I'm 21 undergoing LHR on July 15 - need pre OP and post OP advises please

[tapan]

Hi guys. I came across this wonderful forum through my best friend Google. I am 21 years old and I was diagnosed with perthes syndrome at the age of 4. Later, this syndrome led to avascular necrosis (AVN) which eventually exhausted most of the cartilage in my left hip. I now have osteoarthritis and I have been in pain since the age of 12. Pain from arthritis during my teen years was almost minimal; however, during the past 3 years the pain has become intolerable. I was advised a THR surgery after my full body growth age of 18 years. Well now its about time and surgery is the only option as my pain is unbearable to the extent that even walking a couple of steps seems impossible. My pain isn't consistent and only occurs when my left hip undergoes stress from walking, standing, sitting in certain positions, moving around - basic activities of life.

My surgery date is set on July 15, 2009 in Toronto, ON (Canada) at Trillium West Hospital with Dr. Tajedin Getahun. I have heard great reviews about my surgeon so I don't have any doubts about that. However, I have been advised not to run or sit cross legged in my new life following the surgery. Also, the expected life of a ceramic hip (which will be put in me) was advised to be about 10 years. I don't know if these advises are accurate as I have heard of cases in which hips last atleast 15 years even in people of my age group. Knowing the limited life span of artificial hips, revision surgeries will be needed in my case during the course of my lifetime. About 3 to be more precise.

If you guys can help me out by advising me on any pre and post operation tips, it would mean a lot to me. Although, I am looking forward to having a better quality of life following the surgery, my nervousness relating to the surgery is overriding my excitement of having a painless hip. I have read some threads in this forum and it feels like I am soon going to be part of a new family. Its great to see that you guys are helping each other out by sharing your experiences and even your post OP pictures. I am glad I am now a member of this site. Thanking you in advance :D

-Tapan

 

[Texas]

Hi Tapan...Well first welcome. I bet you are ready to get on with it. That is some story. I am a knee, so I dont want to tell you something incorrect. But the hippies on here seem just fine with their new lil parts..lol... Able to do what they did before and more. I think you will be happy. You wont have that nagging pain anymore. Others will be along soon to post and help better then I can. I sure hope everything goes well for you. Keep us posted...

 

[Josephine]

Hello Tapan and welcome to BoneSmart.

Have you ever heard of or considered hip resurfacing? I think, in your circumstances, it would be a viable option. We do actually have a few resurfaced hippies here so do take a look at this area of our forum Hip Resurfacing Arthroplasty (RA)



You could also look in Surfacehippy where they have lot of members who can tell you their experiences. There is a patient discussion group there as well.

Tell them I sent you!

 

[mdakota]

hi there. tapan
i'm monique. 36 but about to undergo bilat replacement. you sound alot like me. you know whats comming so long that when you start hurting enough you are resigned. lol. its not a bad place to be when you need it done. this board is great. since i'm pre i'll talk about that. stretching and keeping the muscles in shape is the best thing. you'll need them later so keeping them working as much as you can now is great for you. i know pain can be a serious limitation but i took the kids to the lake today and stretched out in the water it was great to feel weightless and get to stretch, and the only reason i go for a walk right now is with a purpose. i use the grocery cart in the store. i wish you the best and were here for you if you need us
monique

 

[mdakota]

oh and the nurse i planned to take care of me has had bilat hip replacements for the last 13 years and still going strong. so my goal is much further then that. following the immediate post op instructions on twisting and such are the type of things that really make the longevity. especially with the cementless. its like tape if you start twisting it after you've applied. you take up the area that has to stick. if you keep it there a while you know it becomes close to impossible to get off. lol. i hope that made sence.

 

[tahoe1009]

So, I am a 32 year old man who is 8 weeks post op. I have a ceramic THR with the cross linked poly cup. From the research I have done you are looking at a lot longer than ten years longeviety. Clinical trials say somewhere in the neghborhood of 15 - 20 years (although that's in a lab as they have not used ceramic that long in people). For younger people it's the prosthetic of choice. Now as for resurfacing... It was not an option. For me as my AVN had progressed so far that there was not enough bone at the femoral head to resurface. If this isn't the case for you then I would look into it!!
As for your post op restrictions they will let you know what you can and can't do. So, don't worry too much about that. Pain will let you know the rest.

 

[JudyS]

Tapan
Welcome you have found a great new home!!!
I am 52, very active and had my hip replaced with a ceramic ball/ highly cross linked poly cup last year. Let me first tell you how wonderful it is. I had restrictions for the first 3 months such as not crossing legs (to prevent dislocation) your surgeon will tell you what restrictions you have and for how long. Usually 3 months is it. As far as running, I was told that was for life. I have run a little just to see how it feels and it feels great, but that is when I am being bad.
Check out resurfacing. Wasn't for me at my age and bone quality (or lack of it). I was planning on more than 10 years also maybe 20 or even more than that. I guess partly will be if I can stay off the running thing.

Welcome
judy

 

[UTdave]

Welcome to the forum! Glad you have a surgeon you're comfortable with. I would echo the other comments made.

1. Check out resurfacing. One hold up may be finding a ceramic component for your resurfacing. It seems they exist, though I have never seen one in the flesh (or in a picture for that matter). The metal resurfacing components may give your surgeon pause as you are certainly in your child bearing years and no one knows what a metal ion means for a fetus. This is a big hang up for most surgeons and you will hear many young woman on this forum raise that issue. Most end up with ceramics as they have amazing wear characteristics.

2. I agree with Tahoe about life-expectancy. 10 yrs seems ultra-conservative. I guess we'll find out in 10 yrs. The lab mockups with metal-metal or ceramic cross-linked poly will last forever, but we're not lab mockups and no one expects the failure to occur at the bearing surface anyway, but rather where the implant attaches to your own bone - especially the acetabulum. That's all dependent on host factors, wear rate, proper placement, etc. I personally am hoping for 20 years of abusive behavior for this set and then tone it down for after the revision and make the second pair last forever or until I die - whichever comes first!

3. Can't sit cross-legged? Tell that to my 74 yo mother-in-law-yoga-instructor or any number of people on this forum.

Good luck! It'll be great!

Dave

 

[kangaroo]

Hi Tapan,
You sound a lot like me (except I'm double your age which still makes me "young to have a hip replacement" )) ...anyway I had THR 7 weeks ago and doing just fine....
I'm surprised that your surgeon only predicts 10 years....my surgeon hopes that my ceramic on ceramic might see me out......thats 57 years until I'm 100! Perhaps I'll need a revision by the time I'm 80
Stay calm, you'll be fine.....and remember even if you can't do certain things like run after the surgery, you'll still be better off than you are now. As a young person, you need to live life, socialize, find love and romance......all of these things are hindered by not being able to dance, and party etc...
Rachel

 

[Josephine]

However, I have been advised .... the expected life of a ceramic hip (which will be put in me) was advised to be about 10 years. I don't know if these advises are accurate as I have heard of cases in which hips last atleast 15 years even in people of my age group. Knowing the limited life span of artificial hips, revision surgeries will be needed in my case during the course of my lifetime. About 3 to be more precise.

Ooops! I missed this bit! My bad ...

Well, surgeons are always going on the ultra safe, ultra conservative about this issue. In my post How to choose a surgeon and a prosthesis, I put it like this ...

Longevity
As for the longevity of the prostheses, official line is 10-15 years, professionals reckon it to be 15-20. Statistics show it to be approaching 20-25 and maybe even more. There are many, many people walking around now, living good, productive and happy lives who had their replacements done in the 60s and 70s! There is a news report at the head of the hip forum, about a lady who had hers done in 1966! See 42 years life span for a hip replacement!!

 

[Bean88]

Hey Tapan

I turned 21 on monday and had a hip replacement on the 1st june, i sound similar to you, i've had arthritis since the age of 5 and basically its just torn its way through my joints, but badly affecting my hips. Before surgery like your self the basic activities of life were impossible for me, i could not stand straight, walk, climb stairs, nor move my legs apart, and if i tried to do this i would get bad pain in my hip. The surgery has got rid of all that - i am now standing tall on crutches and walking around as best i can two weeks post op!! I was due to have bilateral hip replacement but the op took 3 and a half hours on just the right, so we had to stop there. I am hoping to get the left one done in september time to further improve my situation, and i can tell you before the op i cried most days with fear, but its nothing to be scared of - you will be in the best hands and you'll wake up a new person

My surgeon told me my hip could well out live me!!! im not sure what combination i have - titanium and ceramic spring to mind but i will have to investigate

 

[rad14]

Hey Tappan.

I'm 48 and just had mine done 4 weeks ago (left). I was expecting pain and discomfort from the procedure/surgery. The pain compared to before surgery never showed up! I was very surprised. It felt very sore and tender but nothing I couldn't tolerate, especially since I didnt continue using the pain pump after surgery. The medicine they gave me made me sick to my stomach. After about an hour so of this I'd had enough and quit the using the pump. So you should feel the same, as I had very similar symptoms as you did.
The 10 yr issue can be a number of things. Your age and activity level can influence this as well. The experience of your surgeon is "the" most important factor! My Dr. has 30 plus years of surgery and implant development with a well known company. He won't use ceramic anymore due to the "squeak" factor. How much experience does your Dr. have? From the time I left the prep room to surgery and then recovery was 2 hours total including my epidural and prep in the surgery room. I have the cross link cup and ceramic head. I was told about 10-15 years before I needed to replace anything and then it would just need a new cup and nothing else. Talk to your doc about this, it is important to know what can happen down the road. I wish you the best of luck and your life will change for the better no matter what you have implanted. I feel bad that you had to wait for so long but as they say, good things come to those who wait. Your time has come!

 

[tapan]

First of all I thank you all very much for giving me such comforting answers. After discussing with people that are undergoing similar experiences as mine, I feel a lot more confident than before. I agree with UTdave about 10 years hip life expectancy being an ultra conservative number. I am guessing surgeons play it safe by advising patients lesser than actual median life just to avoid any risks in future. After all, hip life depends from individual-to-individual and a general conclusion cannot be made for the entire population.

As for all of you advising me for a hip resurfacing, my situation has worsened (just like tahoe1009) and there isn't enough bone at the femoral head to resurface. I was advised that there are a lot of advantages to hip resurfacing in terms of potential of physical activity being much greater than in case of a hip replacement. However, a Total Hip Replacement was the only option advised to me from all surgeons (I got a lot of opinions from different surgeons in Canada and a few experts in India as well).

I did a bit of research myself and turns out that Anterior approach is the best one suited for me as revision surgeries in future are much easier to carry out than using a Posterior approach. Can any of you guys please share with me the surgical approaches applied to you?

You guys taking the time out to further help me in my thread means a lot to me and I am just so glad I have people to help me out. Thanking you all very much again!

 

[tapan]

Hey Tapan

I turned 21 on monday and had a hip replacement on the 1st june, i sound similar to you, i've had arthritis since the age of 5 and basically its just torn its way through my joints, but badly affecting my hips. Before surgery like your self the basic activities of life were impossible for me, i could not stand straight, walk, climb stairs, nor move my legs apart, and if i tried to do this i would get bad pain in my hip. The surgery has got rid of all that - i am now standing tall on crutches and walking around as best i can two weeks post op!! I was due to have bilateral hip replacement but the op took 3 and a half hours on just the right, so we had to stop there. I am hoping to get the left one done in september time to further improve my situation, and i can tell you before the op i cried most days with fear, but its nothing to be scared of - you will be in the best hands and you'll wake up a new person

My surgeon told me my hip could well out live me!!! im not sure what combination i have - titanium and ceramic spring to mind but i will have to investigate

Hey bud. Sounds like you have AVN on both your hips. I really feel bad for you as I know how difficult it is for me to manage pain in my left hip alone. Even getting in and out of a car seems like bit of a challenge to me. Emotionally as well, I know how frustrating it can get and I am glad you were brave enough to handle physically and emotionally so well all these years. I really envy you for that!:thmb:

I wish the best of luck to you in your new life with your new hips. Hope everything goes smoothly for your left hip as well!

 

[Judles]

Hope AND help is on the way! It's just amazing how wonderful the bionics are today! Each one of us is reaping the benefits!!!

 

[Texas]

You all sound like your doing an amazing job...You all should be proud!!!!
Tapan please take their advice these are terrific people and so caring. We will all help in anyway we can. Im a kneesie so I cant/wouldnt give advice. But sure hope all goes well for you as Im sure it will........Hang in there. I can tell you , you will feel much better when its over !!!!!!!!!!!!

 

[JudyS]

I had a traditional posterior approach. It was preferred by my doc. He is also a revision specialist although I never discussed my own possible revision with him. I am proud of all my scars, but mine is only 5 inches, he told me he is getting good at smaller incisions also some is under the skin. Just an amazing surgery. You will be so happy and pain free.
judy

 

[Jamie]

Tapan, if you do a little research in some of the older threads here, you'll see all the activity that people were able to return to following a total hip replacement. I feel sure that you will be able to do almost anything you want to once you get through recovery. So focus on all the good things to come as you await your surgery date. Waiting is the WORST part!!!

 

[tapan]

Tapan, if you do a little research in some of the older threads here, you'll see all the activity that people were able to return to following a total hip replacement. I feel sure that you will be able to do almost anything you want to once you get through recovery. So focus on all the good things to come as you await your surgery date. Waiting is the WORST part!!!

Hey Jamie. You're so right! The closer I get to my surgery date, the more impatient I get. Its eating me alive. :shk: On the optimistic side, I am looking forward to a pain free life which keeps me going through my impatience. I have booked an appointment with my surgeon 2 weeks before surgery to re-discuss and extract out most of the details about life after my hip replacement. Also, I will have a chat with him about the type of approach he will be using for my surgery and like. I know I am being very paranoid and stubborn by reconfirming things with my surgeon; however, this is something I have been looking forward to since the past 21 years. I just want to make sure everything goes according to my expectations.

 

[Jamie]

It's a huge step in life. Your surgeon will understand and hopefully will give you the time needed to answer all your questions and reassure you that you're doing the best thing for your future. I had the same kind of meeting with my doc before my knee surgery and it really helped. Part of that appointment was to tour the small orthopedic hospital where the surgery would be done and show me the recovery rooms, PT areas, and meet the nursing staff. That eased my mind SO much!!!

I know you'll be fine.....keep in touch with us here and we'll help the time go by faster. Sometimes it helps to talk or just chatter and be silly in those days leading up to the Big Day.