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THR after hip pinning

Discussion in 'Hip Replacement Pre-Op Area' started by margo, Jul 22, 2017.

  1. margo

    margo
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    I am 2 years post hip pinning after having a hip fracture. I was almost 8 weeks non weight bearing after the pinning but had a great results of the fracture healing. I almost returned to full activities which included yoga (my very favorite thing) to do.

    Now pain has set in. Started with groin pain and has now escalated to trochanteric bursitis which is very painful. At times I can barely walk. Then maybe the next day is much better. I live on Aleve and take them at least twice a day.

    I have an ortho appointment next month and may be headed for THR .

    Advice appreciated.
     
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  2. Josephine

    Josephine NURSE DIRECTOR Administrator

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    Hi and welcome to BoneSmart! I am curious because your User name is Margo yet you have chosen your gender as male! Which is correct?

    About that hip of yours. I can almost certainly state that what you are suffering from is a condition called avascular necrosis, which the failure of the fracture to heal and reinstate a blood supply to the head of your femur (thigh bone). This is not uncommon after fractured necks of femur and invariably proceeds to a total hip replacement. This will resolve your pain and other issues though there will be the recovery to cope with of course.

    I'll leave you with our THR recovery articles so you can read up on the essence of the recovery. But if you have any questions at all, please feel free to post them here.

    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
    5. At week 4 and after you should follow this

    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.
     
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  3. alexthecat

    alexthecat Moderator

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    Hi Margo! I had THR after a failed pinning of a fractured hip. I found THR to be much easier than the original surgery on that hip. If you do need THR, I would suggest getting it done as soon as you can. I only had to wait four weeks, but my hip collapsed in that time. It wasn't as painful as a hip fracture, but it was its own form of misery.
     
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  4. margo

    margo
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    Thank you. I really appreciate your advice.
    To answer you, I pushed the wrong button. I am a female.

    My husband and I are scheduled for a trip to Europe and are supposed to leave in a week. We have considered cancelling on the bad days but then when we go to do so, I feel much better. I have found, that if I only weight bear 50% on the affected leg I can walk and some days I can use my entire weight. We have a transport wheelchair and will bring that for when we go out. I will be spending 10 days on a boat so not much walking there.

    I wonder if traveling will make the condition worse and make my chances for a good recovery after surgery less favorable ?

    I have had the feeling that it may be AVN and when asking the surgeon (ortho but not a hip doctor) if it could be AVN and he always said no. He only had the xrays to go by and what I have read is that an MRI is the best diagnostic tool to determine AVN. I lean towards it being that also.

    This is a wonderful Forum. I really appreciate how supportive it is and encouraging to read what others share.

    Thank you
     
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  5. Josephine

    Josephine NURSE DIRECTOR Administrator

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    You will notice you are now female!
    It won't affect your recovery but as Alex said, things could take a turn for the worse while you are away. To be honest I really wouldn't advise it.
    I am astonished! When I was a young nurse back in the 1950's, I was taught how a failed fractured neck of femur would result in AVN!
    In most places in the body that's true. Knees and such, for instance. But in the femoral head it's usually pretty obvious even in the early stages.
     
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  6. Mojo333

    Mojo333 Forum Advisor

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    If you didn't notice it before..:heehee:
     
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  7. margo

    margo
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    Thank you Josephine, so appreciate your information. I have a friend who has had 2 hip replacement, and one who had a knee replaced. Both of them got out of bed the night of surgery for a short walk. I can accept that this may be to prevent a blood clot from forming. They got one week of respite at home and then it was off to PT to do exercises.

    My knee friend even went back to have the knee bend further, not enough bending for the surgeon.They gave her a light sedative but she said it was extremely painful.

    I am glad to read your post and see it is ok to listen to our bodies. When I am well, I am sort of a gym rat. There every day, using the elliptical machines, for cardio benefit. So I know the body will let me know when it is ok to resume.

    Also thank you for returning me to my right gender.
     
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  8. Josephine

    Josephine NURSE DIRECTOR Administrator

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    I don't think that would have been the reason. I would imagine it was to visit the bathroom! It was for me!
    Now why am I not surprised to hear that?!! So many of you US ladies are anyway! But I still repeat, there is no need to do exercises for a hip. None whatsoever. They will recovery perfectly well on their own.
     
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  9. Layla

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    Hi @margo
    Just reading your thread. You sound like an active fun loving woman in tune with her body. Sadly that falls by the wayside with so many as we age. If you are stil scheduled for your European vacation I hope you're able to travel comfortably and get the rest you need, when you need it. Keep in touch with an update on surgery plans.
    We're good listeners here.
    Bon Voyage!
     
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  10. Horseshoe

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    @margo icing the hip, using a crutch/cane helps keep the weight off the aching hip.

    Enjoy your trip!
     
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  11. zauberflöte

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    @margo welcome! You sound full of life, and a new hip will make you even better. I was sad that AlexTheCat and Josephne were both advocating against the trip, because I'd hope that it would be a tremendous mood lifter. Maybe your trip insurance covers leaving the cruise early if things nosedive?

    As Jo said, that little walk soon after surgery (in both my cases, just a few hours, and it feels So Good!) will get you to the bathroom, it will relieve fanny fatigue, it will make you happy (I was walking the halls at 5:00am this time round because I couldn't go back to sleep!), and it will keep all systems go. Some systems, we like for them to go a little more than they want to post op... :wink:
     
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  12. Lerwick8

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    Hi @margo ...

    I have the opposite problem..I got the trochanteric bursitis first and now the intense groin pain. The bursitis is exceptionally painful, I agree.

    Last October, I had my annual month long trip to Japan scheduled and the bursitis was horrible. Fortunately, a cortisone injection knocked out the pain for a few months and then , low and behold, I was back to square one. The next cortisone injection was a complete failure :( And now, it is THR time).

    As for your trip..that is tricky. I recently spent 2 weeks back on the East Coast with my father who is ill. The 5 hour flight really irritated my hip; however, once I settled in at my Dad's house, I was completely resting for two weeks. He is bedridden and I only went out occasionally to the grocery store. My hip felt rested, and relatively pain free, too!

    That said, the long flight back to the West Coast irritated my hip to the point where it was hard to walk for a few days upon my return.

    Life is short, and if you really want a holiday and think you can cope with some off days, then I say go for it. It will certainly not affect any recovery from a THR. It appears that you aren't planning to walk much on your vacation, in which case you may be just fine. The long flight to Europe however, may be a challenge. I splurged on First Class this past go round between San Fran and Atlanta and still had a difficult time with the extended sitting (despite getting up and moving around every hour and being provided with nice ice packs by the flight attendants).

    I wish you all the best!!!!
     
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  13. Mojo333

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    Margo, so sorry I jumped in a little on other thread uninformed. Did not realize you did not have THR . You look like a healthy active pretty lady who is on the go. Hope you get some answers about your hip and knee.
     
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  14. margo

    margo
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    Just came from my Ortho Doctor.

    Yes Josephine, you were right. My problem with my hip is indeed AVN. Gotten increasingly pronounced since my last xrays in June. At least now I know I am not manufacturing the pain. It has really increased a lot since my first post.

    I have in preparation for a potential cancellation taken myself off all anti inflammatory medication. I was on 2 tabs of Aleve twice a day. Now I use ice and often a Percocet at bedtime so I can get a little rest, along with a little Lorazepam. If I get addicted I will face that at a later date when the hip is not hurting.

    So I am hoping that someone who is not in pain decides they want to wait for surgery another time. I will gladly hop in and do it.

    Since I have pins in my hip the surgeon wants to do the posterior approach since that requires less pressure on the femur thereby less chance of damage to the femur. Is the healing process longer with this approach? I think I heard that, maybe I saw it here in this forum.

    I feel better today in my head because many of my questions has been answered. Now I know what is going on.

    I am so grateful for this Forum and all the wonderful members who so generously share their time and experience not to forget our leader Josephine.

    Thank you all. I am fortunate and I have a very supportive husband. I also like my surgeon.

    God Bless you all
     
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  15. bottomshollow

    bottomshollow Moderator

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    moved 12.jpg @margo, from the October surgery list thread back into your own thread where it rightly belongs. You will get far more response and support here.
     
  16. alexthecat

    alexthecat Moderator

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    Margo, try not to worry about the hype around different surgical approaches. It's mostly just advertising anyway.

    I had posterior THR following a failed hip pinning. My recovery was quite easy and completely uneventful. There is a link to my THR recovery thread in my signature, if you'd like to read more about that. It was a lot easier than my recovery from having that hip pinned. You survived that, so you'll sail through THR.

    Sent from my Z799VL using Tapatalk
     
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  17. margo

    margo
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    Hi Alex thanks so much for your reply.

    I spoke to the nurse navigator. She informed me that the first appointment they had a the hospital would be November 9th. She also mentioned that the Doctor said I could not wait that long, I need to clarify that remark with him.

    I have among other things also a very active imagination so I am worried about all kinds of things. Will the entire pelvis collapse? Also would it be better to be on bed rest while I wait?

    However I do know that could present other problems. Blood clots etc . Right now I try to do as much as I can with frequent rest periods. Putting my legs up and icing.

    Maybe I am overreacting. November just seems so far away. Thanks for being here and caring.
     
  18. alexthecat

    alexthecat Moderator

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    No, your pelvis will not collapse, but your pain level will increase a great deal and walking will become a lot more difficult.

    I don't think that's necessary. I think it's better to move around as you're able to and use assistive devices as needed. I was on two crutches before my THR, but I'd transitioned to a cane ten days after my surgery. Using crutches didn't seem to hold me back at all.

    If you listen to your body now and let your pain be your guide, I think you'll be okay. You may want to talk to your surgeon about getting on the cancellation list to try to get in earlier. November seems pretty far away right now.
     
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  19. Horseshoe

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    @margo I bet a cancellation will come through for you :fingersx: . Check to see whether your OS is affiliated with any other hospitals that may have an earlier opening.

    Agree with Alex, I was eager to get my second thr and called every week as a reminder, perhaps your surgeon can pull some strings. In the meantime, icing and using crutches helps take the weight off painful hips.
     
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  20. Jaycey

    Jaycey Moderator

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    The approach does not factor into the recovery time at all. It's all about the condition of the joint when you finally have the procedure as well as your surgeon's skill and experience.

    Do use crutches or canes while you wait for your op. You will feel much better taking some weight off that sore hip.
     
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