Uncemented THR Recovery Protocol questions

[nickji]

Hi Everyone,

I'm confused! I had a R. THR, uncemented ten days ago (36 mm metal on x linked poly) and despite a lot of reading on the net, including this site, but I'm unsure about recovery activity. My main questions are:
1. Is it ok to walk using armpit/axilliary crutches so weight bearing on my Right hip is minimal, or should I avoid walking as much as possible?
2. What are the best exercises to regain strength in the muscles?
3. How long after the op can I begin weight bearing - for example just using one elbow crutch
4. Is there a 'typical' time to reach full strength in the implant/bone join?
5. When does side lying sleep become possible? My body hates the 'all night on the back' experience.

I'm also confused because most people recommend no weight bearing, but my surgeon recommends weight bearing from the start and I've seen a post from a U.K. hospital worker who says that weight bearing begins at once for U.K. non-cemented THR patients.

Any advice would be sincerely appreciated.

I had the operation in India, and am still there, so physio services are limited in my area though hospital and surgeon seemed excellent. Operation cost UK£4,000, private room, full services and meds., and my full time local helper is both wonderful and even at high pay by local standards, easy to afford. Also, I have had absolutely zero pain since day 4 after the op. but want to be very careful of course.

Thanks a lot,

Nick

 

[Peta]

Hi Nick and welcome! I had a LTHR 17 weeks ago with an uncemented prosthesis and I was fully weight bearing from the start. So the minute I got up (which was about 8 hours post-op) I was putting my full weight on my operated leg using a walker for stability. After a couple of days I switched to using two armpit crutches - again fully weight bearing. Don't avoid walking - walk as much as you possibly can without overdoing it.
I had physio twice daily while I was in hospital and shown exercises to continue doing 3-4 times a day when I went home. I also saw a physio twice a week once I went home.

My OS told me that it can take up to 6 months to be fully "healed" following the op. I followed the outlined restrictions for the first 3 months but am now back living life as normal. I am still doing my exercises daily and I now use my pool for a further workout.

Sleeping on my back was THE hardest part of the whole experience for me! I sympathise Nick - I know how impossible it is! I started sleeping on my side (both operated and non-operated) roughly 3 and a half weeks post-op.

You've come to the right place - everyone here is only too happy to share experiences and help out with any questions you might have. Good luck and keep us posted!

Peta

 

[Josephine]

All that Peta has said is spot on, Nick. Never mind what you read on the internet (except here, of course!

) follow your surgeon's advise always.

What I am more concerned about is have you arranged a back up consultant here at home in case there are any problems? I know a lot people go abroad to have their hips/knees done but I do so worry about the (very) few who have issues and need follow-up attention. If your surgeon is 4½ thousand miles away and you need advice or help, to whom do you turn? There was a documentary on BBCTV some months back addressing this very problem and issues included poor ROM from adhesions (knee obviously), dislocated hips and such. Each of the people interviewed told how it was almost impossible to get a local orthopod to take any interest in the issue, much less responsibility for it, as he hadn't done the operation.

I do suggest that, as you are still in India, you ask your surgeon to whom your should go if you have problems or, on return, discuss it with your GP and decide upon a contingency plan. The same would apply for someone who simply went to another county in the UK, by the way. It's a real issue and not ever referred to by the agencies or overseas hospitals that organize these ventures.

 

[Judles]

Welcome Nick, and good luck! Let us know what happens when you return home!
How long will you be staying in India?

 

[nickji]

Wow! Thankyou all. It is so excellent to be with people who've gone through this. I feel so much more confident, and supported, and started weight bearing on my evening walk - still very carefully, but at least heading in the right direction.

There is a small part of me that's scared that my weight could move the femoral component; but the surgeon does seem very competent, so yes, I should take his and your advice. Dealing with fear . . . . an interesting aspect of life.

Thanks for your thoughts on back-up at home, Josephine. I'll see what I can come up with; but 'home' for me has been Asia for most of my life, so though I will be recovering in Europe, if things did fall apart, and I could fly, I'd go back to my surgeon in India.

Thanks again everyone for the support.

Nick

 

[JudyS]

Welcome Nick
I agree with all that Peta said. I even had a crack in my femur , but still weightbearing as tolerated. I used a walker the first and second day then switched to crutches. By 3 weeks I was using one crutch and then a cane. I was swimming at 4 weeks and walking about 1 mile per day with my cane. I was feeling pretty good then. Driving at 6 weeks. I don't remember exactly when It became possible to sleep on the operated side. I did sleep on the non operated side with pillows behind me.

Good Luck to you, we are here for any questions or comments
You will definately need follow up visits at home (I'm not sure where that is for you) If something painful were to happen and I needed a doc , I sure would not want to have a plane flight to get there.
Do find someone where you live

Judy

 

[Josephine]

Well, that's good, Nick. You put my mind at rest. I always worry about people having intercontinental health care!

 

[Jamie]

Welcome to the forum, Nick. So glad to hear that you are doing well. A prayer for you that it continues to be so!!

 

[mvo]

Hi Nick,
I too felt quite nervous about putting any weight on my operated leg, but, it is really just a matter of confidence. My new hip is six months old today. I used 2 crutches for just over 3 weeks, and one crutch for about six weeks after that – gradually easing off until I was only using it for longish (more than a mile) walks or if it had been raining.

My restrictions included sleeping on my back for six weeks and no sleeping on the operated side for 3 months. I found a small sheepskin covered cushion helpful to rest my heels on – they got a bit sore. My last restriction lifts today – officially I am allowed to do gardening – but I hate to think of the state of the garden if I had kept strictly to that!

All the best,
Monica

 

[JudyS]

Wow Monica that is a long time to not be able to sleep on your operated side. My instrucions said I could sleep on it from day one, it would do no damage, but I would probably find it very uncomfortable!!!

Good Luck with the garden now that it is officially allowed
Judy

 

[Judles]

I LOVE to garden! Please be careful Monica! That's REALLY tough work! Its amazing how weeds can take over when you don't lend your tender touch!
Start slow! Things will be flourishing before you know it!

 

[aussie]

Hi Nick and welcome,

I was the same as Peta also..

Weight bearing on operated hip day one. Told by OS to walk as much as I could, down to one crutch by 3 weeks didn't feel I needed it but OS asked me to use it for a bit longer when I went out more as an idicator for the public so I didn't get bumped over. Sleeping on either side at three weeks. Isn't sleeping on your back all the time the worst?????

Good luck with your recovery.

Chris

 

[Peta]

Hi Nick - how are you feeling today? Hope the recovery is going well!

Peta

 

[nickji]

Hi Peta,

Thanks. As you've seen - knee pain. But, recovery feels to have really kicked in now that I'm fully weight bearing on the new hip. I've moved from armpit to elbow crutches, find getting around so much easier, and am very pleased. Thankyou, and everyone, for the advice and encouragement.

This whole experience has been and continues to be an amazing and genuinely wonderful one. From the moment I went into the op.theatre I felt, almost like a blessing, a complete acceptance of everything that was going to happen to me. These minutes, hours, days were a part of my life and I wasn't going to reject anything. After the op they messed up my meds, so there were many hours of the worst pain I've ever had: one part of me was begging for help, but the deeper part opened up into a very strong awareness of my love for my friends/family, and the wish to be fully open to people - I felt then that the pain was opening my heart, and I feel this still. (no, I'm not on opiates !! . As the days pass, relationships have blossomed.

And since then each day has been a joy. My mind is taking practical care of me, making sure I know what I need to know, and exercise as I need to (and to use this site . But I don't feel any sense that I'm waiting to 'Recover'. this is my life, this 'now', this minute. And I'm loving it. Recovery will come in its own time, and I'll be actively helping it along. But this moment is where I am; and I feel absolutely complete, right now.

Isn't life lovely!

Nick

 

[Peta]

That was absolutely wonderful to read Nick! You have a great attitude and deserve all the good things in life! With that sort of mind set you will be able to deal with whatever comes your way. Including recovering from THR! Keep us posted on how you are going......

Peta

P.S. And yes - life is wonderful!

 

[Judles]

Nick! You hit the nail right on the head! Keep up your positive attitude!

 

[JudyS]

wow Nick as I was first reading your post I thought , the worst pain I ever experienced was recently and no relvelations on my part. My mind started having hallucinations to protect it maybe. I stayed in my own horrible world.

REading continuing your attitude is wonderful. you are an awesome person and an inspiration to me.
Happy healing
Judy

 

[nickji]

Hi Everyone,
A great paper at https://diss.kib.ki.se/2006/91-7140-677-8/thesis.pdf It's Titled 'A Clinical Study of Uncemented Hip Arthroplasty'. Not entirely sure if it may have been sponsored by a manufacturer, but the references are copious, and the content fascinating.
Nick

 

[LadyLisa]

I agree that you should always go by your surgeons advice. Everyone is different. Depending on how long you have had problems also makes for muscle weaknesses and weight ect. As for me I am not allowed to go back in the pool because of climbing out of the ladder yet I have to do my four weeks of PT first. And I just now on friday got off my walker and back to my cane and that was just over three weeks out. Its been four years getting me to the surgery I had other problems so my recovery is going to be longer but I deff am doing better.

 

[rodney]

Hey hope everyone is doing great .Went back for my 1 month postop followup and i was surorised that all my restrictions where lifted i know it sounds great just thought it would be at least 90 days before breaking my 90 restrictions were lifted.Had bi lateralthr feb19-9.Biomet 54mmfemoral head on both . I feel great just found it to be kinda quick on the restriction part . although i have lots of confidence in my os Josephine if you might give your insight i would be thankful.My age of 35 didnt hurt but just curious.