THR in five days!

[jbgriff]

First I want to say thanks to all the members here who have shared their triumphs and setbacks. These anecdotes have helped me to muster the courage to go ahead with my surgery next week.
I am a 45 year old male suffering from advanced AVN in my right hip. It's a result of a nasty fall from a bicycle nearly two years ago. I had a really good year in 2007 getting back to mountain biking, swimming, yoga, etc. until the end of October when I started getting pain in my hip again. My OS who did the initial repair (the three 4-4.5" lag screws though the neck of the femur) thought the pain was the result of the pins protruding into the tendons. I got the pins removed in early Feb 2008 and spent 6 weeks on crutches. When I got my final x-rays after the six weeks were up, I knew something was wrong when I heard him say "oh my God" and shut the exam room door.
I was left standing alone as I heard him conferring with another OS in the hallway.
The other OS was the joint replacement specialist and he came in with my primary OS. The news hit me like a ton of bricks...I was in need of a THR! I didn't know how to react... I have two young children and am very active. The joint replacement OS told me how great the new implants are and that the metal-on-metal bearing would last the rest of my life. I started reading as much as I could about the prosthetics, surgeries, potential complications, revision rates until I worked myself into a state of panic. It wasn't until I found this forum that I realized that it's not the end of my active life and there is hope to be pain free and active.
The doctor that was going to use the metal on metal got a bad review from a former patient (he messed her TKR up badly enough that she had to have a revision....by the doctor that she recommended). I immediately made an appointment with the second OS. He does the most surgeries in my home state (Idaho). It took a lot longer to get in to see him, which I took as a good sign. I had a great talk with his associate and felt much more comfortable with our discussion compared to the first OS. The only issue I had when I came out of that appointment was that this OS uses only metal/poly implants. I was convinced that metal on metal was the way to go for longevity and range of motion (both VERY important to me). It was explained that the new implants with the x-linked liners are desirable because the revisions are much easier. If the liner wears out, it is only a 15 minute surgery to replace. The metal implants do not have to be removed unless they have loosened. O.K. That's a good reason... the metal on metal implant are more difficult to revise?

So my questions to the group...
For those that have metal/poly what kind of limitations do you have for movement? I can still touch my knee to my chest!! Will I lose that? Will I be able to do yoga again?

I also really want to mountain bike again. I'll probably take the downhills a little more slowly but I like climbing more anyway. I did read several posts where some are running and doing some pretty bold mountain biking. If I were to fall, do the movement limitations make it really easy to end up with a dislocated hip? It's a little hard to plan how you are to land sometimes....that is, after all how I got into this mess! I guess I should find a riding partner.

What about upper body exercise during the first part of recovery? Did anyone do upper body weights during the first six weeks? I've been working hard to get into shape before surgery and I don't want to lose it. I just bought a barely used Bowflex on Craig's List to aid in rehab (one of the Revolutions....it's very smooth).

Thanks so much again for all the great posts. Please say a little prayer for me on May 13th!

Best regards,
Brian

 

[ripanco]

HI Brian,

Well, I can give you my experience which is not far off from what you are looking for. I had simultaneous bilateral THR in May, '05 at the age of 53. I was a very active, athletic person but having more and more trouble dealing with the pain in my hips especially after runs of more than 15 mi. I saw three different OS before I found the one that I was the most comfortable with and he was awsome! He spent a lot of time with us explaining everthing and wanting to know what I wanted from my surgery. He understood that being active was a part of my life, not just something I like doing. Like you, I had done all kinds of research on the internet before meeting him and was convinced I wanted ceramic/ceramic. However, although my surgeon uses all three materials, he explained to me why he felt the metal/poly would be my best bet. I had enough faith in him and figured he sure knew a lot more than me to go with his recommendation. So I have two lovely titanium/x-linked poly hips that have given me a new life.

After 3 years I still love my new hips. I basically do whatever I want and don't even think about them anymore. I do mountainbike and have taken several good tumbles, plenty of scrapes and bruises but no problem with the hips. I ride horseback. My worst falls have come from that. I do eventing with a greenbean hotheaded Hanoverian mare who has managed to dump me a few times, including a crash into an obstacle that sent me to the ER, but the hips were fine. I got kicked hard (not by my horse) right on my left hip that sent me flying thru the air. When I landed I was sure I had totally ruined the hip, but after I very slowly got up, to my amazement it was ok! I had a nasty bruise the shape of a hoof right over my scar! I had my anual checkup a few weeks later and I was very relieved that the bruise had faded so my surgeon didn't see it and my x-rays showed the hips in great shape! The first couple of bad falls I took really scared me (and my DH!), but as time goes by we are less concerned. The titanuim is pretty tough stuff. And I truly believe that having strong muscles, tendons, ligaments, does a lot to protect the prothesis.

I do yoga and pilates. There are some poses that I will never be able to do again such as pigeon, but I work around that. I have a little less flexibilty around the hips, need to use a mounting block to get on my horse now, but I think it is better to have your hips a little tight after THR. I also kayak, rollerblade, lift, ski, hike and even run a little. So, yea, there is life after THR and it ain't bad! I do realize I may be shortening the lifespan of my hips, but I am willing to trade a few years to maintain a lifestyle I need. My surgeon also told me that when I do need a revision, changing the poly cup is not all that difficult. And even with my active lifestyle he feels I should get a good 20 yrs. Maybe by then I will be ready to slow down.

You asked about lifting post surgery. More importantly, lift BEFORE! Get as strong and lean as you can before your surgery, that will make the biggest difference in your recovery. Because I was so strong going into surgery, I was doing upper body work within 5 days. I was also walking without crutches because I would forget them, 4 days after being home. I got sent home from the hospital only 2 days post surgery. It sounds like you are working on your strength now, so keep it up! The Bowflex should be good. I also found pool running to help. I did it both pre and post surgery. Great workout without pounding your joints. My surgeon let me back in the pool 2 weeks after surgery. The funniest thing was when I first tried to pool run, I went backwards instead of forward! I just couldn't make my legs work the right way at first. I also did my leg exercises in the water. You can get as much resistance as you want without stress on the joints.

Good luck, think positive and let us know how you make out!!

Andrea

 

[JudyS]

You both just made my day. I am 50 and having right hip replacement in 4 weeks.
I too am very active and need to be. I am a mountain trail runner, also cross country ski, not very consistent with going to the gym as I prefer to be outside. I did not do much cross training in my life, but will now. I had 3 level cervical spine fusion last summer and was able to go back to everything.
I had arthroscopic hip surgery on Feb 1, 2008 and was also on crutches for 4 weeks. The plan was to try to grow fibrocartilage as the MRI did not show widespread arthritis. There was widespread arthritis, the fibrocartilage did not work. I thought my OS was crazy talking about hip replacement. I told him it would be ok in about 20 years to talk to me about it.
Well the pain got worse, I am afraid to run so the decision was made after a few months.
We last discussed using ceramic/poly . I too need to be very active and would gladly have the replacement wear in 20 years or less than to give up my life and have it last longer.
I am so glad to hear how well you are doing Andrea, that is the best story I have read on this site.
Brian , I will say a big prayer for you on the 13th. I know you will do great and be out there having fun in not time.
Judy

 

[Josephine]

Can't add to any of that. They have said it all and first hand experience beats anything I can say!

 

[jbgriff]

Thanks so much for the reply Andrea . Your posts describing your levels of activity are so encouraging to me. It's good to hear that you can take some pretty good spills and still have solid hips! I don't plan on getting kicked by a horse but it's good to know we're not so fragile (maybe you should be a spokesperson for the maker of your implant!).
I met with my surgeon today and walked away with a much better attitude. He sat with me for a long time and answered all my questions without the slightest air of impatience. He's a 23 year veteran and it was clear that his staff has the highest respect for him.
So now I am following Josephine's advise and changing my mental state from anxiety to excitement. I have to get past this and move on with my life. Hopefully I'll be up and around as fast as Andrea!

I'll keep you all posted and thanks ahead of time for the prayers.

Brian

 

[Sardi]

Good luck. You will do great!! I had a lot of the same concerns and at 45 I didn't want to give up activity, mobility, etc. The surgery was better than the pain I had before!!! It is crazy how you feel afterwards. I had the walker 5 days and then just on my own.
Being fit and strong will help you so much!!!!
Hang in there. It is a little overwhelming at times to think about but wow, what a diffference you are going to feel.
Let us know how you are doing. I am about 1 month ahead of you!

 

[mikey]

I'm 59 Male and left Atlanta yesterday to visit with Dr. Thomas Gross, Columbia, SC. Patients come to him from all over the country as well as some from abroad.He's going to be my man. I'm convinced. He primarily does resurfacing and does not make so many judgements on age alone. Take a look at his web site, www.grossortho.com. He is also on surfacehippy.info, and on youtube. He has done over 1350 hip resurfacings. His staff is readily "available" to you.

My take on resurfacing is that is a more difficult surgery and many OS's don't need to learn it. They have plenty of patients for THR. The surgery is more diffficult because the femoral neck is not removed making the space more difficult to work in.

I suggest that anyone considering THR to take a look and inquired if they are candidate.

 

[jbgriff]

It's been one week since my surgery and things seem to be going well. The surgery, in the words of my OS "couldn't have gone better." I was out of the hospital and walking about, with the aid of crutches after two days.
There are still a lot of aches and pains, some from the incision and some from my body getting used to the leg lengthening (my femur shoulder had compressed from the previous fracture and my leg had shortened by ~1/2 inch). When I look at my reflection in a window, I seem to have quite a lean toward my left (unoperated side). I'm hopeful that this will resolve itself once I get the muscles stronger.
My most significant milestone this week was transitioning from the Hydrocodone to Ultram! I didn't realize what a fog I was in and my attitude has improved substantially for the better.
I've been taking some good walks and hope to get on the stationary bike a little over the next few days.


Brian