THR My new hip - operation date 7th September 21

Coddfish

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On 7th September I had my right hip replaced, posterior approach, Smith & Nephew Polar 3, uncemented. I am mid 60s, female, osteoarthritis in hip on top of some earlier trauma. Prior to the pre-surgery decline, I was a regular, if not very good runner, also regular swimmer and user of the gym. Fitness and an active lifestyle is important to me. One of my biggest questions before committing was “will I be able to run again”. The surgeon was hopeful, but in any case I had no real choice about surgery as I could by then barely walk, never mind run.

The surgery itself was straight forward. Spinal anaesthetic and enough sedative to keep me settled whilst remaining conscious. All done and dusted in less than an hour. 2 night stay in hospital and then back home with a pair of elbow crutches. Limited pain meds as I didn’t get on with opioids, so just paracetamol, ibuprofen and the occasional ice pack. Thankfully there was never any real pain.

The first week or so was uncomfortable but not unbearable. The main difficulty was sleeping - being advised to sleep on my back led to a dry mouth and frequent cycles of drinking water and visiting the bathroom. Day by day I would be diligent about doing the physiotherapist’s exercises and walking a little more each day. By about day 10, I could walk half a mile or so in a session, using 2 elbow crutches.

Weeks 3 to 4 saw me extend walking distance to perhaps a mile and a half at a time, reduce down to one crutch and to none around the house. By about 5 weeks the wound was fully healed and I was able to restart swimming and light gym use, at this stage not taking much weight through the hips, and I also started driving again. Just short of 6 weeks I was able to complete a parkrun event (walking), for those not familiar with parkrun, it’s a weekly, timed 5k (3.1 mile) event.

During weeks 7 and 8, I gradually increased the distances I could walk without aids, and spent a lot of time working on strengthening glutes and adductors. By the end of week 8 I was able to put the remaining crutch away for good and increase the range of things done in the gym to include more load bearing and other aerobic activity.

At 8 weeks, I am delighted with my new hip and how it has gone. I feel better than I have done for 18 months or so, and am walking normally and well for as long as I want without any real fatigue. My previous limp has gone and I am still sometimes surprised to find I can just get up from sitting without having to go through a painful stretching process. The movement in the joint is excellent and everything feels normal. There’s still an occasional tightness in my hip adductor after a long walk but I think this is just surgery damage still healing. I haven’t yet returned to running as I feel it would be wise to ensure I am fully healed and strong before doing that, but I have invested in some Nordic walking poles so I can get more aerobic benefit from walking.

So most definitely a success story. I am grateful for the skill and care of my surgeon, and to the fact that I could keep some fitness into the operation through regular swimming. I am grateful my bones were healthy enough to allow an uncemented implant, and that I have a prosthesis designed for active people. I spent some months in denial before seeking treatment but am enormously glad I did get this done. For anyone putting off the inevitable, it’s worth considering the impact of further delay on eventual recovery. This, for me, was probably just at the right time. 8 weeks on I feel back to normal.
 
Welcome to the other side of surgery. You are very lucky to have limited pain and be able to get active so quickly. For those members reading this and struggling, this is not the norm. But it does happen and I'm sure you will continue to see improvement @Coddfish .

I'll leave you a copy of our recovery guidelines just in case you need more information.

Hip Recovery: The Guidelines
We are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help. But you have the final decision as to what approach you use.

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 this BoneSmart philosophy for sensible post op therapy
5. Here is a week-by-week guide for Activity progression for THRs
6. Access 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 that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
Thanks @Jaycey
As your guidance says, everyone is different and I benefited as an otherwise healthy and previously active person who managed to retain reasonable fitness into the operation. I think you not only have to listen to your body but also to your mental health. Regaining the activities I love was the driver for surgery, and the motivation to get back to them has served me well over the 8 weeks so far. I hadn‘t read your site’s guidance until yesterday as I stumbled on the site whilst looking for hip forums so I could pass on my experience to those about to go into surgery. Looking through the lens of my experience, the guidance looks extremely cautious and I am glad to have gone at my pace.
 
the guidance looks extremely cautious
Yes, but as it says in the intro to the guidelines, find what works for you. Our members are very diverse and not every goes into surgery with a high level of fitness. We have to take that into consideration.

In the end, everyone will decide on their own approach. Hopefully we all share the same result - life without hip pain.
 
Happy Two Month Anniversary!
Thanks for joining us and sharing your experience thus far. May it only get better! :)
@Coddfish
 
Thanks @Layla. I joined hoping my experience would give hope to others about to go through this. There are a large number of other people out there for whom it goes very well but maybe they don’t write about it because in general if it goes well you are not looking for help or reassurance.
 
Hey, @Coddfish

I saw on another thread that you had had the posterior approach and the short term restrictions were not a problem. I'm just curious on what your short term restrictions were, and how long they were in place?

My sister is getting ready for a THR and, since I had the anterior approach, I don't know what's involved with the posterior approach.

Glad you are doing so well!! :) :-) (:
 
Hi @Schaargi Yes I had posterior surgery, I have a 6 inch scar on the side of my thigh. I was advised not to cross my legs or bend by more than 90 degrees for the first 6 weeks, and to sleep on my back at first. I was able to lie on my side at about 4 weeks, I think, with a pillow between my knees. In general I didn’t find it too bad, it probably helped that I didn’t have much pain.
 
Thanks!!! For me, the back sleeping is the absolute worse. I'm a baby when my sleep patterns are changed. :heehee: That precaution is just about universal.
 
@Coddfish
You’re experience is almost identical to mine. Posterior, no bending more than 90, back sleep only for first 4-5 weeks. My surgery was 9 weeks ago yesterday. Mine has gone well - I was very active, athletic etc going into this and yes, I also think it helped.
I get random aches in different parts of my quad, glute etc but they’re not awful. I find standing after sitting for a while is when I’m the gimpiest. Just need a minute to walk it off.
best wishes!
 
All of mine were posterior and I would rather it be because the surgeon can see the whole joint area for implant replacement . Posterior also has restrictions . The first 6 weeks the bone is growing and securing the implants. My poor brain had the hardest time adjusting to the implants it always feels so different . And a recent study helps address that issue.
A new study has found that chronic pain caused by hip osteoarthritis, or OA, can actually shrink a brain region responsible for processing sensory cues and regulating consciousness and sleep.
The good news is that the brain shrinkage appears to be reversed when hip pain is relieved by hip joint replacement. Now that I have had time to adjust to the hip prothesis it always remains a positive experience. So not only are we healthier more mobile after hip replacement but also smarter.
 
@Hippielife I have experienced very little pain since surgery. I had a spinal block, which obviously gave total pain relief in the immediate period after surgery. I found I couldn’t tolerate opioids (nausea, hallucination) so reduced to paracetamol plus ibuprofen almost immediately and stopped all drugs after two weeks. I have often wondered if it was related to my pre-operative experience. My osteoarthritis manifested as stiffness, difficulty in standing up from sitting and vice versa, reduction in range of movement etc. Discomfort yes, but nothing I ever described as pain.

I also preferred the idea of posterior surgery. 50 minute operation, no bruising, no swelling, everything seems to have recovered perfectly.
 
@Magsmom I really do think it’s important to stay as active as possible before the operation, and (whilst it appears counter to Bonesmart’s philosophy), early mobilisation and pushing the envelope on what I did post-surgery seems to have helped, not hindered my recovery. I mostly don’t notice that I have had the surgery now.
 
@Hippielife I have experienced very little pain since surgery. I had a spinal block, which obviously gave total pain relief in the immediate period after surgery. I found I couldn’t tolerate opioids (nausea, hallucination) so reduced to paracetamol plus ibuprofen almost immediately and stopped all drugs after two weeks. I have often wondered if it was related to my pre-operative experience. My osteoarthritis manifested as stiffness, difficulty in standing up from sitting and vice versa, reduction in range of movement etc. Discomfort yes, but nothing I ever described as pain.

I also preferred the idea of posterior surgery. 50 minute operation, no bruising, no swelling, everything seems to have recovered perfectly.
I also had posterior THR. My first was 2 years ago and is strong and healthy with good mobility.
I am going in for 6 week check up on RTHR with surgeon today.
This time I wasn't allowed to do any abducter exercises until this 6 week check up.
I just started walking in the house with no aides a week ago, up to a few hundred steps this morning with no aid.
Although I don't feel any pain, I do feel like the muscles around the new hip are a bit looser than my other, especially in the evening when I am tired. Also when tired or I don't focus on clenching my butt when I step, I can feel a bit of a squeak or vibration when I put my hand on my hip while walking. Did you experience this around 6 weeks? I'm hoping to get the green light on exercises to strengthen abducter muscles and hope that takes care of that loose feeling.
 
Hi @Sportsider65 I haven’t felt any squeaking or vibration. Do you know what your prosthetics are made of? I have heard ceramic on ceramic can make a noise. Mine is an oxinium femoral head in a cross linked XLPE cup. Oxinium is oxidised zirconium so a ceramicised metal alloy and XLPE is very high thread count plastic. I cant tell it’s there.
 
@Coddfish I have ceramic on ceramic but no noise. :loll:

Mine was anterior op and I'm very pleased with it.
I had a spinal too and am also very sensitive to opioids so was given paracetamol just on first two days It did the trick along side my wonderful, soothing ice packs.
I felt very fortunate to be pain free - but still dislike sleeping on my back like @Schaargi - and it gives me a dry mouth but apparently I don't snore! Phew.
I did still need an anti nausea jab the day after the op but it did the job so I could enjoy lunch.
I'm walking well and and getting stronger every day. I unintentionally did a couple of miles last Sunday and was fine. Isn't it good to walk pain free?!
I was given a fairly comprehensive exercise booklet on discharge and it's actually quite a good guide for those first weeks.
I really am looking forward to getting back to sea swimming but because I've had five weeks off now I think I might really feel the chill as I've not had the normal winter acclimatising period. So I think I might just wait until April and until then walk up and down the beach in my thermals holding the others towels! :)
 
@Hopper The sea swimmers are out in force here. I live on the south coast and used the sea last November when the pools were closed. I swim for fitness so prefer to be in a pool. I went back after 5 weeks but I think I might have waited longer for the sea - we are one of the areas with illegal Southern Water sewage discharge, unfortunately
 
Yes - it's so popular now. I was a pool swimmer but a few years ago started to go in the sea after beach yoga. It was lovely and whilst covid is around I prefer the sea and exercising outside. Just need to get going again now.
 
Last edited:
The 3 month point is looming up soon (my surgery was 7th September). A few milestones have been achieved over the last 10 days - travelling into London on the train, spending a number of hours sitting in a West End theatre seat, spending an afternoon in Twickenham rugby stadium. Pre-surgery, the train, theatre and stadium seats would all cause problems due to my right leg having been permanently stuck in abduction. It’s been great to experience these things again and without pain and discomfort.

All in all, I am so pleased I had this operation and so delighted with my recovery. I think I said on an earlier update that I was in a better place than I have been for 18 months.

Prior to surgery I had been asked to complete an assessment based (I think) on the Oxford hip assessment, and, I think scored around 50 out of 100. Last week the hospital asked me to complete it again, and I was amazed there was only one area where I dropped points - for still not having fully reach to my toes to put on shoes and socks. I can put them on, but it’s still a bit awkward. The revised score was 98.

Plus I have got my walking parkrun 5k time down below 55 minutes, which is about as fast as I might have walked it a couple of years ago. Looking forward to going back to running it once I get past the 6 month point, if all continues well.
 
What a wonderful update! So many accomplishments and it sounds like you’re enjoying it all. Thanks for sharing. I think it‘s encouraging for those following behind you in recovery to see how they may be engaging in life again soon. A great week to you!
@Coddfish
 

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