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THR Left Total Hip Replacement -anterior approach

I'd encourage you to speak with everyone on your medical team about these concerns so each of the providers has this information in their notes.

In addition to talking with your surgeon or his/her PA or NP, be sure to discuss pain meds with the physician who does your pre-op physical so it is in those notes. I also brought it up with the hospitalist who monitored me during recovery, managed my discharge and ordered the medications I was taking home. As it turned out, she already had seen the notes from my pre-op physical.

The anesthesiologist should come in to see you during your surgery prep and will ask you about past experience with anesthesia, and will discuss his/her plan and options.

You are right to advocate for yourself. Don't be reluctant to deliver the same message over and over to cover all your bases.
 
I agree with everything, benne68, noted above. You may want to jot down all of your concerns so you don't forget something you want to discuss when the anesthesiologist visits with you pre-op. You do have the right to express concerns, know what will be used and understand the risks and benefits. You should be able to refuse and request alternate medications, within reason of course.

Thanks for joining, Reader525. We appreciate you sharing your journey here. I hope you have a nice weekend!
@Reader525
 
Good morning, @Reader525. Hope you are doing well.

Wondering if you have been in for your appointment with your surgical team yet? Give us an update when you have a chance.

:flwrysmile:
 
Hi @benne68! I'm so happy you checked on me. Tomorrow I see the surgeon for my 2nd follow up appointment. Then on Friday I see the surgeon to discuss my possible knee revision. I have been so hopeful that it would give me some relief. My knee replacement leg hyperextends so dramatically that the PA noticed it when I was walking in for my first appointment. He's the one who told me a thicker spacer would help me. The knee is very sore after I walk a while, because it's not supposed to bend that far back! So my hip overthinking has been replaced by my knee overthinking!! ;)) I can't wait for Friday.
 
This is good to hear. I hope you hear some positive news in the meeting with your surgeon on Friday. Once your knee works properly, your hip should do so much better. Hang in there!
 
Let us know everything!

Sending hugs to help you get through the next few days. :console2:
 
Best Wishes for your appointment today and Friday's also. Please let us know how it goes.
Wishing you much comfort as you go through the motions.
@Reader525
 
My appointment with the PA went great, he says my leg is strong and the muscles are moving well. It's funny, my hip is really the last thing on my mind, I'm just so focused on the knee. I know my hip is doing great, and the twinges I feel when I move certain ways are normal healing. It doesn't concern me. I know in a matter of weeks they will fade. But my knee, on the other hand, is constantly on my mind. Every time I walk I can't help but be reminded of the way it moves. It's awkward and uncomfortable.
The PA seemed to think the spacer exchange would benefit me but mentioned how they have to be careful they don't compromise flexion when they replace with a thicker spacer. Then he said it's an overnight stay in the hospital, it has to do with insurance. The thought being that a revision involves more observation. I was surprised, they can saw off your bones and put a new knee in and you go home in 3 hours, but a spacer being removed is an overnight stay? Lol
So tomorrow is kind of a big deal for me. So much riding on this. Furthermore, I have an hour's drive to the St. Augustine office to see him. Lots of time to go over what I want to establish. Any questions you think I am not thinking of?
 
Happy to read that you received a good report on the hip, @Reader525.

You've clearly been giving this a lot of thought so I am sure you are well prepared. I can't think of any other questions you should ask; but I do encourage you to take your time. I like to have my questions written down so the doctor/PA can see I have a list and are less likely to rush me. And, importantly: remember that there are no silly questions! You have a right to feel informed before you decide to proceed.

Don't worry too much about the overnight stay. I've did overnights for all of my TKRs and THRs. It seems that every surgeon has different protocols.

Best wishes for that appointment tomorrow. Please keep us posted.
 
Hello Reader,
Great news on your appointment with the PA. :thumb:
You've hit another milestone...Happy Two Month Anniversary!
Safe travels to and from St Augustine today for your appointment. Wishing you the best!
@Reader525
 
Well, here I am, home and I didn't get lost either. The surgeon was pretty confident he could help me. He said I may have to lose a little of my flexion in order to stop hyperextending. I have flexion to spare, though, I bend to 140, so if I can only bend to 115-120, I'll be fine. I'm scheduled for May 14th because he's 2-3 months out, unfortunately. I so wanted to get it done sooner. But it'll be here before I know it. We talked about whether I had a loose ligament area in the back of my knee and I told him I suspect I do.
The injury that started this whole thing was a meniscus tear that was unbelievably painful and huge. I had no insurance at that time and just babied my leg until it "healed". Then I went back to running, until my leg said, nope.. no more running. I think walking on it for almost 7 years before my knee replacement stretched out my ligaments and started my hyperextension. The surgeon agreed. But he told me orthopedists can help with that by putting the correct spacer in for you. So I'm hopeful.
The only thing I didn't get a chance to ask which I will on my pre-op is about the anesthesia and first few weeks of recovery. He did tell me this isn't going to be like recovering from a knee replacement, but he said he removes scar tissue in order to get to the replacement itself and do the exchange, so you have tissues that are going to be affected and that will cause swelling and pain. I don't think it will be as bad as the hip replacement, but I don't know. I hope it's not as bad as the knee replacement, even though he said it's not as bad, who knows.
I have to take a chance and do this, my knee aches and is sore from the hyperextension now, it doesn't like being stretched like that.
I have a pre-op appointment 4/24, and a pre-op with the PA 5/8. I'll have my list ready. I wish I'd asked more but I was listening so hard to his description of the surgery, I let everything else go. :((
 
I think you did a great job gathering information and discussing all this with your surgeon. You’ve definitely made the right decision. You certainly don’t want things to get worse by not getting the joint corrected. It sounds like you have a great surgeon. I’m sure he appreciated your knowledge and the fact that you understand how all the occurred. You’re right, though, that the surgery will be here before you know it. Just take things very easy until then so that your knee and hip stay as comfortable as possible.
 
Good for you for scheduling the spacer exchange, @Reader525! I'm sorry you have to wait, but you know that it will be worth it to have the procedure done by a surgeon you like and trust.

I love your comment about having "flexion to spare." I think so many of us get caught up in the numbers that we forget about function. You are right; at 115-120 you will have all the function you need. Many folks are thrilled to reach that range.

We have had members who had spacer exchanges, and did well, reporting that their knees were more stable. They've also reported that the recovery was not as challenging as their TKR.

I've added your surgery date to your signature, so if anything changes, let us know.
 
Overthinking last night after reading accounts on Mayo's page, I wondered, Am I doing the right thing!? Some reports mentioned the stiffness and awkwardness of the knee after spacer exchange. Some mentioned extreme tightness, so of course I spiraled, but only partly. I thought about how not doing the surgery isn't an option because I just walk so terribly, it's almost unmanageable. I worked yesterday, my first day since surgery, and my left leg is so unstable. I noticed that fatigue makes it worse, like everything.
I was on my feet for almost 6 hours and by hour 3 I just had to sit down. After sitting for about 10 minutes I walked a tiny bit better.
I also started thinking about the epidural. I am not sure I'll be getting one because Dr. Roettges told me the surgery isn't long, only about 45 minutes. So much to obsess over, lol.
I wish there were more posts on this on the forum!! I read what I could find, unless you think there's an area where more is available on here?
 
I’m sorry that you’re not finding more information here on spacer exchanges. Frankly, it’s not a common type of revision, so that limits our member experiences with it. Remember that the stories you read anywhere, including reputable sources like Mayo Clinic, are more likely to be from people who had concerns after the procedure. When things go well, people just move on with their lives and don’t post about it. The comments may also be from people early in their adjustment to the new spacer. Just like anything involving your body’s soft tissues and gait, recovery and readjustment can take months to resolve. Many people expect the “cure” to be almost immediate.

Please try not to push yourself by spending a lot of time on your feet while waiting for surgery. If you must work, see if you can arrange periodic rests for 10 minutes out of every hour. Can you work at least part of the time from home? Or maybe just not work at all until the procedure is completed (best option)?

And try not to worry about the anesthesia. These doctors are professionals who will select the best option for you. Write down and ask questions or concerns if you have them, but don’t worry about it. You are in good hands. Accept that you do not have control (nor the knowledge to make decisions about what anesthetic is used) and trust your team. If you want to be unaware of what is going on, tell them. They have varying degrees of sedation to allow just about anything you prefer.
 
You are right the surgery will be here before you know it. Reading through your posts,I also had pretty severe thigh pain as well during my initial stages of post op THR recovery. I was not prepared for that at all either. No one had ever talked to me about it or had heard that it could be an issue post surgery. It took a solid 2-3 weeks for it to eventually go away.

Be patient with yourself and your healing. You will get better, you just have some compassion for yourself and the trauma your body has gone through.
 
@benne68 Thank you for asking! I have been reluctant to post anything because it would just be me pondering and overthinking, you know how we get with a surgery looming.
Time is passing and 3 weeks from this coming Friday is my pre-op clearance. It's just a little over 6 weeks away from my revision.
I have been working a lot, I'm an executive for a cosmetics company and I visit many retailers, and often stand on my feet for up to 6 hours. I do take sit down breaks, but sometimes I don't have an opportunity. My hip is sore sometimes, I'm about 11 weeks plus I think since my THR. And then of course, my wayward knee hurts. It's a lot but I am handling it.
I have always exercised, be it my running for years, or strengthening exercises, and now I am unable to. If I do leg raises it doesn't feel good, that soreness, you know. I worry about my quads getting weak without any exercises. What's going to happen when they do my knee revision.
Then I'm thinking about the recovery from the surgery, I imagine my knee swollen and sore, possibly hard to bend or straighten. I have zero idea of what to expect, there's very little online about spacer replacement, and just a couple on this forum. So, of course I'm a little worried.
Aren't you glad you checked in??!! Lol
 
All these thoughts are completely normal. Of course no one can promise for sure how you’ll feel after the spacer replacement, but normally the recovery is not anywhere near what you experienced with your TKR. Your job is definitely making some additional challenges for you in the lead-up to surgery. Just keep trying to sneak in some rests whenever you can. Try not to run errands after a day of work. Just head home to rest, ice, and elevate to keep hip pain minimized. It is still healing. Are you planning some recovery time off from work when you get the spacer exchange? You’ll need that.
 
@Jamie Yes I am. I plan on 6 weeks off, I hope I am not being too optimistic. It seems with both my joint surgeries I had surprises, and was unprepared for the pain. I still don't know why they don't inform us about what to expect. I imagine they try to be positive and encouraging, and they don't want to even mention anything about pain and long term problems. But as @PolarIce said, it is something we have to deal with! Knowing myself, if I am prepared for pain, I can deal with it, if I'm not expecting it, I don't really handle it well.
 
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