THR How bad is bad enough for a THR?

[adamf83]

Bit if background, I had my right hip replaced June 2021, all went well (apart from some right knee problems which are now fixed). A little over a month ago, a started to get the same sort of groin pain I had previously experience, but in the left side.

Having tried some PT, I went back to see my original consultant, who agreed that there isn‘t many options for me, I have Ankylosing Spondylitis, so somewhat prone to arthritic conditions. He sent me off for a steroid injection and tentatively we’ve agreed that I’ll have the left hip replaced in early January 2023, this is where the doubt creeps in…..

The radiologist who did the steroid injection is the same one who look at my most recent X-Ray and said he’d seen worse, in terms of damage to my left hip.

I’m now debating whether I should or shouldn’t have the THR. If the injection works, great, it might buy time, but it’s probably inevitable that this will need doing. I have my wedding coming up in August next year and my worst nightmare would be the injection buys me time, but wears off around April/May/June time leaving me no time to sort it properly before August, hence the debate…

Has anyone else struggled with this sort of decision? Happy to post the X-Ray if someone wants to cast an eye over it.

 

[Pumpkin]

@adamf83
I am in a similar position, but not facing a wedding or other important events to take into consideration.

The injection will get you through the holidays if it works, usually surgeons have you wait 3 months after an injection to have surgery, that would put you into February for a THR if that is what you decide. Ask your surgeon how long you would have to wait after the injection to have a THR.

I have challenges with my feet and left ankle right now that are more limiting than my hip, so am waiting for those to settle down before having a THR. Currently hip injections are working so I have time on my side for now.
Just had a MRI, I have moderate hip arthritis, a torn labrum, a torn hamstring and gluteal tendonitis, so when the time comes that my hip is no longer manageable and my feet ankle are better, I will have a THR.

I think most struggle deciding when to have a joint replacement, you have a lot of company.

Be sure to take the score chart in the information below, it will help inform your decision.

New BoneSmart members like you are in various stages of their journey to joint replacement. Making the decision whether or not to have surgery and preparing for surgery can be easier once you have done your research and know what lies ahead. Here are some tools that can help you decide what is best for you.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
Score Chart: How bad is my arthritic hip?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced hip, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing hip recoveries

 

[Hip4life]

There are many members here who will attest that even though their xrays weren't the worst anyone had seen, their lives were being significantly impacted by their pain. Some, as @Pumpkin has done, will also attest to how injections did buy them some time. As you fear, the facts are the relief is unpredictable and only prolongs the inevitable. Arthritic hips do not get better with time and can unexpectedly deteriorate rapidly. The fact that you have a tentative surgery date speaks in itself to what your surgeon's opinion is. You are in a difficult spot with your upcoming wedding (congrats, by the way.) I agree that the above score chart Pumpkin linked for you may be very useful in helping you decide.

Even though no two hips are the same in recovery, keep in mind you already have a decent idea about how recovery goes. It stands to reason that a THR in January would get you to August in pretty good shape. How would going on the way you are now or worse fare in comparison? Only you can decide. We're here for you. Keep us posted.

 

[Eman85]

In your case you've already had 1 done so you know what to expect. I knew I needed new hips when I was 30, held the replacement hardware in my hands in the surgeons office. In 2018 I had the first, didn't want to rush into anything. Choice is yours, no one elses. Like everything in life it's a weighing out of pluses and minuses.

 

[Woodstockhip]

Your story is very similar to mine. I had lefty done in 2020 and, though both hips were pretty bad, lefty was worse. Figured I could hold off on righty with the aid of injections for two years. Once the groin pain began, I got the first injection and it helped, to a degree. When it wore off, about 4 months later, I had a second, which did nothing. After the first hip was done, the second degenerated fairly quickly. I did hold out for two years but in hindsight, I wish I’d done it sooner. If you feel your quality of life is not what it was, you’ll know it’s time.

 

[Caison113]

@adamf83 - this question comes up a lot with people and there is no right answer, but most of us have had to balance the current pain, prognosis for improvement (or getting worse), and what your long-term goals are. You're on the younger side, but certainly not the youngest, and you know what it takes to go through a THR. I think shots are fools' gold for the most part, as no one has ever told me a shot gave them a year+ of relief. It's always like you, at best a few months, then with diminishing returns on future shots. If that's the case, the best you can buy yourself if maybe half a year.

You have many years ahead of you being active. Dragging the other bad hip around is going to hold you back. You will miss out on things or experience lots of pain when doing them, diminishing your enjoyment. If your doctor agrees it is safe to proceed, I would get the surgery sooner than later. Just my $0.02.

 

[subie2021]

My injection gave me 18 days of relief. The surgeon made me wait 90 days from the injection to schedule surgery.
He also told me that imaging isn't everything - some hips look really bad, but aren't painful, while others look pretty good but cause lots of pain. His philosophy is it's more about quality of life than imaging, and if a bad hip interferes with QOL he'll replace it.
Good luck, wishing you happy dances at your wedding.

 

[PolarIce]

Bit if background, I had my right hip replaced June 2021, all went well (apart from some right knee problems which are now fixed). A little over a month ago, a started to get the same sort of groin pain I had previously experience, but in the left side.

Having tried some PT, I went back to see my original consultant, who agreed that there isn‘t many options for me, I have Ankylosing Spondylitis, so somewhat prone to arthritic conditions. He sent me off for a steroid injection and tentatively we’ve agreed that I’ll have the left hip replaced in early January 2023, this is where the doubt creeps in…..

The radiologist who did the steroid injection is the same one who look at my most recent X-Ray and said he’d seen worse, in terms of damage to my left hip.

I’m now debating whether I should or shouldn’t have the THR. If the injection works, great, it might buy time, but it’s probably inevitable that this will need doing. I have my wedding coming up in August next year and my worst nightmare would be the injection buys me time, but wears off around April/May/June time leaving me no time to sort it properly before August, hence the debate…

Has anyone else struggled with this sort of decision? Happy to post the X-Ray if someone wants to cast an eye over it.

From a young patient to another....on xray my hips didn't look bad per say, but the symptoms i had from the labral damage was bad enough that the joint had to go.

If you are here on the forums, it's because it's affecting you quite a bit or you wouldn't be looking for info. I think generally speaking(and every patient has to make the decision for themselves), it's when you start telling yourself "I've had enough" that you know it's time to do it. When the pain starts affecting you daily to the point where it's interfering with daily life-that it's time to do it.

The unfortunate thing with this is that when you reach that point, the hip starts deteriorating REALLY quickly. I did hyaluronic acid injections for almost 2 yrs before I went in to beg him to do the replacement. The other issue is if you also have a bad hip on the other side of your body, you will majorly aggrevate and possibly damage whats left on the opposite side.

Had my surgery in February this year and honestly it was the best day of my life. I have been back riding and training multiple horses a day, and work for our local police force. I have ZERO regrets on getting this done, and wish they had done it sooner.

 

[Jaycey]

@adamf83 Get on that surgery wait list ASAP! Hips can go from tolerable to horrid literally over night. My experience was that the recovery was much longer on the hip that I put off having replaced. Limping around impacts so many other areas of the body. Get this hip replaced so that you can dance at your wedding!

 

[adamf83]

Just coming back to this, all the replies were so helpful and I’m now scheduled to have my LTHR on the 16th Jan 2023.

Onwards and upwards from here!

 

[Hip4life]

Excellent! What a great way to start the New Year-with the gift of a new hip. Not too long of a wait now. Have a very Happy Holiday.

 

[Jujubee50]

Bit if background, I had my right hip replaced June 2021, all went well (apart from some right knee problems which are now fixed). A little over a month ago, a started to get the same sort of groin pain I had previously experience, but in the left side.

Having tried some PT, I went back to see my original consultant, who agreed that there isn‘t many options for me, I have Ankylosing Spondylitis, so somewhat prone to arthritic conditions. He sent me off for a steroid injection and tentatively we’ve agreed that I’ll have the left hip replaced in early January 2023, this is where the doubt creeps in…..

The radiologist who did the steroid injection is the same one who look at my most recent X-Ray and said he’d seen worse, in terms of damage to my left hip.

I’m now debating whether I should or shouldn’t have the THR. If the injection works, great, it might buy time, but it’s probably inevitable that this will need doing. I have my wedding coming up in August next year and my worst nightmare would be the injection buys me time, but wears off around April/May/June time leaving me no time to sort it properly before August, hence the debate…

Has anyone else struggled with this sort of decision? Happy to post the X-Ray if someone wants to cast an eye over it.

Yes! I have the same questions right now. Left hip done in 2021. Right hip is starting to do the same. Not nearly as bad as the left was. I refused to believe I needed that left one done and was terrified. This one, I know it will just be a matter of time. MRI a year ago showed moderate osteoarthritis and cysts. I did 1 injection and some therapy. Scheduled for surgery January 23rd. As of the past week, pretty much no pain but I have not been really doing anything. When I do go on long shopping trips it will give me quite a bit of pain. It scares me to think maybe I don’t need it yet, but it also scares me to keep sitting on the couch and not living my life and gaining weight. I also for sure do not want to live through the same pain I did with the first one.

 

[Layla]

Best Wishes on Monday, adamf83
Please join us on the hip recovery side once you're feeling up to it. We'll have some Recovery Guidlines I believe you'll find useful and you'll find lots of support on the Hip recovery forum too. Hope to see you there.
@adamf83

 

[Mojo333]

One more sleep, and Bye Bye Hip Pain.
See you on the recovery side!

 

[Merrimay]

Good luck tomorrow! See you on the other side.

 

[ladyj]

I hope all went well. My THR is next week!