Hip Infection* Left Hip Revision followed by Right THR

[ralibar]

Hey everyone!
I had a left hip replacement in Dec. 2015. Summer of 2021 started feeling pain, and had a total revision in june 2021 (the socket of the prosthesis had been coming loose). I am now 7 months post op, and still have discomfort and cannot work it hard. My PT guy says this is normal, and am wondering what anyone else's experience may have been with this procedure. Btw, I am having the right hip replaced next month.

 

[Layla]

Hello and Welcome to BoneSmart. Thanks for joining us!
I’m sorry you had to go through a revision.

We frequently remind members that it can take a full year to recover from joint replacement. Even longer than a year for some. Many notice improvement into the second and even third year post op. Discomfort is different than pain and when you say “work it hard” possibly that’s your problem. Would you consider stepping back from PT for a couple weeks at least and see if you notice and improvement? In most cases walking is the only exercise needed for recovery. Unless your discomfort turns to pain that escalates in intensity and frequency. I would try take a break from the physical therapy.

I will share our Recovery Guidelines even though you’re seven months post op so you can familiarize yourself with them for your upcoming surgery. I will leave a few pre-op articles for you also.

Please share the date of your upcoming surgery and we’ll create a signature for you showing all of your dates.

Wishing you comfort for both hips. Brighter days are on the way!

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?
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

 

[Layla]

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:

rest​

elevate​

ice​

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. Here is a week-by-week guide

Activity progression for THRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications​

Wound Closure​

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 the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Layla]

If interested, here is a link to some Revision threads -

Hip Surgery Recovery Area

For post-operative hip patients, on the "other side." Including noise Issues.

bonesmart.org

 

[ralibar]

Thank you, Layla! Good information. I actually have not been doing PT since October, but went back to him for a visit in December as I was concerned about having perhaps hurt myself through exercise.
He manipulated the hip and said it felt fine. I guess my dilemma is I've never had any guidance about what and what not to do, and how much. I went back to normal activities ( I lead a very active lifestyle), after the first replacement, and while i realize that the revision was a much more complex and major surgery, I am having difficulty balancing caution with pushing myself. So i appreciate this info - there is not much online resource about this.
I'm hoping to hear from others who have undergone this procedure, and hear about their experiences with the recovery process.

 

[Hippielife]

Hi ralibar,
Revision surgery is a bit more tricky for recovery. Especially getting back good balance and just daily movements & motions . I did zero PT, just walking as progress allowed.
It took me 3 weeks after revision before I could put all my weight on the op leg.
The greatest help is to get back a good solid gait, build up strength and balance. The best Walker to do that is a Drive 4 wheel rollinar walker with breaks and a seat, also has basket to carry everything. It‘s very secure, gives greater independence and it was so much easier to manouver and walk than the others. Light weight and honestly it was a life saver. It can be turned with one hand. Adjustable height and turns so much easier than the standard stiff Walker. It helps you go about your daily routines without worrying how to carry things, builds up confidence, and turning is much easier. In time strength returns on its own without the daily struggle of fighting the stiff walkers with lil wheel's that fight turns .. This one is available at Walmart and my ins covered it.

 

[ralibar]

Thanks, Hippielife, i appreciate the input. Sounds like you are doing great! Guess I should provide a little more info on my surgery.
The surgeon was hoping to do a partial revision, but could not stabilize the joint and had to do a full one. Since it had been almost 6 years since the replacement, it meant splitting the femur open to get the old stem out, and then strapping it back together with metal bands after inserting the new stem. I was in the hospital for a week, due to a combination of losing 3 units of blood, and intolerance of pain drugs. Couldn't even get out of bed for 3 days. I then was on a walker for 10 weeks with toe touch protocol. I was starting to get in a good routine of walking after that when the other hip started to go bad, so not being able to favor both sides at once, had to stop. My right hip replacement is next month, and I'm hoping that recovery from that goes smoothly, and by late spring I can be bilaterally healed, and able to resume normal activities. This is my hope, and my plan.

 

[Jaycey]

@ralibar What is the date of your RTHR? I'll add it to your signature for you.

 

[ralibar]

Surgery is Feb. 21st. Was supposed to be Jan 10th, but my surgeon is quarantining in France. :(

 

[Hippielife]

Hi ralibar,
Hip revision surgery is a difficult recovery journey. There were a lot of complications from the primary surgery. I went thru the same revision process you described. All the primary components were replaced . The greater trochanter was fractured, caused by the loosening of the primary femur component from metalliosis. Other complications from primary surgery were pseudo tumors, stenosis, necrosis and osteolysis. A ceramic ball and new cup replaced the primary metal ball and cup. A osteotomy was done to remove the primary pressfit femur component . It was replaced with a larger pressfit femur component . The cable system was utilized with clips to stabilize the new larger pressfit femur component to the sectioned femur bone and the fractured greater trochanter. It took me over 3 weeks in rehab before I could put any weight/not full weight on the op leg.
What the rollinator was used for after several weeks of healing I began to just slowly walk. I really credit the rollinator with getting my gait back and eventually walking without any aids. May help you with your other hip replacement too.
I am not a doctor, just wanted to share my journey thru revision and what techniques helped me learn to walk again.

 

[Jaycey]

@ralibar Thanks for giving us more detail regarding your revision. I can well understand why you are still having pain. You had a complex revision including a major fracture. This will take some time to settle.

You keep referring to pushing yourself. Suggestion - don't. Pushing only results in pain. I would ease off the PT and let that hip settle. You want this resolved as much as possible before that second THR.

 

[ralibar]

Thank, Jaycey, I was obviously too optimistic about the healing process, but sorta feel like the revision hip would be further along after 7 months. It was feeling much better after I started walking regularly, but it seems to have regressed since i stopped. By pushing myself, I meant very light exercises and stretching. I had been going to the gym again, but doing mostly upper body stuff, and some easy hip machines (the same ones I had been using in PT, and felt great there). I've backed off almost everything now till after the right hip replacement, but as I am generally arthritic, am worried about lack of movement allowing the arthritis to progress, and make recovery even more difficult. Horns of a dilemma, so to speak

 

[Layla]

Hello @ralibar
Wishing you lots of comfort as you move through the weekend toward surgery on Monday. All the best to you that day. We will look forward to a post op update once you’re resting comfortably at home.
Happy Friday!

 

[Hip4life]

Blessings for a smooth surgery and a good start to a healing recovery. We’ll be looking forward to your update when you’re feeling up to it.

 

[Elf1]

@ralibar wishing you the best tomorrow, may your surgery be smooth and they have you resting comfortably in your room before you know it! When you're feeling up to it we'd love an update.

 

[Mojo333]

Thinking of you this morning and will be looking for you on the Healing Side.

 

[ralibar]

So I am two weeks post-op from the right hip replacement. Surgery went well, went home the following day, and started PT the day after that. I'm feeling really good, pretty much off the pain meds except at night. Been walking a good deal around the house, and using the cane in place of the walker at times. The left (revision) side feels really weak, and while I am eager to start strengthening it, I am content to let the right side heal more fully first.
First follow up is in two more weeks.

 

[Mojo333]

@ralibar
So glad this recovery sounds to be going well.
Happy you are satisfied to relax and give your body the time to heal.
Healing Vibes coming at you

 

[Layla]

Hello @ralibar
It sounds like you’re making good progress.Great news!

Please notice that we have merged your newest thread with your original recovery thread. Having your recovery information contained in one place will make it easier for you to reflect back on. It is also helpful for those stopping by to be able to review your history before advising or commenting.
Please post any updates, questions or concerns about your recovery here.

Have a wonderful rest of the week!

 

[Layla]

Happy One Month Anniversary, Righty!
It looks like your follow up appointment may be this week. Let us know how it goes and how you’re doing, as time allows.
Have a wonderful week!
@ralibar