THR Revision Recovery

[inthebeginning]

I'll keep this short. Really just thinking out loud.
Mentally preparing and physically pre-covering for a THR Revision only 5½ years after it was installed.

Hip doc says there's nothing mechanically wrong with the joint but it appears that bone growth somehow stopped and the stem isn't fully bonded in the femur. It is tight down towards the tip but there is space around the top half. It started to cause some pain on a regular basis about 6 months ago.

I have read way too much on revision recovery (as I did before the first replacement) and am now getting confused on what to expect. I have read no weight bearing for weeks to they make you walk before they release you from the hospital.

I know recovery is different for everybody and I can't base my expectations on what anyone else experienced. I guess I will move forward with the same attitude I had for the first one. Work out as much as I can to strengthen the surrounding muscles and follow all of the post-op advice here on BoneSmart!

I walked out of the hospital 24 hours after the first one. If I can come close to that, I will expect about the same recovery.

 

[Eman85]

If the stem is loose do you think putting strain on it is a good idea? I wonder why the bone growth stopped, did the OS give any clue? We all hope to not have to have a redo at that short of a time.

 

[SelfHelp]

I would be interested to understand why bone would fuse to the stem at one end but not the other. If your hip was fine for 5 years with all your activities, then I presume the stem must have had a good fusion to the bone all this time. I wonder if the bone recessed at the top recently. I have read that resistance training helps bone strength and bone growth. Has your OS suggested any exercises or nutritional plans?

 

[Mojo333]

My thoughts are that you had a stellar first recovery and was able to do alot very quickly.
I would take this recovery easy easy.

I have read that resistance training helps bone strength and bone growth.

I saw the PT with resistance bands you did last time and I'm not a fan. When my PT pressed to go to bands, I could tell it was too much too soon. I could do it, it was just obvious to me it was not helpful and I felt it was actually detrimental. I did the exercises but refused to do them with the bands.
I dropped PT for first months as I could do the simpler things at home and they always push for more.
I do alot of walking for my job, but even that could be done to excess in early days.
After many months, I picked up the PT I seemed helpful...mostly gait training and some hip strengthening exercises.

I think it's alot about timing. Just because we can do things early, doesn't mean we should.

 

[Jaycey]

I have read no weight bearing for weeks to they make you walk before they release you from the hospital.

Has your surgeon specified NWB? It's not always the case. Are you having a cemented implant?

 

[Layla]

Hello,
Sorry you have to experience surgery for a second time on the same hip.
I wish you comfort and all of the best as you move toward your April revision date.
Stay in touch so we can support you on the journey.
A great weekend to you!
@inthebeginning

 

[Josephine]

I have read no weight bearing for weeks

Not necessarily. Most revisions are able to be fully weight bearing immediately after surgery.

If the stem is loose do you think putting strain on it is a good idea?

Well the damage is done so what's the diff?

I wonder why the bone growth stopped

One of those mysteries of life. Eman! Nobody knows!

I would be interested to understand why bone would fuse to the stem at one end but not the other.

See answer above!

 

[inthebeginning]

If the stem is loose do you think putting strain on it is a good idea? I wonder why the bone growth stopped, did the OS give any clue?

Doc said I could proceed with non-impact exercise. As far as the reason the bone growth stopped... not really sure. Everything looked grand at my one year follow up. He said he thinks it was a biological response of my body. The tapered end of the stem was so well embedded, my body thought it didn’t need to produce more bone. He said he’s never seen it but he has heard of it before.

I really wonder if my change of diet starting back in Oct 2017 has anything to do with it. I went gluten free, dairy feee and sugar free all at once. I do take proper supplementation so I don’t think I’m shorting myself on anything.

I’ll keep asking questions as I’ve only had the one office visit so far.

 

[inthebeginning]

I would be interested to understand why bone would fuse to the stem at one end but not the other. If your hip was fine for 5 years with all your activities, then I presume the stem must have had a good fusion to the bone all this time. I wonder if the bone recessed at the top recently. I have read that resistance training helps bone strength and bone growth. Has your OS suggested any exercises or nutritional plans?

That’s the million dollar question. All we have to go off is the 1 Year post-op x-ray versus the one taken last week. OS hasn’t recommended anything exercise wise yet. He knows I’m planning to walk, ride the bike and elliptical up to surgery day. He’s fine with that. No nutritional advice yet.
I’ll keep you posted if he does.

 

[inthebeginning]

My thoughts are that you had a stellar first recovery and was able to do alot very quickly.
I would take this recovery easy easy.

I think it's alot about timing. Just because we can do things early, doesn't mean we should.

I suppose it will really all depend on how I feel when I come out of surgery. Last time I woke up and ordered half the menu and actually walked around the recovery floor waiting for my room upstairs. At least I have the experience of last time to judge it all by. Time will tell!

 

[inthebeginning]

Has your surgeon specified NWB? It's not always the case. Are you having a cemented implant?

He hasn’t said anything about NWB. I read that somewhere. As far as cement, he said that will be a gametine decision. Once he gets in there and sees what he is dealing with he will be able to decide.

 

[Mojo333]

I'm truly wishing you all the best!
I just can imagine if it were me..I would contemplate exactly what kind of trauma my body had experienced, and despite what I felt I was ABLE to do, what I would do is give it all every possible opportunity to get right without extra stress.
I could have done alot more because I AM tough...but I wanted to give these hips the best chance of getting better without feeling like I was competing for the "quickest, bestest recovery.

However, I've been accused of being the resident worry wart

I'll be rooting for you!

 

[inthebeginning]

Not necessarily. Most revisions are able to be fully weight bearing immediately after surgery.
Well the damage is done so what's the diff?

One of those mysteries of life. Eman! Nobody knows!
See answer above!

Voice of Reason!

 

[Mojo333]

If the stem is loose do you think putting strain on it is a good idea

I don't know about it really...but my thought would be that if the stem is toggling and causing undo excessive stress on the bone...that damage done to it...maybe a stress fracture... might not be helpful for future implant.
Not based on anything..just my thought!

 

[inthebeginning]

I don't know about it really...but my thought would be that if the stem is toggling and causing undo excessive stress on the bone...that damage done to it...maybe a stress fracture... might not be helpful for future implant.
Not based on anything..just my thought!

Doc said nothing impact. Bike, elliptical, etc.. would be OK. I won't be doing excessive squats or leg presses!

 

[Hippielife]

Hi inthebeginning... First I would like to let you know I sympathize with your situation.
I’m coming in a bit late and reading this whole thread has me anxious to share my story for a loose primary implant.
After some time of wear after thr, which is different for everyone, mine was loose due to fretting of metals from the stem of the femoral implant. This fretting of metal partials can cause metalliosis and corrosion around the implant causing it to loosen at the femeral end . I am not sure if this is your issue but there are tests that may show up some loosening and will definitely help thru revision to identify the exact cause. It’s nothing you did or the surgeon its sometimes many things that cause this to happen.
If you look up loosening of the components you will find many studies giving several factors depending on the manufacturer of the device. Sometimes it is a good idea to become your own self advocate and learn about thr loosening complications. A revision has helped me get back on track and I am very happy with the outcome.
Sending blessing your way.

 

[inthebeginning]

A revision has helped me get back on track and I am very happy with the outcome.
Sending blessing your way.

Fingers crossed for the same here! Thanks.

 

[Hippielife]

In the beginning...
Whoever your higher power ? I pray that you are watched over and protected & led thru the path of recovery to become self sufficient, independent & free from hip the pain and that you will be given all that is needed to sustain you thru this adventure in life & may you find renewed visions for happiness.

 

[inthebeginning]

Hi inthebeginning... First I would like to let you know I sympathize with your situation.
Sending blessing your way.

Hippie,
Mine is physically loose in the femur. None of the parts of the device are mechanically loose. It looks like the bone didn't grow all the way around the upper half of the stem. The stem is wiggling around in my femur!

 

[inthebeginning]

Well.. if you’ve been reading my Second Chance recovery thread, you’ll know that the doc pulled the old stem out with NO resistance! [emoji33]
I have a longer, wider stem now. He also found a lot of scar tissue around the cup. He said he had to cut some tendon and ligament to remove and clean around the cup. New cup with one screw this time.
So, I have a completely new joint! 2 weeks of 50% weight bearing then we will see.


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