Weight Bearing question

[TPompei]

I'm scheduled for the MIS anterior surgery on New Year's Eve. My surgeon says 100% weight bearing after the procedure is fine.

With a traditional hip replacement, I imagine most people are pretty sore after and would take many weeks to ramp up to full weight bearing, giving the muscle time to repair, thus giving implants time to graft with bone.

How is it that the implants can take full weight bearing right off the bat? Shouldn't they have time to graft in with bone? Wouldn't it be 'prudent' to allow that time?

I'm relatively young and relatively in shape (43 yrs. old, swimmer and equestrian), and am concerned that I'll push things too much too soon.

Thanks for your thoughts!

 

[JudyS]

welcome TPompei

It is always a problem of mine to add on too much too soon. After I had a hip arthroscopy, when I was allowed to weightbear again, I asked my doc exactly how many steps I could take. Of course I was joking , but really did not know how much to do.

I had a posterior replacement in June, I was told to do weightbearing as tolerated. All I can say is the body is amazing, hip repacement is amazing. At 3 months when all restrictions were lifted, I was out hiking my favorite trails and doing everything else I wanted (except running). I have tried little stretches of running, no problem, except for the guilt. I just wanted to see if it was possible.

Good Luck and again Welcome
Judy

 

[Josephine]

To be perfectly honest, TPompeii, it's a mystery to me too! I've always been puzzled by this but different surgeons have different ideas and I can only say that if what the surgeon has told you didn't work, then he wouldn't be telling you to do it.

 

[UTdave]

TPompeii,

If you have components that are press fit - meaning they are held in place due to surrounding pressure from the bone rather than held by screws or cement - the loads of wt bearing only help to maintain that press fit. The act of weight bearing presumably stimulates bone growth as we know the opposite to be true. Now, we're not talking jogging or anything - just weight bearing! This was the explanation given to me when I asked the question. One of my colleagues at work had an anterior (I had unsuitable anatomy for this procedure) and is back at work 3-4 wks out. He looks great. I suspect given your age and fitness, you'll look better.

As far as overdoing it - just listen to your body - it's pretty smart. I was fascinated that post-op day one I could stand and walk with crutches (until the anesthetic and oxycontin hit me with a huge headrush). It really didn't hurt much. Remember, your pain you have every day that got you to the point of having surgery is probably more than you could bear if you didn't have years to get used to it! You're brain will turn off your ability to use certain muscles that were cut or injured during surgery and you may find yourself unable to do certain things even though it doesn't hurt (i.e., I couldn't lift my leg up on its own whilst lying in bed, but I could easily lift it with my hands without pain). As the healing begins, this phenomenon will quickly turn off. I could easily lift my leg a week later, but I know it didn't just heal up that fast, my brain just decided to allow it. Don't expect to be climbing normally up stairs POD 1, but simple weight bearing should be a breeze. Good luck and welcome to the beginning of a good thing!

 

[Josephine]

If you have components that are press fit - meaning they are held in place due to surrounding pressure from the bone rather than held by screws or cement - the loads of wt bearing only help to maintain that press fit. The act of weight bearing presumably stimulates bone growth as we know the opposite to be true. Now, we're not talking jogging or anything - just weight bearing! This was the explanation given to me when I asked the question.

Gee, getting old is no fun ~ I quite forgot that bit! Thanks for reminding me.

 

[BigDog Mom]

Hi TPom,
Part of the nifty design of bone is that it needs to be stressed to grow and stay strong.
The very cool thing about the anterior approach is that you have NO restrictions. I can remember the day after surgery I dropped something on the floor in the bathroom and bent down to pick it up. It was amazing how much more stable my new hip joints were compared to my "original equipment". No more slopping, creaking and grinding around when I stood. ( I had both done at the same time.)
I remember questioning the Doc's surgical nurse about the same things - she said you can take your foot and put it up around your ear if you want to but I don't think you will want to. ;)
It sounds like you have stayed fit - you will be thrilled with how much better you will feel. Your body will tell you when it has had enough. Every day after though, you will find you can do just a little bit more.

Best wishes,
Donna

 

[Laurie]

Hi all, Interesting how there continues to be multiple ways to recover and recover well. Though like Judy I had posterior THR, I was on restrictions for only a month and had no weight bearing restrictions--as she said, just told to do what I could handle. I was up and around with a cane at least some of the time (instead of walker) from 3rd day. Didn't use the walker at all at home except as security when I got into shower, etc.

All a dim memory now. Am at work and agree that this is the best surgery--have a colleague with bad knees and feel so bad for her limping around. She is relatively young and feels she is not ready for surgery. So glad I finally got over that emotional hump. Can't believe I walked in pain for so long.

Good luck with the surgery. Bet you are up and around in no time.

Laurie

 

[Josephine]

Just a cautionary note - the question of restrictions varies greatly from surgeon to surgeon so please make sure you follow your surgeon's directions.