THR THR Questions

@TomT I thought I'd move the dual mobility stuff over to your thread if that's ok with you? I was up until 1:30 last night looking up mobility of hip implants!!! I looked up the Dual Mobility and it's a cool concept but I couldn't tell if it provided more absolute ROM than a traditional single cup, so I started down that rabbit hole willingly. I learned WAY more than I ever dreamed was known about the ins and outs of implants and how they fit us. Being as it was so late, I know I don't remember correctly, but in one article, a team of surgeons created a bunch of computer modelings of various human acetabular shape possibilities and then, still in the model, stuck various cups and various balls on various angles of stems and measured the ROMs of each possibility thirteen ways from Thursday. They measured to "component impingement" and also to "bone/tissue impingement". It was a fascinating read. Either that writeup or the other one I read said that in the end it was all up to human anatomy and the skill of the OS anyway. So!

So now that has me all thinking about my vastly different cups (and probably the balls are different sizes too, can't put my hands on my last xray). One cup is a fairly perfect hemisphere, and the other (in xray anyway) appears to have an inward lip on it, like a beret or tam, sort of. When I saw the image, I asked him if that was going to change anything in mobility and whatnot, and he said no.

They feel very different when I'm asking extremes of them, different things hurt on each, but it feels like soft tissue difference. I can't really do passive ROM tests on myself so don't know if there's a significant difference. I have never been flexible, so I assume my limitations are the same old "this won't do that!" that they were 50 years ago... only 50 years more so.

But I love Shugaplum's story in the Amazing Hip Recoveries. She was at the time in her early 20's, a ballet dancer and teacher, and very flexible, as they all are. Her 5-month "after" photo shows her nearly back to pre-pain ROM already, and as we know, ballet asks extreme extremes. So.... if I were 25, I really expect that these hips I have now would do for me exactly what my natural ones did.

It appeared to me that the Dual Mobility simply provides an extra layer of longevity, as the little inside cup is the one you'd be using most of the time. The advantage may not be ROM, it may be durability. I dunno! I hope I haven't bored you to tears!!!!
 
Wow thanks Zauberflote, I really appreciate you looking into this for me I did end up calling the Ortho after I posted about the dual mobility implant. I wasn't able to speak to him directly but his assistant told me my file says the he picked a Medacta implant, I' assuming its this one.


It looks nice enough but I did ask for her to ask him if its possible for me to get this dual mobility implant as well. As I'd really like to be as athletic as possible after the surgery and do plan on working out quite a bit. She said she would ask him and have someone call me back, so hopefully I can talk to him about this, even if it cost more i'd rather get the best one I can. You certainly didn't bore me at all this was exactly the kind of response I was looking for because I tried to do a little research on it myself but i'm not very knowledgeable about this stuff.
 
@TomT soooo glad I didn't bore you! I'll look forward to hearing what your OS has to say. Just a little thought-- if the OS says, sure Tom, dual mobility, you're the boss, but I feel obliged to inform you that I have never used this implant before and can't guarantee as good a job as I can with the Medacta-- what do you do then? I think part of my recoveries was predicated on the fact that I trusted my OS implicitly. (And to brag, he hit 10,000 THR's shortly after my second, and he cannot have been much over 50!)

There are folks of all ages who've come through Bonesmart on their way to skiing, swimming, snorkeling, ballet, childbirth (that was the ballerina, and she had two kids with no hip problems, thankfully), riding and training horses, ordinary gym working out, competitive running, recreational running, tennis, hiking, chasing grandkids, farming, riding the 4x4 around the farm....and they probably have a wide assortment of hips. I think you'll do well at whatever you decide to do!

My self-brag is my barre classes. I am apparently famous at the school where the studio is, for being so "old" and having muscles. There is another woman in my classes with two bionic hips, and a woman with two reverse shoulder replacements, which is several levels trickier than hips. My SIL had bilateral knees at about 71 or 72, and the first thing she did was take up rock climbing with a grandson. She got quite good! She's climbed mountains, dug the equivalent of a 6x6' hole toChina trying to keep her chickens safe, gardens extensively, etc etc! The sky's your limit, and if you have to have a revision in 30 years, probably it will be quantum surgery, so they will operate on this collection of electrons over here, and your hip will copy them. Or something cool like that. :snork:
 
I wasn't able to speak to him directly but his assistant told me my file says the he picked a Medacta implant
Your surgeon will use the implant they are most familiar with - given your own medical situation and your lifestyle. Unless he has experience with the implant you requested he probably won't use it. After all, you would not want him to practice on you.
 
Zauberflote thank you for the advice, they never did end up calling me back about the dual mobility hip, but I agree with you now that if the surgeon is more comfortable working with this brand I'd hate to ask him to test out his skills on a new implant. They did however call me again and the surgeon said he's going attempt to make my leg longer to match my left leg. I'm not sure how they accomplish this but praying he can pull it off.
 
@TomT I had a leg length difference corrected during my second THR. Basically everything gets stretched a bit and the implant is positioned to allow for the correction. I can't say it was the most comfortable recovery. In the first few days I really felt the "stretch". But that eased quickly.
 
Hello Jaycey thank you for your response. Do you mind if I ask you how much difference did they add to your leg, I think I have at least 3/4 of an inch to make up, I'm not sure they can get it that far but i'll be praying
 
@TomT I had about a 1/2 inch. The surgeon said they would correct as much as they could. But amazingly the body does adjust and balance. I know they didn't totally even out my LLD. But they did enough to let my body adjust.
 
Wow even if they could do that much for me I would really appreciate it, because right now I feel like I'm always standing on one leg when I don't have my shoes on
 
@TomT I had that in actual fact before #1-- if I stood on both legs, and put my feet parallel close together, one of my feet (too bad I can't remember which one...) would dangle in the air about an inch off the floor! Too painful to make it reach the floor. That was most likely me tipping my pelvis or something to deal with the pain. In any case, it went away post op. And got even better after #2.
 
I’m constantly amazed at what can be achieved with orthopedic technology. (@zauberflöte I tend to go willingly down those investigative rabbit holes as well! Lol.) Considering everyone’s anatomy is slightly different, it gives me an even greater appreciation of the skill of an orthopedic surgeon in choosing the best prosthesis for each individual. It also drives home the fact of how important the experience and skill of a OS is in choosing one. If you’ve done your due diligence and are comfortable with the OS, then you should be in good hands and can anticipate a successful result.
 
@TomT, It is great that you are asking questions now and getting things you will need. I did not find Bonesmart until after my surgery, but I did my best to prepare and to manage being nervous.

You asked about crutches. For me, after I stopped using my walker, I used the Forearm Crutches (got them on Amazon), which I liked compared to a cane(s) or regular crutches.

You will be in my thoughts on July 22 for a smooth surgery and uneventful recovery!

Take care.:SUNsmile:
 
Yesterday I did my pre op approval visit with my primary care doctor and this morning I attended the joint replacement class. I now only need to test negative for Covid next week and then I'm off to the surgery room on the 22nd.
 
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@TomT so close! Did they pass around a sample of the hardware? At my class we got to play with a sample stem, and cup/ball. I didn't want to pass the cup/ball on, it was hypnotic to see how friction-free the ball spun in the cup. I guess with covid, you probably didn't.

I had a recent non-ortho surgery, and was ordered to stay home between my covid test and surgery day. Made perfect sense to me. Best of luck with yours!!
 
Hello and Happy Thursday :wave:
Your day is fast approaching and you’re going to love the pain free life this miraculous surgery offers. I’m excited for you! :happydance:

Wishing you comfort as you wait.
@TomT
 
Hi Tom,
Your big day is finally here tomorrow. You’re going to love the result of this great surgery.
Will look forward to following your recovery on the healing side.
See you there soon! :)
 
Best wishes for tomorrow's surgery and a smooth recovery with great pain control. Soon you will be on the shiny side of the street (recovery) and moving forward.
 
Thank you guys for your well wishes, I'm not gonna lie I'm freaking out. I'm really nervous. My check in time is 530 AM tomorrow. I suppose that means I'll have all day to try and complete the physical therapy. I'm trying not to think about but I keep thinking about my leg being dislocated during surgery. I have limited mobility moving the leg to the right and I'm not sure how they do that part. I also blew my back out on Sunday and have been bed ridden for the last few days trying to heal my back as much as possible before the big day.
 
All the best tomorrow @TomT . An early start is great - no waiting around and pacing. See you on the other side soon!
 

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