Hip replacement complication
Hello,
My sister had a THR, anterior approach, 20 days ago and was transferred to a SNF four days later not able to lift her leg. She can bend her toes, but leg is numb and can only move it to the side. She gets PT twice a day, and they scoot her foot forward to take a step. She can't make a step alone.
She hasn't seen her surgeon since pre-op, although he did call to tell her she had extensive damage and recovery would be rough.
Now she's being prepped for release in a wheelchair and her husband is scheduled for training on how to care for her.
This seems very unusual and would be interested to hear of experiences with (hopefully) short term inability to lift leg post op.
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Yes, a little honesty in our medical profession would go a long way. For some reason; from what I had heard and read prior to surgery; I really expected to be walking unassisted in about 5 to 10ndays. I am 3 days short of s3 weeks post op and still deeply need a cane and am beginning to realize that for me; i actually am doing pretty good. I think they hype up the best case scenario because if they told us just how rough it could be; and probably will be; no one in their right mind would ever "elect" to have this done unless they were already practically unable to walk.
What does PITA stand for? I am one of the not so intellectual ones!!! Lol
Expectations probably need to be more consistent, it does seem a lot of variable messages from patients (because experience varies), orthopedic surgeons (although in the consent for surgery all consents will cover the % risks for death/infection/clots/swelling/bleeding/dislocation/revision/nerve damage/numbness/failure), and associated health professionals ( physical therapy seems to be enthusiastic as much as orthopedic surgeons). I have tried to read as many sources as possible the past six months, and I believe serious complications occur regardless of anterior versus posterior versus other approaches even with experienced surgeons - and complication rate may be about 1 to 2 % per year. Yan L, Ge L, Dong S, et al. Evaluation of Comparative Efficacy and Safety of Surgical Approaches for Total Hip Arthroplasty: A Systematic Review and Network Meta-analysis. JAMA Netw Open. 2023;6(1):e2253942. doi:10.1001/jamanetworkopen.2022.53942
If you are interested in the article I hope the link works, if not search on JAMA Canadian hip replacement 2023 and you should see the open access article.
Since complications apparently take place at the rate of at least 1 to 2 % per year (apparently forever), what I have concluded is hip replacement is an extremely serious decision, a major surgery, especially risky the first 3 months, and a good outcome that lasts 30 years without complications would be unusual.
Best wishes
PITA: Pain in the A...!
Oh my!!! What a great acronym! I'll have to store that for future use. Thank you
My x-ray shows moderate to severe osteoarthritis in my left hip, not quite bone on bone though. I can function fine during the day. There's often some soreness and often, I'm told, a very slight limp in my walk but I can still walk relatively long distances and even ride my bike. It's at night when I'm sleeping that the pain, which often goes down to my knee and sometimes lower leg often wakes me up. I find that two arthritic tylenols doesn't do anything for me, and I am reluctant to use Aleve and prescription naproxen very often given the damage that NSAIDs can cause with long-term use and because I'm also on a statin and aspirin. I'm scheduled to go back to the surgeon that I've seen to discuss my case and possibly re-schedule the replacement surgery that I previously postponed. But I am having a lot of second thoughts when I read about the complications some people have post surgery. I question whether I'm really debillitated enough for the surgery since as mentioned above I function fine during waking hours. I think surgery should always be a last resort. I've tried acupuncture, take supplements, work out and do hip-related stretches and exercises and I'm a fit 72 year old. Maybe I'm just postponing the inevitable but as time marches on surgical methods improve. It's cathartic writing this. Thanks for reading through it.
elliott1953 I have always heard that if the pain goes below the knee it is your back causing the pain and not your hip. That is what my hip ortho said and sent me for mri of my back.
Elliott,
Yes, ponder carefully.
Regarding NSAIDS, you might talk with your primary or orthopedic MD about occasionally using celecoxib (once a month perhaps for a day or two). Using the aspirin probably increases risk of NSAIDS however, so it's another risk benefit decision. You might also ease up on exercise occasionally, I have noticed some of my various joint pains get better if I take a few days off.
My situation was similar to yours, except not on aspirin, statin, or any Rx before deciding on surgery. Everything went well until dislocations at 10 and 15 weeks. If you do have the surgery I suggest to be very careful, take it slow, follow hip movement precaution* for at least 3 months, and what ever else is recommended. Currently I have zero pain unless I do approximately 7000 steps, relieved by acetaminophen. Hoping time will allow me to avoid revision surgery, may get a second opinion, right now dislocation is probably a risk bending at the waist or putting on socks.
*precautions vary with the surgeon and some apparently don't recommend precautions, from what I read research is conflicting but if you follow patients out a year or more complications occur (1-2%) regardless of anterior versus posterior etc. If I had it to again I would follow the precautions for both anterior and posterior for six to 12 months and never do ambitious bending ( I am flexible).
If I had it to do again I would avoid surgery if at all possible, but pain interfering with sleep might convince me to do surgery. Would have tried less exercise (less than 10000 steps and heavy lifting), monthly celecoxib or similar, and maintained a healthy weight (healthy diet to maintain weight).
Best wishes
I had read from this site about leg lengthening. So I asked my surgeon prior if he would be doing this and replied no. I did have significant amount of swelling in entire leg by week 5. So much so, that I could not bend my knee. Quite painful. Per doppler, no blood clots. Since I'd been having knee problems prior to hip and was contemplating TKR, I was given a steriod injection in knee. I also slept with wedge for elevation, swelling subsided for the most part, with much improved pain relief.
Btw, when I had shoulder related, surgeon did lengthened my arm. I realized this when my bra strap kept sliding down. Again, information from this group alerted me their same experience. Did your leg stay lengthened? If so how are you adjusting? Best of luck!
Hi! No, my leg did not even out, but I did not expect it to. There was a miscalculation by my surgeon that caused my operated leg to be longer, not entirely uncommon. I now have to have the other hip replaced and they will make even. I had read, and in my case I believe, that I incurred damage to my “good hip”, as a result of the operated hip being longer. Makes your gate unnatural.
In the meantime, to compensate, I order Dr Foot wedges online to elevate my heel inside the shoe and for my better heels I have a prescription that allows my shoemaker to add height to the bottom of my heel. Thanks for your good thoughts. Good luck to both of us😊