THR THR: my journey and outcome

[Josephine]

Actually no! It takes about 8-12 weeks to be complete but gets a fairly good grip around 6 weeks.

And let me tell you that at 59 you are still a wee bairn!

 

[ochaye]

Josephine

Actually no! It takes about 8-12 weeks to be complete but gets a fairly good grip around 6 weeks.


the reason I am asking Jo is, I asked my surgeon on week 10, post op,whilst the both of us looked upon my x ray, if he could tell by looking at the x ray, if my bone had started to grow into the cup. he says it was too early to tell from the x ray and the bone growth would/could take some time to bond.

I am not sure Josephine of the mechanics of my, or any, THR.... mine is,titanium, ceramic ball/ plastic cup.

is there a further metal cup, like a colander, that sits UNDER the plastic cup that bonds with my bone, is that how it works?

one last silly question for you.... how come the spike (as I call it) the stem, does not get pushed further down into the leg if one gains weight/lifts something very heavy, or with general weight bearing?

in the early days I thought it was the STEM that was cemented/cementless,but it is a cup that is attached to the pelvis?

a wee bairn? help ma boab,thanks Jo

 

[Josephine]

You can see how the mechanics of bony ingrowth happen in this article Cemented and uncemented hips.

There is another device under the cup, it's called the shell and it is coated with hydroxyapatite which is the stuff which encourages bone to grow into the matrix. So each hip replacement consists of these four elements ... (the 'metal insert' can also be plastic or ceramic and the femoral head (ball) can also be ceramic)

About the stem: when the surgeon is preparing the femoral canal, he uses reamers of increasing size until the cancellous bone is removed and the bedrock of the cortical bone is left. In this way he ensures that the stem has an accurate and tight fit in the bone so there is no possibility of it shifting in any direction. (all terms are explained in the article). It also needs to be a tight fit in order to encourage the bony ingrowth that anchors the implants to the bone.

 

[ochaye]

many thanks Josephine

xxx

 

[ochaye]

Josephine

Dear Jo

I'm 13 weeks on now since my uncemented THR and getting stronger day by day I feel, but I have a slight concern over a couple of issues that perhaps you could kindly help me with... ?

I see from some of the THR sites on the net that standing ,unsupported, on ones operated leg is a good sign that one is ready to start walking without the aid of a cane and that it is also a good exercise for the muscles. thing is, I can only manage this for short periods before I feel a weakening of the leg, should this concern me after 13 weeks? my operated leg/hip was a mess for many years.....but I managed to walk "through" the pain

my other concern is the limp! boy do I have to concentrate/count to myself, and have to have been walking for a good 20 minutes before I can get to this level.am I being too hard on myself again or should this also concern me at this point?

and lastly......I was very fit pre op from all my walking and training and stuff. getting "fit" takes an awful lot of effort at any age ,never mind 59,and losing that fitness takes a matter of weeks I'm afraid, so on week 2 or 3, post op, I was doing all I could "to keep my hand in" fitness wise, and working around the hip problem whenever possible.as you could imagine it was very hard work and took a LOT of effort. I guess what I am try to ask/say is that some of these exercises, with weight training for instance, that DON'T involve the legs/hips, are apparently much harder and taking more out of me than my pre op days.
am I STILL using vital body energy to heal my wounds/hip, energy that is leaving me that little bit more exhausted and tired from exercises that I once could do in my sleep?

thanks once again for all you help Josephine, you really are an Angel xxx

PS I have an exercise for your Dear readers straight from the horses mouth (my surgeon)

walk slooooow across your room, heel down first, then ball of foot, with your arms in the air like a tightrope walker, slow and deliberate.

with love and gratitude
John

 

[Josephine]

I see from some of the THR sites on the net that standing ,unsupported, on ones operated leg is a good sign that one is ready to start walking without the aid of a cane and that it is also a good exercise for the muscles.

The moral here is that you shouldn't believe everything you read on the net! It might be a good exercise for an otherwise healthy body but not for one fresh out of surgery. The point being that your hip is not weak it's injured. BIG difference.

my other concern is the limp! boy do I have to concentrate/count to myself, and have to have been walking for a good 20 minutes before I can get to this level.

Stop making such a big thing of it and trying to force it. Use a cane if you are limping, simple as that. It will settle in its own good time. Give it time!

on week 2 or 3, post op, I was doing all I could "to keep my hand in" fitness wise. As you could imagine it was very hard work and took a LOT of effort. I guess what I am try to ask/say is that these exercises, with weight training for instance, that DON'T involve the legs/hips, are apparently much harder and taking more out of me than my pre op days.
Am I STILL using vital body energy to heal, energy that is leaving me that little bit more exhausted and tired from exercises that I once could do in my sleep?

Wrong attitude. As I said before, your hip's not weak, it's injured and you don't resolve injuries with exercise. It never fails to amuse/frustrate/mystify me that whenever people have a problem their first thought is not rest and recuperation but more exercising. Recovery should never take effort, just simple walks of a length appropriate to the stage of recovery as defined here Activity progression for THRs.

 

[Hoppy Nanny]

ochaye Hi John you seem to be having same problems as me. I'm 10 weeks post THR and limping....the PT I saw this week says it's very normal to limp for some time considering the damage done walking with a limp for so long pre op. She has advised to use crutch/ cane for any long walks but to practice in front of mirror walking straight with heel/ toe without crutch indoors. She has referred me for hydrotherapy to tighten up muscles. As a matter of interest why do you want to stand on your operated leg? Especially if it's not doing it any good....? I'd forget that one for a few months...not even tried it. Do hope you can go with the flow and take your recovery as it comes...since I joined BS I've realised I can't push my recovery ......I'm even enjoying my little naps....and I've never, ever slept during the day before...think it might become a habit....at the grand old age of 61!! Take care John. Merry Christmas..Chrissie xxx


Sent from my iPad using BoneSmart®

 

[ochaye]

Hoppy Nanny

see page 3

broken link removed: https://www.orthospecialtyclinic.com/documents/Post-Op%20Hip%20Advanced%20Exercise%20Program.pdf


thanks all....luv the lotta yeh xxx

al the best for the new year Chrissie

 

[ochaye]

@Josephine

Dear overworked Josephine

I am aware by now that your message is "take your time and don't overdo things in your recovery"
and that is a great message I might add

thing is if I take some time off or ease up a little I start to stiffen up in my hip again.
things are a little different for me perhaps than some of your members in as much as that I carried this diseased hip for 8 years or more before the THR and therefore my tendons/ligaments, muscles, whatever, are much shorter or less elastic than most folk and getting them moving again takes a lot of work every day to keep up a satisfying level of mobility.

I get the feeling that if I backed off, as you have suggested to me on numerous occasions, I would only have the shrunken/tight tendons to deal with later on down the road, and perhaps a harder job on my hands to deal with. I have of course the added difficulty of ankylosing spondylitis to deal with too...so that doesn't help

I said a few weeks ago to you that my new hip will never be as good as the "real" thing and you posted a few pics of some members in gymnastic positions. I will NEVER be able to do those due to my hip and/or the ank spon.

I am at a loss to fully explain myself as I don't know all the terms and names for all our hip and muscle parts,but it seems to me that I will have to work very hard indeed just to maintain what I already have today in my hip mobility.

had my THR 14 weeks ago yesterday. the surrounding tissues are going to need some strengthening and stretching and I don't think a 30 min walk every day is going to get me very far....I think the point I am trying to make is the less I do, and the easier I take things, the stiffer I become. Dear Lady I am not trying to disagree with your approach , your work and advice on this forum is invaluable. thank you very much

I have tried an experiment whilst out walking recently.......I walk as slowly and deliberate as I can with equal weight on both legs/hips and try my best not to limp .I can manage 50 odd paces without the stick, so after 14 weeks I am still not waking regularly without the stick......alas I think I have some way to go yet

my wifes friends Mother (70 odd) had a THR 5 weeks before me and has sat at home doing nothing, or very little.
last week she was admitted to the Monklands hospital (of all places ) with a blood clot.

I guess we are all individuals and as such should be able to find our own happy medium and method in our quest for recovery

many thanks
John

 

[Josephine]

My dear, dear John. The obvious fact is that you know your body a whole lot better than I do! Plus as 14 weeks, I'd say you are well outside any protocols I've suggested previously. You are also right about your having a somewhat different situation than the norm and so perhaps it's time you got some guided gym work to help out those contracted and stiff muscles. It very much sounds like now is the time! Just don't go at it like a bull in a china shop, okay?!

 

[ochaye]

will do Jo....goodnight love

x

 

[ochaye]

@Josephine

I mentioned in my last post that I was managing short distances without the cane and had to concentrate like Billy O to stop the limp........is still using the cane at 14 weeks post op within an acceptable timeframe?

and my left operated leg is an inch less around my thigh...is this too acceptable at this stage?

I sound like such a wuss compared to that poor lass VETGIRL....she is soooo brave. God bless her

 

[Poppet]

Why good morning from OZ (Sat in my timezone) John

Settle back with a cuppa and read this article, it might help understand the healing process and timeframes my friend

https://bonesmart.org/forum/threads/healing-phases-nutrition.21918/

 

[Josephine]

is still using the cane at 14 weeks post op within an acceptable timeframe?

Short answer: it's acceptable if you are limping!

 

[ochaye]

thanks Poppy and Jo


@Poppet

spoke to my wee sister the other day via Skype...she is in Melbourne with her two boys and her two grandchildren...it was early morning in Oz when she called in the sun was streaming in her windaes (windows)

here in sunny Scotland, actually the whole of the UK, it's gales, rain, storms, rain, hailstones,
rain and the weather is due a turn for the worse ( much colder )

I can't imagine celebrating xmas in the sunshine.....might just give it a go someday though.......

cheerio Poppy for the noo

 

[Butterfly]

I'm at 11 weeks for the first hip and 7 weeks for the second one. My first hip feels very strong, but the second one not quite as good yet (of course it is a month newer). I am now, for the last couple of weeks, using a cane most of the time (thank God I am rid of the detested walker). Without the cane, I do limp a bit and sometimes a twinge or two in the second hip, but nothing awful. I do sometimes find myself in the back of the house without my cane, only to find I've left it up in the kitchen. I figure that's a good sign! And, like someone above, I also have OA in other joints so that might be slownig me down a little. Knees bother a bit, but no one seems to be sure if that is OA acting up or if it is the result of tendons etc. getting used to the fact that I can actually WALK again, or the result of really flat feet and overpronation (probably all of the above). But I am SO happy to be walking gain, even if I do have to use a cane at this point.

PS: If 58 or 59 is OLD, then I am probably approaching fossil-dom! I figure I still have a lot of mileage left, regardless of the age number thing. HA!

 

[Poppet]

Love reading your Scottish sayings @ochaye - we spent several memorable days in the Borders at St Mary's Loch....

Others known to have visited are Robert Burns and even, in 1814, William Wordsworth - in fact we slept in the room WW slept in and wrote some of his wonderful words!

 

[ochaye]

@Poppet
merry xmas and hiv a guid new year lassie

here's a wee song fir yeh tae sing tae yer kinfolk....an' dinae ask me wit it's aboot as ah hivnae a clue

all the best for the new year
John

Auld Lang Syne

Should auld acquaintance be forgot,
And never brought to mind?
Should auld acquaintance be forgot,
And auld lang syne.

Chorus

For auld lang syne, my jo,
For auld lang syne,
We'll tak a cup o' kindness yet,
For auld lang syne,

And surely ye'll be your pint-stowp!
And surely I'll be mine!
And we'll tak a cup o' kindness yet,
For auld lang syne.

Chorus

We twa hae run about the braes
And pu'd the gowans fine;
But we've wander'd mony a weary foot
Sin auld lang syne.

Chorus

We twa hae paidl'd i' the burn,
Frae mornin' sun till dine;
But seas between us braid hae roar'd
Sin auld lang syne.

Chorus

And there's a hand, my trusty fiere!
And gie's a hand o' thine!
And we'll tak a right guid willy waught,
For auld lang syne.

Chorus



Long, Long Ago

Should old acquaintance be forgot,
And never brought to mind?
Should old acquaintance be forgot,
And long, long ago.

Chorus

And for long, long ago, my dear
For long, long ago,
We'll take a cup of kindness yet,
For long, long ago

And surely youll buy your pint-jug!
And surely I'll buy mine!
And we'll take a cup of kindness yet,
For long, long ago.

Chorus

We two have run about the hills
And pulled the daisies fine;
But we've wandered manys the weary foot
Since long, long ago.

Chorus

We two have paddled in the stream,
From morning sun till dine;
But seas between us broad have roared
Since long, long ago.

Chorus

And there's a hand, my trusty friend!
And give us a hand of yours!
And we'll take a deep draught of good-will
For long, long ago.

 

[Poppet]

Oh @ochaye, thank you so much, it is wonderful

I tried singing it to my dear hubby - he said I need a translator

It is already Xmas morning here in OZ, so....

-:mer xm: To you xx

 

[Josephine]

John, I had to give Poppet some lessons in Scottish dialect as she couldn't understand it! @ochaye