws into the pelvis. I'd say the only advice I'd give you is what my surgeon told me, Don't Fall Down. Aside from that it sounds like you understand that the muscle isn't healed yet so you'll just have to go slow.

 

[Sigma1]

I agree with the others. Good deal. The cup is pressed/pounded into a hole that is just slightly undersized. The stem is pounded in to a preshaped hole, and holds well.

I did not use a crutch, but instead uses a walker (zimmer frame) for a while, and then a cane. I made it a point to not limp. You said no pain. Usually a limp is a reaction to pain, is it not?

The muscles that were stretched during surgery was the only pain I felt. The hip joint area, that hurt when walking before surgery, did not hurt after surgery.

Do your moderate therapy, and things get better.

 

[sandiegomom]

You are nice and young, your bone is going to hug all those wonderful parts -- and everything will settle in to place as your body wants it. It's miraculous! You'll be great.

 

[mariustpz]

@Andyinhull yes i know, i was worried that i will move it around until it grew if i put weight...because has no screw.
@Eman85 yeas i also read that the fixation should be good even if i have no screw. I think if the cup was moving or something i should feel pain.
@Sigma1 the limp reaction is not really pain, when i walk i feel that my muscle in the surgery area can't hold my weight, but no pain.
@sandiegomom thank you very much, i sure hope that everything it will be okay.

I went to my doctor this tuesday to get my staples out. A young doctor, i think he's a resident told me too keep the crutch & hip brace for 2 more weeks, but my surgeon heard and told me to walk without the crutch even if i have a little limp and keep the hip brace only in bed, and walk without it. I don't know whose advice to follow.

He told me that i can stay at my desk to work, yesterday i worked for 5-6 hours and at night i think that my surgery area got a little swelling, or it was in my head i don't know because i still have a little swelling around the surgery and the muscles there feels very hard around the cut.

I also had some blood tests, my CRP was 2 of 5 but my platelets were 650 and i saw that the maximum value is 450, however the anesthesiologist told me that is ok and it will come back to normal value in a few days and all other values are in normal range.

My movement is really good now, i manage to move around very fast and the limp is getting better day by day.

 

[Hip4life]

BoneSmart philosophy is to do what works for you. We generally recommend using an assistive device like a crutch or cane until you no longer limp. Another technique I found extremely useful that I learned here was “heel to toe” walking. This is concentrating on a complete step by having the heel strike the ground first and rolling through the foot and then the toe to then push off for the next step. Like this:

We can pick up some bad habits when our hips are hurting so it helps to try and relearn the proper way to walk. Into my recovery I thought I wasn’t limping any more until my husband told me that actually I was. So I went back to my cane for longer walks and concentrated on the heel-toe movement and soon the limp was gone.

You are doing great so early on in your recovery. Slow and steady progress is the plan. Your hip will let you know its limits. Just listen. Keep us posted.

 

[mariustpz]

Just tried that method and it's great, thank you. I walked to the bathroom and back without crutch like that and it went very good. I got a minimal pain for like 30 seconds after walking a few steps in my room and now I'm resting.
I will still use a crutch for a while because i don't want to break my new hip or something else, but I will try also to walk 5 10 minutes without crutch daily.

 

[Jaycey]

@mariustpz You will not do any damage to your implant walking without any crutch. But the soft tissues and muscles may still be tender. Don't push the walking unaided. That hip will tell you when it is ready.

 

[mariustpz]

Thank you Jaycey, sure, that is what i was thinking also, I will use a crutch or a cane until I feel like is ready.

 

[Layla]

@mariustpz
Welcome to BoneSmart and recovery! I was thankful to learn the heel-toe from my PT early on and it did really make a difference in my gait. For me, it took a concentrated effort because I wasn’t used to walking that way. Practice it while you’re still using your crutch and don’t stress about setting aside the crutch until you’re feeling confident enough to do so. You may find it beneficial in crowds as it’s a signal for others to give you some space. I kept a cane in my car when I was no longer dependent upon it, for a couple months post op as security, but never used it.
You’re doing great and you’re on your way!

 

[mariustpz]

Hello again,

I want to ask, is ok to drive 4 weeks after the surgery? It can damage the prosthesis in any way?

 

[Mojo333]

You won't damage your prosthesis...but you will want to be off of your pain meds and confident that you can make an emergency stop.
You might want to check your insurance. Some insurance company will not cover the patient unless they are officially released to drive by their surgeon.

 

[mariustpz]

Thanks.
In my country is not a problem with the insurance, even if a drunk driver makes a car accident the insurance still pays for the damage.
I'm off the meds since week 1, i took the meds only 5-6 days because i had no pain.
I feel ready to drive, i can press the brake pedal and i can move my leg like the left one, the limp is getting better also.

 

[Mojo333]

I'm off the meds since week 1, i took the meds only 5-6 days because i had no pain.
I feel ready to drive, i can press the brake pedal and i can move my leg like the left one, the limp is getting better also.

It sounds like you are good to go.
I was driving at 4 weeks but even riding for any length of time even as a passenger could get uncomfortable.

In my country is not a problem with the insurance, even if a drunk driver makes a car accident the insurance still pays for the damage.

Interesting.
But of course, the main thing is for no-one to get hurt.
I've got to admit I was a bit anxious when I began driving ...thinking I do not want to be in a car accident with new hips still healing.
Took a bit to get the concerns behind me and my confidence back.

Getting some freedom and independence back by driving is good for our spirits.
Hope your day is a good day!