Fractured Neck of Femur/Pinning Hip Pinning Recovery Advice

Jaycey

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why did your doctor not prescribe hip precautions?
Many surgeons are no longer prescribing restrictions post THR. After my RTHR I had no restrictions. I did stick to the 90 degree rule just because my hip didn't want to move that way in the early days.
 
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evangelinaleon

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why did your doctor not prescribe hip precautions?
Many surgeons are no longer prescribing restrictions post THR. After my RTHR I had no restrictions. I did stick to the 90 degree rule just because my hip didn't want to move that way in the early days.
Oh, I see. So were you able to put on socks and undergarments on your own?
 

Age28March2022

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@Age28March2022
Do you mean the x-ray of my pinning look better than yours or the severity of my injury? I assume you mean the former.

The pinning x-ray picture I posted was right after my surgery. It looked good at first but few months down the line the femoral neck is getting shorter (as shown in the picture below at 1 year post OP). I could feel that my leg was getting shorter.
I would say your injury was not as severe as mine (your injury is still severe of course). My hip doesn't even look like a hip anymore... How are you doing now? Did you do a hip replacement?

My PAO surgery was canceled because they eventually found signs of AVN in my femoral head and signs of osteoarthritis. I have to do a total hip replacement now and I am not even eligible for hip resurfacing, so disappointing.
I just saw your post and noticed that you just had hip replacement last week.

Yes I had to have partial hip replacement and it has been almost 6 months. Overall it has been great except that my OP leg is shorter than my good leg by about 6mm+ and I have to wear insole for life.

And sometimes I still feel sharp pain (but not a big issue). The area around my incision scar is still swollen probably due to soft tissue. Good thing is that I don't feel pain
 
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evangelinaleon

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Yes, I'm almost two weeks post-op and I feel great! I'm walking so much better than I ever did after my hip pinning! Unfortunately, my doc did prescribe hip precautions. I'm trying to follow them because I don't think it would be wise to ignore my doc. I just have some incision-site pain and some annoying swelling, but it's manageable with ice and Tylenol.

@Age28March2022 Before my replacement, my doc said that I had leg length inequality and he would resolve it during the surgery. Did they mention why it resulted in a shorter leg for you? Are you back to all your physical activities?
 

Age28March2022

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@evangelinaleon
Do both of your legs have equal length now after THR?

After the pinning surgery my leg was equal in length but my femoral neck was slowly reducing in length over time as it was deteriorating. My pinning leg was 17mm shorter than my good leg right before my hip replacement surgery!

My surgeon tried to lengthen my shorter leg to make it equal, but due to nerve or something he could only lengthen by about 11mm, which means my OP leg is now 6mm shorter than my good leg.

I do not have precaution at first at all but I tried to follow it for 6 weeks.
 
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evangelinaleon

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@evangelinaleon
Do both of your legs have equal length now after THR?

After the pinning surgery my leg was equal in length but my femoral neck was slowly reducing in length over time as it was deteriorating. My pinning leg was 17mm shorter than my good leg right before my hip replacement surgery!

My surgeon tried to lengthen my shorter leg to make it equal, but due to nerve or something he could only lengthen by about 11mm, which means my OP leg is now 6mm shorter than my good leg.

I do not have precaution at first at all but I tried to follow it for 6 weeks.
My surgeon actually didn't tell me after surgery. I was too drugged on pain meds to remember to ask. I will ask him in the follow-up appointment..

Before the surgery, he told me that it was less than 5 mm and that it wasn't significant. He said she would try his best to resolve it. 17 mm is a lot and I can see how it could be a challenge to fully resolve that length discrepancy! I'm sorry you have to deal with that.

Did your doctor recommend lifestyle modifications after your replacement? Can you go back to skiing and other activities you did prior to your accident?
 

djklaugh

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@evangelinaleon Leg length differential problems can occur sometimes when a hip is replaced. From what you wrote it sounds like this was a problem before your THR due to the hip pinning you had. Hopefully your surgeon got that fixed. However it might feel like there's a problem since you went nearly a year after the pinning - so it might take a few months for your muscles to sort them selves out and get use to the new normal.

As for returning to activities - many people do return to vigorous sports and strenuous occupations following hip replacement. The main key to being able to do that is TAKE IT SLOW!!! Heal first then strengthen. Most hips do not need much PT - walking is the best exercise. But allow your self 4-5 months AND get your surgeon's OK before trying to get back on the slopes. When my surgeon discharged me following my bilateral hip replacements the only lifetime restriction he gave me was "no bungy jumping!"... and I was significantly older than you are.
 

Age28March2022

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@evangelinaleon
Do both of your legs have equal length now after THR?

After the pinning surgery my leg was equal in length but my femoral neck was slowly reducing in length over time as it was deteriorating. My pinning leg was 17mm shorter than my good leg right before my hip replacement surgery!

My surgeon tried to lengthen my shorter leg to make it equal, but due to nerve or something he could only lengthen by about 11mm, which means my OP leg is now 6mm shorter than my good leg.

I do not have precaution at first at all but I tried to follow it for 6 weeks.
My surgeon actually didn't tell me after surgery. I was too drugged on pain meds to remember to ask. I will ask him in the follow-up appointment..

Before the surgery, he told me that it was less than 5 mm and that it wasn't significant. He said she would try his best to resolve it. 17 mm is a lot and I can see how it could be a challenge to fully resolve that length discrepancy! I'm sorry you have to deal with that.

Did your doctor recommend lifestyle modifications after your replacement? Can you go back to skiing and other activities you did prior to your accident?
@evangelinaleon

What Deb said above is correct.

I have no lifestyle restriction after my surgery. Yes I can go back to skiing but I will be careful as I am afraid of falling again.
 
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evangelinaleon

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Great, I'm glad to hear that! I'm so eager to have my life back. I feel so much better! Just need to follow hip precautions and use crutches for another couple of weeks per doc's orders!
 

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I also had a displaced fracture of the femoral neck followed by AVN and a THR. I was 37 and 38 so not as young as you but quite young for a THR. My doctor said no running, jumping or any other movements that cause impact greater than walking as that would greatly reduce the lifespan of the implant. My neighbor was in his 30's when he had his THR and at the one year mark he thought he was recovered enough to join his friends in a volleyball game. The first time he jumped he broke the implant and needed a revision THR. I would strongly advise against skiing. Any jump would be bad for you implant. Falling on ice would likely not end well. Revision THRs are more difficult to recover from and have a shorter lifespan so you want the first THR to last as long as possible, 20-30 years or more hopefully. Best of luck to you.
 
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I'm much older but at my six month check up I had a list of can do and cannot do questions. After first few questions she just said, "don't train for the marathon and no aerobic type exercise. "And parting words, "don't fall."
 

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Happy One Month Anniversary!
It's so good to read you're feeling better and easing back into all you love. Another couple weeks and you'll be free of the assistive devices and on your way back to living a full life. Wonderful news!
@evangelinaleon
 
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evangelinaleon

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Fortunately, I don't give a rat's patootie about skiing or running marathons! I could definitely survive without them in my life lol

Dislocation and hardware complications are my biggest fears. When I fell last year and dislocated my hip, it was the worst moment ever and I had never cried so much in my life! I hope I never have to deal with that again.

My family loves playing baseball, especially my dad. I used to play baseball with the family every other weekend before my accident. That story about that 30-year old destroying his replacement right after playing volleyball is frightening! Is that common? I just wonder if I can play baseball with my family ever again, even if it's just once a month?
 

djklaugh

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@evangelinaleon Since it happened to you, you know that even natural hips can dislocate given the wrong kind of torque or injury. Artificial hips are a bit more likely to dislocate early on in the healing process but over time that chance gets to be about equal to the chance of a natural hip dislocating. Think about what you were doing when you initially dislocated that hip. Is that something that would be likely to happen playing baseball?

Can you get back to playing baseball with your family? Maybe! This would be a good question to discuss with your surgeon. You are still too early in the healing process to give a definitive answer to that. Here is the chart we have about dislocation possibilities.

1664823728804.png
 
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evangelinaleon

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@evangelinaleon Since it happened to you, you know that even natural hips can dislocate given the wrong kind of torque or injury. Artificial hips are a bit more likely to dislocate early on in the healing process but over time that chance gets to be about equal to the chance of a natural hip dislocating. Think about what you were doing when you initially dislocated that hip. Is that something that would be likely to happen playing baseball?

Can you get back to playing baseball with your family? Maybe! This would be a good question to discuss with your surgeon. You are still too early in the healing process to give a definitive answer to that. Here is the chart we have about dislocation possibilities.

Thanks for sharing the chart, it's super helpful! I'm finally done with precautions, but doc said I need to be gentle when breaking precautions. I didn't get a chance to ask him, but when do you think it would be safe pivoting with the operated leg when walking? My other leg is starting to hurt so much because I'm only using it to pivot.
 

Jaycey

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If your restrictions have all been lifted it should be OK to pivot on that leg. However, do be warned - new hips do not like twisting or pivoting. Go easy at first.
 

Layla

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Happy Two Month Anniversary! @evangelinaleon
I hope you have a great weekend, blue skies, sunshine and all that's good!
Take care. :SUNsmile:
 
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evangelinaleon

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Thank you so much for the advice and support!

I'm doing a lot better now! At this point, I feel like I never had a hip replacement, and I am pivoting the right leg with no problem. ROM seems to be back to what it used to be! My leg kind of gets a little fatigued after walking more than a mile without breaks, but I feel no pain, swelling, or stiffness whatsoever. I'm back at the gym doing lower-body workouts and have no problems!

The next milestone is to be able to go on my favorite 3-mile hike and of course, play a little baseball with the family in next coming months.

I tripped in the street a couple of days ago but thankfully didn't fall. I am much more vigilant about tripping hazards now. Be careful out there, hipsters!
 

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