Should I have surgery??

[PBhips]

This is the question I’m struggling with. I’m told that I am a candidate for two new hips. I have bone spurs that keep them from rotating properly, mostly I have very little internal rotation. I can’t cross my legs, I can’t squat even close to the floor, I can’t lean over and tie my shoes, but I can sit down and do it with only a bit of a challenge. I can no longer step high enough to get on and off of my bicycle. Having said all of that, I have no pain. I have occasional little zings up at the very top of my thigh in the middle of one leg, but just for a second. I play Pickleball 2 to 3 hours most days, no problem. I’m not kept awake at night by pain. I can walk all I want, but I am always aware of my hips when I am walking. They just don’t roll smoothly, but they are not painful. Just a bit awkward. But when I am sitting or lying down, I feel perfect. Is it worth having two surgeries to get that range of motion back? I know that in the end only I can make that decision, but I’d really like the opinions of some of you have been here before me. I’ve only read The stories of people who have been in a great deal of pain before surgery. I’ve never come across anybody in my position, with no pain and being able to be almost fully active. I feel like I could trade never being able to ride a bicycle to avoid 2 surgeries. I’ve been agonizing over this decision for about six months now, and the stress is really eating away at me. The surgeon I saw said that I will need both replaced, but it’s up to me on timing since I’m not experiencing pain right now. Is it possible that I will never have pain? Was anyone else out there in the position I am now?

 

[trailrunner]

My first two symptoms were similar to yours: I couldn't get on and off my bicycle, and my leg rotated out when I bent over, which made it hard to put on socks and tie my shoes. Some of my biking shoes with a strap and ratchet on the outside were almost impossible to put on or adjust once they were on. Otherwise I didn't have much pain.

I was playing a lot of tennis, and some pickleball, and soon my groin started hurting. It got worse and worse until it got to the point that if I played tennis for two hours, I'd have to come home a lie down for two hours until the pain subsided. Finally, one day I played tennis in the morning, and tried to play pickleball in the evening, but after about 20 minutes I had to stop. The next day our coach was recording us, and I saw how I was hobbling around. That week I went to the doctor, and got the bad news. Since then, it got worse, to the point that I couldn't bike, couldn't run, and hiking and walking were painful.

It's not clear if you still have any cartilage in your joint. I also had bone spurs, but I had also lost the cartilage and was rubbing bone on bone. Is that your case?

My limited ROM prevented me from biking. I figured out how to get on and off my bike, but my bad leg was tracking outward. That wasn't comfortable, but I also couldn't get any power out of my bad leg, and my good leg was doing all the work. After playing pickleball or tennis at our club, we'd often meet for dinner afterwards, and I dreaded taking a shower because it was so hard to get my shoes and socks on. I also hated it when my shoe came untied, because it was such as struggle to tie it.

 

[djklaugh]

@PBhips There are folks who have little or no pain who get hip replacements and do very well with them. The most common cause of pain in the hips is when the padding between the femur and the pelvis wears away completely - call being bone-on-bone. But bone spurs, cysts, and other damage are legitimate reasons to get a hip replacement or two. You have already seen one surgeon who agrees that hip replacement is appropriate for you.

As for getting both done at once here are the reasons my surgeon gave me: 1-less risk (re having anesthesia and also stay in hospital) having just one surgery and one hospital stay (mine was done pre Covid so several days in hospital was the norm, now most folks stay only one night or even leave the same day); 2-I'd have just one recuperation period; 3- I would be able to regain normal gait and not have to limp on one bad hip between surgeries; 4-Surgeon would be more assured of getting both legs the same length thus avoiding any leg length differential problems (which does happen occasionally). While there could be real and valid medical reasons to not do a bilateral procedure, that would be up to the surgeon to determine.

Here are our pre op articles and suggestions - look carefully at the "how bad is my hip" one - print it out and be very honest with your self when you answer the questions -- and take it along with you when you see same or other surgeon.

Hip: pre-surgery considerations

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 in stories of amazing hip recoveries

 

[Freyagirl]

I went for a long time with no pain, but with hip dysplasia and bone spurs. Then within a few months I went from occasional discomfort to chronic pain. I had both hips replaced 2 months apart. It definitely improved my life, but the recovery requires time and patience as well as determination.

 

[Layla]

Hi and Welcome to BoneSmart. Thanks for joining us!
I noticed you posted to a couple of members that haven't been around in quite awhile, looking for information on their surgeon. If you're interested in a second opinion from an OS in your area we may be able to help. Please let us know if you'd like Admin to check their resources for you and we will tag, Jamie, for you if you're interested.
I hope you have a nice weekend!
@PBhips

 

[AlanInAZ]

This is obviously a personal decision, however in my case, I chose to live with a situation like yours for several years before pulling the trigger 11 years ago on my right hip and most recently with my left hip. My criteria was could I walk without very bad pain. For both hips I reached a point where walking even a few hundred yards was very difficult and the decision to have surgery was very easy. The decline to very limited walking ability happened rather quickly. Up until surgery I avoided weight bearing activities and remained active with cycling and aqua jogging. When I could not swing my leg over the bike saddle I bought a step through bike and continued cycling outdoors and eventually moved indoors with a trainer. It would have been reasonable to pull the trigger earlier but then the long recovery process may have been harder to accept. I am now 6 weeks into my left hip recovery. I am now able to walk about 2 miles each morning without much discomfort and without a cane. It is more than a year since I was able to do that. An activity such as pickleball is much farther into the recovery process for me.

The primary function of joint replacement is to remove pain, second to improve function. If you are not in serious pain and have good function then it is prudent to wait on a major surgery with some real risks. My surgeon reminded me that the surgery is elective and my condition is not life threatening but obviously quality of life limiting.

 

[mendogal]

My issue was knees, not hips, but I will share why I chose to have mine replaced sooner rather than later:

Osteoarthritis is always going to get worse. Bone spurs are a significant cause of pain, also of inflammation that further damages the joint.

As our range of motion and gait slowly become compromised, our entire weight bearing structure becomes skewed trying to (mal)adapt.

As a community health nurse working with seniors, I saw that a frequent consequence of delaying surgery was a slow loss of muscle mass and tone and of stamina. I was able to do significant knee-friendly "pre-hab" to be in the best possible shape going into surgery.

It's largely a quality of life issue (I couldn't walk the distances I wanted to). That means it truly is an individual decision with no one right answer.

 

[Eman85]

I had pain, lots of pain for a long time to go with reduced range of motion. If I didn't have really bad pain I would never have had my hips replaced. It's a major surgery and it's elective. Bad hips won't kill you. Comes down to it's all your choice. It's a very common surgery but it does come with a lengthy recovery and some risk.

 

[EalingGran]

. I play Pickleball 2 to 3 hours most days, no problem. I’m not kept awake at night by pain. I can walk all I want, but I am always aware of my hips when I am walking. They just don’t roll smoothly, but they are not painfu

As everyone says it is a very individual decision.
I would definitely look at the hip scoring charts in the posts below and complete them.
The risk is that if you have surgery before you have much pain, you will find the post operative period challenging and be dissatisfied, particularly if it doesn't go smoothly. Although as others say, leaving it may cause more wear and tear and you will be older having surgery.
These are decisions I understand.
I currently don't have much hip pain, although I have been told that based on my MRI findings I will need my right hip done at some point. However it is is currently functioning well ( it improved after having my leg straightened with a partial knee replacement). I did find the knee recovery challenging though. I hadn't had much knee pain paradoxically- so for months I had worse pain post-op than pre-op in the knee.

 

[Law]

It also depends on how quickly you can get it done once you decide to pull the trigger(s). mine was about 4 mths out. I got a cortisone shot to tide me over and it helped. But also, you need to just think about your life in general and plans, what time of year you would like to be recuperating and all of that and then you need to factor in whatever your surgeons timetables are. It's all a bit of a guessing game. I had been doing PT on and off for about two years and it got to the point where it just wasn't working and I went back to the surgeon he took the x-rays and said yes it's time.

i didn't want to wait till I could barely walk.

 

[AlanInAZ]

The claim that OA always gets worse is not true. In my case I was scheduled for two hip replacements 11 years ago. The right was a bit worse than the left and was scheduled first. During my recovery the PT plus changes to my walking pattern helped the pain in my left subside and I cancelled the second surgery. I gained 11 years, 10 of which were good functional years. Arthritis on the x-ray doesn't go away but function and pain can improve or at least stabilize, sometimes for extended periods.