What is normal recovery time/ progress for total hip replacement?

New to MayoConnect, posting about something rare, so maybe limited comments. Experiences apparently vary widely based on posts I am seeing, pain, meds, activities, etc. I have a good surgeon, focused on outcomes. I had a little pain at night the first week, and perhaps should have used oxycodone(severe pain as needed Rx), but never used oxycodone/tramadol/opioid meds. A nerve block helped the first 3-4 days. Celecoxib 200mg twice a day, and Tylenol 1gm three times a day for one month covered pain. Prednisone 5mg/day for 14 days also covered inflammation/pain. Your kidneys, stomach, gi, bleeding/clotting tendency may require different meds. Recovery may be good in 6 weeks, but I believe 6 months at "half speed" might be a good safeguard. Unfortunately I pushed at 70 to 100 %, 1/2 to one mile the first week, perhaps better to let tissues heal. I have had 2 emergencies, painful dislocation, which resulted in urgent ER reduction (popping back into joint), and may require repeat surgery (called revision). I'm hoping 3 more months of careful walking/stairs, stricter avoidance of bending at waist to ground, will allow me to avoid revision surgery. Cause of my dislocation is unclear, unexpected, remotely possible lumbar/sciatic instability or tissue loose after 20 years of yoga. If anyone has had 2 dislocation and managed to avoid repeat revision surgery, please let me know. Hopefully no typos, autocorrect, phone typing is suboptimal.

@heyjoe415 I think this member is calling you!
It sounds a lot like your too-vigorous try to get back to full splde.

Hi tallbackhip,

Sorry you had to go through a dislocation. Very painful.

My dislocation occurred four weeks after surgery. I returned to the gym in two weeks, mostly to spin. I did myself in with an IT Band stretch that requires (while standing), crossing the feet (crossing legs, first mistake) and bending from the waist and putting my palms on the floor (bending hips greater than 90 degrees, second mistake).

My hip dislocated, and five painful hours later in the ER (heart attacks, strokes and gunshot wounds all come before hips), closed reduction was used to pop the femoral head back into the new hip socket. I was "consciously sedated" with a mix of ketamine and propofol. I don't remember the procedure, but it worked, and scared the hell out of me.

I'm lucky it didn't do more damage, and no surgery was required. Hips are deceptive wrt recovery. The incision looks good as soon as the bandage comes off at two weeks, and all the pre-op pain is gone.

As my Dr later explained, it takes time, like months, for the hip capsule to scar over.

What were you doing when the hip dislocated? Did the surgeon use an anterior or posterior incision? Dislocation happens mostly after a posterior incision. Mine was anterior..... But crossing your operated leg over the other, and bending the hips greater than 90 degrees can lead to dislocation.

Lesson learned, the hard way. I hope you can avoid revision surgery.

(Thanks Sue!)

Joe

Anterior approach, doing exceptionally at 10 weeks, but dislocated at 10 and 15 weeks, doing movement which was "second nature " but in hindsight very risky, 1st episode bent at waist then bend knees so upper body weight on hip (fulcrum effect, in crawl space), 2nd 15 week episode just bent at waist but still the 90 degree violation. Both times I held my femur weight and hip to avoid pain and damage, no damage or fracture on xrays. Arm and back muscles quite stressed from holding leg for 3 to 4 hours before ER sedation and reduction of the dislocation. Five days later I have zero to 3 discomfort, active but extremely careful, try not reach below knees, use a grabber. Probably will get hip brace for daytime, use caution 12 weeks and xray. May need second opinion, xray lumbosacral area (unstable? ). I am interested in any suggestions, and if anyone healed OK with out revision surgery after either 1 or 2 dislocation episodes?

Hi again tallbackhip,

I mentioned my dislocation story above. I was fine after closed reduction (although like you, I had to wait close to 4 hours in the ER before they put it all back together). I am now 5 plus weeks post-dislocation and all is well.

Xrays were taken of my femur and pelvis to ensure no fractures. The only good news to come out of this is no fractures and no damage to the prostheses. In fact, my surgeon said the X-rays showed my bone was already starting to grow into the prostheses, even at 4 weeks. I've been fortunate all my life though and recover and heal quickly. I have no defense against doing stupid things, alas.

I was doing a really aggressive stretch, right foot over and next to left (so crossing the right leg, a no no), and then bending at the waist far enough to put my palms on the floor (an old and now bad habit from my running days, and I'm very flexible. hips bent way past 90 degrees, another no no). That was enough to pop the femoral ball out of the socket. Ouch.

From your low pain level, it sure sounds like the closed reduction was successful, very similar to mine. If anything, my anxiety level was through the roof for the following week, walking on egg shells and fearing a repeat. All is well now, five plus weeks after dislocation. My hip was sore after the dislocation, but that was expected.

So my advice is to do what you're doing. Be careful how far you bend, don't cross your operated leg over the other leg, continue to use your grabber, and go back and do the rehab exercises provided right after surgery (foot pumps, heel slides, quad sets, abduction, and on).

For what it's worth, I have a very bad lumbar spine - all the problems you can think of. I've had no pain in the lumbar/sacral region, and the sciatic nerve was not bothered by the dislocation.

If you feel any symptoms of sciatica, pain in the back of the leg or legs, get to your Dr. Fortunately, it doesn't sound like that happened.

Final advice, give the hip capsule time to scar over. I don't know how long that takes. I have my last post-op on June 13 and I'll ask if and when I can be a bit more aggressive with stretching. Until then I'm following guidance!

(One other phenomenon I went through - hip snapping. This is where my IT Band would cramp and move out of position over the greater trochanter. It felt like a dislocation, but would snap back in place with a "thump-like" feeling when I straightened my leg. Nerve-wracking feeling! Happened mostly when putting socks and shoes on without a grabber, or sitting on a hard surface with hips too far down and knees slightly up relative to hips. Apparently hip snapping isn't uncommon after a THR.)

Finally, the things you describe, while warned against, shouldn't have caused dislocation - just my opinion and I'm not a Dr. I'm sure you've had your new hip checked out via X-ray. I'd ask the Dr about it anyway - that is, can you ever cross your legs or bend farther than 90 degrees?

All the best to you.

Joe

I’m glad your PA suggested you were being too aggressive trying to get off oxycodone. We all experience pain differently and doing what’s best for our own recovery is the most important thing for recovery! Good for the prunes, anything that gets us moving!