Revision THR Recovery following RTHR 10/20/20

[rowergal]

Hi everyone!
I had my first join replacement, a TRHR with anterior approach, a week ago today. It was at Suburban Hospital in Bethesda, MD with Dr. Sri Durbhakula of the Ortho Bethesda practice. I stayed over 1 night for "observation". They had me up the next morning and by that afternoon, I was discharged.
Here's what's happened since I got home:

• First couple of days were hard, getting used to how to move around, get in and out of bed, more pain, etc.
• Was able to alternate between sleeping on my back and my left (good) side from the very first night.
• Stopped taking 5mg Oxycodone after Day 5. (Days 3 and 4, I just took one pill before bed.) Now just taking Tylenol. Pain is very manageable.
• Got to remove my bandage today. Looks like the scar just has Steri-strips on it.
• Have had 3 at home PT sessions and will have 3 more. At today's session, my PT said "grab your cane, we are going for a walk outside"! I haven't been past the front porch for a week, so this was awesome news. He officially graduated me from the walker to the cane after just 1 week. I'm amazed! It helps to be on the younger side (63) and a normally very active person, I guess. Also, I had 15 PT sessions and lots of at-home exercises just before surgery because I was trying to avoid a hip replacement. I'm sure that helped up my muscle strength before surgery.
• I'll see my doctor at the 2-week point (next week).

The only concerns I've had are these:

• I have a lumpy spot next to the scar that the medical assistant says is likely a hematoma. I'm going to do more elevating of my leg in addition to the icing I've been doing a lot of.
• I have a very sensitive spot in the crease where my leg meets my torso that the Med asst says is likely referred pain right over the joint. It hurts most when I stand up from sitting or lying down.

All comments welcome! Good luck to all of you in your own recoveries!
Danna (aka "rowergal")

P.S. I've been on a competitive masters rowing team for 15 years. Sadly, COVID has kept us off the water for all of 2020. I'm hoping we'll be able to start again in April 2021, and my new hip will do great!

 

[Pumpkin]

@rowergal
Welcome to the OtherSide!

Sounds like you are doing well, already using a cane!

Here are the Hip Recovery Guidelines, the articles are short and will not take long to read.

Hip Recovery: The Guidelines
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:

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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 these

​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

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Activity progression for THRs​

6. Access these pages on the website

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Oral And Intravenous Pain Medications​

Wound Care In Hospital​

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.

 

[Going4fun]

Welcome.

Sounds like you're off to a good start. I've spent many hours at Suburban Hospital. I grew up in D.C., and have had various family members treated there. I think it's a really good place!

On the lumpy spot and the sensitive spot, I'll let others come on board who are more familiar with those issues than I might be. But it sounds like you're doing quite well.

You can get quite the workout with the cane. But I have to say: I liked the walker more than I thought I would.

 

[Schaargi]

Hi! I had my left hip replaced,with an anterior procedure on June 9. I had a painful lump near my scar, too. Mine was the site of my drainage tube. Weirdly, it took longer for that lump to heal than did my scar tenderness. I think it was still there, albeit small, at my 6 week post-op appointment. I'm not sure if you had a drainage tube, but that was my experience. Happily, it's gone now!

 

[Mojo333]

Hi @rowergal
So happy to see how well you are doing.
Most small hematomas resolve with time as the collection of blood is slowly reabsorbed into the body. You are getting back to activity quickly which is great, but as you say, icing and elevating and babying your leg after this major surgery is also important.
I was lucky to have good upper body strength as I have a fairly labor intensive job, but certainly you have a great advantage with your fitness level as a rower.
Makes it easier to get ourselves up and about these early days.
I had that tightness/tenderness in that crease area also and not sure if it was referred pain...felt more like tightness caused it....but in either case, there are lots of healing happening and All Temporary became my mantra during my recovery.

Hope the rest of your week is sweet.

 

[rowergal]

Hi! I had my left hip replaced,with an anterior procedure on June 9. I had a painful lump near my scar, too. Mine was the site of my drainage tube. Weirdly, it took longer for that lump to heal than did my scar tenderness. I think it was still there, albeit small, at my 6 week post-op appointment. I'm not sure if you had a drainage tube, but that was my experience. Happily, it's gone now!

They didn't use a drainage tube for this surgery, although I've had them for previous surgeries.

 

[rowergal]

Hi everyone,
I'm wondering if anyone has had a similar experience in their recovery to what I'm about to tell you:
My surgery was Oct 20. It's now 5.5 weeks later. The beginning of my recovery was amazing! I used a walker for week 1, a cane for week 2, and then nothing. The 3rd week I was able to walk a mile or so, unassisted.

I was so pleased with how everything was going! Attributed it to all the PT and home exercises I was doing BEFORE my surgery.
Then at 3.5 weeks, I had a big setback. That day I had had a fairly strenuous PT session (which made sense as I was getting stronger and doing great). After a couple hours back home, I decided to join my husband for a walk. About half way through, I knew I had to turn around. I was in a great deal of pain in my hip joint. I now needed the cane again.
So, I figured, OK, I guess I overdid it this week, and I'll feel better in a couple days. Nope. On the 4th day after the setback, I called my doctor's office. They reassured me that it was highly unlikely that I had an infection (that's where my mind went), but just that I overdid it and my body was telling me to dial it back. They prescribed Celexa as an anti-inflammatory since I'm still on Aspirin.
I continued to ice and elevate and take it easy. From 3.5 weeks to 4.5 weeks I was in a great deal of discomfort. It started in my hip joint, then it was my quad muscle that really hurt, and recently I have had some groin pain. Still going to PT although it's now far less strenuous.
I'm finally starting to get better again, but still not to where I was before the setback. I can get around with no cane in the house, but use it outside.

Has anyone else had this experience? I've been told it's not that unusual - that some people are very slow to progress but it all goes in one direction and other people are like me and do great at first and then go backwards before getting better again. But I haven't heard that from any actual THR patient.
I was really discouraged at first, but am feeling more hopeful now. Just anxious to get back to my active lifestyle!!
Hope everyone had a nice Thanksgiving during these strange COVID times.

 

[Eman85]

If you read a lot of threads on here you'll see that setbacks and pain from overdoing happen to just about everyone of us. It's so easy to get feeling good and thinking you're having this incredible quick recovery and then you over do. We usually never have any pain while we're over doing, it always seems to hit the next day. There's no time limit either, it's easy to over do at 3 mos or a year, I've done both.

 

[FCBayern]

You've been way more active than the muscles and soft tissues that were completely abused during surgery are ready for @rowergal. For some reason a lot of OS still prescribe PT, hips don't really need that and your PT has been hurting you. One of the mods will be along soon to give you the recovery guidelines, but you can find them near the beginning of every thread here on the recovery side. Pay particular attention to "Activity after THR" and you'll see you've been doing WAY too much.

 

[Jaycey]

@rowergal Sounds like you have been a bit over active for so early out of major surgery. At only 5.5 weeks out it is very early days in a process that can take up to one year or more. Slow down! I would stop all that PT if you are already doing all the walking. You are not in training for anything. Your hip is recovering.

Do you ice and elevate? Your muscles and soft tissues are inflamed. Ice and elevation will ease this.

Use a cane until you are no longer limping. And go back to using a walking aid anytime you find yourself limping.

 

[Schaargi]

Hi @rowergal ,

Sorry you overdid it! That happened to me. I got over-excited when I found I could lift my leg off the bed. As a result of showing off my new trick too many times, I injured my hip flexor and didn't get it fully back for 3 weeks!

So, yes, take it easy and ice. You will get back on track!

 

[rowergal]

Thanks for all the responses, everyone. I had my 7-week follow up with my doctor and he told me this: one of the drawbacks of the non-invasive anterior approach surgery is that people tend to think they are way ahead of the curve in recovery and do too much. He also said this usually happens between 2 - 4 weeks after surgery...exactly when I had my setback. I've learned from this experience!! When I need the other hip done, I'll take it a lot easier. I think I was just too anxious to get back to normal activities!

 

[Mojo333]

one of the drawbacks of the non-invasive anterior approach surgery is that people tend to think they are way ahead of the curve in recovery and do too much. He also said this usually happens between 2 - 4 weeks after surgery...exactly when I had my setback

No truer words can be said....aaaw, we live and learn.
Slow and steady does win this race and your hip will be all the happier by giving it all the time it needs to get back to activities incrementally.

Thanks for sharing your cautionary tale...is likely to help others and I'm hoping things get back on track very soon.
Wishing you a happy holiday.

 

[Eman85]

the non-invasive anterior approach surgery

I love it! It's really interesting how they can sell this surgery as "non-invasive".

 

[FCBayern]

Non-invasive anterior approach!

 

[Layla]

I think we should initiate a snowball fight with those two jokesters above.
Whadda ya say? I think we can take em



Happy Two Month Anniversary! I hope you’re feeling better these days.
Best Wishes for a very Merry Christmas!
@rowergal

 

[Layla]

Happy Three Month Anniversary and Happy New Year!
How are you doing? We’d love to hear you share something good. Hoping all is well, you’re enjoying steady progress and getting back to living life.
Best Wishes for a happy, healthy 2021!
@rowergal

 

[rowergal]

I have to have a right hip revision surgery on April 10. Found out 2 weeks ago that I have aseptic loosening of the cup. I've only had the new hip for 2.5 years (since 10.20.20), but have had ongoing pain throughout. I had an iliopsoas tendon release surgery 12.17.21 (14 months after hip replacement), which did allow me to walk correctly again, but the "startup" pain continued. After trying tons of PT, dry needling, cortisone and PRP injections, as well getting MRIs and more x-rays, finally I saw with my own eyes that the bone wasn't adhered to the cup, and the cup has moved slightly! At least I now have an explanation and not just a theory...
I found a great surgeon (not the same one who did the original TRHR, who also has a great reputation and patient satisfaction) who specializes in revisions. He says there is a chance I'll wake up and he'll have had to redo the stem portion as well...and there's always a chance the femur will break or they'll have to cut the bone to get the old stem out. Yikes!! (I'm wondering how often these types of complications happen?)
This has been quite a journey. I've managed to stay active with walking, but I'm a rower and can't row with the kind of pain I have because it's flexing/straightening that hurts the most.
Hopefully I'll heal fast from the revision and one day be rowing again. Good luck with your surgeries, everyone!

 

[Layla]

Wow, this has been a long journey for you and it will finally be addressed and resolved soon. I am sorry that you've endured pain since your THR and the uncertainty that goes along with all of the appointments and tests. Thankfully you've found a reputable surgeon that specializes in revisions. It sounds like you're confident that you'll be in good hands. I appreciate his honesty in enlightening you of possible complications.
I have read of femur fractures during revision, but certainly not routinely. I believe it normally requires non weight bearing for a time if you experience this complication. You can type key words into the SEARCH at the top of the page and threads will pop up where the "key word" was mentioned. Instead, I'd suggest you think positive and hope for the very best for which the odds are in your favor! I wish you comfort as you wait and hope you will continue to share your journey with us.
@rowergal

 

[myglasshalffull]

Good luck, let us know how it all goes.