Shopping for a Hip

[barbaranna]

Hi. I 'm new here and would like to introduce myself.
My name is Barbarann,64 yrs old, just had major surgery in April, unrelated to hip and was told now that i need a hip replacement. So I have been shopping around and I am overwhelmed. I have never gone to a Dr for another opinion before and I am finding myself looking for the third Dr. This type of surgery is not like any other . You can go home and rest after and wait for the healing process to take place. This type of surgery I find is very detailed on what happens during recovery and that is what scares me to death.That something will happen during that time..Didn't ask the first Dr how it was done, I didn't know there were options . When I went to the second Dr he said I do it posterior and the other Dr does it anterior. Well I looked them up and it seems that anterior is faster recovery and I see why because of less muscle cutting but why does it have a lower risk of dislocation and why is it that you dont have as many restrictions as the posterior such as bending etc. If possible I would love for any of you to send me stories about each of them and how it was step by step. I work or a self storage company and that is office work cleaniing units moving stuff and I am afraid that it would dislocate. I will live with that nightmare. I also smoke though want to quit and havent been successful and wonder if any one else does and it healed correctly. I am also diabetic through medication. I have to make a decision and it is getting close. I live alone and dont want to go to rehab they said i didnt have to but want to know how much help do you really need after thanks for your help

 

[Jaycey]

Hello Barbarann! Welcome to BoneSmart!

We have all been in that place as well. It's all very overwhelming when you first learn you need a new hip. Then the restrictions are even scarier. I felt the same. But from my experience the restrictions really aren't that difficult to follow. Sure you will need to be careful for at least the first 6 weeks. But these hips are very tough. Once you get the all clear you can get back to doing pretty much what you want to do. My two restrictions are no bungee jumping or parachuting.

You won't be able to do any heavy lifting or moving furniture while on restrictions. This is to ensure that hip gets seated properly. Be sure and discuss any restrictions with your surgeon.

BTW - there are no muscles cut using any THR approach. And recovery is very different for everyone. I had posterior THR and had no problem except back issue (that were present before the THR).

I was alone most of the time in recovery. They will not discharge you until you can get around and climb stairs on your own. A bit of preparation like freezing some meals and putting things in reach and you really shouldn't been anyone with you constantly. I would suggest having someone check in on you the first few days. But if that's not possible there is always the phone.

Have a read in the Hip Recovery section. The treads there are the step by step reports from members on their recovery. And the Library is full of great information as well. Here are some threads to get you started:

Pain management and the pain chart
How Long Does Healing Take ......
Chart representation of THR recovery
Dislocation risk and 90 degree rule
Energy Drain for THRs
Elevating your leg to control swelling and pain
Activity progression for THR
Some suggestions for home physio (PT) and activity progress
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds

Do come back and ask all your questions. We are here for you through this journey.

 

[Cookie42]

Good morning, Barbaranna (a lovely name, by the way). I cannot give you any recovery stories because I'm in sort of the same boat as you. It's my first hip as well and and I also have diabetes. That's one reason I wanted to get this surgery now -- while I still have good control and will heal well. I also wanted to get it done before I'm in worse shape and will have more trouble recovering.

From what I've read here -- and it's been a lot -- any restrictions wouldn't really hurt you at work because the restrictions will be gone before you feel like going back to work. I opted for the anterior approach, mainly because of fewer restrictions. There were other reasons for my choice, but after reading here, some of them turned out to be hype! I'm looking forward to getting it done, but not looking forward to the doing, if you know what I mean.

I've been doing the exercises the doctor told me to do pre-surgery, hoping that will make recovery faster and thinking the stronger the muscles are before, the better they will be after. Time will tell. Since I'm older and retired, I'm not needing to get back to work, but wanting to get back to sitting with my grandbabies.

I feel so lucky to have had so many more good years out of this old hip than so many people here have had. Read the stories here. I started reading on the pre-op side then read the post-op. Lots of hours and lots of good information. We'll make it!

 

[sharonslp]

Barbaranna, you are raising a lot of questions....many of them we can answer based on our individual experiences, but there is NO guarantee that it would be the same for you. Also, have you read any articles in the library yet? Many of your concerns are addressed there. Here are a few to start with:

Choosing a surgeon and a prosthesis
Dislocations: what are the risks?
Smoking and joint replacements

There are lots more. Go to the top of the page and click on the Library Tab. Then click the Library Index.

The most important choice you need to make is the surgeon himself. Don't worry about which approach (anterior, posterior), because there are pros and cons to each, but in the end the outcome will be the same. If you select a very experienced and highly-regarded doctor, it will be a good outcome no matter what....at least as much as a doctor can make it be.

Your other health issues may make a difference in how quickly and how well you recover. But in general, most people need around 12 weeks before they return to work. Even with an anterior approach, while you will be more mobile and have fewer restrictions immediately after surgery, it is still major surgery and you tire easily during the early healing process. If you are returning to a job that requires a lot of physical effort, you might need even more time off.

Here is my experience with two hips: I had a posterior approach for both. I was in the hospital for two nights with the first; one night with the second. With both of them, I could get in and out of bed by myself before I went home. So once I was home, I could take care of myself. I had home health care for the first five days for both hips; a nurse came over the first day home, and I had home physical therapy for the next four days. An occupational therapist came over for the first hip, to make sure I could manage at home by myself. I didn't feel any need for the OT for the second hip. I was allowed to be fully weight-bearing for both hips right away...this makes a huge difference in being able to take care of yourself if you are alone. I used a walker for the first week, and was able to switch to a cane during the second week. For my first hip, I could drive after two weeks; fir the second hip...the left one....I could drive very short distances after one week. This is unusual...it does take most people longer. With both hips, by six weeks, I was pretty much back to full functioning. I am fortunate that I was retired by the time I had my hips done. I used to be a teacher, which is a very active job. It would have been VERY difficult to return to work until about 12 weeks. Recovery is not something you have to be scared about....but you do have to respect the fact that you will need time to recover well.

In regard to the difficulty of quitting smoking, I recently met a woman in our age bracket who was using electronic cigarettes to help her quit. She was quite positive about them. My daughter is a smoker, so I looked up information about this, and it does indeed seem to be a very reasonable method to ease into quitting, for anyone who can't do the cold turkey approach.

Welcome to the beginning of this journey toward better health and less pain.
Sharon

 

[Josephine]

This type of surgery is not like any other . You can go home and rest after and wait for the healing process to take place.

So you do with a hip replacement. There are many sites on the internet that speak of hard work and aggressive PT but that's really not necessary. Check out that article on home PT, Jaycey posted for you.

This type of surgery I find is very detailed on what happens during recovery and that is what scares me to death. That something will happen during that time..

Yes, when they star talking about dislocations , broken stems, loosening and all, it is scary but also very rare. For the most part, recovery is much like any other surgery - just sit back and let it happen!

Didn't ask the first Dr how it was done, I didn't know there were options . When I went to the second Dr he said I do it posterior and the other Dr does it anterior. Well I looked them up and it seems that anterior is faster recovery and I see why because of less muscle cutting but why does it have a lower risk of dislocation and why is it that you don't have as many restrictions as the posterior such as bending etc.

Some people do have a very speedy recovery in the first few days but after that, it's pretty much the same for any approach. There isn't any actual muscle cutting in any approach, more like they go between muscles , through the natural planes that exist. But in the anterior, though there are about as many muscles as at the posterior or lateral (side), they are much smaller. In other words, the hip is nearer the surface at the front than it is at the back or the side!

As for the restrictions, much is said about them but it all depends upon the surgeon. Some surgeons don't believe in them and others are regular martinets about them. But don't look for any logic in that - they are all individuals and have their own ideas about what's right and what's wrong. However, most surgeons who do require restrictions usually stipulate 6 weeks.

I live alone and don't want to go to rehab they said i didn't have to but want to know how much help do you really need after thanks for your help

If you have restrictions, it would help to have some help staying over during the first few weeks. If you don't have any, then a few days would be enough with people popping in to check on you on a daily basis for a few weeks thereafter.

There are heaps of things you can do to prepare for this (here come more links!)
Tips for an easier recovery: a must have down-loadable list for pre/post surgery!
Tips for an easier recovery: comprehensive list for hospital and home

But just keep asking posting your thoughts and questions - we'll get you there in the end!

 

[bellaroma]

I echo others comment, if you feel comfortable with the surgeon and they have done the surgery alot than don't worry about the method. Electronic cigaretts work we, just make sure you buy one with varying nicotine levels

 

[aa1pd]

Find a surgeon who specializes in hips, does it a lot, has been doing it for years and let him/her choose the details of the procedure. A great surgeon doing what they do well is much more important than the specific minutia of the particular procedure they choose to do.

I am the most expensive (and most skilled too ) horseshoer in my area and I get to choose the style of foot prep, the choice of shoe, the type of nail to be used, the number of nails to be used, the nail size to be used, and I extend the same courtesy to my Orthopedic Surgeon.

 

[jazz6661]

I just wanted to say good luck and do try the electronic cigarettes. Both my husband and I were able to quit using those. We both smoked for at least 20 years and we did it!

 

[Josephine]

Excellent analogy, George!

 

[Weezy]

Find a surgeon who specializes in hips, does it a lot, has been doing it for years and let him/her choose the details of the procedure. A great surgeon doing what they do well is much more important than the specific minutia of the particular procedure they choose to do.

I am the most expensive (and most skilled too ) horseshoer in my area and I get to choose the style of foot prep, the choice of shoe, the type of nail to be used, the number of nails to be used, the nail size to be used, and I extend the same courtesy to my Orthopedic Surgeon.

This is the method I'm using! And the surgeon I'm going to is even an expert in FAI issues (femoro antetabular impingement) and hips are ALL he does....a variety of surgeries re the FAI problems and hip replacements. He does several THRs a day 3 days a week and other hip surgeries 1 day a week.

While I THINK (and hope!) a THR is going to be his recommendation given my age and the amount of impingement; however, given his expertise, I'll certainly listen if he recommends something else.

BTW....I did the same thing when choosing a farrier for my horse (many many years ago) I worshipped the ground he walked on! He was also handsome and single which didn't hurt ...back in the day when I was young and single too. Sigh.... so long ago.....

Weezy

 

[aa1pd]

BTW....I did the same thing when choosing a farrier for my horse (many many years ago) I worshipped the ground he walked on! He was also handsome and single which didn't hurt

I'm not young, but I am single

 

[Weezy]

I'm not young, but I am single

You forgot handsome!