THR What about hip dislocation after a posterior hip replacement?

tehdarwinator

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I'm having my right hip replaced next week with a posterior approach. I have read horror stories about hip dislocation from bending too much. My doctor mentioned dislocation being a possible complication, but he didn't seem too worried about it. He said I would feel it in the joint if I bent too far before it was a serious problem. Does anyone here have some insight on the topic? How far is too far to bend? I have a pretty high pain tolerance, so I don't want to count on that to warn me.
 

Celle

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Don't worry too much about dislocation.
You will be told what actions and positions to avoid. Dislocations don't happen often, so stop frightening yourself with reading about them.

Here is some pre-op reading for you:

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
 

Celle

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And here are the recovery guidelines for hips:
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
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

5. At week 4 and after you should follow this

6. Access these pages on the website


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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 

Layla

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Hello,
Welcome back! I experienced posterior approach with my THR and didn’t have any restrictions. I was advised to move slowly, thoughtfully and if anything hurt, STOP!
I loosely (emphasis on loosely) imposed some restrictions on myself because I figured it couldn’t hurt, right? Not saying you should do the same. Do as your surgeon advises and move slowly and you’ll do great. Only one week to go!
Wishing you comfort as you wait.
@tehdarwinator
 

zauberflöte

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@tehdarwinator I have a pair of anteriors, and my dislocate position is something I'm not sure I could do happily in my 20's! It is an extremely deep forward yoga-type lunge, with plenty of weight on the back foot, with that rear leg rotated inwardly. Or, you know, wiping out in a big way on a surfboard, skis, a bike, car wreck-- all of which things could also dislocate an original hip as well! Dislocation is something I only think about when doing a stretch which is supposed to resemble a front/back split. I take care to rotate both legs outwards, and since I am never in this life gonna do a real split anyway.... I'm not at all worried.

Plenty of posteriors, laterals, and all combos thereof ought to be by to reassure you. Meanwhile, read around the recovery side, see how happy we get with no bone-on-bone pain!
 

leejaa

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@tehdarwinator , I have two posterior hip replacements and no issues and no horror. My surgeon has 6wk restrictions on not bending past 90 degrees and not crossing legs and that is all. It is a matter of listening to your hip and soft tissues. Even with a high pain tolerance post surgery it just seems easier to remember not to move too fast and you actually don't want to. If you have a good surgeon that you trust and have rapport with you will do fine.
 

Eman85

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How far is too far?, That's pretty hard to say. I've got 2 posterior THR's and so far so good. I had restrictions for 6 weeks and adhered to them. I do a lot and really don't think about my hips dislocating but I am aware that it's a possibility. There's a chart somewhere of the diminishing likelihood over time.
 
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tehdarwinator

tehdarwinator

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My thanks to all of you for your encouraging words! I have a great deal of confidence in my surgeon (he has a lot of satisfied customers around town) and I'm lucky enough to have a physical therapy group in town that doesn't believe that inducing pain is a necessary part of the healing process. I've just noticed recently that I tend to cross my ankles when I'm sitting or lying down, and I know that's not a good thing after hip surgery. It sounds like the key is to keep a pillow between my lower legs at all times. I probably won't be making any fast moves until the hip is starting to stabilize.

It has taken a while to get the surgery scheduled given the events of this spring. I'm in enough pain right now that I am actually looking forward to the surgery next week.
 

Jaycey

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@tehdarwinator Please don't worry about dislocation. I had posterior approach with my LTHR and lateral with my RTHR and never had any problems. Your hip will tell you quickly if you have gone too far.

Here's an article from our Library that explains it all: Dislocation risk and 90 degree rule
 

leejaa

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There is something about increasing pain in the hip and decreased ability to do anything that makes it easy to look forward to a surgery. I just kept focusing and marking off dates (I actually had an excel spreadsheet with days to surgery on my desktop). I had a 6m wait for surgery so the spreadsheet helped me feel like time was moving and I would celebrate every so often as a month or a week would go by.
 

Eman85

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Pillows and ice will be your new best friends. It's pretty easy to get used to a pillow between your legs and it will help you when you can roll to your side if you're a side sleeper. Pre-op on my rt. hip I was using pillows to block myself in position so I didn't move into a position that made my hip hurt. Even ended up with a specialized pillow contoured for between my legs which I still use at times. It keeps me side sleeping which helps my back.
 

Hip4life

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I had posterior approach and had the 1. No bending past 90 degrees. 2. No moving leg past mid point of body (belly button) like crossing the legs. 3. No rotating op leg inward. All these movements in concert are what they do in surgery to dislocate the diseased femoral head for removal, to explain why. My understanding is that a few adjustments in technology and techniques has reduced the chances of dislocation but it still is a remote possibility. No reason to tempt fate. Anyway, my OS didn’t have a cutoff to the restrictions but as time goes on, I don’t think too much about it, anymore. I have more or less adopted what someone else said: their OS just told them not to violate more than one restriction at a time. However, I was very vigilant through my first months and first year. Follow your OS’s advice and you will do fine. So glad you will be free of that arthritic hip pain soon. ❤
 

CricketHip

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You have received some really good answers to your dislocation question... so I'm popping by just to say that you will do just fine and oh my gosh, your surgery date is almost here and you can say goodbye to that nasty arthritic pain!

Wishing you the very best and see you on the recovery side. :thumb:
 

Lucy4

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I had my surgery Tuesday, July 14, right hip, posterior method. I’m doing great and and after all my worry about the restriction, it’s no big deal at this point. Knowing what I know now, i would only be concerned about the surgeon not the method!

One thing my surgeon did say is you can’t go in again with anterior and he not did those on older patients, for what that’s worth.

You will do great and be so happy the Pre-surgery pain is gone!
 

zauberflöte

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One thing my surgeon did say is you can’t go in again with anterior and he not did those on older patients, for what that’s worth.
That's fascinating! I don't know if 61 and 65 is "older", but that is all my OS did, like an assembly line, 400 a year!! Dislocation wasn't a big discussion, nor was revision. Of course, I was and still am head-in-sand about revision, so wasn't asking. Do Not Want, as I could be in my 80's or older!
 

Going4fun

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Posterior approach surgeons have done a lot of work on reducing dislocation rates. One of the two choices I had for surgery was a posterior approach person. And many posterior surgeons do something called "soft tissue repair," which refers to the way they suture you up after implanting the device so that dislocation risk is reduced.
 
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tehdarwinator

tehdarwinator

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You guys are great! I seem to be moving on from my dislocation fear to general free-floating anxiety. Tomorrow is the big day and I can’t wait to be post-surgery. My hip kept me awake half the night, so at least I am 100% sure that this is the right course of action.
 

CricketHip

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I seem to be moving on from my dislocation fear to general free-floating anxiety.

I'm sorry but this caused me to laugh out loud! Free floating anxiety is a good way to say it. I found, with both of my surgeries that as the day before progressed, I became more calm and focused... when you get to the hospital or surgery center, the staff takes such good care of you and it's very comforting. Wishing you the very best and look forward to seeing you on the Recovery side!
 

Layla

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Try not to be anxious. Easier said than done, I know.
You‘ll have surgery in the rear view soon, on your way to recapturing life as you knew it before the pain. Will look forward to following you on the happy hippy healing side!
See you there soon. :wave:
@tehdarwinator
 

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