THR Superpath recovery what to expect

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Hi awesome bonesmarties and moderators. Marks wife here . I have been looking at threads to prior to my surgery and it was very helpful reading especially to mitigate my fears. Now I’m day one post op and I need some help. I don’t know exactly how this all works and have never participated in a forum in my life so I look forward to your direction.

I’m 46, have 2 boys 1 1/2 and 5 and have ankylosing spondylitis (an inflammatory arthritis) which has attacked my right hip creating a terrible situation. I underwent total hip replacement yesterday and had the super path procedure done by Dr. Chadha here in San Diego. Because he did not cut muscle I do not have many of the restrictions that the posterior and anterior patients do but the problem is that I have almost no strength in my right leg due to favoring my left for the past six years. I’m day one postop and I need help getting in and out of bed. Is this normal? Any tricks? I watched the video of the 20 something physical therapist getting in and out of bed but she can move both legs and I can’t. So I need some extra tricks!

 

[Layla]

Hello and Welcome to Recovery. So happy you joined us. Congrats on your new hip!
Getting in and out of bed can be difficult and it seems that's where upper body strength comes in as well as help from the hubs. When he's not available there is an assistive device called a Leg Lifter that many use in the early days / weeks. You'll find it in the Recovery Articles. Others use a tie from a bathrobe, or even a belt to make it easier to lift their leg.

Following you'll find the Recovery Guidelines. Please don't hesitate to give us a shout about anything. We'll be here ready to help when we're able. The support and encouragement here is second to none.
Wishing you comfort as you begin the journey!

 

[Layla]

Oopsey Daisy - that was wrong article, lol
Here we go....


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:

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

Activity progression for THRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications
Wound Closure​

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.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Jaycey]

@CLS Welcome to the other side!

Because he did not cut muscle I do not have many of the restrictions that the posterior and anterior patients

Just to clarify - muscles are not cut with either of these approaches. They are moved aside to access the joint. And these days most every patient has no restrictions post op - no matter what approach is used.

Regarding the strength in your op leg - I called this log leg. The brain says move and you just can't engage the muscles. Much of this will ease in a day or so. Ice and elevate to get the internal swelling down. A belt from a bathrobe make an excellent leg lifter.

I look forward to following your journey.

 

[PetMama]

Hi! I had my Left Hip SuperPath on July 10th. I called it having a dead leg. The leg was just so heavy! It does get better with time.
I am not doing as well post-op as I must have delusionally believed I'd just breeze through. But, like you, I waited a very long time before I had the surgery, and it was probably silly to think that I'd just start walking without a limp. The limp is almost ingrained in my brain after 4 years. I think it's going to take awhile to walk without it. I read somewhere that it'll take the brain 6 weeks to accept that your leg isn't too long (which it will feel that way), so I imagine it takes that long for your brain to relearn how to walk without the limp. Let's hope, eh?

 

[HipsterKat]

Welcome @CLS! I second Layla’s suggestion to get a leg lifter loop to help you get in and out of bed. Also don’t forget to engage your abdominal muscles when moving your legs around — helps take the stress off your back.

 

[Mojo333]

Hi @CLS and welcome to the forum..
First one I've participated in also and I'm not even an avid facebooker.
Never would've imagined that my anxiety and search for the answers to "is this normal" would lead to a remarkable joint recovery forum that has kept me engaged ever since.

That log leg and all the other strange sensations are due to the trauma involved in having a prosthetic hip installed...and irregardless of the approach, is not a small thing.
All temporary, my new hippy pal...and will lead to a recovery that will get you back to a hip pain free happy healthy life.
Just roll with the weirdnessess for now and I'm guessing you will do just great.
First days are definitely tough...but you've got this!
Healing Mojo coming your way.

 

[CLS]

Thank you all! I bought the leg strap. I don’t think realized what a long process this all is going to be. I’m coming to terms with it though and will just take one day at a time!

 

[CLS]

Oh I have a question - I cannot get comfortable sleeping. How exactly can you position your body with pillows etc to be comfortable? I know some of the does and do nots but I’m really looking for what works to get sleep on your back!

 

[Calgal]

I put a very soft down pillow under my knees. I can squish it by sliding my heels up (this takes some time to do though!) to be as narrow or wide as feels comfy. At first I had two pillows at head end as I slept almost sitting, but after a few weeks reduced to one. My PT suggested that the one under your head be quite flat so as not to cause pressure on the small of your back. This worked for me. I'm now very comfy sleeping on my back although at 10 weeks I'm now able to sleep on both sides but not for very long. Good luck!

 

[Calgal]

I don’t think realized what a long process this all is going to be. I’m coming to terms with it

It seems many surgeons / hospitals /n websites are doing a terrible disservice by 'over selling' various approaches as miracles which enable people to rise like Lazarus within days after surgery! Particularly to the younger patients like you. It makes me so angry! .

No matter the approach, what mojo and Layla and the other advisors here say is true - THR is major surgery and involves a lot of soft tissue manipulation which requires time to heal. Weeks and months not minutes.

Be gentle with your body and your mind. Try not to stress. We're all here for support just ask any question. We know that yes, it WILL get better and you WILL get your life back. Go with the flow. . Just don't fall!

 

[Rbc]

Recovery with two little boys, I’m sure you’ll be creative! I’ll second being unprepared for a realistic recovery. Getting comfy for sleep still challenges me but now and then I get it right! I liked @Layla’s advice of lots of pillows. Just to support me at my sides was helpful, even lying flat. Side sleeping- i find it takes experimentation to figure out where I want the pillow- between my knees, ankles, thighs? The edge of the pillow or full thickness? It varies day by day, depending on where my pain concentrates. My first weeks were a challenge (and I felt comfort from the forum that I wasn’t being a baby)!

I finally bought the cheapest body pillow at Bed, Bath and Beyond. It’s super squishy and provides a good barrier in our double bed when my husbands elbows fly. I used the guest room for a few days but one day it suddenly felt unbearably lumpy to me, and I returned to my own bed. (It’s on the third floor so I wasn’t eager).

My log leg resolved, but until it did, the crook of my cane also helped me lift my leg into bed.
My sister shared her wisdom about sleeping on my back “It’s like giving up sugar. You get used to it.” That always makes me smile when I’m getting irritated with my position! I hope you’ll find lots of help and support here. Be kind to yourself

 

[CLS]

Thanks for all the advice and encouragement. I thought we weren’t to put pillows behind our knees? But I definitely cannot sleep just completely flat. Last night I did pretty well with 3 pillows under my legs. But my back is killing me. We have a temperpedic bed so it’s rather squishy which makes it super hard to get in and out of. Nothing I can do about that tho. So what do I do today since laying in bed hurts now (back). Just move around from room to room trying out chairs?

 

[gertie]

'over selling' various approaches as miracles which enable people to rise like Lazarus within days after surgery!

ha! I remember watching YouTube videos put out by a surgeon's office (not my OS) of his patients' wonderful recoveries from the direct superior approach (which my OS uses)--walking without assistive devices in the hospital corridor hours after surgery, riding a horse 2 weeks post-op, etc. Let's get real. To his credit, my OS did not spout any of that nonsense--in fact he strongly suggests that patients use a walker for the first 10 days or so and take a slow, steady approach to recovery.

 

[Layla]

Good Morning!
Another little trick that works for shifting around in bed is a plastic garbage under your rear.
Makes it super easy to swivel into place.

You're way ahead of me as I slept on my back, in a recliner for three weeks. I was to afraid to attempt the bed. Silly, I know. I found the close space comforting even stuffing a soft pillow in on one side, wrapped like a taco, lol. Kind of like swaddling our babies!

I find the more pillows the better. One here, for my arm to rest on another there, pillows, pillows everywhere. One I can't live without and highly recommend is a simple body pillow. I got mine from Target, only $10 and find it invaluable to this day. It really comes in handy when you're able to begin side sleeping as you can wedge it comfortably between your legs and it will run the length of your leg. Comfy, cozy, love and use it every night.
Happy Wednesday! I hope you have a lovely day.
@CLS

 

[SaraK]

I had SuperPath for both of mine. One thing my surgeon told me was that this approach could cause the muscles to be "tighter" for the first couple of weeks than other procedures. In particular, lifting the leg was problematic and I was told by him and the PT not to do leg lifts or marches for awhile.

I can't lay on my back for other reasons, so I pretty much camped out in the recliner day and night (it was also my bed for a year before surgery) for the first couple of weeks. The recliner was also easier because I had pneumatic calf wraps that had a cable running to a central pump and they didn't get tangled up like they might in a bed. I did switch to the bed (sleeping on both sides) after the first couple of weeks, though. I know some say not to use a recliner, but I was told it depended on the features. I didn't have an electric one, but I had one that didn't swivel or rock and had a handle to put the leg rest down so that I wasn't having to push down with the legs to do it.

You are very early on but it will start getting much better soon! I found that days 2 and 3 were the worst because the numbing meds they put in during the surgery wore off. Then it started improving every day for me. You may find that the first few steps are painful each time you get up, but that will ease up some after those first few steps (my PT would say "motion is lotion").

Best wishes as you move through this!

 

[CLS]

Thanks - wow what a difference a day makes. I slept last night pretty well. Dr told me ok to take unisom and I know from the past just to take the tiniest amount- literally about 1/4 of a pill and I slept 10-1 and then about 2-6. I woke up feeling much stronger and have been able to get in and out of bed myself several times (of course it’s slow and exhausting but I can do it! I’m now shocked in a good way.). I’m using a scarf to pull my leg but it will be nice to have the leg lift when it comes. It’s so nice to get all the good advice! Thanks all!

 

[Jamie]

Having two little ones, I thought you might enjoy reading this essay written by one of our members years ago:

Nurturing mother: how to let go and accept help

You probably don't need this information as much right now while you're newly in recovery. You instinctively are resting and taking things easy. But once you get past the first few weeks and start feeling more like yourself, the temptation will be there to leap back into life. There are many reasons why you might want to delay this as much as you can not only for your benefit, but also for your family's learning experience.

All the best to you and congratulations on your shiny new hip!

 

[Eman85]

Temperpedic is a foam mattress? If so you can slide a piece of OSB or plywood under it to firm it up. That's what we've always used under our mattress. I was told no pillows under the knees, but it sounds like every OS is different. I have heard some say their legs get tight if they keep them bent like that. My OS recommended a rolled towel under the ankle 15 mins at a time to keep the back of the leg stretched out.

 

[CLS]

Thank you for the mom stuff Jamie- yes it’s “easy” right now since I can’t do much - it’s taking an army to keep everything together. It’s going to be tough to take it slow in a couple of weeks tho
So sometimes when I first take a step with my walker my new hip feels like it’s dropping a bit. I don’t know how to explain it. Kind of like a mild popping? Should I be concerned or since I’m day 2 post op don’t worry since it’s all gotta heal and gain strength?