THR Post Op - Techniques for closing incision

[Skydove]

Hi all,
Well I’m back. 3 years after having my first LTHR just had my RTHR on 14/12/21 and home 17/12/21. Operation went well and I expect recovery to be okay. Seem to be able to get around on the Ward better this time. Perhaps because I knew what to expect and knew the drill of the nursing staff.

My surgeon said I was to have a R Anterior THR closing the incision with dissolving stitches. I was quite annoyed to find out post operatively that he used STAPLES to close the incision. We had discussed this at his rooms and as we live in a remote rural area about a 4 hour one way drive from hospital and his rooms, he said he would do dissolving stitches as the recovery is easier and I would not have to come in to his rooms or hospital or med centre to get the staples removed. After the op, I asked him why he put in staples, he sia, “oh yes, you wanted dissolving stitches” that was all. No explanation. I also noticed the anterior scar on the L hip was beautiful, straight and clean. The one for this right hip is huge, curved and a bit like Frankenstein with all these staples. I am at a loss!!!
When I googled this it stated that staples are used by surgeons as they are quicker and they can put through more patients if they don’t have to sew someone up. This was extremely disappointing to me and I feel like I’ve lost faith in my surgeon who up until now was very good.

Has anyone else experienced this?

Thanks.

 

[Jaycey]

@Skydove Welcome to the other side again! So sorry you are disappointed at having staples. Do you have a local family doctor who could do the removal? This can be done by a nurse in the office. Or do you know someone who is a nurse?

It is disappointing that you didn't have the incision closure you wanted. But given all the pressures on health systems these days, I am sure surgeons are trying to work as quickly as possible to treat as many patients as they can.

Please don't worry about how the scar with look. I had staples my first THR and glue and dissolvable stitches my second. Both scars look the same now - just a thin, white line.

The good news is that you had the opportunity to have your THR! Here in the UK there are literally millions of people waiting for surgery.

I'll leave your recovery guidelines here for you.

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​

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 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

Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[Skydove]

Hey there Jaycee,

Thanks for your reply and good to hear from you again.

Yes, I do understand the pressures on the health system and that’s why here in Australia my husband and I choose to go private for the last 40 years. We’ve paid hundreds of thousands of dollars for good health care ie private doctor and private hospital which means by doing so we and any other number of people with private health coverage are not u sing the public system and are paying top dollar for everything that is done> We not only pay for the hospital and surgeon, but for bandages, blood tests, X-rays and every little thing that’s done whilst we are in hospital. Therefore if a private surgeon said don’t worry, I’ll do dissolving stitches so you don’t have to travel another 8 hour round trip to get the staples out, he jolly well should do it. We live in an isolated remote rural area with no town, no medical centre, no shops, no nothing. So, Iguess that’s why I was so disappointed.

On the converse, if a surgeon said I’ll remove your gallbladder and in fact took a kidney, I am sure you would not be too happy either,

I am not worried about how the scar will look, it is mainly having my husband and I both having to take a day off work to travel for four hours to get them out then I four hours back home is what’s making me feel annoyed. Especially coming from a surgeon who is receiving thousands of dollars to carry out this operation. So naturally I’m feeling very jaded right about now.

Incidentally this is not me having a go at you Jaycee as I always appreciate your input, I am just very annoyed with a fee paying health provider who simply forgot what he was supposed to do.

If he did use staples to do a quicker operation, then that means he makes more money by doing so.

Really jaded today.

Hope you understand I am just venting! I guess when you’’re paying for everything yourself, including the implanted device and having planned for everything, including the trips in and out, you start to question things when they do not do what they say they are going to, for no other reason than they forgot. Okay so that’s my rant for today!

 

[Hopper]

That's so disappointing for you @Skydove.
I've an anterior too and can't imagine having staples in my groin!?
Most of us would be pretty jaded too if a surgeon just 'forgot' the agreed protocol - private or not.

 

[Layla]

Hello Skydove and welcome back. I’m so sorry you had this experience.
I feel your frustration and fully understand your disappointment and I think you should let your surgeon know how unhappy you are about what he did and why, by sharing all you‘ve communicated here either in letter, or in person. His reaction was dismissive, I’m sure only adding to your frustration. You made it perfectly clear why you didn’t want staples and your reasons make sense given the time involved to make the trek to the surgeon’s office. Hopefully your dissatisfaction prevents him from going against his word again.

All of that aside. I hope you’re doing well and I wish you a happy holiday season with all those you hold dear. Stay in touch so we can follow your progress.

@Skydove

 

[Skydove]

Hi Layla

Good to hear from you again.

Thanks for your comments, I was just annoyed at the time and thinking of all the inconvenience etc. but actually, I need shut up and realise just how lucky I am to have had the hip replaced, whether or not he did what he said he would or not.

We do have a different health system here in Australia, so if you are working and can afford to pay for private health cover, you do. That way you can select your own private surgeon and private hospital, the difference is even though you pay big premiums each month for this privilege, you still have to pay the hospital excess before entering and every little thing is charged for, which you pay when you leave. Some things are fully covered others aren’t so quite different.

I just need to stop and think about how fortunate we are and be grateful for our wonderful health system, as things could be far far worse.

So thank you lovely BONESMART ladies for your advice and support and listening to my rant.

Cheers

 

[Going4fun]

It's disappointing for sure--even demoralizing that your surgeon "forgot" this ... which should be impossible. Surgeons should be following checklists. There should have been a nurse or operating assistant who knew this information and the surgeon should have a system for pausing to think before closing you up.

No, you don't need to shut up. Sometimes making ourselves prematurely shut up actually prolongs the disappointent. But I hear you: the point of going to an expensive private guy was to avoid problems like this. Maybe use this mess-up to claim any extra time you want with the surgeon on your removal visit and to claim fast return calls and time at future appointments.

It is true, though, that when the hip heals and you are mobile and without pain ... heck 5 round-trips would have been work it! And who knows: besides this messup, he might have done a fantastic job. And that's worth celebrating.

Speaking of which, you're about 5 weeks into your recovery, how ARE you doing? How are you moving? How is your pain? How subjectively does the new hip "feel"?

 

[Skydove]

Hi everyone

I am now back in hospital because my hip replacement fractured and I now have a broken hip. Is this a normal occurrence? I am feeling very upset and weepy.

 

[Skydove]

Hi Going4Fun

Unfortunately I am back in hospital, yes 2 days before Xmas. I was operated on for TRHR on 14th Dec and discharged from Hospital on 17th Dec. on 23rd Dec I was standing in my living room and all of a sudden a very loud CRACK immediately followed by pain and I could not weight bear on my right leg at all. Luckily My husband was at home at the time,

Called ambulance, taken to hospital, X-rays and CT showed fractured hip.,

Now I cannot walk at all, cannot get to the bathroom and can barely move at all.

I am feeling very unhappy and weepy now.

 

[Layla]

Hello Skydove, I’m so very sorry to hear of what you’re going through. How frightening and sad. It is a blessing you weren’t alone and had the support of your husband as you waited for an ambulance. It’s understandable you’re feeling weepy, it had to be quite traumatic for you. I can’t even imagine. With the time difference I’m not sure whether you’ve had surgery yet, or you’re still waiting. I hope your comfortable no matter what. Please know we’ll be thinking of you and we’re here for encouragement whenever you need us.
Big hugs to you!
@Skydove

 

[Jaycey]

@Skydove so very sorry to read your news! Breaks do happen during this procedure but they are rare. Not sure how this could have been missed in a post op x-ray. You haven't had a fall have you?

Please keep us updated!

 

[Going4fun]

I am so sorry to hear this ... this is horrible ... you must be really questioning your surgeon right now.

This is horribly frightening. Keep updating us please ...

 

[Seattle1522]

@Skydove
So very sorry to hear you’re having such a tough time of it! It sounds just awful. I hope things improve for you very soon…will be watching for new updates - sending thoughts for healing and strength.

 

[Eman85]

Sorry to hear this has happened. You say your hip broke, do you mean the bone or the implant. I think I remember someone having an implant break, others have had a femur fracture. I can't imagine the pain and how frightening this must have been.
@Jaycey I think the surgery dates are incorrect, might be from a typo from the first post.

 

[Jockette]

@Jaycey I think the surgery dates are incorrect, might be from a typo from the first post.

Thanks for calling this to our attention, it has been corrected.

 

[Jockette]

@Skydove I‘m so sorry you have a fracture.

 

[CricketHip]

Oh @Skydove , so sorry for your bad luck with the fracture. Try to keep positive if you can. But can just imagine how disappointed and in pain you must be right now. ((Hugs))
I am guessing that your femur fractured where they implanted the prosthetic?

take care and you will heal, it’s just a different time line for now.

 

[Sigma1]

Unfortunately I am back in hospital, yes 2 days before Xmas. I was operated on for TRHR on 14th Dec and discharged from Hospital on 17th Dec. on 23rd Dec I was standing in my living room and all of a sudden a very loud CRACK immediately followed by pain and I could not weight bear on my right leg at all. Luckily My husband was at home at the time,

Called ambulance, taken to hospital, X-rays and CT showed fractured hip.,

That's the first I had read of such an event. That's sad.

Tell us more. What fractured -- femur where the stem was inserted?

 

[Boxmaker1917]

Skydove, what a discouraging as well as painful set-back. I'm sure you feel especially sad and lonely with this occurring right before Christmas. For what it's worth, there are a whole bunch of us out here who are thinking about you and hoping for your complete and speedy recovery. Wishing the absolute best of everything.

 

[Skydove]

Hi everyone,

Thank you all so much for all your posts which touched me greatly.

Here’s an update.

After waiting hours in emergency at the hospital on 23rd Dec, they finally contacted my OS who was away on holidays at the time. He ordered X-rays and a CT. The X-rays showed nothing but the CT definitely showed a fracture of the greater Trochanter bone. Dr in ER said my OS told him to treat it conservatively which means no surgery and to give me pain meds. As I can’t walk or weight beat all on the leg, they admitted me to this small country regional hospital.

I am very worried as I am not due to see my OS until 24th Jan,

I went home on 25th of Dec with no treatment and just some pain killers. Luckily I have a “shopping Walker” at home and I have been using this to get to the bathroom and back. Slow but sure.

I still cannot walk and nothing has been done since it happened. I am worried and upset as I don’t know what to do and now my tail and back are starting to hurt as I’ve been flat on my back since the 14th of Dec, cannot move.

I rang my GP and got an appointment on 29th Dec to see her and have had the Staples removed from my leg and groin. She said wound looks good, but we need to wait and see what OS says. Unfortunately his practice is a 6 hour drive from us and also my GP is a 4 hour drive as we live in a remote rural area, there is only our sheep farm out there and nothing else. Closest town is 40 mins away and it took around 50 Mins for ambulance to drive out to our farm

incidentally, I did not have a fall, bone just spontaneously broke (went off like a gunshot). Doctor in ER said I most likely have Osteoporosis. My GP said she needs to have a Bone Density Scan done and bloods tests before she would diagnose Osteoporsis which she ordered. I’m having Bone Density scan on 6th Jan along with Bloods tests.so this is another 6 hour trip to get to these places.

So, that’s the update. I have had no treatment, OS is still on leave,

I am very upset, and wondering what is going on. Not sure I even want to see my OS ever again.

From the treatment I received at the hospital (which was only 2 x Panadol) the whole thing has been a nightmare and it is still going on. I am frightened and scared that the bone will start repairing itself the wrong way and the leg will be crooked or shortened. At the hospital before discharge, I was told to go home and stay in bed as there is nothing that they can do for me. So that’s what I have been doing. Dr in ER said it will take up to 6 months for bone to heal. Does this mean I have to be in bed for 6 months?

What will I do?I am hurting from laying flat on my back for 17 days now and I won’t know anything else till after the scans.

Thanks again to everyone who answered my previous post, I was very touched and comforted by your words and it made me feel not so alone.
I am very scared and upset at this point.