THR THR and New to Forum

[Jaycey]

Re: Leg length discrepancy

Almost every hippie feels this difference just post-op. Please don't worry at all about it. This usually disappears on its own.

It is recommended that you not do anything for the leg length for at least 3-4 months. If you still feel a difference you need to have a professional measure you accurately. A small lift in your shoe will take care of this.

But honestly - things usually settle. Here's a thread from the Library about LLD.

 

[uktanny]

Re: Leg length discrepancy

Hi Cheeky,

I know EXACTLY how you feel. My operated leg felt much longer after my op. I too couldnt put my legs straight as the long one bent at the knee. When I sat down my operated side stuck out at the knee by about an inch. I was so worried and upset that I had a new problem to deal with

I remember that I could only do my side leg raises on tiptoe as otherwise my longer leg wouldnt clear the ground

Fast forward six months. I DO have a little discrepancy and am seeing a podiatrist in a couple of weeks. But it is very minor and it doesnt cause me to limp. Well I always limp for a few paces when I first get up, but once I'm going I am ok.

Please try not to worry, your tissues are still traumatised and very swollen (my thigh is still swollen a bit now!) things will definately settle. Put the whole thing on the back burner until at least 3 months and then see where you are.

Good luck

Tanny x

 

[Jyoti]

Re: Suggestions for wound? Bilateral dysplasia?

Hi,
Yes, I had my hip dysplasia since birth but it was only when I was 3 before they diagnosed it. My pain began in 2010 in my right hip, but I had a LLD and limited ROM since a child which progressively became worse as I grew up.

Despite yours being found later in life we have had to have our THR's at similar ages, but I think you had more pain then me which is not fair. It must have been horrible!! Because it was the pain which made my decision to have the THR.
Jyoti

 

[Jamie]

Re: Leg length discrepancy

These folks are right. It's way too soon to worry about a leg discrepancy. Remember, your pelvis didn't tilt to adjust to your bad hip overnight....or even in a few weeks. It will not right itself that quickly either. Just concentrate on walking with a good gait (no limp). If that requires you to continue to use a crutch or cane, then do it. In the end, your boady will right itself and you'll feel much more "normal."

 

[special lady]

Re: Suggestions for wound? Bilateral dysplasia?

Cheekychops,

I have coxa volga which is a deformity in both hips.. Or maybe I should say had in both hips...It was never a problem for me at all while growing up, as a matter of fact it actually helped in gymnastics, dance, water skiing, and even with equestian sports such as cross country jumping and such because it enabled me to be extremely flexible. Then a little over two years ago after making a career out of all the equestian sports, it all caught up to me, and I had no choice but to do something, because of all the damage to one hip.

I ended up having the osteotomy "barbaric" surgery,
(by the way great name of it) which turned into a nightmare, resulting in 4 more surgeries and one more to go.

I don't blame you at all for putting off surgery on the other hip until the bitter end, and you can't put it off any longer. I'm going to do the same with the non-operative hip. Who knows maybe we will get through life without having to have anything done to the other side... one can hope

My scar is 22" long and I've used tea tree oil, and lanolin, and manuka honey...although I have to say I would think the other over the counter creams would probably help just as well... The one key I've found is to message it as often as you can once your wound is completely closed...to get rid of the bumps and lumps... I've done this for many years with the horses and their wounds and scarring.. and it does help.

My best wishes to you for a speedy recovery but listen to your body it tells you more then anyone else can say if your doing too much or too little for that matter.

 

[cheekychops1412]

Re: Suggestions for wound? Bilateral dysplasia?

Hi yes Jyoti,
The amount of pain had become immeasurable after the osteotomy! My hip seemed to crunch and grind with every step taken and because of the job I do (I'm a Registered Nurse on a very busy medical ward), I was constantly on my feet and I had pain etched on my face.
I was prescribed Zomorph 30mg twice daily (slow acting Morphine), Nortriptyline at night and Morphine solution 10mg 2-4 hourly as required which masked my pain a little, but opened up a whole new issue at work when it was suggested to me that I was unable to continue to work due to the potency of the prescribed medications! Good times, eh?
So pleased to start the New Year post-operation rather than still waiting. I was initially told it would be March/April this year before my surgery and was only placed on the waiting list early November but I was fortunate to get a cancellation!
I'm fiercely independent as I'm sure most of us our, but I'm really trying not to be too hard on myself and to let nature take its course. It's been a long road so I don't want to risk any set-backs at this stage.
As you're of similar age and have/had dysplastic hips, could I be so bold and ask how long did it take you before you felt 'normal' after your surgery and maybe any tips for accelerated rehabillation?
Thanks a million :biggrin:.

 

[JuliaB]

Re: Suggestions for wound? Bilateral dysplasia?

Hi Cheeky - I also have bilateral dysplasia, I was born with two dislocated hips and severe coxa vara on both sides. I had osteotomies on both sides at age 4. I got through most of my life without much visible indication of any problems - I just wasn't particularly athletic and could never sit cross-legged.

I had my left THR almost 2 yers ago, and it took me about 14 months to lose my cane. I walk with a very slight limp, and I think I'll be fighting to strengthen my abductors for the rest of my life, constantly. I'm pretty comfortable with my gait, my golf, and whtever else I do now, but I have to say I think I'm still improving a little more all the time. My flexibility is still improving, and I walk faster now than a few months ago.

I'm scheduled to have my right THR in late March. It's time, and I'm grateful it has waited this long to let me know that. I really would not have wanted to undergo the experience again without my body getting to this point, finally.

I think your body wil let you know when it's ready for the next one.

 

[cheekychops1412]

Need for aggressive physiotherapy or not?

Dear all,

I am gathering that physiotherapy post-op isn't normally advocated in the UK post-THR, but I'm wondering whether or not to ask at my follow-up if some physiotherapy maybe pertinent in my particular case.

I've had two major surgeries and an additional incision for removal of hardware in fifteen months and the physiotherapy I had been receiving post-derotational osteotomy surgery had to be aborted when it became apparent I still had residual impingement and excruciating pain!

What do you more experienced hip recoverers think? Is there anything to be gained from more aggressive physiotherapy or should I be content to manage this myself at home with exercise and stretches advised on this forum? I have substantial muscle wasting to right hip, thigh and buttock and I really don't want this to be detrimental to my recovery .

 

[Jyoti]

Re: Need for aggressive physiotherapy or not?

Well cheeky chops all I can say was I was referred by the Physios at the Hospital after having my thr. I found it helpful and also I was referred for hydrotherapy which really helped. Unsure about aggressive physio. However, the NHS physio didn't take me all the way so I was lucky to find a private Physio who I have been seeing for 3 months. Think I said before that he gave me accupuncture which helped release my tight muscles allowing me to increase my ROM and allow me to stretch and do more resistance work.

I also have a smaller right leg and buttock but others tell me they don't notice but I can feel it. Doing physio will help and I would ask for a referral. I know others have said that we don't necessarily need it but it does no harm.
Jyoti

 

[Jyoti]

Re: Suggestions for wound? Bilateral dysplasia?

For me I stopped the meds at 3 weeks which was great and my hip is doing great. But what I found hard was that my right knee ached loads as well as my right foot. What happened was through the alignment my hip was finally straight effecting both my knee and foot who were confused as difft muscles were being woken up. My knee was inflamed. It has improved but I still have aches and also my 'crepitus' - creaky knees have become worse.

I still don't feel 'normal' but that is such a subjective feeling. I have no hip pain which is brilliant and I have a longer leg and bettet ROM but I still need to get off the crutch. Once I do then I will feel more normal.

Don't get me wrong I do feel happier with everything. I was actually told by my OS that I will feel the full benefits in 2 to 3 years.
Jyoti

 

[Tykey]

Re: Need for aggressive physiotherapy or not?

It's the "aggressive" bit I'd worry about. If the doc decides to refer you, make sure it starts very gently and work it up slowly.
The point about us brits not doing therapy is that we tend not to do any until after several weeks ie after we have healed.At that stage you can start rebuilding the muscles.
If you do too much too soon, all you do is damage the bits which are still trying to heal.

 

[Jaycey]

Re: Need for aggressive physiotherapy or not?

I found PT very helpful post op. I have major back issues that were aggravated by my THR. PT helped me overcome those and got me on the right track with stretches and building muscles.

The only issue is on the NHS they will only give you 6 sessions. You will be discharged ready or not. But if you are prepared to work during all the sessions you will see the benefit - or at least I did.

 

[Jamie]

Re: Need for aggressive physiotherapy or not?

You might consider waiting for therapy until you get past the major healing stage of recovery. That is the time where you would want to start rebuilding those atrophied muscles.

 

[Poppet]

Re: Need for aggressive physiotherapy or not?

Hi cheeky - great name by the way

I can only speak from my experience here in OZ. I worked out with the physio in the hospital and she gave me three sheets of exercises (identical to Jo's in the library) upon discharge.

These exercises ranged from the basic one's for the first couple of weeks to more advanced as the weeks progressed.

I added, walking aided, slow walking on the treadmill and cycling (on the floor cycle machine, not a regular exercise bike as this did not break my restrictions) and pool work.

I had decided with my surgeon that all of this was sufficient until my period of restrictions were lifted. He was more than happy with that approach.

Although sometimes I have thought I could do more, I resisted.. My period of restrictions are for 12 weeks, I am heading into week 8.

I went back to work graduated last week and have really appreciated the fact that I did resist, as for me and I stress this is my situation not necessarily yours... I am feeling so much stronger each and every minute.

The only PT my surgeon suggested was to get a physio to check my gait, but other than that he said - just keep moving..

I guess I am just reiterating the previous advice to take it slowly, there is so much deep healing that has to occur and it takes a long, long time - good luck with your recovery....

 

[Josephine]

I'm now 2 weeks and three days post-operation and feeling amazingly well... my worry is perhaps I'm doing too much due to feeling so well... feel so good I could actually ditch my 2 walking sticks and walk unaided, albeit with a little bit of a residual limp. When is it acceptable to ditch my walking sticks or even reduce to one?

Well don't just yet! You're still recovering from a major surgery and need to give yourself more time. Take it as you feel able.

Read these
Pain management and the pain chart
How Long Does Healing Take ......
Chart representation of THR recovery
Energy Drain for THRs
Elevating your leg to control swelling and pain
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Some suggestions for home physio (PT) and activity progress

I am aware of weakened thigh muscles when mobilising but think that this may be due to not achieving full rehabilitation from previous osteotomy. Has anyone received any specific post-op physiotherapy following their THR in the UK?

I see Jamie has already given you the link to some good articles for this. Do read them. We don't tend to get the hands on physio that they do in the States but you can get some if you ask your surgeon or GP.

I'm concerned how I'm going to manage my job in the long term... sadly I have a fair few years to work before I retire.

What is your job?

One last query...has anyone had experience of excessive nocturnal sweating since they had a THR? From about 8pm onwards and right through the night, I'm sweating excessively but apyrexial! I underwent a laparotomy for removal of ovaries at age 35

Well, I think you may have just started the old post-menopausal hot flushes! I can sympathise because it just happened to me! I had a hysterectomy at age 39 followed by 25 years of HRT. Stopped that about 6 years ago. But last year, the hot flushes started with a vengeance! After lots of tests and stuff, I went to see an endocrinologist who recommended a drug called clonidine and it work from the very first dose! I take two 50mcg tablets morning and evening and haven't experienced a hot flush since I started taking them about 4 months ago. It's a very old medication but it works for me! Have a word with your GP. btw, I can promise you he won't consider putting you on HRT at this late stage!

 

[cheekychops1412]

Good morning Josephine,

This site is amazing and offers some great tips from personal experience...wish I'd found it before my surgery and then I may have been a bit more clued-up.

Firstly thank you for your reply and secondly for your wise comments regarding not ditching my crutches yet...I learned the hard way unfortunately in so far as I was thinking I was okay and recovered after TWO weeks because I felt great, but then this last week I've been in a lot of discomfort deep inside almost the entire length of my femur-luckily I did see sense for myself and hadn't ditched the crutches. I've been taking things easier this last week...listening to my body more, I think!

Regarding my job, I am a Registered Nurse on a very busy, often physically demanding medical/Cardiolgy ward. I've tended to work night duty for years as this was deemed somewhat 'easier' for me but as more often than not the only trained nurse on duty, there's a substantial amount of foot work involved and for that reason alone that concerns me. Also my left hip is presenting on clinical examination alone the same as my right did in terms of extreme restriction of movement and pain. After my last surgery, my employers had to complete risk assessments etc and a letter from my hip preservation Orthopaedic Surgeon concluded that I was unable to get to floor level, so somewhat unlucky for a paitent who collapses on the floor lol!

Thanks again.

With regards to the sweating at night, maybe I should have mentioned that I've been having oestrogen and testosterone HRT implants since the age of 35 when my ovaries were removed. The implant's life are variable but usually last me 6-12 monthsand I had my last implant in August 2011. I have to stay on these apparently until the age of 53 to protect against bone loss etc. I think the sweating may be due to the Oramorph which I'm still taking as requiredand especially at night, but I'm also weaning myself off slow release Zomorph 10mg under the guidance of my GP so that also may be having some impact!

 

[alexthecat]

Re: Need for aggressive physiotherapy or not?

I had intensive (though not terribly aggressive) physio after my THR. That was necessary for me but is not for most people. I had been unable to walk for some months prior to THR. In addition to the muscle wasting, I had forgotten how to walk and needed physio to relearn that. It's not something that I would have been able to work out on my own. Most people are not in that position however.

 

[welshjane]

Re: Need for aggressive physiotherapy or not?

Hi cheekychops (love the name!)

You're right, we don't get offered any physio after the THR in the UK. I went to see the local physio privately once and he's given me some exercises pretty much the same as the ones in the library here, but crucially also helped with my gait. But the one thing I wanted to mention, for the benefit of any UK hippies out there, is exercise on prescription. I'd heard of this but thought it was just for old people with heart conditions. But when I went along to my local gym (a local authority leisure centre) to see about unfreezing my membership (which I'd frozen for the duration, not knowing when I could get back to working out), they told me that I'd qualify for exercise on prescription, which is of course free. So I got a form from the doctor and went back to the gym. I was impressed with the thoroughness of the consultation I had there (with the lady who also teaches pilates, which I've had to stop for the time being of course), and the care with which my programme was constructed. You get 12 weeks free gym membership with each THR, so it might be worth investigating as an alternative or adjunct to 'aggressive' PT. Hope this helps!

 

[Josephine]

Re: Leg length discrepancy

Read this LLD (leg length differential)

 

[joanna]

Re: Need for aggressive physiotherapy or not?

That's interesting Jane about the free exercise. Though I've never seen inside a gym!

I'm heading into wk 9 or maybe 10 I've lost count, have had no 'physio' so to speak. But starting to feel I'm not improving and need to do something to fix this. Gait is terrible, and unaided right leg tires very quickly, starting to feel this can't be right.

Jo