THR THR Questions

TomT

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Hello my name is Tom, I'm a 38 year old male in some what good shape, unfortunately due to a childhood injury were I broke my femur ( just below the femur head) and the corrective surgeries I under went to correct the issue, blood flow to the femur head was cut off I was left with a miss shaped femur head and now terrible arthritis, so bad that I can barely walk lately. I'm seeing an Orthopedic surgeon next Monday to go over the xrays but I'm fairly certain he will say a hip replacement is required due what my general physician has told me. I had a few questions to ask you guys:

1. This thing about not crossing your legs - is this something that is only for your recovery time or after your recovery you still can not cross your legs and if you do what happens? Do you just feel discomfort from this or does it cause your hip to become dislocated?

2. After your surgery will they make you walk the next day? They did this to me as a child and it was very painful I was actually a bit traumatized from it. How long will you be in the hospital and when you came home did you require a hospital bed or could or was your bed just fine?
3. I have a slight length discrepancy due to the fracture when I was younger is this something that could be corrected with a hip replacement by giving me a slightly longer replacement?

I know you guys are not doctors so if you can't answer the 3rd question I understand, thanks for reading and for any replies.
 
@TomT Welcome to BoneSmart! It's a tough time when you first learn there are major issues with your hip. Keep calm and stay with us here. We will see your through this.

1. Crossing your legs just post op is not a good idea no matter what approach your surgeon uses. It puts a lot of pressure on the joint that is trying to heal. Crossing your legs months/years is probably not going to be a problem (she says as she uncrosses her legs). But you just get out of the habit of doing this.

2. They will have you out of bed and walking as soon as possible. Depending on the time of your surgery this may be the same day. The good news is your post op pain will be controlled. And don't feel pressure to move until you are ready.

Each surgeon has a different scenario about how long you stay in hospital. For both my THRs I stayed 2 nights. But these days some patients go home the same day or the day after surgery.

You won't need a hospital bed as you will be fully mobile before leaving the hospital - including going up and down stairs.

3. Yes I am not a doctor but I did have this problem before my RTHR. My surgeon fixed the leg length issue (LLD) during my surgery. How much is your LLD? Be sure and discuss this with your surgeon.
 
Hello Jaycey thank you for the reply, the LLD is quite a bit about 3/4 an inch, I've been wearing a shoe lift ever since I originally broke my leg. I'm happy to hear that correcting that might be possible as its always caused me back problems through out my life.

I'm OK with not crossing my legs during recovery but I was wondering if you did cross them, did it just hurt? Or did something else happen? I don't really cross my legs now as I've lost some mobility from the bone graph surgery I had when I was younger but I do cross them at the ankles sometimes. One last question, are you able to sleep on your side? I'm a side sleeper and I sleep on the side that has the bad hip, will this be possible for me in the future?
 
after my hip surgeries, I slept on my back for about six weeks, with a wedge between my legs to keep me from crossing them. After six weeks, I was allowed to sleep on either side, with a pillow or blanket between my knees, again to keep me from crossing my legs. Now that I am fully recovered, I can sleep however I want.
 
Thanks for your reply Kernsac, I guess this won't be too much of an adjustment for me since I already sleep with a pillow between my legs, I almost never sleep on my back so hopefully I will be able to find a way to force me to do that until i'm fully recovered.
 
Hello @TomT Welcome to the forum! :wave:

The sleeping on your back issue is made better by renting a reclining lift chair. It made both of my recoveries so much nicer and I think I used mine for about the first three weeks. Home health supply stores will deliver it and set it up in your home and also come back to get it when you are ready for it to go.
The one that I used had a zero gravity feature so it was almost like sleeping flat on my back but much better..

AS for the crossing of the legs, it mainly will depend on what approach your surgeon uses and his preferences. I have no restrictions but wasn't keen to cross my legs regardless..
I hope you let us know what the Surgeon says next Monday..
 
Welcome to bonesmart. I am glad you found us. I do not have a restriction of crossing my legs now and actually do it more with the hip that was done in 2017 than with the new one which is only 7m old.

Sleeping on your back is a bit of a trial at first but I found that I would put a body pillow next to me to remind me not to turn and that helped. I, too, slept in the recliner for the first couple of weeks as it was easier to get up and wander around in the middle of the night. I am not a good sleeper in recovery and this way I did not disturb my husband. I had a regular electric recliner but not a lift one that we already owned. I know some people will rent one but others have gone and bought one or already have one at home. Some people have even found some on Craig's list.

For both hips I was in the hospital overnight and pretty much out a bit after noon. Yes, they get you up but with the pain control it is not hard to do and if you cannot then they wait. I know if you are not ready to go home they will keep you longer. Hospitals want to make sure you are safe to leave and be home.

I made a list of questions and had them written down when I met with my surgeon and jotted down answers so I would not forget.
 
@TomT welcome! I had two anteriors 4 years apart, and I am pretty sure I was cautioned not to cross for some weeks for both if them. I've since lost enough weight that I can cross each thigh over and then wrap the ankle behind the other!! It's not comfortable, but I count it a showoff trick when amongst those younger than I.

My surgeon only gives two lifetime precautions: do not do a yoga-type lunge, wide and deep, lots of weight on rear foot, and turn the leg IN. This is where my dislocation risk lies. So long as I keep the leg turned out under that positionasly challenged pose or anything with leg far behind, I can (and do) pretty much anything! The second has to do with running: if I take up fitness running again (not likely at all), I will wear the hip out faster. We are all rooting for these hips of mine to be lifetime hips, so I will sprint for the car in a downpour, and chase my still-infant grandbaby around all I like when the time comes. Those were specifically approved. However, there are plenty on here who have gone back to actual running, so that one is up to the individual.
 
I was wondering if you did cross them, did it just hurt? Or did something else happen?
Crossing the legs isn't painful. If you think about what happens to the hip joint when you cross your legs you will realise why this is a restriction. Crossing one leg over the other puts pressure on both hips with a slight tension put on the ball part of the joint pulling away from the socket. Normally there are muscles and tendons holding the joint tightly in place. But a new hip does not have this firming up around it making it a risk for dislocation. I just got out the habit of crossing the legs. In any case my LTHR surgeon said it wasn't good for the circulation.
are you able to sleep on your side
Ask your surgeon if you will be allowed to sleep on your non-op side early out. You may be able to do this with a pillow between your legs. You won't want to sleep on the op side at first. In most cases the area is just to tender at first.

I was lucky in that I was already a back sleeper before my THRs due to recovery from spinal surgery. Eventually you do get used to back sleeping. But for some it is a big challenge at first. Do you have a recliner? It is a very good option in the early days of recovery.
 
I had anterior THR and only restriction was no bungee jumping. I’m no dr but I think crossing your legs early on or even crossing your ankles might restrict blood flow and you don’t want to do that. They encourage you to move your feet and ankles as you are sitting to diminish the chance of a blood clot as you are healing. After the first few days you are moving about more so this isn’t as much of a concern.

I’m not a back sleeper but found I was able to adjust and sleep on my back. When I first tried going to my operated side, it felt very strange so I stayed on my back but over time I got more used to the side again and it wasn’t a problem. I don’t remember the time frame but it doesn’t seem like it was more than a month or two before I was back on my side. There is lots of healing going on at first so you don’t want to disrupt that.

With all your concerns, the recommendations may vary from one surgeon to the next and from one surgical approach to the next so even though we have all given you our opinions and told you what we were allowed to do, you should raise these same questions with your surgeon to see what he/she recommends.
 
Thank you guys for your replies, I'm very happy to have found this place to get this kind of advice. I'll surely be ordering one of the lift recliners that you guys have suggested. I guess with the leg crossing issue, I'm not so concerned with crossing my legs but just kind of freaked out to learn of this kind of restriction. I guess when I think about it honestly I'm already living with severe restrictions due to the arthritis that I'm suffering from so it shouldn't be that big of a deal specially if I can return to doing non-impact cardio. I love waking up in the morning and going to the gym and doing cardio on the elliptical and I always thought that was safe for my hip since its non impact but over the last few months I'm not even able to do that anymore. I'll update this post to let you guys know what the orthopedic said about my surgery and what approach he plans to use and also if lengthening my leg will be possible.
 
Hello and Welcome! Just stopping by to say Hi and thanks for joining us. :)
You've already received a lot of good advice so I’ll simply wish you well with your upcoming appointment and look forward to your update afterward.
A great weekend to you! :wave:
@TomT
 
Thank you Layla, all you guys who frequent this board to help people through their surgery worries are awesome. Going through something like this can be really scary and to have a place like this were you can get the advice of people who've gone through it is huge.
 
I hear you. We’ve all been there and understand through personal experience. The prospect of surgery does cause varying degrees of anxiety, but know we’re here for you to advise as best we can and to support and encourage you when you’re needing it. You’ve just made yourself a bunch of new friends! :wink:
Have a good one!
 
@TomT I realize I may have given you a wrong impression about crossing my legs post-anterior. It doesn't hurt at all. It's that cross with an extra twist that's uncomfortable. On one side my groin speaks up, on the other side a knee and the twisted up ankle cause discomfort. I cross my legs All The Time-- for some reason it takes a little strain out of my lower back. Plus, it feels very good to stretch the muscles on the outside of the hip. Double plus, it discourages cats sometimes. If you enjoyed sitting with a leg crossed, or sitting tailor fashion, you will enjoy those again! The points about it cutting off circulation are very important!
I myself wouldn't do any exercise that took me to a gym immediately post-op, and I mean absent Covid. It appears I'm 31 years older than you (my phone doesn't show me enough to be certain), but my post-op fatigue was very very real. A younger person may have energy reserves that I used up on my difficult kids. You will be able to walk "half as far as you think you can and then come back the same way" as soon as you like. I came home the next day, and walked laps on our deck that evening. I'd walked laps on the ward the night I was in hospital. It felt very good! And I have a feeling DH only had to dump and refill litter boxes once on my second hip.
 
No problem Zauberflote, I appreciate your reply. I'm excited to hear about how quickly you recovered its giving me a lot of hope.

Hello guys, I just wanted to update my post because I visited the orthopedic yesterday. I spoke with two orthopedics they both concurred that my hip is very bad and that I should undergo a hip replacement ASAP. I asked the doctor frankly " how does it look " he responded with "absolutely terrible." I then asked him if he were my age and had a hip scan that looked like mine would he undergo the procedure, he told me absolutely with out hesitation. He told me that they do the anterior approach and there would be an opening available for next month on the 22nd. I said to go ahead and schedule me for that date. I also asked them if it would be possible to lengthen my leg during the procedure, his assistant answered me right away saying no they wouldn't do that. However, I received some reading material one my way out that stated sometimes the surgeon will attempt to make your leg longer or shorter so that they will be even. This morning when they called to confirm the 22nd schedule I asked again about if it would be possible to at least lengthen the leg even a little, I was told it is possible and the surgeon will do everything he can.

I was told now that they will schedule an appointment with my GP for an assessment if I can go through the surgery. I expect to pass that as I'm generally in pretty good shape. Is there anything else I should expect ? Do they do a measurement to make sure your hip will be an exact fit for you?

How do you guys feel about me asking the surgeon to lengthen the leg? Is that something I should really ask for or is there a risk it could complicate my surgery?
 
Can't answer about leg length as it wasn't a factor for me so I have no knowledge about it. I had bad hips for decades and pins in my left for 50 years. I was very specific with Dr.s when talking to them about a replacement as I knew the pins were a complication. I went to my OS for 2 consults before agreeing to schedule surgery so we were on the same page and clear about what he could accomplish. Never asked where he was going to put the hole, that was his concern not mine.
Restrictions are pretty simple and if you are all in for this surgery and a good result it's no big deal to follow them. I was always a leg crosser at the ankles so I made a conscious effort pre-op and it was never a concern post op. Back sleeping isn't my thing either but if you want to sleep you'll figure it out and it won't be long before you can roll on your side and sleep. My biggest thing was the raised commode, happy when that went away. I can move in ways I couldn't before and the big lifetime restriction is don't fall down.
 
Is there anything else I should expect ? Do they do a measurement to make sure your hip will be an exact fit for you?
During your procedure the surgeon will have access to a set of implants. The ball and socket part of the implant will be fit to you once the joint area is accessed. Don't worry - surgeons are very skilful at looking at this.
How do you guys feel about me asking the surgeon to lengthen the leg? Is that something I should really ask for or is there a risk it could complicate my surgery?
Any hip surgeon should be able to do this. They may not be able to make up the whole LLD. But they should be able to balance things a bit more. Sounds like this surgeon's assistant doesn't know what they are talking about. And no, this will not complicate your surgery.
 
Just going to back to an earlier point, yes they will get you up to walk after surgery but with a walker. And you'll be moving slowly with a nurse or aide standing next to you. At some point the physical therapy will arrive and lead you through walking and going up and down stairs safely--again with a walker or a cane.

You won't be forced to walk without assistance.

Surgeons have discovered that people recover much faster when they get up after surgery. Partly it's confidence. Surgeons want you to feel that you can trust the hip while moving--slowly of course.
 
@TomT ..... it sounds as though you are getting your questions answered from members and staff. Please be sure to let us know if there are still concerns about your upcoming surgery. Even though you're just about there, I'll provide you with some short articles to read that we give to our hip pre-op patients. Don't hesitate to ask anything. We're here for you to help make this go as smoothly as possible.

New BoneSmart members like you are in various stages of their journey to joint replacement. Making the decision whether or not to have surgery and preparing for surgery can be easier once you have done your research and know what lies ahead. Here are some tools that can help you decide what is best for you.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:

Score Chart: How bad is my arthritic hip?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?


If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:

Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?


And if you want to picture what your life might be like with a replaced hip, take a look at the posts and threads from other BoneSmarties provided in this link:

Stories of amazing hip recoveries
 

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