THR LTHR - Dysplasia & Legg Calve Perthes Disease

[JT56]

Hi All
I am on day 4 of my recovery from a THR in my left leg.
I am 56 years old and have always been pretty active. I was born with a congenital hip dysplasia and then went on to be diagnosed with Legg Calve Perthes disease when I was 5 years old. Apparently to have both of these conditions in the same hip was extremely rare so my mum was told I may never walk again. Luckily I did and I really had very few restrictions on my life growing up. I was advised to keep my weight down, not to run and to try to do as many non weight bearing activities as possible (swimming, cycling, horse riding etc). As a child I was told I would probably need a hip replacement by the time I was 30 and I have actually made it to 56 before doing so. I think the doctor who treated me all these years ago must have done a pretty good job!
Had my THR on 29th March and I am now recovering. I feel pretty good but because I have a higher risk of dislocation due to my previous issues I need to wear a leg brace for 6 weeks. That is tough as it is hard to walk and my leg is very heavy (and doesn’t bend). It makes it more difficult to sit down or use the toilet.
Otherwise I am relatively pain free and feeling positive. I am sure I will have my ups and downs so it has been good to read the recovery stories on here.

 

[JT56]

…. mine was a posterolateral procedure with two incisions so I have full restrictions on movement. The concerns about moving my hip in the wrong position are what worries me most at the moment as I definitely don’t want to dislocate my new hip!

 

[benne68]

Welcome to BoneSmart, @JT56! I'm glad you found us.

Since you are only a few days post-op, I think you will find our Recovery Guidelines helpful. The articles are short and informative and will help you have a less painful recovery.

HIP RECOVERY 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.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

2. Control discomfort:
rest
elevate
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
BoneSmart philosophy for sensible post op therapy

5. At week 4 and after you should follow this
Activity progression for THRs

The recovery articles
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 that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[benne68]

The concerns about moving my hip in the wrong position are what worries me most at the moment as I definitely don’t want to dislocate my new hip!

I hear you! Even though I didn't have the same issues, I was VERY cautious about movement until the surgeon cleared me. You are wise to take things slowly.

We are here to support you, so please keep posting!

 

[JT56]

Thank you! I guess I am better to err on the side of caution. It feels scary to think that the wrong movement could dislocate the new hip. When did you start to relax?

 

[djklaugh]

@JT56 Welcome to BoneSmart! Wow what a history you have! Kudos to your doctor for taking such good care of you that you could get to your age before needing a hip replacement! I do completely understand your concerns about dislocations ... but even with your history and current need for a brace it is not that easy to dislocate a hip. So yes be cautious and also don't waste time and energy on worrying about it. There is an article in our library about this that may help ease your concerns and give you some helpful suggestions: https://bonesmart.org/forum/threads/dislocations-what-are-the-risks.8759/

And here is a chart that gives information about when dislocations might happen:

 

[benne68]

It's hard to remember exactly, because it was in 2019 and my knee replacement was more recent (and a lot harder!) but I worried about doing something"wrong" for about 4-5 months post-op. Then, one day, I realized I had not thought about my hip all day!

Be patient. You will get there, with time!

 

[JT56]

Thank you @benne68 and @djklaugh. I am feeling positive - almost no pain. The only difficulty is the lack of mobility due to the brace making sitting very difficult. I worst case scenario is I spend most of the next couple of months in bed when I need to sit/ lie down. The hospital was great and I was very impressed with my doctor. I know he just wants to make sure he totally minimises any risk of early damage.
Maybe I need to stock up on some good books

 

[benne68]

Books are a good idea, but you might want to start with some light fiction. If you are like most of us, you'll find it hard to concentrate during the first month.

I ended up binging a lot of TV (and I'm not normally much of a TV watcher). until my brain fog cleared.

 

[JT56]

Another question. I have developed a rash - I have a nickel allergy and it actually looks like that. It started on my THR leg and has now started to spread up my back and onto the top of my other leg. It’s not like hives - more itchy blister spots that I get with a nickel reaction. The surgeon was aware of my nickel allergy so said he would use appropriate materials however I am a little anxious now. Has anyone else had this? It could be a reaction to the medications also I guess, or possibly just because I am spending all the time sitting/ lying on my buttocks and back.

 

[djklaugh]

@JT56 I think you should contact your surgeon and perhaps send him a picture of the rash.... or get into see him. Rashes can be difficult to figure out since similar looking ones can have multiple different causes.

 

[JT56]

I will do. The only issue with my hospital and surgeon ( they were wonderful) is that it’s not very easy to get to. It’s in the centre of NY and a 2 hour drive or train ride away. I will call him tomorrow to see what he says.

 

[Layla]

Hi @JT56
How is the rash? Hopefully better or you received some reassurance from your surgeons office.
Happy One Week Anniversary!

 

[JT56]

Yes, thank you. The doctor thinks it might be the surgical wash so suggested that I wash the area with a disinfectant wash and I watch it over the next 5 days. If it gets worse or doesn’t go away I should let them know. It’s already a little less itchy

 

[JT56]

I am 12 days post THR and yesterday/ last night and today my wound has been painful, throbbing, tingling and in general very uncomfortable. I am also getting pins and needles in the hand at that side. Hoping it all settles down over the next few days I think the pins and needles are as a result of the pressure I am feeling when sitting on the hip area

 

[Jaycey]

Early days @JT56 ! Are taking your pain medication as prescribed? around the clock. Icing and elevating?

Yes, in my experience the pins and needles are a result of pressure on one side for an extended period. As you get more mobile this should ease.

 

[JT56]

I probably eased off the pain meds too quickly. I take one at night to help me sleep and two acetaminophen in the morning. Maybe I should take a couple midday too. I hate taking too many meds though. I have been icing. Not elevating too often as it’s hard as my leg is in a brace. Probably need to lie on the bed for a couple of hours every day and elevate my legs. My hip joint is great at the moment. Just the leg/ buttocks and the wound that is really bothering me.

 

[Eman85]

Our hip joints are all in the trash can, the new ones don't hurt. Post-op the feelings we have are all soft tissue and nerve even though at times it feels like the old hip joint pain. We all want to be med free and have ideas that if we take them for too long we'll have a problem stopping. The meds are there and prescribed for good reason and can make recovery much easier.

 

[JT56]

Rash has now gone, wound so much better and walking is getting easier. I was hoping to be able to move on to a cane but my surgeon said that I need to continue with the walker, brace and restrictions for the minimum 6-8 weeks. I am getting some lower back pain now but I am recognising that it’s all different stages of healing and I am not worried. Everything seems to be moving in the right direction- it’s just uncomfortable rather than painful now

 

[Layla]

Great update above. I hope all is still going well for you.
Happy One Month Anniversary!
@JT56