Update on Revision THR

Posted , 12 users are following.

Just wanted to post an update for my fellow hippies, especially those of you who are worried about your operation.

TLDR: Op went great. 2 days post op walking with a cane. Almost no pain.

Background: 70 yr. old male. Broke hip on bicycle accident Dec. 16, 2017. Got a partial replacement. Recovery went fine, but fell on sidewalk and knocked everything loose. Hobbled around, unable to walk more than 100 yds., until Sept. 12, 2018, when I went in for revision THR. Very worried old implant wouldn't come out without osteotomy, requiring no weight bearing for 6-8 weeks before starting normal THR rehab. But lucked out -- the implant wobbling around, causing all my pain, came right out, so I was only under for 2 1/2 hrs. Ceramic pin with plastic cup. Fantastic surgical and anesthesia team, great nursing care.

So now I'm 3 days out of surgery. I'm in less pain than I've been in for 7 months. I take a 500mg Tylenol in the morning and one at night, not so much because I desperately need it, but to keep ahead of pain.

I was up walking 6 hours after the surgery, and within the next 24 hours did about 20 rounds around the ward on a walker. I probably overdid it a bit, mainly because I was so amazed to be rid of the pain deep inside my hip. I went home about 24 hours after the surgery.

Home health care came to see me yesterday to check out the house. My ever attentive wife had already taken out all the throw rugs, removed obstacles, etc., so the house was totally safe. Medicare gave me a walker, which I absolutely hated. I got rid of that on the third day, and went to my cane -- but only after the physical therapist confirmed that I was steady on my feet.

She gave me five exercises. Three of them I do on a bed. 1) bring your heels up toward your butt 15 times. Not past 90 deg. - I can't get close to that yet anyway. 2) move your ankles up and down 15 times, stretching your calf muscles. 3) flex your quads and glutes 15 times. Then, at a counter, do 15 side stretches, where you first step on your good leg and move your bad leg out to the side while keeping your hip centered. Then do 15 on the other side, letting your operated hip bear the weight while supporting yourself on the counter. Last exercise - marching in place 15 times. I do these 5 exercises 3x per day.

Most important - walking. The PT emphasized that form was very important. Since I had been limping with a cane, and in extreme pain for 7 months, my walking form was abysmal. The three main problems were that I was "posting" with my bad leg, i.e. placing it off to the side to minimize direct pressure on the cup in the pelvis. Secondly, my bad hip step was much shorter than my good step. Third, my feet were too far apart. So I take three 20 minute walks a day, concentrating on those 3 things. It's harder to do, but I think it will be well worth it in the end.

The bummer is that the PT has put me on "house arrest" for the next two weeks -- no going out to restaurants, no overdoing it. Oh well, I probably needed that anyway.

Medications: They gave me a 3 day regimen of steroids - 3 pills the first day, 2 the second, 1 the third. I have Oxy, but I'm going to return it to the pharmacy. Stool softener, because the anesthesia tends to make you constipated. A couple more pills for inflammation. Tylenol 500mg, which is the only thing I'm taking for pain, 1 in the morning, and 1 at night.

If you're thinking about not having this surgery, think again. I know it's scary, and I was very nervous prior to the operation. But I'm so thankful I had it. I'm looking forward to resuming my active life. Yes, I'm giving up road biking, but I will ge an indoor cycling machine, and I have my weight set ready to go.

The last thing I'll say is this. I think it makes a big difference at my age to be in shape. I got out of shape after I broke my hip in December, but I was in really good shape, riding around 125 miles a week, before that. Once you pass 60 yrs. old, your body isn't so forgiving. So, if you have been living a sedentary life because of your pre-op pain, let this operation give you a new lease on life.

 

And thanks to all the hippies here who gave me advice and encouragement before my operation!

5 likes, 11 replies

11 Replies

  • Posted

    That’s great news, I hope that you continue your good recovery. You’re so right, trying to get as fit as you can before the op is so important. Onwards and upwards , and enjoy some meals out when you are allowed!
  • Posted

    Hi Chaco

    Well done. Sounds like you are progressing well. I had a revision a year ago - 2 stage due to infection. I don't do as much physio as you but i am still riding my bike. But i am fairly careful and have always been more of a plodder than a racer.

    Mike

  • Posted

    Well done, Chaco. I am 6 weeks post op and have my check up tomorrow. I can do most things that don't require breaking the 90 degree rule, including driving my car which give you back a great sense on independence. My only niggle is that for the last week my hip makes a noise when I do the marching up and down on the spot exercise. Apparently this will to as the hip "beds in" and all the surrounding tissue is fully healed and the muscles regain their full strength. I hope you continue to make good progress. I totally agree with you that anyone who is nervous about the operation should go ahead and do it. It's such luxury to be pain free!

  • Posted

    So happy you are doing so well! I also got my life back thanks to this surgery! I had both hips done at the same time. I am one year out and yesterday I taught 5 dance classes!(4 of them were tap!) I would do it again. Being out of arthritis pain with every step is heavenly!

    Congrats on your recovery!

    • Posted

      Wow! Both hips at once -- I don't know how you did that, but kudos to you!

  • Posted

    Just a quick update here, 4 days post-op.

    Was having stomach problems. Looked up side effects of various meds, and I think it's the steroids that are the problem. Fortunately, today is the last day for these.

    Walking around 6,000 steps a day with the cane (3 x 20 min). Difficult, because I'm concentrating so much on form -- not posting my bad hip, even step length, right distance apart.

    Able to sleep fine on the non-operated side.

    Pain level at around 1, but only when walking. Keeping it under control with 500mg Tylenol in am and evening.  

  • Posted

    Really good to hear.  But why did you get a half hip replacement after initial break?  I have osteoporosis as I have to use a wheelchair with MS so they gave me a hemiarthroplasty.  Didn’t go well so am facing revision in future and terrified of dislocation and everything else.  Was the surgery simpler because they were just replacing an original half hip op.?
    • Posted

      I should have had a THR to begin with. The problem was, I had a bike accident and broke my femur in two. They delivered me to the emergency room in a great deal of pain. The surgeon on call had 4 surgeries that day.

      Basically, I believe they did the fastest surgery to get me out of there. Hemis are usually indicated for very old people or couch potatoes. I am 70, but was very active, and they knew that. I made it clear to them that I cycled 120 miles a week. I even had an orthopedic surgeon friend of mine call the attending doctor and she asked him to do a full replacement. His response was, "We don't do that here."

      Not knowing anything about hips, I just went along. Now I know better. It's also difficult to make a rational decision when you're on dilaudid for the pain.

      No need to be terrified about dislocation. Just follow the movement restrictions, and you'll be OK.

      The only reason the surgery was simpler is that the old implant was loose anyway, which is why I had been in pain for 7 months. It more or less popped right out. If that were not the case, then I would have had a much more difficult recovery, probably with no weight bearing for 6-8 weeks, followed by a normal 6-8 week THR rehab.

      I understand you're terrrified; I was too. But I am SOOOOOOO glad I went through with it. Yes I lost a year of physical activity (which at my age is a big fraction of the time I have left), but at least I can now look forward to both legs functioning like they're supposed to.

  • Posted

    Update 7 days post-op

    Major loss of energy today, and significantly more pain. The PT came in and was concerned about possible bleeding from my sutures, and I was able to get an appointment at ortho that day. The nurse cleaned everything and pronounced it in good order. I was even able to spend a few minutes with my surgeon.

    She was happy with the healing progress. She explained why I was probably feeling so tired and pained. I had finished the course of steroids two days earlier, and it was likely the steroids were now leaving my system. They pumped me up. Once they wear off, it's normal that one feels really tired and down.

    Went to bed at 7pm that night and slept straight through to 3am. Got up for 2 hours, then slept another 2 hours, for a total of 10 hours of sleep.

    That was all i needed. Today have less pain than I've ever had, lots of energy, very little pain. I stopped taking Tylenol 3 days ago, and I think I'll have no need for it from now on.

  • Posted

    Thank goodness.  There aren’t enough “happy” posts and I was really encouraged to read yours.  Absolutely shocking that they gave someone your age and fitness a hemi.  You’re the only other person on this site who seems to have had one.  Even with my problems I wish I’d had the full op. as I can still use a treadmill.  Duke of Edinburgh is 96 and he got one.  Damn sure I can walk as far as him.  His after care is probably better.  Good luck with your continued recovery.
  • Posted

    Great news you made it thru revision without osteotomy . It's all good news for you from here on out you'll be back in shape in no time .... your on your way! Stay positive and strong you have a great attitude! 

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