Bilateral THR Tiare’s Recovery Thread — Let’s do this!


junior member
Mar 1, 2021
San Francisco
United States United States
I made it! Bilateral THR on 4/2 - and I’m feeling pretty good so far! The surgery went well, but took longer than my surgeon expected due the fact that I’m small and have small bones, and the structure of my hips was even more irregular than they had expected. The first 24hrs were rough, as my blood pressure was quite low and they ended up giving me a blood transfusion. I was able to get up for PT once the next day, but was still pretty weak from the low blood pressure.

But yesterday was way better! My blood pressure was good all day, and I had a great session of PT, and am cleared to be up and walking, using the bathroom, etc. While I’m moving slowly and carefully, it’s so exciting to be upright and moving at all. I woke up kinda groggy today, but I think some food and movement will help. As long as things continue this way, I’ll be released to go home from the hospital today.

So very many steps (figuratively and literally!) left in my recovery, but I’m feeling ready to begin!
:welome: to the healing side @Tiare! Sounds like you are doing well. I'll leave the BoneSmart recovery guidelines below.

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
take your pain meds by prescription schedule (not when pain starts!)
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for THRs
6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
@Tiare :welome: to the BTHR club and to the recovery side! You are doing splendidly ... and doesn't it feel marvelous to have no bone-on-bone hip pain?! I bet you'll feel even better once you get home.
Thanks all! Made it back home yesterday, but it was definitely an exhausting day — so much more movement and interaction than the past few days.

I had a brief freak out yesterday when getting from the hospital wheelchair to the car, as my right foot got stuck in the wheelchair footbed as the person assisting me stand turned too far. It was scary, as my two restrictions from my surgeon are no outward/turn out movement and no backwards movement with the hips for six weeks. I felt a pain in one of the muscles in my inner hip/butt, but we stopped immediately and got the foot out, and the pain has stopped since. Hoping this is just something to watch moving forward but not a major concern now that the pain is gone?

It’s also so hard to time the pain meds (I‘m on Oxy and a couple others). Does anyone have pointers or experiences to share about managing the pain in a safe, responsible way while beginning to see if you can extend the dose intervals or the dose amount?
Way too early to worry about extending time between pain meds @Tiare. This early on you are better off taking pain meds on the suggested schedule. You will start to forget to take doses as the pain recedes and you don't need them as much.
Don’t worry @FCBayern - I’m not lowering my pain doses yet, I’m just curious how you begin to do so! That’s really good to know, that it just happens naturally as you recover.
Great to see my new Both at Once Pal.

This isn't a game of firsts, so take it sure and steady
You've got this.
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Hi @Tiare - Congratulations! I know that pain in the backside well! It is scary but normal. There will be more but don’t fret - so long as you’re not in nonstop agony with your leg twisted oddly, you’re good. I was worried that I dislocated my hip and learned it is quite rare. Not that you shouldn’t be careful - I found that with time the pain like your joint is turning starts to subside.

As for meds, I knew it was time to lower my pain dose when it was time to take more oxy and I didn’t need it. After a couple of weeks I found that I didn’t need my mid day Tylenol. I just gave up my nighttime Tylenol a few days ago, but I still need something in the morning. I just passed 4 weeks post-surgery. I only had to deal with one hip, so you may need a little more time. Even with the pain letting up, there are still strange days when I am more uncomfortable than others. It used to make me worry but now I see it’s part of the process and I just take a Tylenol or Ibuprofen.

As for the other drugs for relief (Celebrex and Gabapentin) - at my 3 week appointment I was told I could taper off one then the other over a period of days if I didn’t need them. The doctor said most patients taper off those around the one month mark.
Hi! I am glad you hip replacement went well! How are u feeling today? I am scheduled for a left THR on April 22.
Thanks so much for all of the info, @SCee! You were totally right about the pain in the side — that’s mostly stopped, and I‘ve started reminding myself that all the little aches and pain just mean that my muscles and legs are waking up again.

Everyone’s advice about tapering off medications by simply noticing when you start to forget to take the next one/notice when the pain is less has been spot on advice! I started to just let myself feel what I needed (instead of timing it incessantly) and I’m down to mostly 5mg doses for the OxyContin, supplementing with extra strength Tylenol when needed. I’m also on Gabapentin and Celebrex, as well as a blood thinner, but I believe I just slowly go off of all three over the next three weeks or so.

Hi @Creakygirl51 - congrats on your upcoming surgery! I’m feeling pretty good today. This first week has definitely had its ups and downs, but overall I’m feeling more and more confident walking with a walker, and I’ve been able to do three stairs (enough to get me onto our back patio for some much needed sunlight!).

I’ve had moments of frustration and doldrums too, as being so reliant on help is not something I do very well, but it helps to remember that this isn’t forever, it’s just part of recovery.
@Tiare My surgery is tomorrow. I’m ready! Boy, recovery from a bilateral must be hard. How are you feeling?
Oh my gosh @Dmcfad2 — congrats on your surgery yesterday!! Sorry I didn’t see your message until now, but I just read your thread and I’m so happy to hear that the surgery went well! I hope that you get settled at home today and am looking forward to reading more about your journey.

Recovery from a bilateral is definitely intense, though as I’ve never experienced doing just one hip, it’s hard for me to have perspective on the difference! Though it is really interesting to see how each leg is progressing differently than the other leg in terms of strength, pain, etc.

Overall I’ve been feeling good — been moving and walking a little more each day, and today I’m going to try going upstairs! I got to halfway up the stairs when my home PT was here on Monday, and he said that I’m ready to try going all the way up. We’ll see how it goes, but I’m so excited to be able to get to the rest of the house (rather than my bedroom/bathroom/patio recovery area on the first floor). Wish me luck!
Also question for anyone with both hip and knee problems: how did you protect and strengthen your knees while recovering from a hip replacement?

I have naturally super loose ACLs in both knees, and tore my meniscus in my right knee years ago (arthroscopic surgery to repair in 2013). Pre-bilateral THR, I would wear knee braces whenever I was doing anything more than day to day chores/life/etc, and that really helped to give my knees additional support. Now that I'm on the recovery side with my hips, I want to be as concious and careful of my knees as I can, so that they also become stronger as a result of my fancy new hips.

Any tips or tricks to share? Thanks!
Also question for anyone with both hip and knee problems: how did you protect and strengthen your knees while recovering from a hip replacement?

I have naturally super loose ACLs in both knees, and tore my meniscus in my right knee years ago (arthroscopic surgery to repair in 2013). Pre-bilateral THR, I would wear knee braces whenever I was doing anything more than day to day chores/life/etc, and that really helped to give my knees additional support. Now that I'm on the recovery side with my hips, I want to be as concious and careful of my knees as I can, so that they also become stronger as a result of my fancy new hips.

Any tips or tricks to share? Thanks!

Lifting this question back up - would love any advice about protecting weak knees while recovering from THR. Thanks!
You might want to pose your knee question to your physio.

Many new hippies have issues with their gait. Your hips and knees will benefit if your gait is correct. Have your physio check your gait. Doing slow heel/toe walking will help correct gait issues. Plant your heel and then roll your foot forward.
Thanks @Jaycey - my gait actually seems to be coming along just fine so far (*knocks on wood*). My PT and I have been doing a whole lot of heel/toe walking, and he’s recommended that I just continue with wearing my knee braces to help make sure that they don’t collapse as much.

Was mostly curious to hear if other hippies on bonesmart had/have any similar experiences with their knees, and found any other good solutions.
Exciting news - I made it up and down the stairs - twice! First time was on Thursday, and then I went up again yesterday. And even more exciting was the fact that I was able to cook my own food as well! Being stuck downstairs has made me very dependent on my partner, and while I'm so grateful to him, I'm also so pleased to claim a bit of independence again.

I've been going on little walks up and down the block as well, which is a fun way to track my progress. Still very much using the walker though - the hospital gave me the usual two-wheel walker, which is very hard to use on the cement sidewalk outside. Lucky for me, my mom had an old four-wheel walker (she has MS and is now wheelchair-bound) that my dad was able to drop off, and it’s made walking so much easier.

The incision and front of thigh hip area is still pretty tight and tender, so I’ve been working on posture a lot. Just not going to be great until the incisions fully heal and my quads and hip flexors can recover.

It's all still such a balance between trying new things and not overdoing it. Especially as the legs are recovering at different speeds - one day the right leg feels great and the left groin muscle feels out of whack, then the next day the left leg feels better but the right quad is unhappy. The balancing act of a bilateral, I guess.
Good job, Tiare! Even with one hip replaced, sometimes the other leg seems to suffer. It’s whacky. My PT reminds me that the balance and interplay between the two legs is important. I imagine the knee - hip connection is the same. I actually went in to an ortho for my knees years ago and learned that my hips were the issue.

For me, about a month in, when a lot of the swelling went down, I started to see real improvement. Sometimes I get annoyed that I still get achy and that I still have one leg longer than the other - which I hear takes months to resolve. But it really is much better! I am not the most patient person. ;)
Thanks @SCee. I'm definitely not the most patient person ever, either—which is not the best characteristic for a long recovery! Glad to hear that it's getting better for you! And I’m sure you’re right about the knee-hip connection.

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