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pharman

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Well, I had the RTHR on Monday, Nov. 24th. I'm home and doing fine. Almost no pain, and getting around fine. My question is concerning the precautions we are given. Not to bend the joint past 90 degrees, etc. I am so worried about bending too far or twisting too far. I fear all the time that the joint will dislocate. The PT I worked with in the hospital and the PT who has visited me at home both told me the joint was secure, but it just seems like all I've heard about are the precautions and I really worry about it.

Does that get better with time? Does there come a time when we don't have to take the precautions? So many of you here are running and swimming and hiking...I'm so afraid of hurting the new hip.

Your advice is greatly appreciated.
 

UTdave

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Pharman,

Congratulations on the surgery! I suspect every surgeon is different, but, in general precautions seem to be lifted around 6 weeks. Your chance of dislocation will vary with surgical technique, device used, what disease you had that led to the replacement and individual patient factors - but at the end of the day, early post-op seems to be the risky period and, thus, the precautions.

Have your PT bring you to the edge of your allowed ROM. You may be suprised at how far 90 degrees is! I remember waking up my 2nd or 3rd day home and thinking I had dislocated while asleep because my foot was pointed off to the side. In fact, it was just pointed out like any normal person's would be, but years of limited range of motion made it look and feel terribly abnormal from my point of view!
 

Laurie

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Hi, I had the same surgery on August 26 and remember feeling exactly the same way, probably for about 4 weeks. AS other here have said, seems the body tells you by a distinct discomfort if you are moving past "precautions." Soon you will be more relaxed, as your hip heals. I panicked when I took a good fall hiking a few weeks ago. But except for some good bruises, the hip and I were fine.

Have a great recovery. Looking back, the time goes fast and some of the details early on fade in memory. Yesterday, at over 3 months, I almost ran I was walking so fast. Felt good. Amazing surgery.

Laurie
 

Josephine

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Well, the first thing to remember, pharman, is that dislocation is a risk not an inevitability. And the restrictions are just a precaution. Seems to me like they didn't explain to you the reasons for these precautions very well so let me try.

First of all, all the muscles that have been disturbed or even cut, have been securely stitched back together and the main part of the healing has happened after about 10 days. But what needs to be restored is the tone of the muscles and this is why the restrictions are necessary. Usually it's just for 6 weeks after which it is reckoned that the muscles are back to their normal state and can hold the hip firmly on their own, just like in a normal hip.

So in that time, you have been advised not to put the joint into positions where it might slip out of place but it's not something that happens slightly. You'd be well aware of the consequences if it did. So don't get too anxious if you get pains and strains around there, you're bound to get those. But putting the joint into 90 degrees of flexion is to be avoided expecially with turning the leg inward. This includes sitting in low, soft chairs, in and out of the bath and sitting on low loos. Check out this site - is good and clear.

Also when you get into and out of a car there is a safe way of doing that which you can see here.

Other than that, I'm sure you have no need to worry. Once the 6 weeks are up, you can go about your life and totally forget you ever had a new hip put in!
 

JudyS

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Jo is so right about forgetting you ever had a new hip put in you!!! I have been at that point for a few months.
I had my right hip replacement on June 6th. I had a traditional posterior approach with full 3 months of restrictions. I was swimming shortly after 3 weeks. At 3 months fully back to my hiking trails, biking the gym, you name it.
I do remember being really worried about breaking the rules accidentally. Like when sleeping. I told the nurse I would probably need to duck tape my leg at nite so it would not cross the other one!!
Sure enough, my leg just could not do the "not allowed" moves. When headed in that direction, the discomfort would stop me. You will continue to feel better and worry less, then your restrictions will be lifted!!!
For now rest!!
Judy
 

Shamrocker

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My in-home physical therapist told me the riskiest time for *violating* hip precautions is when you start to feel better and have easier mobility. He was absolutely right. When I was first home and quite infirm and miserable, the precautions were at the very forefront of my mind, but as things improved, there were a few times I caught myself just in time. I could see how easy it would be to slip up once you're feeling more "normal" - walking without aids and not having as much pain. My PT said he's actually seen quite a few dislocations over the years (maybe he was just trying to scare me into compliance?).

I remember shortly after learning I would need hip replacement, I was speaking with an acquaintance who'd had it. I mentioned how I was so looking forward to being able to cut and polish my own toenails again. She told me that I would NEVER be able to do that, and that the hip precautions were LIFELONG!! I was positively horrified at that thought! And at the time, I didn't know about this wonderful community. I'm so glad that turned out not to be accurate. Maybe it is for some rare cases, but most of us are, within a few short months, happily getting back to doing lots of things we haven't been able to for ages. And it feels fantastic!

You're off to a great start, Pharman, and I'm sure you'll be back to normal in no time. Just remember, no matter how good you're feeling, you still just had major surgery and you need to be kind to yourself.
 

Josephine

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I've seen quite a few dislocations as well BUT most usually occur within the first few days and the rest in the following 2-3 weeks. They're also most often in the elderly and/or more frail patients who didn't have good muscle tone to begin with.

Don't forget that this issue of regaining muscle tone is a gradual thing and whilst your muscles will be below par for the first week or so, after that they'll gradually start building up. As they do, the true risk of dislocation diminishes.
 

Peta

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Speaking of precautions - can anyone advise the correct way to pick something up off the floor (without using my trusty reacher?) I am 7 weeks post-op THR LHS and doing extremely well. Walking (almost) normally with no aids, and muscle strength improving daily. I'm more than happy to comply with the precautions for as long as it takes - but I'm wondering how I will pick things up off the floor once they are lifted? Also - as a woman of 49 - how do I go about cutting/polishing my toenails?? I am SO looking forward to being able to do that myself! LOL
 

PRGal

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If your doc hasn't lifted precautions yet, that's definitely a question for him/her, just to be safe. I had anterior approach THR, with no precautions at all (sorry--not rubbing it in, that's just how it is), however, certain movements were difficult/painful in first few weeks, so I'm happy to share how I would bend over & pick up things (think I saw this on some web site, but can't be sure). Assuming your "good" leg is fully functional, simply slightly extend the operated leg behind you and bend the knee of the "good" leg to lower yourself to reach the object you want to retrieve. (It's kind of like an old-fashioned deep curtsy.) This keeps your operated hip from bending more than 90 degrees & uses the thigh & butt muscles of your good leg to do most of the work both going down & coming back up. I used this technique even in the first week at home while holding on to my walker so I could reach the dog's water bowl.

As for toenails--however you used to do it before--comfortably-- is how you should be able to do it once muscle tone & flexibility are back. That's the really cool part of THR! (Flexibility seems to be key. My normal-hipped, long-legged hubby is apparently as flexible as a rock--he resembles a tangled up praying mantis when clipping his toenails! :) So moral of the story--if you couldn't play the piano before, you can't now! :)
 

JudyS

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My precautions were lifted at the 12 week point. To pick things up off the floor, I bend at the knees. It is a challenge until the quad muscles are strong . Then there is something called the golfers lift, your back leg goes straight back.
You will soon be there.
Judy
 

Peta

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Thank you both! :) I saw my surgeon at the 6 week mark and he said to continue precautions until 12 weeks (which I will definitely do), but I neglected to ask him how to go about picking things up off the floor! And as I won't be seeing him again until early April 2009, I figured someone on here would set me straight! Thanks for your help - I appreciate it! Merry Christmas everyone - it's going to be a hot one here in Brisbane Australia - around the 32 degree C mark! Thank goodness for air-conditioning!
 
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