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THR Pros and cons of early intervention

Hurtiehip

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Hi, I am looking for some advice? I do realise in reading through the level of pain and discomfort that some of you are in, that at the moment I have a mild to moderate presentation, but want to understand what the options are in earlier intervention, and how wise it is given my age.

I am a relatively fit and active 53 year old. Over the last couple of years I have had what I now realise are classic symptoms or oesteoarthritis in my right hip (limp because of reduced movement, moderate pain while walking) this week I went to the consultant, I thought to look at what he could do to help with a bone spur, and have come away with the more shocking diagnosis of arthritis.

His prognosis was, at some point I will need a new hip, he was clear on that; but not yet. I am Not yet in sufficient pain, and at my age, he would not yet consider a replacement, because the later you have the replacement, the less likely you are to need a replacement. (He did talk through a steroid injection, but having had one last summer, which did not really help the underlying stiffness, it does not seem worth it.)

The more I think this through though, it is already limiting my ability to do what I want, running is now limited, long country walks are only doable with the help of ibuprofen, and the backpacking around Europe that we would have been doing this summer without COVID is completely out of the question.

So is my consultants opinion the general held believe, or is it worth getting a second opinion, do I have other options?
 

Jaycey

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@Hurtiehip Welcome to BoneSmart! First, I think your surgeon is very "old school" in their stance on your age being a factor. I was about your age when I had my LTHR. In my case I had no choice as the joint had collapsed.

Sounds like you world has already narrowed. If your current surgeon won't proceed, yes I would find another surgeon who has more experience with younger patients. Life is too short to live in pain. And in my experience getting the hip replaced sooner made for a much easier recovery.
 

leejaa

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I second the motion to find a surgeon who is not so old school. Your world is shrinking and you are not able to do things you love or want to do to enjoy life. The increase in pain can come on very suddenly and not go away so pain is not always the best barometer when a joint needs replacing. I was 62 for my first hip replacement but in my late 50s for my knee replacements. My life is so much better now as I can do what I want and enjoy it. Life needs to be enjoyed.
 

Celle

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Hello, @Hurtiehip , and :welome:

It sounds to me as if it's time to get your hip replaced. Hip replacements nowadays can last a long time, some as long as 30 years, so it's possible that you won't even need to have a revision of the replacement.
Knowing this, surgeons are now replacing hips on people younger than you are.

It sounds as if your hip is already compromising your quality of life. I suggest you do the Score Chart listed below, to see how much your life is affected by your hip.
The other articles will help you prepare for surgery, if you decided to go for it soon.

I spent 9 years of my life waiting until I was "old enough" to have a knee replacement. Those were wasted years, during which my quality of life gradually become worse and worse, until I was almost housebound. They were wasted years, years when I was otherwise fit, and I could have been doing so many more enjoyable things. I wouldn't wish that on anyone.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
Score Chart: How bad is my arthritic hip?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced hip, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing hip recoveries
 

Mojo333

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Got both mine replaced at age 53...back to a full happy active life with no hip pain.
Only you know how much you have been restricted with a bad hip ..but I certainly have never regretted getting my life back.
 

Hip4life

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If I had gotten my hip replaced (or even properly investigated) at the stage you are describing, I would have saved myself a lot of suffering. Not only that, but I honestly believe my recovery would have been easier and less painful had I done it sooner. That you didn’t get much relief from the steroid injection seems to be telling you something as well. I am also recommending a second opinion. Life is too short and precious to be limited by pain.
 

kernsac

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I remember thinking I wasn't ready for my hips to be replaced. I could still get out and "walk" the dog (okay, "waddle" the dog!). I wasn't bedridden or anything. And the medical professionals were talking about how osteoarthritis was treated in steps, starting with medication and physical therapy, then shots, and if nothing else helped, hip replacement. I kept trying to follow the non-surgical steps, and finally realized, with my husband's feedback, that my life was shrinking despite my best efforts. I had both hips replaced, and can't believe how much better I'm moving, and how much I'm enjoying being able to move!
 

Going4fun

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Does sound like your consultant was old school. For one, really you don't want to worry about the durability of the device. Surgeons are feeling pretty good these days that the new devices will last a long long time. Do NOT delay for that reason ... you undermine your life quality now ... and there will likely be vast improvements in revision surgeries in 30 years ... And it's possible you won't need a revision.

I could walk pretty well when I had my surgery. Indeed, I did some running on a treadmill in the weeks before my surgery. Yes, that running ached afterwards ... But ... I was continually in a start and stop mode of exercising (I would stop when the pain reached a certain level ... wait ... and then try again) and I was sick of it.

You might consider looking for surgeons who operate on highly active and athletic people. Those surgeons don't expect people to delay surgery until they're crawling up the stairs. These surgeons have patients that want to get back to their active lives. And that was me. My surgeon was fine with operating a little early ... as long as I was clear about wanting the surgery, which I very much was. And I'm back to running and biking and all kinds of activity without pain. I'm amazed at how natural and solid my new hip feels. BTW: I definitely got out of shape during the time when I delayed having surgery--much more than I thought. I was avoiding activity much more than I thought at the time, which made the recovery a bit more work for me, some of that work being getting back into shape.
 
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Hurtiehip

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Thank you all so much, I felt so alone last week, with no idea how to get any advice. What a difference a week makes.

You are all quite clear, get a second opinion; look for a consultant who is happier to intervene early. I do tend to underestimate the impact on my life, my husband can attest to that. But to quote Jaycey my world has narrowed and I need to be clear, I would rather have my mobility now, who knows where I’ll be in 15-20 years. On to search for another consultant me thinks!
 
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Hurtiehip

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Just thought I would give an update after getting a second opinion.
My new consultant, who sees a larger proportion of younger patients ( great at 53 to be categorised as young!), gave a completely different opinion, no reason to wait, he confirmed the wear and tear at around a 7/10, the damage is done, and rather than wait, get it sorted out now. There were recommendations on which implant, given my age and higher likelihood that I will need a replacement in 20 years......It really does illustrate how important it is to look again if you are not happy with the advice given.
So roll on November, when I will hopefully get a new hip, and a return to a fitness that I am only just realising I have lost over the last few years.
 

Going4fun

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Sounds like good news. The only odd part is talking about devices. Lots of surgeons these days are confident that the device will last a long time. Ceramic on cross-linked polyethylene is an extremely popular device among many top surgeons who are operating on highly active patients.

Yes, it's great to make that decision to want to really live and thrive now. I posted my two-year update on my hip a few days ago on the recovery side. I was in a similar position as you are. Went for a good run tonight, got in some sprinting. My knee feels a bit sore, but that's because I ran one of my longest runs in a decade a few days ago. I should have taken another day off and ridden my bike.

You get my point. Just endorsing the thinking that there is lots of great activity on the other side of successful surgery.
 
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Hurtiehip

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Sounds like good news. The only odd part is talking about devices. Lots of surgeons these days are confident that the device will last a long time. Ceramic on cross-linked polyethylene is an extremely popular device among many top surgeons who are operating on highly active patients.
As I remember, it was a ceramic/ plastic combination that he recommended, his point was that it is smaller, and not Cemented as extensively as others, meaning in the unlikely event I needed revision, they could “whip” it out more easily. He only raised it as we asked the question, given what my original consultant had said.
But as you said aground good news.
 

Mojo333

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Yay for getting the green light to begin getting this hip show on the road.:ok:
I am ever so glad to be rid of my bad hips.. and back to a healthy life.:egypdance:
 

CricketHip

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So glad to read your thread and see the results of your second opinion. Sometimes, just making that decision for surgery is a big relief.
What is your next step? I guess you wait to hear back from the Surgeon for a surgery date?
 

Jaycey

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@Hurtiehip Good news about finding another surgeon. I do hope you don't have to wait too long for a surgery date!
 

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