Possible hip replacement?

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tessa

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I have had problems with my hip , on and off, since I was child. Intermittent pain, limited movement (could never sit cross legged!). In Sept 2015 started getting pain in my hip more or less constantly. GP requested X ray which showed "mild osteoarthritis " in both hips and a dysplasic appearance to left hip. Referred to MSK service had physio and 2x steroid injections, first was amazing for 6 weeks , second limited effects.

I am now taking naproxen and paracetamol throughout the day and even with this am still in pain, limping and can't walk more than half a mile. I used to be so active, swimming, walking at least 10 miles at the weekend. I struggle at work getting up off the floor ( I am a nurse assessing disabled children).

I have now been referred to a surgeon, appt on 20th March for consideration of hip replacement. I don't want surgery but can't see any other way forward, but am worried as I only have mild arthritis (but not mild symptoms) I will end up having to struggle on.
Would be good to know people's views and if anyone has has similar experience ...


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Well we have all been in that space. You get the diagnosis and just can't deal with the solution for all that pain. The good news is that waiting and wondering about the surgery is worse than the actual event! You may have "mild osteoarthritis" but dysplasia will contribute to hip deterioration. Sounds like you have explored all the alternatives. Time to move on!

Have a read around our hip recovery area. Lots of happy hippies who overwhelmingly agree that they waited far to long for this life changing surgery.

You will be active again post THR! Swimming, hiking - great exercise for new hips. We are with you through this journey!
 
Hip replacements are not to treat the arthritis, they treat the pain so the patient can get back to a normal life! From what you've said, you are more than ready for a replacement and should get it done sooner rather than later. Allowing your hips to deteriorate will only make for a more troublesome recovery.
 
Hi Tess,
Welcome! I am also a new to this site. About a week. Congratulation! for finding the site so early. I wish that I had. The mental transition seems to be the hardest. I am having surgery on May 2nd and still have moments of anxiety 2 or 3 times a week. I imagine as one gets closer it will be more frequent. The one thing that I don't have is doubt about having the surgery. First I remind myself to only concentrate on what I can do today. Each day I do a little research so I know what to expect. I read the suggestions and stories on this site. I smile about what the surgery will allow me to do physically again. We are both going to get through this process. It took me from August last year December to make the call in January to be scheduled. You are definitely not alone. It seems like support is email away anytime everyday. Sending you warm hugs.
 
Hip replacements are not to treat the arthritis, they treat the pain so the patient can get back to a normal life! From what you've said, you are more than ready for a replacement and should get it done sooner rather than later. Allowing your hips to deteriorate will only make for a more troublesome recovery.

Thank you! I think that is what I wanted to hear, I am just worried I will see the surgeon who will say things are not bad enough looking at the X ray.
I have been putting this off for at least six months so it's not like I haven't thought about it, and of course nobody wants to put themselves through major surgery for nothing.
As you say, I just want my life back!


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:hi:@tessa - and :welome: You'll be so glad you found Bonesmart. It has been a lifesaver for me. First I was told I needed a hip replacement, and when the surgeon looked at my x-rays then told me I needed both replaced. Big shock - reckoned I'm far too young for this. However, the fact that I was in pain and my life was shrinking before my eyes I hit Bonesmart with every question under the sun, airing all my anxieties and asking questions. Then everyone flooded back with answers, suggestions and professional advice and support. I couldn't have been more blessed.

The fact is your surgeon knows what he's looking at so if its a replacement then I do suggest you don't delay. The longer you wait the worse it will get which will in turn impact on your recovery. You might like to click on my pre and postOp threads (below my signature). When you read the postOp one I suggest you scroll through to my detailed account of surgery day and subsequent days. Truly the waiting was the worst. Have a good read around the library - it's really instructive. I felt the more forearmed I was the more accustomed I felt to the idea of proceeding. Getting you, your home, your recovery aids in place will make you feel more in charge. We're all here to support you. :friends:
 
Oh I don't want to delay, just worried the surgeon will! I am retiring in September and want to be able to do all the things we planned!
Just sitting here waiting for the pain relief to kick in....just getting up and showering is enough to cause pain!
 
Brill - then if he won't do it find another experienced surgeon with a good number under their belt. Josephine is a good source for advice on that but see how your first consultation goes.
Yes, just going about everyday things (which others take for granted) is such a trial.
 
UPDATE.
Well saw the surgeon who says is is reluctant to replace the hip as "there is still reasonable joint space" .
Feeling so deflated, I don't care what it looks like, just how it feels!,,
He has arranged an MRI, just to make sure he is not missing anything and did talk about possible key hole surgery, but reluctant to do that as it may make things worse.
So fed up!


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@tessa it's helpful to emphasize the pain and the impact OA has on your everyday life, day and night. Write down all the things you cannot do, be specific, and note the pain, tip: try not to underestimate your pain score. Maybe see another OS, it's good to get a couple of opinions. Xrays are very useful but don't indicate levels of pain or disability.
 
Hi @tessa and welcome,

Just curious - did the OS ask you to complete some sort of questionnaire ?

Maybe something like this?

http://www.orthopaedicscore.com/scorepages/oxford_hip_score.html

I would expect that all OSs should use something similar to this to objectively score the impact of hip issues on lifestyle? But maybe my expectations are too high.

This information, in conjunction with x-rays, pain levels etc, should be what is then used to grade the severity of hip issues.
 
Yes, that was done by the MSK service as part of my referral ( scored 25).
He seemed to base decision on xray
 
:fingersx:I am one of those people who likes more than 1 opinion, no matter what. So horseshoe may be correct in you needing another opinion. My pain was for a different reason, and after my THR, but I absolutely needed to advocate for myself and make sure whoever I talked with knew how it was affecting the quality of my life. When someone would not listen, I would try again or move on. It was actually me trying another OS, and me knowing what I felt better than anyone else, and not giving up trying to get help, that got me my answers and a solution. Of course I had some great help from these very moderators on this site. Don't give up! You should not hav to live in such pain. Keep working to find the answer for yourself. ...And I am well aware of the fact that when you are in pain, it is the hardest time to advocate for yourself :(. Sending positive energy :fingersx: and keeping fingers crossed-Cathy
 
@tessa Hi and welcome! The first surgeon I went to told I was too fat for hip replacement and that my xrays weren't that bad. Later I had an MRI which detailed the "exuberant osteophyte growth, the widened acetabulum and the flattened head of the femur" which supported the pain level I was feeling. I went for a second opinion and what a difference in Doctors. This one took one look at my xrays and said, "You need a new hip?" I'm set for surgery 4/4.
Don't let one doctor deter you. Only you can determine your pain. Best of luck to you!
 
Well I have an MRI arranged for Friday. I have also received a copy of the consultation letter which says, " as there is minimal joint space narrowing on X ray I think an MRI scan would be useful to further evaluate the hip and to evaluate the extent of degenerative change before considering a hip replacement" so it appears I will have to wait for a decision!
Interestingly I looked up the surgeon on the NJR, he is not very experienced and has a very low rate of surgery on younger patients....although that may be a result of the demographics of where I live!
 
Interestingly I looked up the surgeon on the NJR, he is not very experienced and has a very low rate of surgery on younger patients.
Based on this I would seek a second opinion from someone more clued up on younger patients. This is about quality of life - living in pain is not necessary.

BTW - an experienced surgeon usually does not need an MRI. Most just look the the x-ray and diagnose based on it.
 
FYI Burlington, the town I live in is small, and even though there is a big hospital here, I drove 2 hours for another opinion and then 5 hours for a 3rd, though that was for evaluation of something that was already wrong with my surgery. My revision and now this surgery, were done by same surgeon but at the 2 hr away place. good luck with the MRI. I hope you find some answers for yourself. -cathy
 
Hi Tessa,
Good luck with the MRI. In my case, it was only after the results of that showed Labral tears and more detail of the OA that a THR was recommended. I also then did more research on hip surgeons and got a second opinion from a surgeon who was very experienced. He took one look at the x Ray and asked me why I was waiting as I would get the same opinion if he showed it to 20 other OS! I agree with Jaycey - find the right surgeon.
Best wishes
Diane
 
Well I had my MRI ( very uncomfortable lying flat for 15 mins!) and am seeing the surgeon again on the 24th. Hopefully I will be able to present a good enough case, really do not want to have to start again with another surgeon, although of course if I have to I will!
 
Tessa, didn't you say the OS was not very experienced? Think it is vital to get an experienced surgeon to have best chance of a good outcome. Far better to spend a bit more time on research and be confident in the ability of the OS, than to have regrets later if things don't work out well.
Best wishes
Diane
 
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