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Walking post THR

Posted , 12 users are following.

JeremySt
JeremySt

I've had a lot of very useful info from this forum since I joined not so long ago - thank you all very much! I have a couple of questions:

1) Post LTHR op to exercise must I walk outside, or can I walk just inside the house (difficult terrains outside the house)? Has anyone in this situation just walked inside the house and got better?

2) Will I need to move the bed downstairs, or will I be able

to use the stairs? Does the PT practice stairs while still in hospital?

Sorry these may be elementary questions, I would really appreciate to hear about your exoerinces. Thanks, Jeremy

0 likes, 69 replies

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  • maggie93798
    maggie93798 JeremySt

    Posted

    If you do your own research it is a good idea to google the surgeons name. It should come up with the number of ops etc. The national joint register also gives some stats. But. As Graham has said no two people or operations are the same
    • JeremySt
      JeremySt maggie93798

      Posted

      I did Google - but nothing! Will try the register. Thanks, Jeremy
  • linda38528
    linda38528 JeremySt

    Posted

    It is natural that this conversation has morphed into a discussion about the track record of individual surgeons and what you can learn from the UK Registrar database. It is interesting that I have worked on teh research funding side of the health system in Canada for decades and yet I don't  honestly know if we have anything similar here - perhaps at the provincial level. I went to the 'rate your doctor' sites as a first step then spoke with colleagues who work in this field. As I mentioned before, I was suprised (maybe even shocked) by the number of friends and acquaintances who had had (a) THR(s) by my surgeon and of course delighted by the excellent reputation he has for both the technical and interpersonal skills that make for a good patient experience. I suspect that the second component is also key in establishing success rates as, patient compliance with the three 'holy movement restrictions' and adherence to exercise guidelines associated with a particular surgical approach can have a significant impact on recovery versus initial surgical success. And the surgeon has to play a big role in emphasizing this - not just the rest of the health team we encounter.

    AND NO, everyone - I am not leveling blame on patients versus the surgeon when something goes wrong but we do have a role in ensuring a strong recovery. 

     

    • JeremySt
      JeremySt linda38528

      Posted

      Ok. Very good ideas on paper. But how do you capture the details (data) of both surgeon and patient behaviour to report and improve on the end-to-end THR process?An impossible task unless a formal 'project' is commissioned, funded, developed and implemented. This would require ongoing participation of both surgeons and their patients over periods of n years. Who would fund such a project though? I am not sure if the NHS in the UK has the funds. Maybe an international consortium of private orthopaedic surgeons? Or maybe a large healthcare organisation? As you say, we have deviated quite significantly from the core discussion topic!
  • linda38528
    linda38528 JeremySt

    Posted

    Hi Jeremy - I don't see this type of research project as impossible. In fact a quick Google showed literally hundreds of research grants funded by the NIH in the US and others by the Medical Research Council in the UK and the UK Clinical Research Collaboration which it supports. One of the  projects highlighted and funded by Arthritis UK uses 9 years of accumulated data from the Total Joint Registry to draw conclusions about product safety (safety of several types of prostheses used and the way they are inserted. And the NIH in the US is funding a prospective study of hip and knee patients in a new total joint regististry. Check Medline for hundreds of projects funded re hip replacements and various dimensions of it. 

    So protocols for the technical elements of the surgical interventions exist. I think the second element (a qualitative component following up with patients to look at other dimensions and longer term satisfaction of patients) is also funded but it was hard to tell without more digging.

    My bottom line ... everyone should consider participating in research if you want to help support the very best practices in our health systems - it isn't all discovery research - muchof it is trying to improve what we are already doing. ;-))) 

    Sorry I think I just got back on my hobby horse! 

      

    • JeremySt
      JeremySt linda38528

      Posted

      Hi Linda - I totally agree with you: every patient and every surgeon should agree to participate in an ongoing project in which they would provide information of their experiences about individual THRs. As part of this project, back office staff would need to be appointed to collate, structure and report this information in order to analyse the data for EACH THR operation ONE patient's experience, including progress at each milestone. A second report would aggregate for EACH surgeon progress details of ALL her/his patients.

      To get all parties to participate in such a project I believe there needs to be incentives provided: the majority of people won't provide their time on an ongoing basis for free!

      I believe most (perhaps all) of the details relative to both surgeon and patient experiences can be gathered by the surgeon, then passed on to the back office/IT guys for processing and reporting.

      Challenge-1: which organisation should be tasked with persuading the surgeons to collate patient and surgeon experiences, and where would the funds to support this would come from?

      Challenge-2: which organisation should be tasked with the creation and on going management of the back office/IT environment to analyse and produce the two types of reports above?

      For this project to take off, and as the very first activity, I believe there would be a need to appoint a Project Manager to co-ordinate and drive all thinking and tasks required to get the project off the ground, including geographical boundaries of the project. Would this person be you, Linda? I would be prepared to help if required (after all I'll have some idle time at home soon following my op!). I am sure others in this forum would also be interested to support such a project? What do you say guys? Why not take the bull by the horn?

      If the above is to be progressed would it be worth starting a new thread? Linda?

      Regards, Jeremy

    • linda38528
      linda38528 JeremySt

      Posted

      So  ... I think we are alone in finding this interesting!  I will contact past colleagues to see if anyone is doing work like this in Cda or the UK and will let you know if I find anything good. There are just sooo many interesting questions that have been raised in discussions I have read since joining this forum that could be addressed. 

      The type of project sketched out above needs all kinds of ethics and consent forms from dozens of organizations. And to get those you need a research team with a strong track record and funding from an organisation like those identified above.

      It has been fun chatting about this though. 

      Cheers

    • renee01952
      renee01952 linda38528

      Posted

      Hi Linda and Jeremy,

      It is interesting for sure - Not sure how it can be done though..

      I live in Holland - would not know where to start ... 

      The hospital orhanization has send me a letter  asking if I would be so kind to fill out the questionnaire on line regarding my THR surgery and experience - I took the time (almost did not feel like it) , about 15 minutes .... 

      I don't see how surgeons will have the time or interest adding this to your day ... secretaries? Back office?  I am not sure how it is in the Uk, but here due to budget cuts, more offices , front and back, are pooled together - like one office for 4 disciplines ....

      My surgeon quit because of all the outside stuff that became mandatory in addition to performing surgery, for which he was trained - too bad because he was good and in the prime of his life (mid forties) - 

      So many questions were asked, posted here - 

      have you checked 

      https://patient.info/forums/discuss/thr-useful-resources-487147 -

      Graham's, aka as Rockeman's Layman's website?

      Big warm hug

      renee

    • JeremySt
      JeremySt renee01952

      Posted

      Hi Renee - as I said before, it would be a massive project but doable subject to lots of things happening (see the conversations with Linda over the past few days).

      Will the surgeons spend the time providing the required info? I am not sure. But reasonably certain that it's in the GMC 'constitution' that 'patients interest' is paramount. An this would be in 'patients interest' wouldn't it?

      Graham's site is great. Just imagine all the output from the project we have been discussing also incorporated into his website! Wow!

      Have a good weekend, Jeremy

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