Hip Arthroscopy Is there life after THR & Arthroscopy? You Betcha!!

[Meggzie]

What a glorious day!! The sun was shining, the birds were singing, the ponies were jumping and I got out of the house!!! I seem to have survived the 20min drive each way, and a sensational afternoon soaking up some vitamin D from the sun...ahhh, bliss! The only way it could have been better is if I'd been riding - but ya cant have everything, right? I am truly blessed!

Oh, and horsecrazy I forgot to say earlier that hiring a golf cart to get around at the show is truly inspired!! You are one smart cookie!

 

[horsecrazy]

Meggzie, WOW I woke up to the best morning surprise ever---what fun watching you and your VERY VERY good boy go XC! You are my hero! Your boy obviously loves this sport, his little ears are pricked forward almost the entire ride I was not quite as nervous watching your ride as my friend's because you are a nice steady rider--well done! Much like you I didn't start riding till I was 40 -- I had never even been on a horse till then but the minute I jumped on and took a lesson I was hooked--bought a horse within a year I agree 100% that it is the social aspect of riding that makes it the best sport ever, most of my friends are adult amateur and we all do it for the fun, not for the ribbon. We too share lots of Maybe someday I'll come to your part of the world, or you mine and we can have a ride and share a brewski I have to admit, I used to jump lots and did the lowest level of XC and I do miss it on occasion and I totally understand the rush you are speaking about!
I can't WAIT to see your next/first ride as soon as you put on your glasses, set your watch, and roll out the gate! Thanks again for sharing.

 

[Meggzie]

Hi horsecrazy glad you had fun riding along with us My pony is an absolute superstar, I am so lucky to have him. He is an angel on the ground, a jumping machine under saddle - in his younger days, he was jumping 1.30-1.40 m classes! His dressage is a bit indifferent, but so is mine, but maybe I'll improve with new hips and maybe he'll respond to better, clearer aids....hope so!

My dear Johnnie started his life with me as a loan horse from an incredibly generous local rider, not long after my previous horse died suddenly after complications from colic. We had a rocky start, I fell off every five minutes..he moved so much bigger...and IS so much bigger than the last one..he would jump me out of the saddle all the time. The solution? Ride better! this horse has taught me soooo much!

For around 6 months, I think I cried after every ride because I couldn't ride him well enough. I felt bad for him, and every now and then I'm sure i could hear him say under his breath "hmpf, &:$;)*€ amateurs!" In disgust. But he is as honest as the day is long and tolerated my very average riding. Anyway, I persevered and one day, out of the blue, it all seemed to drop into place and we haven't looked back We even have the occasional 'oh, wow' dressage moments!

Then, Johnnie's owner rang me a week after my THR and said that seeing as Johnnie and I were having so much fun together, he was going to transfer ownership to me. So now, he's mine forever and I continue to be floored by this man's compassion for me and the horse. I have a charmed life, and I am grateful on a daily basis!

Not talking too much about hips these last couple of days....I can't say I'm even close to forgetting about them, but everything is manageable and I've got my eyes on the prize. I hope you had a great day out with your friends watching lessons yesterday too, and you're feeling well and motivated - oh, and I'm up for brewskis anytime!

 

[horsecrazy]

Meggzie that is a great story about Johnnie! Well, back to hip talk. I saw my doc for my first PO visit (will be 6 weeks Friday). I still have pretty significant groin pain (just when doing certain things/movements). He reminded me that because I'm not the "typical" THR patient, meaning my THR was the result of a prior injury and when they took the hardware out that fixed my prior breaks a lot of damage had been done due to the ill fitting nails/screws, etc. So he told me to wait 3 more months and if the groin pain persists we will track it down. He said I was free to do anything I want (within reason) now and have no more "restrictions". He did say he typically tells people not to ride for about 3 months. So, I'm really hoping my pain gets better with time and I plan on riding sometime in early Oct I'm pretty much back to work full time, which is a good thing.

 

[Meggzie]

horsecrazy Great that you've had your restrictions lifted!! Now you can start to try all of those things that have been forbidden...like putting on socks without a sock aid!!! I just wish that when my OS lifted mine it meant that suddenly I was 'able' do those things - my body wasn't so sure. So, as you try for greater range of movement, my advice would be to try new movements slowly, and the second it's painful, stop and go back to the gadgets for a couple of days.

And back to work full time is amazing! You're clearly made of tuff stuff - at 6 weeks I could only manage half days. Watch out for that energy drain, and if you have a freezer at work its great to have icepacks on hand in case pain or swelling kicks in (thanks to Poppet for that tip early on in my recovery). And if you're in office based work - try to get up and move around every hour (or more frequently). Sitting still for too long can be a killer when it comes to getting moving again!

"In riding a horse, we borrow freedom" - and freedom for you could be as soon as 6 weeks! That's awesome. It makes sense that your old hardware might have caused some atypical soreness for you - I'm sending all the healing vibes I can from downunder, hoping that your groin pain resolves and you can get that photo up on BoneSmart way before me!

 

[Meggzie]

Hi Josephine I'm sorry to bother you, but I'm after some post arthroscopy info regarding knee and IT band soreness. I've had a dig around here in Bonesmart and done a ton of Google-ing, but either the info's just not out there, or I'm using rubbish search terms. There's LOADS on THR, but precious little for arthroscopy. I'm hoping you might have some info at hand, or can point me in the right direction, and/or can dispense a little of your no-nonsense wisdom....I would love to hear from anyone else who has had experience with hip arthroscopy too

All of the info I was given (and have found independently) talks very vaguely about groin, knee and thigh pain and/or numbness being possible after an arthroscopy. Wow! Newsflash! Really?? Who'd have thought!?!? I do know that to apply the traction, one's leg is yanked on from the ankle - and there's a dirty great post between your legs to stop you from sliding off the table when they yank on your leg. Your other leg is also tethered to stop you from sliding around the post when the operative leg is yanked on. Nope, not at all surprised that there's a bit of pain in those areas. What no-one seems to discuss is what sort of severity to expect - what's "normal" and what is worth getting one's knickers in a twist over.

So, the majority of my pain is right at the bottom of the IT band where it attaches at the knee (right at the bottom of the yellow section as pictured). It is very tender to touch (about an 8!)...feels a bit like it's been clubbed - and no, I dont repeatedly poke at it - lol!!. When bending the knee to do prone quadricep stretches, the pain increases...needless to say I avoid that stretch now. There is also general tenderness all along the IT band from knee to a point midway to my hip - about where the "iliotibial band" label is on the pic. It feels like a combination of the soreness after a massive session of squats and lunges at the gym, combined with bruising from the aforementioned clubbing (or horse-kick)

Given that the leg is yanked on (ok, pulled with steady pressure) from the ankle hard enough to "distract" the hip, am I right in thinking that the knee cops a bit of the same and that the IT band is stretched/strained in the process? Should I just stop whining and get on with it (rest, ice, meds etc) because this is what they meant in their vague descriptions, or should I be a bit concerned that some unintended damage has occurred? I am seeing my GP on Thursday to have stitches out and to review my return to work plans - I will definitely be raising the issue with him - but thought I'd seek answers here too.

Thanks for taking the time to read, I'd be very interested to hear what you think. Cheers!!

 

[Josephine]

There's LOADS on THR, but precious little for arthroscopy.

That's because much of the THR stuff applies equally to hip arthroscopy.

So, the majority of my pain is right at the bottom of the IT band where it attaches at the knee (right at the bottom of the yellow section as pictured). It is very tender to touch (about an 8!)...feels a bit like it's been clubbed - and no, I don't repeatedly poke at it

Perhaps you should poke at it! The very best treatment for ITB tendinitis is Acupressure massage. I have used this frequently and it's a great easy to use means of getting that inflammation and pain down and under control.

You should also bear in mind that this is actually a very painful procedure and you are only 9 days out. So what you are experiencing is actually nothing more than plain old post-op pain. Oh, and in addition to all that pulling around and everything, please also bear in mind that your hip joint is partially dislocated with the traction and also with being inflated with about 750mls saline. That also leaves a legacy of short term pain.

So now I have some questions to ask you:
1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing that knee and for how long?

4. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

5. what kind of PT and exercises are you doing? How much and how often?

I'll be back!

 

[Meggzie]

Josephine thankyou so much for the sanity check. I think I knew the answer, its just nice to hear it from someone who really knows I guess I hadn't really given enough thought to what the knee goes through in this. In hindsight not sure why I was so freaked out.

Ok, start poking...check! ;)

To answer your questions

1. Pain at rest 1-2 hip, knee and everywhere else, 3-4 knee and thigh when walking and 8 when I poke at my IT band/ knee area ;) the hip area is pretty constantly at 1-2.

2. in the beginning I was prescribed Targin 20/10 ((20mg oxycodone hydrochloride/ 10mg naloxone hydrochloride dihydrate) twice a day, Endone (oxycodone) 5mg x2 every 4 hours if needed for breakthrough pain, 500mg paractamol x 2, 4 times a day and Celebrex 200mg once daily. I was also given Panadine Forte (500mg paracetamol/30mg codeine phosphate) to use when the Targin ran out. I stopped the morning dose of Targin 4 days ago and had the last night time dose night before last.

Right now I take the celebrex with food in the morning, panadine Forte x2, 4 times a day, and a couple of endone before bed - this is what gives me the pain scores in 1, which are very manageable for me.

3. Icing the knee 20 min every 2 to 3 hours.

4. Activity...about 90% of my day on my butt with trips to the bathroom and kitchen. My cooking consists of nuking pre-prepared frozen meals, my groceries are delivered. I drive out to my horse to say hi once a day (5 min each way) and a friend does all the work, I just cuddle the pony...need to walk about 100m to the horse from the car. Laundry is one or two loads a week, not a whole lot of bending etc there - have a little trolley for the basket and a low inside clothes line. As for floors - meh - they can wait!

5. PT - exercise bike for 5-10 min, glute, quad and hamstring squeezing, heel sliding, prone lying. 10 reps twice a day of standing abduction and extension, knee raises only if no pain (usually do about 3)

 

[Meggzie]

Oh, and in addition to all that pulling around and everything, please also bear in mind that your hip joint is partially dislocated with the traction and also with being inflated with about 750mls saline. That also leaves a legacy of short term pain

I was aware of that, and I guess because of that, I expected a whole lot more hip pain than knee or ankle pain - it has thrown me a bit that the pain is predominately in an area not directly battered by the procedure (other than the traction) and the hip is really feeling like a non-issue...

 

[Josephine]

Gotcha. But I think much of your problem - and pain - is due to all those exercises you are doing, it's quite a lot for 9 days out and therefore little wonder you are experiencing pain. Even hip replacements don't need that much exercising and your hip hasn't had anything like the degree of surgery involved in a THR!

Hips generally have a way of sorting themselves out if given half a chance. I suggest you quit doing most of them - or only doing half the amount every other day - for the next couple of weeks at least and I am sure you will find it solves the pain/discomfort problem. I can't see any of these that are absolutely necessary to do this early out apart from the muscle squeezes and maybe the prone lying. Walking would more than make up for the rest and maybe 5mins on the bike every other day, just for the next couple of weeks until things settle down a bit.

 

[Meggzie]

Josephine and here I was thinking I'd been taking it easy! :rolleyes: As it is I've been forced to take up crocheting to try to beat the boredom ;). Hmmmm guess I just have to dial it back a bit further

Thankyou so very much for taking the time to help me out, it really is much appreciated. You rock! :D

 

[Josephine]

 

[Meggzie]

I was supposed to be seeing my GP on Thursday this week, but I had to take a trip into town to have a prescription filled, so I asked the GP if I could see him today to save me another trip later in the week. Fortunately he had time in his day and agreed. It was great to get the massive number of stitches out...all two of them!

Apart from my knee/IT band issue, I am feeling remarkably well, and not nearly as affected by the energy drain this time as I was by the THR back in May. I was originally going to be off work for two weeks, returning on Monday 9 Sep. The GP was very happy with my recovery so far, and echoed the excellent advice provided by Josephine No surprises there!!! Of course our resident Mother Hen knows her stuff - even docs down-under agree!!

Regardless of how well I'm going, the doc wouldn't hear of me going back to work as planned. He wants me to have another full week off, and then start back on half days from 16 Sep, then full days a week later. He emphasised that while this was no THR, it WAS still a major surgery, I was less than two weeks out and that I ought to be kind to myself. Who am I to argue, I thought - he was clearly channelling our dear Jo, and I aint gonna cross her!!

Guess it time to get back to the crocheting!!

 

[horsecrazy]

Meggzie I can beat the crocheting -- I actually did a 1000 piece jigsaw puzzle during my early rehab
Glad you are having good luck with all things rehab related!

 

[Bionic woman2]

lol Horselady, I'm becoming the queen of Solitaire!
How are my Hipsters doing? I hope you both are progressing nicely.

 

[Josephine]

The GP was very happy with my recovery so far, and echoed the excellent advice provided by @Josephine No surprises there!!! Of course our resident Mother Hen knows her stuff - even docs down-under agree!!

Regardless of how well I'm going, the doc wouldn't hear of me going back to work as planned. He wants me to have another full week off, and then start back on half days from 16 Sep, then full days a week later. He emphasised that while this was no THR, it WAS still a major surgery, I was less than two weeks out and that I ought to be kind to myself. Who am I to argue, I thought - he was clearly channelling our dear Jo, and I aint gonna cross her!!

I am delighted to hear this. He might even had done some training in the UK - lots of Aussie orthopods do! I am also delighted at the confirmation that I am on the right track - it's always good to have that! Thank you so much.

 

[Meggzie]

Oh Josephine I don't think there's ever been any doubt that you know what you're on about!!

 

[Meggzie]

horsecrazy Bionic woman2 - oh dear, although we are still spring chickens, it looks like we need to resign ourselves to granny type activities....but just for a short while!!

 

[bottomshollow]

Hey! I was a granny at 47---so maybe you should just say very old lady activities

 

[Meggzie]

Oops! I guess I should have chosen my words a little better!

Very old ladies activities, it is! Thanks for straightening me out bottomshollow