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THR June 10 THR Trochanter Fracture?

sundae

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I had right anterior hip replacement a little over two weeks ago. I am on crutches for a month due to a weakened gluteus medius. After my surgery, Dr told my husband that my hip was worse than he expected and that he had to remove bone spurs. I won't see my Dr. for post surgery visit until mid July due to his vacation.

Last week, I felt like I was having a surprisingly good recovery and I reduced my pain meds to just tylenol. I felt great for 3 days, but now have developed some pretty significant pain in just to the left of my incision and into the groin area. The pain isn't very noticeable when I walk but very noticable upon movement that involves bending my knee (sitting down, in and out of bed). My PT said it could be a trochanter fracture, but not to worry. Of course I'm worried :-( I called my drs. office and the nurse said take more pain meds, but just wondering if anyone else had this increase in pain or experience with a trochanter fracture. Or, as my granny would say, am I making a mountain out of a mole hill?
 
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Layla

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Hello, Welcome to BoneSmart. Thanks for joining us and congrats on your new hip!

We ask that you leave the exact date of your surgery so a signature can be created for you.

Please step away from PT until you’re able to meet with your surgeon for your post op appointment. You don’t need PT this early on, walking will suffice, but not to excess. It is a possibility you overdid it in PT since your recovery was running smoothly. I suggest you read through the Recovery Guidelines below giving special attention to The Activity Progression for THR and the BIG TIP.

In the interim, lots of icing and elevation may help reduce the pain. Ice for 45-60 mins, no less, several times per day. You may need OTC meds to get through this setback, or the meds originally prescribed.

Wishing you comfort and speedy relief. Stay in touch, we’d love to support you as you‘re healing.

Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this
6. Access to these pages on the website

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
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sundae

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Thank you! Surgery was on June 10th. My OS requires PT so not sure I can step away completely but will ice and take it easy. Also, I don't have PT again until Tuesday and will cancel if I still have pain. I appreciate your advice.
 

Layla

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I apologize, I just noticed your surgery date in your thread title. :blush: Thank You!

PT is optional. Some members aren’t comfortable going against their surgeons advice...it’s personal, but in the end it’s your choice. PT can be a resource you access a few weeks down the road, if you feel the need.

Your pain is concerning because you mentioned you were doing well. I guess I’d want to know all was stable before continuing PT. Please do cancel your next appointment,
as you mentioned you will, if you’re still hurting on Monday.

A peaceful Sunday to you. :)
@sundae
 
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sundae

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Thank you! I have gone back to my original schedule for pain meds and the pain has improved quite a bit, although I feel quite nauseous and a bit out of it from the pain meds. I am taking tylenol, diclofenac, and 5 mg oxy every 6 hours which completely controls the pain but makes me feel awful. I will likely call the nurse tomorrow and find out if there are other meds I might take that would control the pain with fewer side effects.
 

Jaycey

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My PT said it could be a trochanter fracture, but not to worry.
Your PT has no place diagnosing this.

Sounds like you just stopped your medication too soon. Ask your surgeon's office for anti-nausea medication. Your nausea will probably ease with time but why suffer?
 

zauberflöte

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@sundae I agree with Jaycey regarding PT as overstepping bounds there. Let us know what OS office says. I ALWAYS ate a fatty snack with my opioids, usually nuts/peanut butter but sometimes.... ice cream! And plain yogurt worked best for the middle-of-the-night dosing, as it went down easily and didn't make my mouth taste "un-fresh".

I had so many pains that were the result of undermedicating! we have to remember that the whole body was involved in this THR-- a cross between machine shop and a train wreck went on, and muscles they overstretched while you were sleeping are going to need recovery just as though you had done an inadvertent split on the icy pavement!

By a couple of weeks out on the first hip, I had a system in place for attempting to wean off the percocet tiny bit by tiny bit, replacing each missing half-tab of percocet with a half a 325mg tylenol. For number two, the rx was for every four hours instead of every six, making the process easier-- and I got off them even sooner (partly because I was having a reaction to the meloxicam which mimicked the "codeine itchies", only on steroidS :flabber:).
 
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sundae

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This is so helpful! Thank you for taking the time to share this. I am feeling better today--much less pain without the oxy. I was told to "stay ahead of the pain" and I think this made me take more oxy than I actually needed and caused my extreme nausea. I'm thinking instead I'll use it as needed in small amounts and hopefully that will work out.
 
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sundae

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I am feeling much better today. I am off the oxy and hope to use it sparingly if at all moving forward. My pain is minimal and mostly around my incision.

Although I had anterior surgery, I was givent posterior hip precautions for 3 weeks due to a damaged gluteus medius. Today is my last day of precautions, but I am tentative about giving them up. I am still on crutches for one more week. This seems a bit unusual just wondering if anyone else had this protocal.
 

Layla

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Hi there, I hope you’re having a good day so far. Wondering what you’re feeling is a bit unusual? Is it the restrictions due to the damaged gluteus medius?

If you don’t feel ready to give up the restrictions while you’re still on the crutches for another week, don’t give them up yet. I can’t see that it will do any harm. I experienced posterior approach, had zero restrictions, but followed some on my own, loosely. I figured what could it hurt? :shrug: Your best bet now is to avoid PT if you’re able until your appointment so you don’t land in the ODIC (over did it club) again. You’re doing better so it would be nice if you could build on that for a couple of weeks. Please consider icing your incision for 45-60 minutes each time you ice, no less, and hopefully it will help ease your pain.
Have a great rest of the day!
@sundae
 

zauberflöte

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Hi @sundae ! I don't know enough about precisely what the gluteus medius has to do with anterior THR to really speak to it, but this screenshot (please pardon informality!) did show me some info:
D4FB76D8-48A8-4D6B-9DE9-68466FF10BE1.png
I AM NOT A DOCTOR!!! lol so I'm just hypothesizing here.
So this muscle evidently helps rotate the femur around, is what it looks like to me? If it's damaged, maybe it can't help you keep your leg from turning in? I was told that twisting the leg inwards wasn't such a hot idea for the first few weeks. "Torquing it", they called it. Maybe your precautions have helped the glute muscle to cope without added stress, and thus to heal better? It certainly can't hurt to continue precautions until you feel more comfortable going off them. Especially if you're comfortable sleeping. Some side sleepers here have figured out very ingenious uses of masses of pillows and bolsters to be able to sleep on their sides.
 

Jaycey

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Today is my last day of precautions, but I am tentative about giving them up.
There is no need to rush to get rid of restrictions. When I had my RTHR I had no restrictions. But there were times when my hip just didn't want to move in a certain way. As you gain confidence you will naturally drop the restrictions.
 

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Hi @sundae,

I have found slower and careful is best when it comes to healing!

My posterior surgery resulted in my gluteus medius muscle and other soft tissues to be irritated, painful and not function properly. Fortunately, after a great deal of effort, my gluteus medius muscle is now back to par!

Very glad you are feeling better:)

Best,
Golden
 
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leejaa

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Continue to listen to your body and your hip. If you are more comfortable not doing certain moves, don't do them. Your hip and body will let you know when the time is right.
 

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