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THR after fractured pelvis - best decision I ever made

otrw

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Hi, I've gotten a lot out of reading the threads in this forum and wanted to share my story.

A year and a half ago I went through the agony of a broken hip following an assault while on a business trip in the UK (I live in the US). It turned out I had a fractured acetabulum (hip socket) though a misdiagnosis by the emergency room doctor at the hospital I was brought to made the injury much, much worse as I was discharged with a pair of crutches and a couple of aspirin. As a result, I was walking around on a broken hip for 12 days (a definite no-no, as any real orthopedic doctor will tell you!). By the time I got back to the States, the hip was essentially shattered. It took a nine hour operation by a trauma surgeon to piece it back together again with an ORIF -- he put in multiple plates and a dozen screws. I was in hospital for 10 days, followed by a week at a rehab clinic, and I was non-weight bearing for almost three months afterwards while it healed.

Nine months later, despite having done my physical therapy exercises religiously (I went two or three times a week and followed their instructions to a T), I still needed a cane to get around and was still in severe pain. Even though the repair held together nicely, arthritis had set in and apparently (as I found out later) there was also significant scar tissue and extra (heterotropic) bone growth, all of which severely limited my ability to function. I could not sleep without prescription painkillers and could barely move at all. Because it was my right hip that was injured, driving was especially difficult and painful.

My surgeon delivered what I saw as extremely bad news at the time: if I wanted to get my life back, I had to undergo a second surgery: a THR. He tried to put a positive spin on it: what I had, he said, was equivalent to "a rusty hinge." The good news was that the hinge could be replaced.

I was devastated. The first surgery had taken so much out of me, and it seemed as if it had caused as many problems as it had solved. But it appeared that I really had no alternative if I ever wanted to lead a "normal" life again.

Although I liked the surgeon who had done my ORIF, I did not care for the hospital he operated out of (serious nursing issues), and in any event he himself did not do THR. I began doing a lot of research, and decided to have the THR at the Hospital for Special Surgery in New York. I had read a lot of good things about the anterior approach and asked if my THR could be done that way, but unfortunately the surgeons I consulted with all felt it was not appropriate in my case because the ORIF had been done via the posterior approach. Interestingly, some of them wanted to leave in the existing hardware, while others wanted to remove it during the THR. Ultimately I decided to have one of the revision specialists at HSS do the surgery. He leaned towards leaving the hardware in, though he said he'd make the final decision during the surgery itself, while he could "see first hand what was going on in there." I really liked his thinking and his thoroughness, and I felt quite confident in his abilities.

It took quite a while before CT scans and blood tests showed that there was sufficient bone healing to do the THR, but finally I was admitted to HSS in October, 2013 -- nearly a year after the original injury. (I should stress that I continued physical therapy in the months leading up to the operation to keep the muscles as limber as possible -- advice I had gotten from my original surgeon).

Post to be continued...
 
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otrw

new member
Joined
Jun 7, 2014
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6
Location
New York
Gender
Male
Country
United States United States
As it turned out, the THR operation was a piece of cake! (Especially compared with the ORIF.) I was in and out of the operating room in just over two hours, and within minutes of being awakened I could already tell that 90 percent of the pain was gone! Yes, I was on IV painkillers, but it was still amazing. Less than 12 hours later they had me on my feet and taking the first steps on my new hip... still almost completely pain-free.

The next morning the surgeon came to see me and said he had taken out only three screws and was really pleased that he'd been able to leave the rest of the hardware in place as he felt it was ensuring a really tight fit around the new prostheses. He offered to send me home that same afternoon! I decided to stay an extra day because I was still a bit wobbly (though still mostly pain-free), and because my insurance covered it anyway, plus all the staff at HSS were terrific. By the second day, they were allowing me to walk with my cane again (accompanied, of course, by a nurse or physical therapist) and I went home the following morning.

After just six weeks of physical therapy (twice a week) and daily walks on my treadmill, the surgeon cleared me to drive again and said I could ditch the cane any time I felt ready. Though I still had a bit of a limp, I was more than ready!! I continued physical therapy for the next four months, getting stronger every day. This time around the therapist did a lot of massage directly on the incision area, and a lot of intensive stretching, all of which helped tremendously. During the entire recovery from the THR I did not need a prescription pain-killer once; extra-strength Tylenol pretty much did the trick, and in any event I was mostly feeling soreness as opposed to actual pain.

It's now seven months since the THR, and most days I'm not even aware that I ever had a problem with my hip. Occasionally I get a little sore, but I probably only take a Tylenol or Advil once or twice a week, and I haven't felt anything close to real pain. My limp is completely gone, and I'm back to full activities: shopping, cleaning, swimming, pretty much everything I used to do. Incredibly, I still feel like I'm making progress; every week I feel stronger and stronger. The only restriction the surgeon has given me is to avoid impact sports (jogging, trampolining, etc.) though he did tell me that if I wanted to play tennis, that would be okay. I've never been particularly athletic, but I'm feeling so good now, I might just take it up!

Oh, and I should mention that I just turned 61, and that I've been overweight my entire life (though I did lose nearly 50 pounds between the first surgery and the second one). But I have to say that I've never felt better in my entire life! Having that THR done was definitely the best decision I ever made, and I would urge any of you out there who are considering it to go ahead and take the plunge. Just make sure you pick your surgeon carefully and that you take the physical therapy seriously.

I hope all of you have as wonderful an outcome as I have been blessed to enjoy.
 

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