Potential hip replacement

[Jayhawk]

First a confession....I found this site a week ago and have participated in the knee replacement side as I have recently had total arthroplasties on both knees (eleven months ago on my left knee and four month month ago on my right knee)...my surgery and recovery had been exceptionaly successful!!! Now the confession....was searching for information on hip replacements when I found this site.

My situation is that I played sports at the collegiate level and have been athletic all my life (played baseball, basketball, play golf, racquetball, snow ski, weight train, etc.)....unfortunately l had five knee surgeries prior to the total arthroplasties. I fought severe arthritis for years, and years and finally had no choice but to have my knees replaced. As a result of walking with a limp for so long I have damaged my hips and now my right hip has degenerated significantly.

At this point, my hip does not prevent me from participating in any physical activities, nor is the pain debilitating. At my three month appointment with my doctor for my right knee we discussed my hip condition and he scheduled me for a cortisone injection (the procedure was performed in the hospital with imaging). Interestingly, the radiologist had a difficulty getting the needle into the joint and actually had to repeat the procedure three times.

So, my situatiion is that I know I am a candidate for a hip replacement but do not know when..... know I am not ready today!! If possible would like to delay for a couple more years....as long as the pain is tolerable. When I made the decision for my first knee arthroplasty I did extensive research on the surgery, doctors in the Houston area who were specialists in knee arthroplasties and even the prostheses manufacturers and then commited 100 percent to the process. I will do the same for the hip.

Would welcome comments.


Steve
Spring, Tx.

 

[Judles]

Welcome, Steve! You certainly have been through a lot with yur knees! I just have one question..since your hip has deterioratd, why wait to have the hip replacement? I've found tht cortisone shots help in the beginning, but become less effective as time goes on! Besides, who wants to keep getting shots into the bone? Sure must NOT be good in the long run!! Good luck in your research and keep us posted!!

 

[TBONE]

Hi Steve and welcome. It's a shame that you are a Jayhawk. Had you been, oh, I don't know, a VU Wildcat, for example, perhaps we could have helped you more. :0) Kidding aside, I am a big KU fan and if you played basketball at KU, then that is a very high level!
My situation was completely different from yours as I never addressed my arthritis until it was very late in the game. I can tell you that my OS friends advised me to (1) take PT, then (2) get cortisone or other shots, then (3) consider surgery as a last resort. My sense is that hip surgery has advanced a lot so that may not be completely true anymore and living pain free now is also important. So, I would say that when your quality of life changes substantially, it's time. I am told that you will know when it is time. In my situation, I was in immediate need of hip replacements.
Someone, perhaps Josephine, will give you a link to an article about orthopedic surgery to help in selecting a surgeon. That is a very good place to start. As I recall, Texas has some very good surgeons, so that article may be a good starting point to identify hospitals with good reputations for orthopedic surgery. You might ask your TKR surgeon also for a recommendation. I actually was assisted in finding my surgeon, in part, by emailing privately, a BoneSmart member who had bilateral hip replacement surgery with great results. I also did a lot of additional homework though.
Many people, including myself, spend a lot of time researching prosthetics. My post-op sense of it is that the choice of an OS is far, far more important than the choice of a prosthetic. Having said that, I researched and requested large, metal on metal joints, and my surgeon agreed. But each of the joints, whether metal, plastic, or ceramic, has its advantages and drawbacks or risks. My OS used an anterior approach as opposed to lateral or posterior which, in hindsight, helped me with early recovery. So you may want to look into some of these alternatives. However, here again, they all appear about the same after a period of time.
This website proved invaluable to me in my decision making process. The people on it are going through or have gone through similar situations from all over the world and are pleased to share their experiences with you. You might also check out surfacehippy, a website for those considering resurfacing, as opposed to THR. Depending upon your age and other factors, that may be an alternative to consider. I think most hip replacement candidates ought to at least consider whether resurfacing is appropriate for them.
Best of good fortune on your decision.

 

[Jamie]

Here is a link to the (broken link removed: https://bonesmart.org/clinic_lookup.php that will help you locate doctors and clinics in your area. That's a good place to start. Also check with your primary physician and the idea to ask your knee doc is a good one too. Since you are in Philly, you should have plenty of great doctors from which to choose. Interview a few and go with the one who makes you most comfortable and has the solid experience with hip surgery.

 

[Josephine]

My advice is - don't wait too long! There are two principle reasons though I am sure others could come up with more.

1. As the pain increases, you will start to cut back on your activities. I expect you know what I mean from your arthritic knees. But don't let it rob you of too much of your life. What you lose you will never get back. And early replacement means you recover more quickly as well.

2. The bones, principally the femoral head, can get deformed as the disease proceeds. If the deformation gets too advanced it makes the job of the surgeon more difficult which means a longer op, longer anaesthetic, etc., etc.

Just don't wait too long!

 

[tapan]

Hi!

I would agree with Josephine about not waiting too long to get a total hip replacement. I am 21 years old and I have my left hip replacement surgery due in 3 weeks from now. The pain in my left hip is intolerable to extents that even basic walking seems bit of a challenge to me. The best option for me is to rest it out by sitting or lying down in bed.

I think the reason why everyone is recommending you not to wait is to avoid a bilateral hip replacement. Waiting too long for your operation means more body weight being put on your defective hip which will eventually wear out the cartilage completely and you will end up in the same situation as me - extreme pain. As a side effect, your other working hip (non defective at the moment) starts taking most of the load which will also deteriorate over time as well. This would lead you to have surgeries (total hip arthoplasty) being conducted on both your hips. I would say just get it done asap without waiting any further to avoid any future complications on the rest of your body. Having a bad hip means your body posture is not normal and has bad long term effects on your spinal cord. You don't want that!

For me, I have AVN (avascular necrosis) and my left leg is 1.5 inches shorter than my right leg (due to premature growth in the left hip). As a result, my right knee occasionally pains due to all the burden transforming on my right hip. This leads to pain in my lower back (near the spine area) due to bad body posture. This is the reason why my doctor recommended me to get my surgery asap to avoid any further damage to my spinal cord and my right knee.

I am not saying the same will happen to you (as our conditions are vastly different) but in my opinion, better being safe than sorry!

Also, I think your doctor will 99% recommend non-cemented hip replacement for you. You are young and its a known fact that artificial hips don't last forever. Due to their limited life expectancies, further revision surgeries will be needed in future. Non-cemented hips make it easy for future revision surgeries. Even in non-cemented hips, there are various types available (ceramic, metal, titanium, etc.) Talk to your doctor to find out which one is best suited for you.

 

[TBONE]

Jayhawk--I, too, would have to agree on waiting too long. I figure that having had several knee surgeries, you may be aware of this. My only regret was that I ignored my problem for so many years and I am paying a price for it now with reduced flexibility and much required PT.
Here is the link from U.S. News that someone sent me. I hope it helps.

https://www.usnews.com/directories/.../name+/metro_area+/zip+/distance+/detail+less

 

[mdakota]

hi jayhawk. i'm with the dont wait tooo long crowd. but i have two more things to add. one

you may be a candidate for synvisc at this point in time, adds extra lubrication and has been used for years and is approved for knees but is now being done for hips. if you have a joint space it can be done under flouroscopy. a friend had it done and has been fine for the last year.

#2. you might be the perfect person for resurfacing which there is a home for here. especially if everything else looks good. that might delay a total for 10-15 years, and stop the pain.

of course i'm not a dr and jo is a great resourse, but if i had had either of those options i really would have jumped at them. i wish you the best.
monique.

dont let yourself suffer. waiting too long can cause nerve shortening like i'm dealing with now and irreparable damage, even with the thr.

 

[webbie73]

Jumping on the bandwagon here. My advice it not to wait too long. For the reasons Josphine stated and also to not let the muscle in your leg shorten from lack of proper use. Your recovery could be longer if that happens.

Another thought....look into MIS computer navigated surgery.

Keep coming and let us know what you decide.

 

[Jayhawk]

Thanks for the comments.

Difficult decision for me right now as I am not limited in any physical activities. I worked extremely hard on my knee with physical therapy and continue to workout in the gym....ride a bike and weight train. Also, playing golf and have been able to start playing racquetball again (have eased back in slowly as I have not been able to play competitively for a few years due to knee problems). Interestingly, I have not been physcially able to run for several years.....I can now run!!!! I was not a "runner" before and do not plan to jog now....but was a tremendous moment when I could physical run again without pain. My recovery from the knee arthroplasties has been phenomenal!!

So the dilemma....the radiologist stated that I had significant degeneration of the hip joint...and I do have some stiffness and experience some pain. I guess that I will continue my due diligence on the hip surgery and when I begin to lose my level of capabilities will move forward with the surgery. Also, will learn more about the Synvis injections for the hip...had several rounds of Synvis and Hyalgan injections in my knees.


Steve
Spring, Tx.

 

[rad14]

Jayhawk, What are you thinking??

Git'er done. Why put off the inevitable! Your in great shape and can have a tremendous recovery now!
I just had mine done 5 weeks ago and I'm not in as good of shape as you , but I'm doing great on my recovery.
Knees are worse than hips, trust me. I,m a firefighter and theres guys on the job that have had both done and one guy who had 2 knees and a hip. Not waiting is the best thing he ever did. If I would have known this 3-4 years ago I would have done it then instead of going thru all this pain and discomfort plus herniating a disc beacause of bad hips. I just don't get why you would put yourself thru all that suffering and shots and pain and shots and pain and well you get it. It aint gonna get better!
I have no pain and some lack of mobility in my right hip, but no cartilage either. Guess what, 8/4/09 is my next surgery and can't wait. I found out in Feb I had bad hips. May was my left and soon the right one. You will be so much happier when you get it done. I guarantee it!!
Good Luck to you.

 

[Jayhawk]

Very convincing arguement!!!!!

Steve

 

[diane.US]

I feel you, Steve. I just had both hips replaced and now my knees are acting up with all the exercise! We are what we are, and thankful for the fixes am I.