THR Xazar's THR Recovery

[xazar]

I'm a 62 year old male who had a fractured left femoral neck and an osteoarthritic mess.

I was scheduled for anyerior THR on March 13 but the doc had a cancellation and got me in early.

The surgery took 45 minutes longer than planned because I was even worse than he thought, but he described the result as "MAGNIFICENT!"
30 minutes after I was rolled out of the operating room.

I knew they were evaluating whether they should sign off on me going home right away, so I was putting on a show, but before I started my first walk I tested my left/right and forward/backward stability, and I was solid as a rock.

I was literally "power walking" around the hospital halls with the physical therapist laughing behind me.

As I was rounding a corner I howled at a couple of doctors "OUT MY WAY ... OUT MY WAY".
I buzzed up and down the stairs and the nurses were pointing at me in surprise.

So I got out of there a few hours later and even though the bruising is like nothing I've ever seen and my leg basically feels incredibly SORE, My function is already really great.

For example, they typically say toe touching is a month or two out from surgery, but I accidentally touched them while checking my stability with a little stretch/warm up.

I attribute 5% of this to keeping somewhat active and mobile up to surgery and 95% to the expert Surgeon using the challenging "muscle sparing approach".

I'm wondering how typical is it to bounce back so immediately?

 

[mendogal]

Oh my!!!! You sound like I did waking up in recovery after my knees!!! We are the exceptions and with that I share my experience:

It doesn't mean our actual healing process is faster. Healing from the soft tissue and bone trauma of surgery is a cellular level process that can't be speeded up.

So while we are both incredibly fortunate in waking up with better function than most, we are all of us going to experience post op swelling and stiffness as part of healing.

Rest, icing, and elevation will be key to healing well, along with walking within your current limits. Your hip will let you know when you're overdoing things by yowling with pain and swelling.

HIP RECOVERY 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.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

2. Control discomfort:
rest
elevate
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
BoneSmart philosophy for sensible post op therapy

5. At week 4 and after you should follow this
Activity progression for THRs

The recovery articles
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 a 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 history before providing advice.

 

[mendogal]

What's your actual surgery date? We will update your signature.

 

[xazar]

My surgery was 2/22/2024, thank you!

 

[mendogal]

Thank you!

 

[myglasshalffull]

Welcome to the forum, happy to see everything went so well. Don't overdo, you don't want to end up in ODIC! (Over Did It Club)!

 

[Layla]

was literally "power walking" around the hospital halls with the physical therapist laughing behind me.

As I was rounding a corner I howled at a couple of doctors "OUT MY WAY ... OUT MY WAY".
I buzzed up and down the stairs and the nurses were pointing at me in surprise.

I think some of this may have been the pharmaceuticals. In hindsight, don't you?

You were definitely faster out of the gate than many, but go s-l-o-w. I'd hate to see you land in the ODIC
(Over Did It Club) and stall the wonderful progress you're making. Check out this article on healing phases to help put it in perspective. Healing: how long does it take?
Have a wonderful week, xazar!
@xazar

 

[xazar]

Hello everybody!

I'm a 62 year old male, about 6 weeks post op THR, anterior approach.

My immediate results were amazing good. 30 minutes off the operating table I was powerwalking and I could scurry up and down stairs with no hands or walker or cane. During the first week I developed swelling, bruising, and a mild tingling sensation on the front of my thigh, but my function remained strong. The tingling diminished to the point that I only feel it when I touch the incision area.

The alarming setback is that about 2 weeks ago I began to have pain and weakness in the operated side quads. I can also readily see that my quads have gotten smaller. I understand that it's possible to suffer nerve damage during the procedure so that may be what's happening. Or it may be a more temporary type of thing associated with the tingling sensation I have been feeling.

Any wisdom/experience out there?

Thank you for all the great support!

Danny

 

[myglasshalffull]

Good AM Danny,
I'm afraid all I have to offer is slow down! Power walking 30 minutes after surgery? You have been reading here, right?
So you are about 6 weeks in to recovery?
I think it's totally normal at this point for the quads to hurt a little, Are you icing when you have the pain?
I'd ice & relax a little see if that improves, otherwise if you are very concerned maybe check in with your doctor.
Let us know!

 

[Layla]

Hello and Welcome to BoneSmart!
I will leave our Recovery Guidelines to start with and type more in a post below that.

HIP RECOVERY GUIDELINES
As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

2. Control discomfort:
rest
elevate
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
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for THRs
The recovery articles
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?

Nutrition is of paramount importance. Available here are dietary tips, nutrition basics and additional food supplements. These articles are both general advice on food and specific guidelines aimed at people both pre- and post-surgery.

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 a 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 history before providing advice.

 

[Layla]

Wow…Thirty minutes out of the OR and most are usually still groggy and in recovery.

There is really no reason to be power walking and I can’t imagine who allowed that as far as the medical staff or a PT. Same goes for rapidly ascending and descending stairs. This definitely seems like too much too soon.

Swelling and bruising are common and considered normal.

Your leg endured major trauma, in a very small area. Your muscles, tendons, ligaments and other soft tissue is going to cause you discomfort and pain for a while yet.

The first stage of healing is the inflammatory phase. During this time it is very common to notice swelling. After lower extremity surgery, or trauma involving bleeding and inflammation, there will be fluid in the leg causing the sensation of heaviness. Gravity pulls the fluid downward and since the patient is less mobile the fluid is not pumping back through the heart as quickly. The swelling gradually eases, but can persist for up to 3-6 months in some cases. Regular movement will assist in the reduction of swelling, as will elevation and ice. Your surgeon may prescribe compression stockings for a short period of time.

As far as your incision goes, small sensory nerve fibers are cut with the incision. These nerve fibers run from the inside to the outside of the hip and cutting them causes the hip to feel numb after surgery. It is a temporary sensation that normally resolves over a period of six months to one year post op. While healing you may experience sensations of tingling, pins and needles, itching, burning and even the feeling of a minor electrical shock. These are usually good signs that the nerves are spontaneously firing through the regeneration process.

My best advice is to dial it back, then slowly proceed adding time and distance to your activity. Use ice for pain and swelling as often as you care to, for as long as you like, always placing fabric between the ice source and bare skin.

Give it all time. You’re only six weeks into a recovery that takes a full year for many.
Stop back often and share your progress. We love updates.
Thanks for joining us!
@xazar

 

[xazar]

As far as the power walking, let me explain. That was just a spontaneous thing that happened joyfully because IT WAS SO EASY AND STABLE. I fully expected to be in no shape to do that but as soon as I got on my feet, I checked my stability forward and back, then side to side. Much to my surprise it was obvious to me that I was solid as a rock. Then I started walking and everything felt great. I challenged a little side to side while walking and still could tell there was no chance of me falling or anything. Another part of it was whatever the anesthesiologist did, there was no grogginess, my eyes popped open and I was wide awake. Then as I continued walking I got overwhelmed with happiness and broke into an easy and stable power walk. The medical staff were laughing and pointing at me. I think they could see that I was in no danger. I believe my surgeon did an amazing job that allowed all that to happen.

I have since been well aware that no matter how lucky I am, my body went through a serious trauma and will take time to heal, but I did not expect to get worse.

Thank you all
Danny

 

[Layla]

Then as I continued walking I got overwhelmed with happiness and broke into an easy and stable power walk. The medical staff were laughing and pointing at me.

They were likely astonished! I was in reading it, lol. Thanks for the explanation, xazar.
Don't hesitate to check in with your OS's care team with concerns. The reassurance they'll likely offer is worth the peace of mind it may provide.
Best Wishes always!

 

[mendogal]

With the combo of better meds used nowadays for both short acting anesthesia and localized numbing, it's not unheard of to feel really good and walk really well immediately on waking in recovery room (me after both knee replacements)... as the initial meds wear off and the normal post-trauma inflammation kicks in it's quite a different story!
You'll be fine. Take things easy, walk only as much as is comfortable, get ample rest.

 

[Eman85]

I'd say the reality has set in and your body wants to heal. A lot to be said for the skilled surgeons but some has to do with better living through chemistry. Immediately post-op I wanted to keep making laps around the hospital floor. Didn't take long for the chemistry to wear off for me. Best I can tell you now is to sit, ice and relax and give your body a break.

 

[xazar]

I just had my 8 week checkup after a total hip replacement, direct anterior approach. Surgeon did a capsulotomy, sutured the front ligament before finishing. I'm a 62 year old male, 6'4" 200 pounds.

He described my surgery as "Magnificent". He said my recovery so far is perfect.
I asked this question: "Based on everything you know about my particular condition, what restrictions should I respect, after I fully heal?"

He answered: "When you feel comfortable, which may be around 4 months from now, you can do anything you want. Work on splits, running, deep weighted squats, extreme yoga, martial arts, or gymnastics. Your new hip will be as hard to dislocate as your native hip."

I AM DUMFOUNDED!

The other doctors I consulted with all recommended lifelong restrictions to different degrees.

My surgeon has done tons of these procedures with a long list of extremely satisfied patients.

I'm just wondering what other people make of this prognosis?

 

[Anna_K]

Hello there Well that sounds like a nice prospect. My docs said I had to be extra careful first 4 month and then after 6 month come back to normal. Just be aware of my hip, and always think before doing anything. I’m super scared and upset cuz I feel like my body is super fragile but I hope it will pass.
I don’t know about marital arts and extreme yoga and splits but I think if things are done wisely hip will survive (I hope)

 

[Eman85]

Your results may vary. Do a little reading and see what conclusion you come to. I can say that I can do everything I want to do and I also know that if things go bad I'm the one that will pay the price. Did you get all of that in writing with a money back guarantee?

 

[benne68]

@xazar
Please notice that I've merged the last two threads that you've posted into your original recovery thread. We ask members to maintain just one recovery thread.

This is important because it keeps all your information is in one place, making it easy to find and serving as a diary of your recovery. It also enables our staff and other members to advise you better. And you won't miss or lose relevant posts and advice.

So, please post any further updates, questions or concerns here. If you’d like a new title, let us know what you want, and we’ll change it for you. You may want to bookmark your thread to make it easier to find.

For more on how to navigate the forum, you can read through this article:
How can I find my threads and posts?

 

[benne68]

He described my surgery as "Magnificent".

Yes, something about certain surgeons-- they love hyperbole, especially when it comes to their own work!

As my OS likes to say: "joint replacement surgery is easy for the surgeon -- not so much for the patient."