Soft Tissue healing after THR

Most people have a spinal block and some sedatives during there THR. Althoigh you can chose to stay completely awake or partically awake. I had a spinal block and GA during my THR because my surgery took 7 hours and the spinal wouldnt have lasted long enough. Also had surgry under Ga on Thursday. Its really not that bad but i do really struggle to come back around from the GA and sends my heart rate nuts.

As for the muscles, it will take some time to strengthen them back up but if you had healthy muscles to begin with it shouldnt be to bad. Before my surgery my muscles wee the size of a childs and my surgeon had tk atretch them to make them adult sized so now im having a lot of trouble strengthening them. But i suppose if you do some strengthening before the surgery it will make things easier.

Try not to worry though because thag just makes things worse hun x

Hi John

My muscles have completely repaired - I can see no difference at all - I am not sure about internal scarring, but I do know that a complete recovery of these muscles is entirely possible with rest and then following exercises to the letter every day. Building the muscles up slowly with exercise, walking and cycling (after you are given the go ahead) will be very helpful.

Investing in a good and reliable physio will be paramount to your recovery and confidence in my experience. It is a good idea to research one now, and see if they can come out to your house to visit, many do offer this service. It is very helpful, as they can start as soon as you are home, and you do not need to attempt a car journey again which you may prefer not to in the early days. 

Some surgeons 'part' the muscles rather than cut through them, it might be worth asking your surgeon, as the recovery is much faster with the parting of muscles for obvious reasons.

Secondly the spinal block is infinitely more widely used than the GA. Most patients are sedated with a spinal block. You can't hear or see anything - and wake up in much the same way you would with any surgery. If you are worried about GA then I would recommend a spinal block. I felt completely fine afterwards, no side effects or feelings of sickness.

If you can manage try and do as much exercise as you can now, in readiness for the surgery. The better shape you are in now, the stronger and faster your recovery will be. 

Hi there,

I had a general and the gave me a sedative prior to it as they expected to give me a spinal. I wasn't aware of anything to be honest and when I came round I was on the ward and felt great. I had a really lovely long chat with my anaesthetist and you could write a list of questions to ask him, you'd see him the day before the op usually (I'm in UK). I had bilateral THR and haven't felt too sore with the soft tissue healing, twinges here and there but I had anterior do not sure if that cuts through the same muscles.

I know it seems daunting but for the surgeons and nurses it's routine ops done frequently every day, this helped to reassure me.

Best wishes,

Sheila

hi john, 

I read in one of your previous posts that you will get the superior approach to THR surgery - not sure then about the parting versus cutting of tendons and muscles -

I like Rose's response - first hand and all that -

It is best to ask your surgeon - there shouldn't be any reason why it would not heal completely, however there are no 100 % guarantees -

I chose to have GA - the thought of there being a chance I would hear or feel or smell something I couldn't deal with - I had 2 THR surgeries, both GA - I took a deep breath, opened my eyes and was done ....no nausea or any after effect except some drowsiness - 

Come back anytime you have another question or concern okay

big warm hug

renee

 

I had a spinal block and then a sedation.  I did wake up during the surgery.  Something I had always feared but it was no big deal.  I couldn't feel anything but I could hear the hammer and I could hear voices though I couldn't tell what they were saying.  It was like it was all very far away.  Just lasted a minute or two and back under I went.  

I don't know about the muscles and the healing.  I know by the time I finally had the surgery I was feeling pretty weak and I had been a strong person before that.  But just two weeks post-op, I'm feeling pretty strong.  Walk (with the walker) with little to no pain.  Able to do the exercise with ease.  I am confident that I'll be able to build back up and be strong again.

Good luck with your recovery!

Hi john,

Snap (excuse the pun!). I'm having my 2nd THR in August too.

It will be an anterior approach which is an incision at the front of the thigh between the muscles, so no damage and faster healing. I have a 6 inch scar which after 6 months is still tender but healing well.

Whichever method you have, from reading comments on this forum, the main outcome is the same and of course it all depends on your personal fitness before the op.

There's no need to worry about the anaesthetic - you go to sleep, you wake up, that's it. You will be monitored until you regain consciousness and then your recovery will begin.

If you have a worry about your muscles healing, I suggest you speak to your surgeon for clarification.

John, good question! I think that the vast majority of the time, whatever they cut or dissect or split does heal just fine post-op. I, however, had the lateral approach and ended up with a complication that will have me in surgery again a year later to repair a tear in my gluteus medius. Here is what my operative report said about soft tissue cutting and repair in my THR last July:

"Tensor fascia femoris was cut and split proximally and distally...Subperiosteal dissection of gluteus medius, minimus, and anterosuperior capsule at the proximal femoral area...[for the repairs] Gluteus medius, minimus and anterosuperior capsule reapproximated at the proximal femoral area with [various kinds of sutures]."

Everything that was taken apart was put back together again. However, afterwards I never was able to walk without pain and a severe limp on my surgical side. After getting a second opinion from a different orthopedic surgeon, it was discovered that I have a torn gluteus medius that is bad enough to require surgery to repair. It must have torn soon after the surgery. My new OS has much more conservative restrictions post surgery to prevent just such a thing. Also, he does not do the lateral approach for total hip replacements, partly, at least, to avoid cutting those particular connective and muscle tissues. There is some evidence that those who have had the lateral approach are more prone to permanent limping after THR.

It is my belief that far too little attention is paid post-op to keeping the soft tissue that gets stretched and/or cut/dissected/split during THR safe from further injury until they fully heal. We are all thinking about the bone and the implants, when those are generally strong and solid. The soft tissues surrounding them are not, especially after injury during surgery.

So, do your best to be kind to those soft tissues post-surgery and you will very likely be just fine. 

I had general anesthetic, as do most people in my area of the US. I had no problems with it at all. Will be having it again for my repair and exploratory hip surgery in 6 weeks. Best of luck with your future hip replacement!

You got great responses, so I will simply wish you good strengthening exercises before the operation (esp hydrotherapy if you can as the resistance and support of the water really provide great therapy), for the surgeon's hands to be smooth, your nurses to be kind and have a good sense of humour and your family and friends to pamper you throughout your recovery.

Best wishes.

Linda

PS. I am pleased with the recovery of my muscles and 'looking forward' to my second posterior in late summer.

Haveyouever had general anasthesia,for dental work.Any anasthesiologist should discuss that with you.There is a lot of info on diet to promote tissue healing.Vitamin c is very important.I put natural ways to promote bone healing on you tube and found a good tutorial by a physician that was very good. Information is power so arm yourself so you can best prepare.This is a very helpful site.Keep coming back

Hi John

I just had my 2nd hip replaced about 8 weeks ago. I healed very quickly however I don't have the full strength of my new hip yet my leg muscle is still not strong but going on my other hip that does come back after time to its full strength I promise you.

Just do your exercises after your op and you will be fine.