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THR Hip replacement after hip arthrosocpy

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Rdwolfe94

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So my OS surgeon contacted me yesterday. He actually admitted the hip scope failed. He gave me the following options.

Surgical dislocation: not doing as Hospital for Special Surgery does not recommend in patients over 45. I am 49.

Hip resurfacing: would allow me to run again one year after surgery. Would be almost 51 by then. Will see what replacement surgeon says on Tuesday.

@Vic Mackey. How do things go for you on Monday?

Leaning toward replacement but have mild arthritis and not limping. OS said a hip replacement is a possible treatment for hip arthroscopy. Also, they cannot do surgery until 07/15/19 as I had a cortisone shot 04/15/19. I guess they want you to wait 3 months after a shot.

Last question for anyone out there. I am 6½ months post op from my scope. Would 9 months be too early from the scope to have the hip replaced?
 

Owithurts

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Sorry, I didn’t see your question until today, Thursday, the 2nd. No, after several discussions with other doctors, they all said because of my age to go straight to the replacement. It really stinks. Two years ago I fell doing yoga and ended up having cervical fusion and then 2 shoulder surgeries. Not for sure if the labra tears are from that fall. I am kind of a klutz. Really looking forward to getting back to tennis and swimming. Guess they will have to wait another summer.

Good luck with whatever you decide to do.
 

Rhiannon89

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I had a scope for FAI in March 2018 and had my THR in March 2019, the scope was meant to put off the inevitable but it didn't do a thing, I had the injections too but no relief. Luckily my surgeon had always said a THR was on the cards and just wanted to exhaust all options first.

I wasn't limping either, I was just limited in life, had to give up the hobbies I enjoyed and couldn't go anywhere without planning when I could sit. I think it's best to get it done before the limp sets in as the recovery is that bit easier due to your muscles not having to change to a new way of walking again! I'd definitely say go for it, it will be your end result regardless, might as well do something you know is definitely going to get rid of your pain rather than do a few things that may or may not!
 
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Rdwolfe94

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@Rhiannon89 Thank you. It sounds like your situation is similar to mine. Did you have anterior or posterior THR and how long were you on crutches or a walker?
 

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I had FAI surgery in April 2009, and was bone on bone by Sept 2009.

Xrays and CT showed “mild arthritis”...surgeon said when he got in there it was “pretty beat up”. They did the whole cam/pincer thing and tried to reconstruct the labrum.

Recovery from the replacement was WAY easier than the scope recovery. Mine was 4 weeks w 8 hrs a day on CPM and toe touch weight bearing for 6 weeks.

The replacement was “weight bearing as tolerated”. It DID take me a looonnnggg time to be off crutches, but that was mostly because I spent most of the time from April ‘09 to Jan ‘10 ON crutches.

I had the second hip replaced 7 1/2 weeks ago. Again, xrays and MRI showed “mild or moderate arthritis”, doc said “multiple areas of bone on bone”. I mostly don’t use walking aids at this point unless I’m fatigued, and would have been off earlier if my adductors weren’t a mess.
 

Rhiannon89

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@Rdwolfe94 I had posterior and was on 2 crutches for probably 2 weeks, I still use 1 or a cane if I have far to walk as my knee is very weak on that side but my hip has no issues! I had no restrictions either, been driving since about week 3 and went back to work this week
 

Josephine

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He actually admitted the hip scope failed.
Wow - a rarity! But I think he might have said it was "unsuccessful"!
Surgical dislocation
What did he mean by that?
Hip resurfacing
Hip resurfacing, hip replacement - not much difference actually!
Leaning toward replacement but have mild arthritis and not limping.
One very important bit of advice - go for it earlier rather than later.
Also, they cannot do surgery until 07/15/19 as I had a cortisone shot 04/15/19. I guess they want you to wait 3 months after a shot.
Indeed!
I am 6½ months post op from my scope. Would 9 months be too early from the scope to have the hip replaced?
It depends upon what the individual surgeon is prepared to accept. There's no hard and fast rule about it.
 
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Rdwolfe94

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@Josephine Thanks for the reply. A surgical dislocation is where they surgically dislocate your hip out of its joint and repair the labrum. No way I am doing that. They do not recommend it over the age of 45. I think the resurfacing is just a precursor to a replacement. See the replacement Surgeon Tuesday.
 

Josephine

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A surgical dislocation is where they surgically dislocate your hip out of its joint and repair the labrum.
Yes, I know that but that's just what they do for most hip surgeries! It's not a procedure on its own, it's simply part of the procedure of labral repair.
 
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Rdwolfe94

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@Josephine I guess they state that I keep my hip with the surgical dislocation and then put it back after they repair the labrum and cartilage which occurs after they surgically dislocate it. they said it gives them a 360 look at there is no replacement. Not going to do that.
 
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Rdwolfe94

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@Josephine @Jaycey Saw the hip replacement Dr. today. He scheduled my surgery for August 7, 2019 as I had a cortisone shot on April 15, 2019 and have to wait 3 months.

To refresh, I had a hip scope 10/18/18 where the Dr could not get into my joint and debrided the labrum and shaved bone. Been in pain ever since. He says my imaging MRI and xray show that at some point I am going to need a hip replacement and can wait based on my pain.

However, he says based on my pain now he would have it done. Cannot even drive more than 15 minutes without incredible stiffness and pain in my hip from my hip flexor to my groin and inner thigh. He also said he saw many hip scope patients end up having a hip replacement eventually. Have heard all of that on here.

I forgot to ask him the following: My surgery will be just under (11 days short of 9 months) from my scope. I read on here that most surgeons will not go back in until a year after a scope. He told me that if my pain is better, I can cancel late July. Any advice on this time frame would be appreciated.

I am going for it on August 7 unless it would be advisable for me to give it a year. However, my labrum is still torn and was not fixed as they could not get into my joint during the scope. Any input would be greatly appreciated.

Thanks,

Bob
 

Jaycey

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I'm not a medical expert but if it were me I would go for your THR. Your surgeon is willing to do it and that hip won't get any better waiting. I think most surgeons want to "wait and see" to insure the scope has worked. But your's has obviously failed.
 

Hip4life

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I am also not a medical orthopedic expert but I dinked around with “this might help, that might help, let’s wait and see and then try this next” way too long. Looking back, I was essentially disabled. Scares the heck out of me to remember how I increasingly got worse and how much pain I endured and for how long. My advice now is: get the THR as soon as the OS is willing. You’ll thank yourself later.
 
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Rdwolfe94

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@Jaycey @Hip4life Thanks for the response. I doubt my pain is going to get better but the delay is the 3 month window from the cortisone shot I had last month. I agree that my scope was a fail.
 

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However, he says based on my pain now he would have it done.
If the scope was done with the expectation of it producing a cure for your symptoms then he has deemed that this failed and a hip replacement is now necessary. If I were you, I'd thank God for a compassionate surgeon!
 
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Rdwolfe94

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@Josephine he echoed a lot of what you said on here. He said my age (49) was not a factor and it is better to get it done when I am young and not disabled yet. He believes I will have a fast recovery. He does the anterior approach. I forgot to ask him if I need a raised toilet seat or ted hose. I know other patients of his that did not. I wonder if anyone on here can tell me their experience with an anterior replacement after a failed scope.
 
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Rdwolfe94

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Can anyone tell me what the relation to BMI and the anterior approach is? Is there a cut off?
 

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