THR in 2 weeks

[NoviceGuy]

Scheduled for THR in 2 weeks and have few questions,
1. OS said he would use ceramic on cross-linked poly, is this a good implant,
does it last long and any suggestions.
2. he is doing Anterior minimum invasive hip replacement, anyone had this
done before and how was it?
3. Also does the anterior approach has the leg length issue because i have
been reading stuff where there is good chance to have one leg longer then
the other with THR.

Thank you so much for your support.

 

[JudyS]

Welcome
I had a right THR 7 weeks ago. My surgeon and I agreed on the ceramic ball and cross linked poly liner. The reasons being that I am extremely active, 51, and that combo should have the longest use. Also no metal particles with their unknown health risks. He believes the new ceramic does not have the same shattering risks of the old ceramic.

I can not comment on the approach. I had posterior as my surgeon was the most comfortable with that approach. I told him to go with the one he was the most comfortable with.

Judy

 

[Josephine]

Scheduled for THR in 2 weeks and have few questions,
1. OS said he would use ceramic on cross-linked poly, is this a good implant,
does it last long and any suggestions.

I can't think of a prosthesis on the market that isn't okay, NG. They've all been pretty much tried and tested over the years so I wouldn't worry about it. Debating about this or that material is so much semantics.

2. he is doing Anterior minimum invasive hip replacement, anyone had this
done before and how was it?

There are pluses and minuses about MIS hips. It has a bit more of a history than MIS knees, but there is still a long way to go.

Having said that, the results so far are looking pretty good and the benefits are less soft tissue invasion and a quicker recovery and rehab.

The cons are placement can be a problem - which is why some MIS surgeons use computer guided assistance or robotics.

We have just opened a new forum in here for this called MIS/Robotics - The Future of Joint Surgery but it had yet to be 'christened'! If you don't object I shall copy this thread into there so you can be the first!

3. Also does the anterior approach has the leg length issue because i have been reading stuff where there is good chance to have one leg longer then
the other with THR.

Thank you so much for your support.

There is AWAYS a chance of having a disparity in leg length, NG. It has little or nothing to do with MIS, anterior or posterior approaches.

 

[electron]

NG welcome aboard.

i am avn also,on 7-1-08 my OS put in ceramic/polymer(I think for the durability).Mine was a lateral approach computer assisted. I have not noticed a LLD? ( length problem). my incision was large because he went in to look around to ensure no other problems were present and to confirm if I would be a "hip-resurface" or a total-hip.( total it is due to a fracture he found at the femur neck).

I originally wanted a "metal-on-metal", a larger size is available, and I thought that would mean a larger Range Of Motion.
The one I now have looks real close symetrically with my real one in the x-rays.

I have heard from more than one OS that nobody really knows what happens long-term with the new metal-on-metal since it generates chromium and/or other ions.

good luck,.. this is a great forum you will be able to find a lot of info here.

jon

 

[Bob A.]

Welcome NG
I am scheduled for bilateral hips in the beginning of October and he wants to use ceramic with a triple cross linked poly liner. I had been for metal on metal but this is what he uses so I will go for it. He thinks he can put in a pretty big ball, close to what I am now.

This surgeon also is going to use a MIS anterior approach. He said the incision is about 4 inches and should minimize trauma to the leg. If it wasn't for the MIS, I wouldn't be doing both at the same time. My wife is a PT, she has worked with one of his MIS bilateral hip patients and was amazed at how far he was only a week or so after the surgery. From the discussions with him and from what I have read on the web, it is a more complicated surgery and those doctors who have done it for a while prefer it to a conventional approach. From a patients perspective, it greatly lessens the recovery time and pain if all goes well.

Good luck on the surgery, please post afterward when you can and let us know how its going.

 

[NoviceGuy]

Any suggestion about the preparation for the surgery and also the
post op recovery. Thanks all for the info.

NG

 

[electron]

I know there's a list out here somewhere.

Just off the top of my head

1) maintain your health/diet etc.
2) if you are able to do basic leg and hip excersizes now it should help your recovery.
3) Bank some blood
4) I was able to get by with a backpack that carried basic toiletries, reading/writing/ drawing pens and pads, a few magazines, maybe a lucky charm or stuffed animal from a friend.
5) my kids bought me a nintendo Ds and some games. ( I barely used it, I was either wiped out or too busy or not able to concentrate).
6) Ipod and charger or headphone radio and batteries.( this really helped distract me from the surroundings so my body could start recovering)
7) I don't have a laptop but was ready to get one.
8) you will need items at home and maybe help "hip-proofing" your house.( walker, raised toilet seat, move items you need to lower shelves, there are a few lists out there )
9) I pre-checked into the hospital( maybe all of them do that)
10) (I'm sure I forgot some major items help anyone?)


when I came to,.. a lot of things from before did'nt matter. I was so happy to have a friend and loved one waiting in my recovery room. the rest of my time was dissected into it seems like half-hour intervals.

I went in at 7:00 am on tues and left at 1:30 pm thurs. (not very much time to deal with) I tried real hard to do everything they required me to do at the hospital. the next steps at home were tedious and I felt like I was'nt getting healed,.. so BE PATIENT!!!

I hope you can find a better Pre-Op list. I have seen several online under a general Hip-surgery search.

wish you the best of luck.

jon

 

[Josephine]

All good stuff, jon!

 

[NoviceGuy]

Thanks to everyone... you guys are the best.

 

[JudyS]

Novice Guy,

I sure thought I had a leg length discrepency after surgery. My doc told me the operated leg would seem longer . He also told me the post op x-rays had them both at the same size. It took a number of weeks before they felt the same size.
I am not sure if everyone has major swelling, but be prepared. I certainly was amazed at how swollen I was down to my toes. I could hardly recognize my feet, the day I was leaving the hospital was when I noticed it, I told the nurse my thigh was so big , bigger than the abdomen when I was about to give birth.
I had gained 20 pounds and did swell in both legs.

My mantra, which I got from my friend Patty here on bone smart, was to take those pain meds on schedule. That would be my immediate post op advice.

That swollen leg will also feel like it weight 1,000. pounds and be impossible to move alone. All normal
When you get home, rest,rest, ice, rest, take your pain meds!!!!

Good Luck
Judy

 

[JudyS]

Oh and take your stool softeners to counteract your pain meds
Judy

 

[rejoyce318]

Novice Guy,

3 wks. ago TODAY (!), I had a LTHR, anterior incision. I think my prothesis is titanium post, chromium/cobalt ball, & poly liner. I had asked about ceramic on ceramic & was told that my OS tends not to use that b/c the manufacturers have not figured out how to prevent the loud, permanent squeaking that a small %-age of patients get from that prosthesis!

I am VERY happy that I had an anterior incision because my recovery has been so much faster - I do have muscle weakness & tightness, but PT definitely helps. My incision is 5.5 in. long, btw.

Joyce

 

[Josephine]

Note - we have a special forum for that problem here now but has yet to be christened.

 

[NoviceGuy]

Thanks Joyce for the info...

1. Are you able to walk with any assistance?
2. For how long did you take pain medication?
3. Were you able to walk without any limp?
because for me this is the biggest worry other than the surgery.

 

[rejoyce318]

Novice Guy,

I just thought I posted to you, but forgot to hit "send." SIGH
To answer your questions:

1. I still use a cane for support & posture. When I walk w/out the cane I waddle, not just limp!

2. Stopped taking the Lortab (Tylenol + codeine) 2 days after discharge, b/c all it did was make me unsteady on my feet, & my pain wasn't bad. I went back to taking the 8-hr. Tylenol I took the month pre-surgery, after I had to stop taking Advil (ibuprofen). Since my OS took me off aspirin therapy yesterday, I started taking ibuprofen again. Tylenol takes the edge off, but the ibuprofen is also anti-inflammatory, so that's helping
my residual pain from the muscle strain I caused myself a week ago.

3. The limp is my biggest concern, too. I'm hoping that after another month of PT, I'll be limp-free, b/c I know the LLD I had was corrected with the THR.

Never be hesitant to ask the OS or surgical nurses any questions, both before and after surgery. There are NO silly questions!

Best Wishes.
Joyce