should i postpone my THR?

[Traceyleth]

Hi everyone, I am a 35yr old female who has had problems with hip/pelvis since the birth of my first child 14yrs ago (I have 3 kids) for the first 6 years i was mis-diagnosed with tendonitis of the groin after giving birth to my 3rd child i severed the ligament which runs from the base of the spine to the front of the pelvis and was correctly diagnosed with symphysis pubis dysfunction which i probably had from the first pregnancy and was told this would clear up in a few months. It didnt and in 2003 and MRI showed OA in my left hip since then my limp has got worse and the intensity of my bad days incresed. Finally after 6 horrendous months i went to my surgeon in January of this year and scheduled surgery for July 21st. I am allergic to nickel so we decided to go with ceramic on ceramic THR instead of the resurfacing op. The reason i did not have surgery then was purely because of work/family comitments. The last couple of months have not been so bad pain wise and thought it would be a good idea to join the gym to get fit for surgery as i had done no excersie for over a year ~It is a gym/physio centre that deals with injury rehabilitation specificallly joint replacement. I joined last week and now 2 things bother me. Firstly when using a machine like a bike but with your legs out in front of you the hip grinding with every revolution suddenly i had a searing pain and i actually heard a noise but after that everyting seemed easier for the past 3 nights i have slept on my side (havent been able to do that in years) my limp is less pronounced, I am not getting stuck everytime i sit down (only sometimes) and 80% of my pain has gone. I always said i felt like the hip was not in its socket properly could this be the case? The physio said the joint could of been getting stuck on a piece of bone fragment. I am sorry for the long post but the difference has been dramatic and i am confused. One more thing when i was having my assesment and they measured my height i could not stand with both feet together and legs straight. If my arthritic leg is straight and i put my rightleg straight next to it that foot does no longer touch the floor i can only have both feet on the floor and both legs straight if my feet are a few inches apart. Sorry to go on but if anyone has any suggestions i would be very grateful.
TRACEY

 

[Josephine]

What a conundrum! Thing is with an arthritic hip, that the deformity caused by the condition may very well have caused some slight displacement - what is known as subluxation. It's not OUT of joint but not fully IN joint either. This can be caused by the debris shed from the joint surfaces and/or the damage itself as in this femoral head

only occasionally the head can be much more deformed than this and cause subluxation all on its own.

So, whilst you might have had some resolution from your exercise by making the head reposition and/or shifting debris, the fact remains that your hip
seems to be badly damaged and in need of replacement.

But - given the significance of your improvement, I would suggest you make an appointment with Ms Muirehead-Allwood and discuss it with her. She will probably be very willing to hold off a while and get you in when you reach the point of yelling 'help'!!

 

[Traceyleth]

Thanks Josephine