Guest viewing is limited

Got to lose weight for MIS THR

Status
Not open for further replies.

Marina

new member
Joined
Jan 2, 2009
Messages
6
Location
United States
Hi All,
Apparently I have Avascular Necrosis in both hips. Othro surgeon said go lose 100 lbs or the operation and recovery will be a problem. So I'm on that road but now i was wondering if anyone else out there has had successful MIS replacement with same diagnosis. how did it go? I have had increased pain in both hips over the past 6 months. so i am researching now.
Please get back, Marina
 
Marina, I moved your post into a thread of its own to make sure you get people's attention. You'll get better input that way.

I have to ask - what is your weight now? How tall are you and what is your age? These are all important factors before I, or others, can offer input and assistance.

BTW - welcome to BoneSmart!
 
Welcome to bonesmart Marina
I don't have experience with avascular necrosis, but did have a sucessful right hip replacement. It is a great surgery. I had the traditional posterior incision with all the precautions. I have a wonderful new hip.

Judy
 
Hi Marina,

I'm 5 days past the operation for a total hip replacement due to AVN from a previously fractured femur. I had the anterior approach done in New Albany, OH by Dr. Berend.

For me the post operative situation is much much better than the constant pain of the previous avn joint pain. The surgery went very well. I'm in very little discomfort, transitioning on to tylenol and ice for pain. It's amazing to be able to walk without that constant joint pain! I was up and walking 5 hrs. after the surgery.

Prior to surgery, I focused on four things, keeping muscle groups around my hip strong, improving my flexibility, diet, and overall physical condition. I had a physical therapist help me with an exercise program that I felt didn't aggravate the avn.

I applaud you for taking care of your health! Anything you do prior to surgery will improve your recovery and quality of life after the hip surgery. It's like money in the bank.

Best of Luck,
Tom
 
thank you everyone for the encouragement.
Tom, i am particularly interested in the blood supply to the bone issue. how does that get fixed? i'm confused about it.
I will be interviewing few surgeons out here in Los ANgeles
regards ,
Marina
 
Marina,

I live in Sierra Madre, east of LA, just east of Pasadena. I have a wonderful surgeon in Pasadena who works out of Huntington Hospital. Let me know if you would like info.
He is very gentle, handsome, brilliant, calm , young, does many hip replacements and is also qualified to do revisions. The nurses at the hospital love him, the home pt I had said if she needed any type of knee/hip surgery she would go to him.
Just let me know.
Anything else I can do, we are neighbors, let me know.
Judy
 
thank you everyone for the encouragement.
Tom, i am particularly interested in the blood supply to the bone issue. how does that get fixed? i'm confused about it.
I will be interviewing few surgeons out here in Los ANgeles
regards ,
Marina

Hey Marina,

I'm not Tom, but I slept in a Holiday Inn last night! ;-) I assume you mean the lack of blood supply that caused your AVN to begin with? The femoral head is unique from the rest of the femur as it normally receives is blood from peri-articular arteries that run through the joint (i.e. foveal) or along the joint capsule. When you have a dislocation or severe trauma, these arteries can be compromised causing the bone to die from lack of blood. Drugs can also cause this problem (steroids being the most notorious). When you get a THR, they cut off the femoral head and the rest of the femur gets blood from elsewhere making it a non-issue. If you opt for a resurfacing (you have a well-known surgeon in your area for this, by the way - Aumstutz? misspelled, I'm sure) the blood will flow toward the stump from the rest of the femur. Apparently as AVN progresses, there is more blood flow to the femoral neck and head this way as your body adjusts to the lack of normal blood flow.

That's how I understand it. I'm sure there are millions of exceptions and qualifications, though!

Hope that helps,

Dave
 
Wow Dave, thanks that's making me feel better. I did hear of Dr Amstutz and plan to see him to. as of a year ago the damage was only seen on MRI, but since then there has been a significant increase in pain in bilateral ischial areas.
So I need to get updated films done.
TTYL Marina
 
Judy, Hi
Yes I'd like the name of your surgeon too. I know a few folks at Huntington. But i want to check out a few.
thank you. Marina
 
thank you everyone for the encouragement.
Tom, i am particularly interested in the blood supply to the bone issue. how does that get fixed? i'm confused about it.
I will be interviewing few surgeons out here in Los ANgeles
regards ,
Marina

What UTDave said! Couldn't put it any better myself!

the home pt I had said if she needed any type of knee/hip surgery she would go to him.

Any nurse or PT that says that - that surgeon ranks very highly!
 
Yup, ditto Dave.

From what I've read and discovered, a great question to ask your potential surgeon is how experienced they are in the particular surgery you're talking about.

In my area, the surgeons were aware of but not very experienced with the direct anterior minimally invasive surgery approach, only having done a dozen or so. I was able to find someone within two hrs. drive that has done 400. I did go through a few surgeons before finding the right one for me.

Bottom line: keep asking questions

As far as the avn goes, here's my story. I fell off a horse three years ago, breaking my femur at the neck. It was repaired right away with three internal screws. After a long recovery, I still had pain, with that pain increasing the past year or so. An MRI confirmed the AVN diagnosis. That's when I started asking lots questions and reading!

So, the fix was a total hip replacement. The blood supply to the head of the femur did not re-establish after the break, so the ball of the hip joint was disintegrating. That started wearing out the joint, to the point I was in pain. For me, resurfacing (or partial hip) wasn't an option due to the weakened joint capsule and previous surgery.

So, I'm on day 6 post hip replacement with the anterior MIS procedure and doing great!
 
Marina, there is a highly respected & successful surgeon in Santa Monica (St. John's Health Center), Dr. Joel Matta, who apparently was somewhat of a U.S. pioneer in using the direct anterior approach. He's done hundreds of hip replacements, is considered an expert, and teaches this approach to other surgeons from across the country. Here's a link to his web site to get more info:

https://www.hipandpelvis.com/

My surgeon (I'm 10 weeks out from a right hip replacement using the anterior approach) did a one-year fellowship with Dr. Matta a couple of years ago, learning the technique. I have been extremely pleased with both my doctor and the results of the surgery itself. I have only a 4" incision, my recovery has been quick and relatively uneventful, and there were none of the dislocation precautions associated with traditional hip replacement surgery approaches. (As for the doc--he's only 33, younger than my daughter, so I call him the "boy wonder"--but his skill far outdistances his age!)

Hope the above info helps as you continue to do your research!
 
No, I had a total hip replacement. (Resurfacing is generally an option primarily for young and/or very athletic & active patients--I'm 58 & was bone-on-bone with no cartilage left at all, plus some bone spurs. From my research, I also got the impression that most people diagnosed with AVN are not resurfacing candidates either due to the damage to the head of the femur usually caused by AVN).
 
Neither of those are strictly correct, PRGal. Some surgeons do perform resurfacing on older patients even up to 60 and beyond. And some AVN people can be resurfaced, it depends how far the avascular necrosis has spread.
 
Knew you'd clarify any even slightly "off" opinions, Jo--thanks!

Marina, I will add that if you have the luxury of time to wait & do research, take advantage of it! First OS I saw (referred by my GP) automatically dismissed resurfacing, anterior approach , etc. It was traditional approach, take it or leave it. He even seemed somewhat annoyed that I asked so many questions--like I knew "too much." At that point, I didn't care if he'd done more THRs than anyone else on the planet--attitude knocked him off my list. Asking questions & being well-informed is not about challenging any surgeon's education, experience or professional judgement--it's about coming to the best solution for you, based on trust.
 
Dear PRGal and Jo
both well put. that's why i joined this site. not only am i dealing with the AVN but I also have MS, so while i have given myself a year to lose the weight (100lbs) I am checking & interviewing. the only snag maybe that i will be requesting new xrays & Mri to determine progression since the last ones were done in late 07.
SO now my goal is to go to an MS exercise program with a "Cool Pool" cause otherwise i can't.
Anyway, PRGal have you found yourself returning superwoman status?
 
Superwoman--Ha! In the last few months, I've decided that is WAY overrated!! It was an uphill struggle, though--I let my husband vacuum & clean bathrooms my first 2 weeks post-op until I couldn't stand how he was doing it! Needless to say, my body said "knock it off, you idiot," and I had enough sense to listen--for another week or two, anyway. :-) Seriously, I've had some ups & downs, but overall I'm doing quite well at 12 weeks out--pretty much completely back to all my normal activities.

So sorry you also have to deal with other health issues, but you sound very determined & confident, so I'm sure you'll attain your weight loss goal! Not sure what a "cool pool" is, but will say that I've been going to low-impact water aerobics classes a couple of times a week at the local Y pool & I really enjoy them. Depending on how hard you go at it, you can get a real workout, but it's pretty easy on your joints.

Keep us posted on your progress . . .
 
Status
Not open for further replies.

Staff online

Back
Top Bottom