Newly replaced hip dislocated after 4 weeks.

Well I'm 10 weeks post-op, 6 weeks post-dislocation and all seems well. I haven't had any more instances of "hip snapping" and I have zero pain.

I mean, who would think that bending over poses a risk. Yes, it violates the 90-degree-max rule for the hips, but I wish we were provided examples, pics of what not to do. I would get a lot of hip snapping just putting on my socks and shoes - which also breaks the 90-degree rule.

I hope you are better. Dislocating your hip in a crawls cape must have been a nightmare.

(I am back to working with my trainer. I can do leg presses, mindful of staying at 90 degrees max, and hamstring curls. Dr has said no squats for now. I also spin 5x week, and I keep my body behind the handlebars, with a slight tilt forward of my torso, and a light touch with my hands on the handlebars.)

One last thing, my Dr prescribed a muscle relaxer for the hip snapping. Hard for me to say if it helped, or if it's just been the passage of time.

All the best to you! Pls stay in touch.

Joe

Hi Joe,

Following up to see how your hip is, and what Precautions you (or others on this string) suggest.
1. Are you doing well, I'm guessing you are about 3 months dislocation and successful closed reduction in the ER?
2. Other than not bending at the waist past 90 degrees for 3 months (?), any other precautions? How long before tieing your own shoes? Do you avoid crossing legs, low chairs? When seated, knees point away from midline? Do you use a grabber for objects on the floor? Any exercises you avoid, for example do you do a shallow squat, or avoid those?

I'm about 6 weeks post 2nd successful closed reduction. Usually no pain, no medication, so could be worse. CT indicated nothing major, though injured so probably at least 3 months healing.

Thanks for any suggestions from Joe or others.

Hi Tailbackhip and thanks for replying!

I'm coming up on 3 months post hip dislocation (4 months since the initial replacement surgery). A few thoughts in response to your questions:

- Tying my shoes and putting socks on. For the first two months after the replacement surgery, I experienced "hip snapping", especially when bending down to pick something up, tying shoes and putting on socks. After the dislocation, I was much more careful, but these things remained a challenge. In my case, the IT band was slipping over the greater trochanter, the part of the hip bone you can touch.

As nerve wracking as these incidents were, they always resolved in seconds. Now I'm at the point where I don't think about putting on socks, tying shoes, or bending over to pick something up. That happened gradually, over time.

- I try and avoid situations where my hips bend more than 90 degrees, but again and with time, I do this on occasion and it doesn't cause any hip snapping (much less dislocation).

- My advice for people coming out of a THR - be very careful with all of these things! Don't freak out if your hip snaps, this resolves over time.

- Even with all this advice, which the surgeon provides, some common sense goes a long way. When I dislocated my hip 4 weeks after replacement, I was doing an extreme stretch for my IT band. standing up straight, knees locked, I crossed my right foot over the left (first mistake, don't cross the operated leg over the other), and then bent down, knees still locked and put my palms on the floor. I was way past 90 degrees bend in my hips - probably closer to 130 degrees or more (second mistake).

While I'm grateful to have this flexibility at age 70, it literally pulled the metal ball of the new prosthesis right out of the new socket. Intense pain immediately ensued until the ER Dr did a closed reduction, about 5 hours later.

My surgeon's RN reminded me that it takes time for the hip capsule to "scar over". Just because we can do something doesn't mean we should do it. I think dislocation of the hip after an anterior approach is pretty uncommon. But what I did was 1) dumb and 2) uncommon.

So I feel great now. No more hip snapping and I'm following the other rules pretty closely. The big change is that I don't think now before I put on socks, tie my shoes, or just bend to pick something up.

As for exercises, I think shallow squats would be fine after 3 months. I do simple stand and sit squats from a workout bench. And I do straight leg presses on a machine (15 reps at 190 lbs, 4 sets).

Next up - left shoulder replacement in early August. I am literally running out of joints to replace.

I hope you and others find my reply useful. If you (or anyone) have questions please send them!

All the best to everyone!

Joe

Hey Joe, Just wanted to touch base and clarify something you said in your post about scar tissue. Muscles are not the only tissue in the body that scar. Fascial tissue forms scar tissue. In fact, when you cut into the body there will always be formation of scar tissue around the incision. Just didn't want you to confuse anyone with that piece of your post.

Thanks so much for that clarification, much appreciated.

I didn't know about fascial tissue forming scar tissue at the incision site. It certainly makes sense.

What I was trying to get across is the importance of doing all recommended rehab after a joint replacement - especially knees and shoulders. Getting into rehab asap after surgery, and per a Dr's guidance, is very important for good, lt outcomes.

Thanks again for the clarification!

Joe

I had anterior THR 10 days ago. I walk without walker and am able to bend my knee up to my chest enough to put on socks, pants. If I bend down to pick something up, I do it quickly...not stretching it. My PT guy in hospital said bc I had anterior process, bending forward to pick something up on floor was not a problem. Main no-no was crossing legs, surgery foot/leg turned outward, and leaning over with surgery leg stretched to the back.
My most important advise...Ice, ice, ice. Move around every hour, and Rest.
I am in good shape and will begin PT in 4 days.

My friend had hip replacement and all was going well - he felt great and had few if any limitations as far as pain goes. One day he was at his desk and his pen or pencil fell off his desk so he backed his chair up and scooted on his hands and knees beneath the desk to retrieve it - not good. His secretary heard him screaming and could not figure out what was wrong. Called ambulance and flew him to hospital hour away. Apparently one should not get on their hands and knees, at least not him. I do not know which approach was taken to access the joint but apparently it came out of place!

@franee and others, HeyJoe

Dislocation and serious complications do occur, not often, but it's important to recognize the need for precautions after joint replacement, indefinitely.
Doesn't seem to matter surgical approaches either (reference JAMA Hip replacement article published in recent years), 1-2 % per year complications even with the purportedly safer anterior approach.

In talking today with my surgeon, follow up 7 months after anterior hip surgery and 3 months after a 2nd dislocation, I mentioned the case reports of anterior hip replacements dislocating several years after surgery with forward bends in yoga. We noted this occurs perhaps 5% or less of the time, but disagreed slightly on whether or not people needed to know the risk existed. (I was pain free, highly mobile, and cleared of all precautions after about 8 weeks, then dislocated. I'm in good health, no chronic diseases.)

Anterior approach or "Super " or posterior surgical approach or any other, all have risk. Search on hip replacement outcomes mentioning the approach or technique you care to review, published patient research indicates no approach perfected or proven superior, complications 1-2 % per year.

So beware bending the waist more than 90 degrees, certainly more than 130 degrees, for a year or perhaps indefinitely, unless you are willing to accept the low risk (2 to 10 % eventually? ) and a very painful trip to the emergency room. Shark's report above seems to indicate bending at the waist more than 90 degrees in a chair is a risk also, which makes sense. Personally I am wary of most chairs, chairs being too low for people taller than average.

For now I am using a sock aid to put a sock on the involved foot. I use a grabber or my good foot to pick objects off the floor. Step in shoes or sandals. A loofah on stick for the shower. If you need these sorts of tools, suggest to look for a "hip kit" online, I found a reasonably priced kit from "Nourislif" but I'm not financially linked and don't necessarily want to say any product or source is best. I wish I had a hip kit right away after surgery.

If you have a dislocation, you might search on the terms research hip dislocation after hip replacement causes, to see positions and movements causing dislocation.

In regard to healing - agreed fascia, tendons, muscle, nerves, blood/lymphatic vessels and other tissues need time, ideal nutrition, and moderate exercise to scar or heal. Hoping all my tissues will heal despite my two dislocations!! Hoping to avoid revision, which is riskier than first surgery, and my surgeon agreed things seem positive today.

Best wishes

Thanks for this valuable intel Tailback,

It's been 5 months since my THR and 4 months since the dislocation. The "hip snapping" I experienced after surgery has stopped. I think that was due to my IT Band passing over the outer edge of my hip bone. The bark from these events is worse than the bite. It happened most frequently when I put my socks on. Just another cautionary tale to give the body time to heal, maybe especially with the lower-trauma THR. (Fortunately, the hip snapping has stopped.)

When I did dislocate my new hip at 4 months, I was doing a stretch for my ITB - right foot crossed over and next to left foot (mistake #1) and bending forward at the hips, keeping knees locked, with palms on the floor (I am very flexible, but this took me well beyond the 90 degree max, mistake #2), and out popped my new hip. Fortunately, no bones were fractured and the prostheses are intact.

I'm glad you mentioned yoga. I did hot yoga for many years and loved it. But there are too many postures/asanas that 1) require crossing the legs and/or 2) require a bend of greater than 90 degrees at the hip.

So I've decided that these things just aren't for me anymore (ITB stretch described and yoga). At my age (71 next month) the risk isn't worth the reward, and I'm still fortunate to be able to do so many things at my age. I think part of successful aging includes a willingness to move on from things that were part of my life for so long - like marathons, yoga - but just can't be done anymore without great risk.

Speaking of joint replacements, I had my left shoulder replaced on Aug 6th (anatomical, not reverse). I'm running out of joints to replace! I feel good, been in a CPM machine for two weeks, and start PT in two days. Stay tuned......

All the best!

Joe

Good for you Frannee!

It's been 5 months since my THR, 4 months since dislocating it. It's all good now. I am very cautious when bending more than 90 degrees, although I think that isn't the same risk it was 4 months ago.

Overall, joint replacement is a miracle of medicine, imo. My life is so much better without that pain!.

Take care Frannee, and thanks again!

Joe