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THR How do you know if it's your hip that's causing the pain

Indygo

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A long title! I had a right knee replacement two years ago and did fine. The left knee needs replaced as well, but covid hit and I put it off. Over the past few months my right leg (the leg with the new knee) started giving out and then I had upper thigh pain, which got worse until now it's difficult to walk or climb stairs. The pain is front right thigh and sometimes back of the thigh or front left. If I sit on the floor with my knees bent and feet together, I can push my left knee down to the floor but can only get the right down halfway. My GP thought it might be bursitis. I was afraid I might need a knee revision, but went to the surgeon for x rays. The knee replacement is fine but my right hip has severe bone-on-bone arthritis and spurs. Do I assume my recent pain and lack of flexibility is the bad hip or could it be a back problem? How do I know? My left knee is also a disaster, but do I replace the joint that's giving me the most pain and lack of mobility first? Eventually, the surgeon said, I'd have all four joints replaced. Lucky me. This has taken me completely by surprise, though it shouldn't have. I just turned 70 and have had arthritis for decades.
 

Celle

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Hi @Indygo ,

It's more likely to be your hip than anything else that is causing the pain. You know it has bone-on-bone arthritis and that is going to be hurting. The lack of flexibility is also a giveaway.

I'd be inclined to replace the hip first, so that you have one good leg when you have the knee replacement.
Also, recovery from a hip replacement is a little easier than recovery from a knee replacement.
 
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Indygo

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Thank you Celle! Though I was hoping I wouldn't have to be back so soon, I love this forum. I practically lived on here during my knee replacement.
 

FCBayern

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Walking for 30 years on a bad knee wore my hip out @Indygo, which was quite a surprise for me at the time. I not only found that THR was an easier recovery than TKR, and replacing the hip actually improved my knee as well. I agree with Celle, having one strong leg should make the recovery easier when you do the other knee. I can't imagine what it would be like with a bad hip on one side and a brand new knee on the other.
 

Going4fun

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If you've got severe bone-on-bone arthritis, my doctors told me, that is going to cause pain at some point. That's pretty straight forward.

Severe bone-on-bone is not some minor matter. That means the cartilage cushioning (in layman's terms--I'm not a doctor) is missing.

You could also have some back stuff, but fixing back issues are a different matter, though they can present like some hip issues at times.

If you didn't have severe bone-on-bone, then yes, investigate the back. Severe bone-on-bone, that is going to cause pain.

After my surgery, I also got some work done on my back in PT. But I absolutely needed the hip replacement.
 

Hip4life

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Bone on bone with spurs is a pretty sure sign it’s your hip. You might be surprised at how much many of your symptoms improve once the hip is taken care of. It’s amazing how our bodies shift their functions to compensate for damage and pain. That was certainly my experience. Did the OS mention setting a surgery date or did you want to think about it first?
 
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Indygo

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Thanks all! We didn't set a date because I was so surprised by it! Also, I'm a teacher and have eight weeks left in the semester, so I have to factor that in as well as check on insurance. I'd love to just get it done because it's harder to walk each day, but I'm retiring at the end of the eight weeks. While I could fairly easily make arrangements for two of my classes, I have one once-a-week Monday evening class that I can't really get someone else to take over for me. Since it's all on zoom anyway, is it possible to have surgery on, say, a Tuesday and be with-it enough to teach an online class in six days? I'm positive I couldn't have done that after TKR, but the hip seems to be a slightly easier recovery. Is that just wishful thinking?
 

Celle

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Since it's all on zoom anyway, is it possible to have surgery on, say, a Tuesday and be with-it enough to teach an online class in six days? I'm positive I couldn't have done that after TKR, but the hip seems to be a slightly easier recovery. Is that just wishful thinking?
I'm pretty certain that's going to be a "No".

Even though recovery from a THR is somewhat easier than recovery from a TKR, it's not that much easier. You're still going to be stiff and sore and probably taking narcotics for pain relief. You'll possibly still have the post-op brain fog that prevents you from thinking clearly and you won't be sleeping well. to do what you suggest is likely to be wishful thinking.

Eight weeks isn't so far away. My advice would be to set a surgery date for shortly after your eight weeks are completed, then you can take as long as you need to for recovery, without the pressure of having to teach a class on a set date.
 
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Indygo

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Thanks, Celle. I'm sure you're right, but was hoping it might work!
 

FCBayern

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After 2 weeks you would be pushing it really hard in my opinion @Indygo. Anything less than two weeks would be miraculous, or a disaster.
 

Hip4life

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Agree it would be difficult. I’ll paraphrase my OS: it’s surprising to most people how much this surgery takes out of them. So, if you can make it 8 more weeks, especially to retire, it will be so much better. When I had hip surgery and had to stress over returning to work. I had another major surgery (non-joint) after I had retired. The stress level was so much better without the return to work. If you need to, use a cane to assist you. I eventually had to as I waited for my hip surgery. I wished I had started using it sooner. Keep us posted. ❤
 

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