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Trochanter Bursitis, Tight ITs, Is it better to treat before THR? Will cortisone shot delay THR?

Discussion in 'Hip Replacement Pre-Op Area' started by VSlowLife, Aug 4, 2019.

  1. Jamie

    Jamie ADMINISTRATOR Administrator

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    You may have to meet with Dr. Della Valle personally to know the answers to your questions. I wouldn't get too hung up on a particular approach, but instead let your surgeon say what he believes will be best for you.
     
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  2. Layla

    Layla FORUM ADVISOR Forum Advisor

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  3. VSlowLife

    VSlowLife junior member
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    Thank you!
     
  4. VSlowLife

    VSlowLife junior member
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    @Jamie @Layla,
    Jamie, Perhaps you can enlighten me more. How long are the average restrictions on angles for anterior and posterior approaches? Are the restrictions only for the healing period, or are they for life?
    Unfortunately, most doctors at HSS do not take Medicare as payment, including Dr. González Della Valle, and the are out of network for my other insurance. So we are talking about 100s of dollars for traveling and the office visit, to ask a question.
    I prefer to get opinions from direct superior approach/SuperCap/ surgeons who also perform anterior or posterior, because direct superior/SuperCap has the shortest recovery, ( I live alone ) and no restrictions on angles of the hip, once it starts healing, which will serve me well, especially around my big dog.
     
  5. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    Sorry but this is not necessarily the case. Recovery is all based on how you personally react to the surgery. Unfortunately there is no way to predict this. Some take only weeks and are back to daily activities - others take many months/years.

    IF you have restrictions they will probably be for the first 6 weeks. Again, this varies with surgeons. Many are no longer imposing restrictions at all no matter what approach is used.

    The only lifetime restriction I have was post LTHR. I can never bungee jump or parachute. Since I have no interest in either of these activities I have no life time restrictions.
     
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  6. VSlowLife

    VSlowLife junior member
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    Oh Jacey, thank you, I needed a little levity! No Bungee jumping or parachuting for me, either.

    I would love to be able to do yoga again.

    I had just read a Feb. 2019 article reporting on their latest research regarding posterior THR, by Dr. Sculco of HSS. Dr. Sculco says with the posterior approach, they conducted a study of post surgical restrictions, verses, a narrower focus on restrictions, and more on movement, and the two groups had nearly the same low, dislocation rate, so they are finding that can work just as well. That is great news!
     
  7. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    That's a trend we are seeing here as well. I had 6 weeks of restrictions post LTHR and 4 year later no restrictions post RTHR. Frankly you hip just does not want to move the wrong way when you are first out of surgery.

    We have had several members here return to yoga. Some needed to modify the poses a bit. But there is really no reason you can't once all is healed.
     
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  8. Ptarmigan

    Ptarmigan senior

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    If I were to paraphrase your search for a surgeon it sounds something like this: you are looking for a OS who understands the specific requirements for acetabular cup positioning after lumbar fusion to minimize the risk of dislocation. If the SuperCap consult doesn’t encourage you to move forward, you might consider this: reconnect with the surgeon who did your fusion. Perhaps he can recommend an OS who has worked successfully with his patients like you. Or perhaps he can give you a letter to show prospective OSs, that will precisely describe the unique concern you are bringing to the consultation.

    Then, you can simply present yourself as a hip replacement patient (see xrays), with a history of prior lumbar fusion and specific concerns (see letter), and then let the surgeon tell you whether he meets your criteria for expertise, and whether he can accomplish the acetabular positioning required (see letter), and how he proposes to accomplish this.

    I spent some formative time in my youth as a professional commission-only salesperson, where one of the first things you learn is to distinguish between buyers and shoppers. Some time ago, a person in a position of authority told you that you should not be a buyer until you turned 65, and you believed him. So, you’ve been a shopper since then, waiting for one of two things to happen: a surgeon to make you an offer that’s too good to refuse (either an expert or a procedure so sure-fire it removes the downside risks) or for your life with dysfunctional hips to become intolerable and force your hand.

    Please understand, I wholeheartedly support shopping until you know you’ve found the best option. I also disagree with the “expert” who told you to wait until you were 65 - which is easy for me to do because I received the opposite medical advice. I don’t want to see your life become any more intolerable than it already is. The question here, I think, is whether you’re ready to stop shopping and start buying. You’ve said you hope to schedule this November...sounds like maybe you are. We’re rooting for you!
     
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    Last edited: Aug 7, 2019
  9. Jamie

    Jamie ADMINISTRATOR Administrator

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    Sorry about the insurance issue. I was not aware Dr. Della Valle didn't accept Medicare. I saw that on the website. If you didn't do so, you might call his office to verify insurance accepted. Sometimes the web information is not up to date or they can sometimes make accommodations.
     
  10. Eman85

    Eman85 post-grad

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    There are so many that get worked up over the horror of having restrictions. They are really no big deal and you're better off consciously having the restrictions than falsely thinking you can ignore them. The consequences of a dislocation far outweigh the minor inconvenience of the restrictions. If you read posts on here of people that have dislocated it will easily convince you. I know there was one of someone pushing Yoga a little too soon, not a happy day.
     
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  11. susanne

    susanne post-grad

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    I had all my replacements at NYU hospital for joint disease. Loved my dr. Started with him in 2010 for hip revision and he did my knee replacement also about 5 yrs ago. But sure what technique he uses now but if you live in area I will send you his name. His office is in new Hyde park
    Susanne
     

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