THR Worried about posterior approach

[KittensMom]

@ChickensMom I had no restrictions post RTHR but my hip just didn't want to move past 90 degrees in the early days. A grabber, sock aid and a firm cushion to use on soft furnishing may just make life a bit easier at first.

only restriction I will have after the surgery is not to lift over 90 degrees and bend at the same time.

I assume she means no heavy lifting and don't bend past 90 degrees. I would confirm with your surgeon on the day. PT should not be setting any restrictions. It is really the surgeon's call.

I didn't phrase it very well, sorry. She said no rotating inwards and bending over 90 degrees at the same time.
It is so strange to think I could rotate my hip inwards, I have not been able to do this since I was a teen.

Could I ask you if you had to keep your foot straight at all times? I am guessing no restrictions probably means no, but I am curious, because I feel like this would be extremely hard to remember.

 

[zauberflöte]

Hi @ChickensMom ! I had anterior, so maybe my experiences aren't really germane, but I can tell you about the "keep your foot pointed straight forward" and how it's affected me. My right hip was10 years ago. When I was discharged, one of the things I was to avoid for a while was using the right leg as a pole to rotate on-- meaning, don't stand on that leg and make a turn to left or right. When I mentioned this to the "concierge nurse" assigned me by my insurance, she immediately translated it to "the leg must not rotate one tiny millimeter outwards or inwards" and that was that. I'd been walking and sitting in a somewhat relaxed manner, trying to avoid additional tension in the leg, and allowing the leg to roll outwards gently and naturally when elevating it. No more. I made sure that leg did not deviate. By the time I was cleared for normal motion, about 6 weeks, the muscles had set up in that position. To this day I have less ROM rotationally in the right than the left. For the left I just followed the "don't get carried away with my movements" paradigm, and that one healed up just fine. I will say, I was much more confident in my ability to judge good movement vs bad with hip #2! I have lingering "bad weather pains" in the right hip flexors, and the scar is gnarly compared to the left side. There could be many explanations for the differences, and one of them certainly is the tenseness of those thigh muscles that I caused myself.

I would say, listen to your surgeon and his/her personal staff for your instructions. We all tell you what we know-- and your surgeon may differ in this way or that way. For your peace of mind, take our experiences as just that, and find out what your own surgeon is going to recommend. I am only an expert on me!

 

[Merrimay]

Hi @ChickensMom , I had posterior LTHR in October 2022. I, too, was intimidated by all the rah-rah over the anterior approach and frightened that I'd break the 90-degree rule and dislocate because I live alone and have a house and pets to care for.

The notion of having to sleep on my back for a few weeks also freaked me out. I remember @Eman85 reassuring me that I wouldn't even want to turn on my side until my hip let me know it was ready. He was right. Do you know that I grew so comfortable sleeping on my back, something I swore I couldn't do, that at 5 months it's now my preferred position? Just place a pillow between your legs and ice, ice, ice.

My point is that your body will respond as it's going to. The 90-degree rule was easy for me not to break: my hip was too stiff. Instead, I kept a grabber in every room, and within 2 days I considered taking up spearfishing because I'd gotten so good lowering and lifting things onto the floor. I put on my slip-on Skechers with my grabber, as well as my pants.

Showering was easy. I used a grab bar, shower shoes, and long-handled brushes. If I dropped the soap, I picked it up with a grabber.

So despite my worry about how much control I wpuld or wouldn't have with the posterior approach, I just went with the flow. I think you'll find that your body will tell you what it needs, and when it's ready to do what,, assuming you'll listen. If I was unsure, I called my OS team and posted questions on bonesmart and received hundreds of informative and supportive messages. You will not have to recover from posterior surgery on your own if you keep in touch with us!

Wishing you a successful operation and much happiness in the result!

 

[Eman85]

I understand wanting one voice. I am fortunate my OS had a very good program and it did not include any PT.
The only thing to understand about restrictions is why they exist. In order to do the surgery they have to dislocate our hip. If you have posterior it means they dislocate the feMur and rotate it towards the back where they make the incision. So for that reason any movement that would force the femur to rotate that direction is restricted as the muscles are weak that would control that movement. You can move your foot any way you want as long as you don't move the leg.

 

[KittensMom]

I am not complaining, but hip-wise I am having a really decent week with almost no pain. Gosh do the thoughts creep in: Is this a mistake? Your hip is doing fine, you can get to and from work with only minor pain. Why not wait a few years, before you do something irreversible.

22 years of pain really teaches you to enjoy the good days, and quickly forget how devastating the bad ones are. If this wasn't the case, I think arthritis would have broken my spirit years ago.

I am doing this because I want more from life than getting to and from work.

 

[Caison113]

Funny I had the exact thoughts including the night before my surgery. And then I woke up at 2am unable to sleep due to something I tweaked in my hip that kept me up for the rest of the night. It was clearly a sign lol. No more doubts and into the operating room I went.

 

[Gloucestergal65]

@ChickensMom - I had my op postponed for six weeks because I caught Covid and that seems to be the rule in the uk. During that time I hardly went out or saw anyone because I was paranoid about catching something and having it postponed again. My hip was better than it’s been in years, basically because I wasn’t doing anything so no pain. But I didn’t want to live that life in the long run so in the end it was a no brainer. At 3 months out I’m not perfect but I’m so much better than I was.

 

[KittensMom]

I just got a call from the hospital saying that they were checking everything for tomorrow, and one of the parts for my surgery was broken I was supposed to come tomorrow at 6.30, but instead they pushed me to 9am and there is a possibility that they may have to reschedule for the following day.

I don't know how to cope with all of this. Not to mention that the fact that a part can be broken is something I didn't want to even think or consider, but now can't get it out of my head.

 

[Jaycey]

@ChickensMom So sorry for the delay in your surgery. It really isn't fair they can't confirm your surgery will be tomorrow. This is probably due to not knowing the actually delivery time of the component.

Frankly, I doubt the broken component was part of your implant. They are VERY tough. Could just be part of the tool kit that comes with every implant.

Fingers crossed for tomorrow at 9AM. If not - it will be March 23. Please keep us updated!

 

[KittensMom]

Thank you for the encouraging words @Jaycey.

I always imagined hospitals (especially private ones) to have many of the parts on hand, so the fact that this is the second time they mentioned ordering a part, surprised me. I am just hoping for a successful surgery this week, next the latest. How I get there I know is not the most important part, but emotionally it's not the easiest to navigate.

 

[Jaycey]

I always imagined hospitals (especially private ones) to have many of the parts on hand

No, these components are pretty expensive. And there are thousands of sizes and types. Don't worry, your surgeon will use the implant that they know best given your own medical situation. Several sizes of the components will be available so that the surgeon can give you a perfect fit. You are in good hands!

 

[Layla]

How discouraging. I certainly hope your surgery is still on for tomorrow, Wednesday, I can't even imagine feeling in limbo over date / time in addition to the normal pre-op anxiety. I am sorry you're having this experience.
Fingers crossed and best wishes all is still on according to schedule. Hope to hear from you soon!
@ChickensMom

 

[KittensMom]

I am admitted to the ward now and on an IV. I hope this means I am not leaving here without a new, awesome hip

Spirits are up, I am knitting away on a summer blouse, trying to think positively and imagine all the things I will do pain free after surgery.

I have to say, the scrub last night and in the hospital (Descutan) has left my skin so tight and cracking that I don’t even think about how hungry I am, just lotion!

 

[Jaycey]

So glad to hear you are on your way! See you on the other side soon!

 

[Charly]

I get dealing with the pain for so long. And not being able to take care of yourself. I had posterior left hip replacement 3 years ago and have been using my walker since then. This past October I fell onto the floor on my left side and also hit my head. Ended up with 2 brain bleeds and a tiny fracture at the base of my skull. Stayed in the hospital for 2 weeks and then in an acute rehab center for 2 weeks. I’m quite sure that caused the new pain I’m having in my left thigh and groin. I live alone also and had to hire a caregiver for help doing basic chores. With no long term care insurance it has really taken a hit to my savings. Worrying about that along with knowing I was going to make a decision on a hip revision due to stem loosening and no bone growth. My left leg is a lot shorter than my right and had to have lots of my shoes fitted with a lift on the bottom outside of shoes. After my original hip replacement I chose to sleep in my lift recliner chair. That way I knew I couldn’t move too much side to side. I kept a potty chair next to the chair so if needed I didn’t have to walk all the way to the bathroom. That’s my plan when I have the revision done. I hope that my leg can be the right length again. I’m also very concerned about dealing with becoming anemic again since I did last time. Also I’m dealing with CKD and all pain meds are very dangerous for your kidneys. I’ve come a long way in improving my kidney function and I worry that I could fall back into where I was when diagnosed. But I made this very hard decision to get the revision done and pray it is the right decision. I want to walk with no walker and drive myself and take care of my home without outside help. My family visits me on Sundays and that is my happiest day of the whole week.

 

[KittensMom]

I get dealing with the pain for so long. And not being able to take care of yourself. I had posterior left hip replacement 3 years ago and have been using my walker since then. This past October I fell onto the floor on my left side and also hit my head. Ended up with 2 brain bleeds and a tiny fracture at the base of my skull. Stayed in the hospital for 2 weeks and then in an acute rehab center for 2 weeks. I’m quite sure that caused the new pain I’m having in my left thigh and groin. I live alone also and had to hire a caregiver for help doing basic chores. With no long term care insurance it has really taken a hit to my savings. Worrying about that along with knowing I was going to make a decision on a hip revision due to stem loosening and no bone growth. My left leg is a lot shorter than my right and had to have lots of my shoes fitted with a lift on the bottom outside of shoes. After my original hip replacement I chose to sleep in my lift recliner chair. That way I knew I couldn’t move too much side to side. I kept a potty chair next to the chair so if needed I didn’t have to walk all the way to the bathroom. That’s my plan when I have the revision done. I hope that my leg can be the right length again. I’m also very concerned about dealing with becoming anemic again since I did last time. Also I’m dealing with CKD and all pain meds are very dangerous for your kidneys. I’ve come a long way in improving my kidney function and I worry that I could fall back into where I was when diagnosed. But I made this very hard decision to get the revision done and pray it is the right decision. I want to walk with no walker and drive myself and take care of my home without outside help. My family visits me on Sundays and that is my happiest day of the whole week.

Oh Charly I am sorry you have had a tough time in your recovery. This is just me but I don't think you should give up on the idea of being more active again. If you do decide to have the revision, I wish you all the best of luck, from the bottom of my heart!

I am happy to read that you have family close by so that they can visit you. I am an expat and none of my family live in Sweden. As much as I am grateful for my friends, there is nothing to boost your mood like seeing faces of your loved ones. The first thing I am planning once I can fly again, is to travel home to see them

Sending you a big hug and I hope you are keeping well this spring day!

 

[Charly]

Chickensmom, thanks for your kind words and wishes. I do hope you will be able to fly soon and get to see your family. You’re right, that’s what always makes me the happiest is when my people come over. They are coming tomorrow.
I’m definitely having the revision done on May 24 so I will be getting all of the required bloodwork and tests done for surgery approval from all of my other doctors in the next few weeks.
I guess the hardest part for me is remembering the bad experience I had when my first surgery was done. They say revision surgery takes longer and recovery can be harder. I say to myself, I’m not sure it can be much worse than the first time around. My walker has been my best friend the last 2 years but looking forward to throwing it in the ocean. I live in Florida and the weather here is pretty warm nearly all of the time. Reading about your snow, I’ve never seen snow except on TV. Maybe one day I will get to see it.
You take care and keep healing.