From tkr to hip

[1jt@atime]

Jo and others,

I finally got a soft copy of my hip Xray and wanted to ask if anyone has had similar experiences. Since my most recent tkr 8 weeks ago and on the same side as my hip that's pictured, guess which one..... my foot has been rotating outward when walking and I walk on the outer edge of my foot. Of course I try to correct it but that's sometimes hard. It's making my already messed up foot more painful. Jo, I am thinking this new gait of wanting to favor the outer side of my foot has more to do with my hip then it does with my new knee. I do know my leg alignment was straight going into this tkr but my hip has been really bothering more then average since just before the surgery.

Also, as you see from the Xray, my hip fracture was quite severe and now, 20 years later, I am looking at getting the hip replaced once I get over the knee replacements and show my face at work for awhile. I am, however, hoping to hang in there for a couple of years longer. Jo, have you ever seen a hip replacement on someone already full of metal? Of course this isn't a 3D but I wonder how much of this metal will get in the way...or will the surgeon simply remove some of it? The surgeon and I have been so busy with the knee replacements that we've not hit on the hip issue too much. Thanks for any input! Karen

Oh, notice the leg length descrepancy. Over an inch! I'm standing up straight in this picture. I'm a mess!

 

[Josephine]

Oh my! What a fistful of plates! Have scrubbed for ops like that myself!

Left hip, btw!

Well, they will obviously have to remove the two screws in the femur but it's entirely possible that the pelvic plates won't be in the way at all. If any are, it will be bottom four screws on the vertical plate but they may just be able to remove the screws and leave the plate as it would be extensive to remove it completely. But my guess is it probably won't be a problem.

I enhanced the image so you can see it better.

(The eagle eyed amongst you will have noted the judicious use of 'entirely possible', 'may just' and 'probably' in that answer! Tiptoeing around it like walking on the proverbial egg shells!)

 

[1jt@atime]

Josephine, Do you think they might need to do a larger then average incision? Hopefully not. I've aready got a 2 foot scar from this surgery! Do you think there would be a difference in going in posterior or anterior since there's an additional issue to deal with?

I realize your info is purely a maybe but I appreciate your input either way.

 

[Nursepair]

Oh Karen, that drunk driver really did do a good job on you didn't she? You are a real trooper the way you get on with your life and I thank you for reminding me how lucky I am!!

Hope you continue to recover well with your 2nd TKR and that you get your hip sorted out soon. ((((((((((HUGS)))))))) Sue

 

[Jamie]

Wow, Karen....I was hurting just looking at your xray!!! You are one strong woman!!! I hope that when you finally are able to have your hip surgery that it makes things much better for you. I'm sending you an extra special (((HUG))) for dealing with all that you have on your plate. Your spirit is an inspiration!!!

 

[Josephine]

Josephine, Do you think they might need to do a larger then average incision? Hopefully not. I've aready got a 2 foot scar from this surgery! Do you think there would be a difference in going in posterior or anterior since there's an additional issue to deal with?

I realize your info is purely a maybe but I appreciate your input either way.

I doubt it will be anything but a perfectly routine procedure apart from maybe removing some screws. Mind, if the surgeon is a total pedant, he might want to remove that lower plate completely just in case it reacts with the new hip but I doubt it. Although I haven't seen your existing scars which might bear some influence, I can't see any reason he wouldn't use his accustomed approach be it anterior or posterior.

 

[1jt@atime]

Thanks Sue and Jamie for your kind words. You know God only throws you what you can handle so I guess he thought I could handle a lot. It has been a hard road to travel but I try to stay optimistic. I am here and I am happy to be alive! I had my third daughter, by a scheduled C-section two years after this surgery and a few others for the rest of the injuries and I always tell her she is meant to do something special with her life because she is really lucky to be here. She says, well thanks Mom for pressure! She's a good kid.

Thanks for the info Jo. I was hoping it would be a fairly routine surgery. I think we all over analyze a situation. I only spoke briefly with my current OS when we were doing an overall review of my joint issues last year and he did mention he would probably cut below the screws in the femur but did not mention the plates and screws in the pelvis. It was just a quick review and our first meeting. My scar starts mid-thigh, comes up around the front of the hip, curves over and around the hip and ends at the middle of the butt. Hope that makes sense. So the scar wraps around the front and the back.

This was a really long surgery. I left my hospital room at about 6:30 AM and returned about 6:30 in the evening. Going into it, my surgeon said he did not know if I would ever walk again. Afterwards he said I would walk but was not sure how well I would walk. I've managed to walk most of these 20 years without most people ever noticing I had any type of limp so I would definitely say the surgery was a success. I also feel lucky the actual hip has held on for over 20 years now but what I have been upset about is that everything is falling apart at once. At least I've gotten the knees done! YEA FOR THAT!

 

[Josephine]

Amen to that, Karen. I have always been constantly amazed at how successful this kind of surgery is. To think, when I was a young nurse, a patient with that kind of injury would have spent around 10-14 weeks in bed, 8-10 weeks of that in traction (similar to the picture) and then been so stiff and badly healed, would very likely have spent the rest of their lives on crutches if not in a wheel chair!

Then the Swiss came up with this marvellous, scientific approach to internal fixation since when we can fix anything from fractured fingers and jaw bones to pelvises like yours! And all from the experience they got treating injuries sustained in skiing accidents!