Newly replaced hip dislocated after 4 weeks.

Oh, Joe! I understand your pain as I too dislocated my hip after revision - they had to anesthetize me just to move me out of my house on a stretcher.
I'm afraid the answer to your question is "Yes" - 180 degrees is more than 90 degrees, and the muscles and tendons just haven't healed enough to hold everything in place. After this experience, you probably won't need anyone to tell you to slow down. I think it was nine months before I could safely do that ITB stretch.
You are luck they could do just the closed reduction. The next day, my surgeon saw me and did a manipulation under anesthesia that told him I was at risk for another dislocation - led to a 2nd revision so he could insert a larger ball (all has been well for 14 years now!

Thanks Sue,

Yeah it was just carelessness on my part and thinking that bending forward was somehow not bending the hip. Duh......

Well lesson learned. But damn, the pain! I don't do well with opiates so they gave me ketamine. That worked great for about 15 minutes but I was feeling very, very weird. And when the Dr did the closed reduction, they gave me ketamine and propofol. Felt like Alice in Wonderland.....

So you needed a second surgery to put in a larger femoral ball? Wow.

Thanks Sue.

Joe

Hi Joe, first of all congratulations re your level of fitness! Second, from what I've been told after all of my hip replacements and revisions, the other post op do-not-do that you did was crossing your legs. I must have had conservative surgeons, because they told me I had to observe the post-op rules for 12 weeks. So glad all turned out well for you!

Hi Janeen,

Thanks for replying. A conservative approach is always better and if I had followed that, I would not have been bending over so far just 4 weeks after hip replacement, and I would have avoided the pain and inconvenience of a dislocated hip. That's totally on me.

The incision healed very quickly and the swelling subsided. But it still takes time, months - up to a year - for everything to settle and for the body to adjust to the prostheses. My bad for not paying more attention. I think your conservative surgeons are right!

Joe

My surgeon, who invented the Superpath method, walked into the outpatient surgery center room with a multipage document from the hospital with the instructions on not crossing legs, etc. He tossed it in the waste paper basket and told me he had only two rules for me: (1) take my medicine (which we later agreed I didn't need and could stop) and (2) be a couch potato for the first five weeks because the one thing he can't do is make bones grow. So your return to exercise after two weeks may have been more at fault than your bending over. You didn't give your bones a chance to grow over the implant.

Thanks for taking time to reply Steve. Those are interesting comments, especially your surgeon telling you to do nothing, even physical therapy, for 5 weeks after hip replacement.

There may be something to that. The anterior approach doesn't cut any muscles, so there is little to no chance of scar tissue forming. In that case, resting is fine. But hey, it's still a traumatic procedure and even after the incision has healed, there's a lot of healing going on inside.

As for giving the bones time to grow into the metal prostheses - that is important and probably takes years. And in the hip, the only metal that comes in contact with the bone is the acetabular cup where it connects to the pelvis, and the stem that is driven into the femur.

Anyway, I admit I was too eager to get back to the gym. But I believe the dislocation was due to the extreme ITB stretch I did - 1) right foot crossed over left (right hip was replaced) and 2) bending at the waist to put my palms on the floor, bending way past the recommended limit of 90 degrees. The instructions are clear - don't do these things.

Now if I hadn't been in the gym I wouldn't have had the injury. I don't think the dislocation was due to not giving the bone enough time to grow into the prostheses. I think the dislocation was due to my stubbornness and stupidity. My surgeon can't fix that.......

The whole idea that bone can grow into metal amazes me. I had both knees replaced in 2022, and I waited two months before returning to the gym. Knee replacement has a much longer recovery time than hip replacement.

(For those reading this who are learning about joint replacement - there are two types, cemented and cement less. If a patient has osteoporosis, degeneration of bones, the metal prostheses must be cemented in place. For patients with healthy bones, cement is not used. The metal prostheses have a microscopic and porous layer of metal where it touches bone. Over time, bone will grow into those pores, essentially bonding with the metal. Wild stuff.)

Thanks again Steve. Hope you are doing well.

Joe

Your comment about your surgeon and his two rules . . . after my hip replacement, my surgeon had two rules as well: ABSOLUTELY NO YOGA and NO RUNNING UNLESS SOMEONE WAS CHASING ME OR I WAS GETTING OUT OF A BURNING BUILDING! The hip replacement was done in October of 2015 and so far, so good! The hip replacement gave me my life back.

That made me chuckle! I was allowed to run and do Yoga after my healing period, but I was told no jumping (I was still playing volleyball up to the week before surgery) if I wanted my hips to last. My lungs are such that I don't run much anymore, but I still to play tag with my littles. Hard to think, but it's been nearly 20 years since the original implants, and 14 since revision due to faulty components - last year my ortho said everything still looks great - now wondering how long I can "baby" my knee that was repaired 30 years ago - it is starting to yell at me every day. And Joe, I started more quad exercises to see if I can tighten it up!

Thanks Sue, I'm glad you're working on your quads!

One easy exercise is to sit straight up in a chair, preferably on a firm surface, extend one leg and contract the quad. Hold this for 30 to 45 seconds, enough so that it gets uncomfortable, starts to burn a little, and then switch legs. Three sets of these each day will keep your quads alert.

A variation on this is to extend your leg and, engage quads, and for your right hip, extend your leg out to the right away from your body and bring it back in - and reverse for the left - each time for 30 to 45 seconds with continuous motion, away from the body and back in, rinse and repeat. This will strengthen the quad and some muscles, mostly glutes, that keep the hip stable.

I got the ok from my surgeon to return to spinning after the hip dislocation last week! The only rule, don't bend over the handlebars. That one is easy because I always spin upright, with a slight forward lean - mostly to keep my lumbar spine in its correct position and to engage core muscles.

Sue have you heard of the SuperPATH method for hip replacement mentioned by Steve? It sounds too good to be true - smaller incision than anterior and no post-op restrictions on hip movement, bending, tying shoes, and on. I never heard of it but plan to ask my surgeon on my second post-op visit next week. Well for what that's worth, the surgery is done......

The surgeon who came up with this has patented the method. So I wonder if Drs and hospitals have to pay a licensing fee every time they use the procedure. I have a very good knee/hip surgeon, Cleveland Clinic experience, and I'm sure he would have mentioned this - unless the hospital is unwilling to pay licensing fees.

It looks to be a far better procedure than the anterior approach, which itself is a vast improvement over posterior and lateral methods. Just curious.