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Questions regarding total hip replacement
Hi, I would appreciate any feedback. My left hip joint is totally collapsed and has been for about 4 years. For some reason, I do not have pain. However, the collapse has left my leg shorter and has forced me to be heavily dependent on a cane. I've seen 4 orthopedic surgeons over the years and have gotten varying suggestions. One said not to get THR because I have no pain. Another said he could do it with anterior approach but it would require a lot of cutting, etc., and probably not be the best result. The third said he uses anterolateral approach but he had never seen a collapsed hip without pain. He said that the surgery would be a success but he didn't think I would be happy with the outcome because of possible damage to already weak muscles. The 4th said that he would do it with a posterior approach (is there only one type of posterior approach?) that he thought would give me the least damage. I'm 65 and would like to again enjoy some active years without a cane. I've read that hip surgeries are among the most successful but I get scared when I read forums. My friends remind me that people who have successful THRs don't usually get into forums because they don't have problems. Is that right? Or is the marketing for THRs not mentioning the infections, etc., that come afterward? And how/why do these infections occur? I want to move on with my life but I don't want to exchange a very inconvenient limp/cane for pain and problems. Am I just being a worrywart or ? Thanks for any thoughts.
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Hi Mamie,
You ask very good questions to help you weigh the risks and benefits of a total hip replacement: anterior approach, risk of infection and why do they happen, rehab and healing, etc. I'm tagging other members like @lynzze @marysapp @mrcapri @mrfish and @janelaine to join you in this discussion. @marysapp and @mrcapri mentioned elsewhere on Connect that their THR was done via anterior approach.
Mamie, I can understand that you get concerned when you read forums and hear about people's negative results with THR. It is possible that more discussions on forums in general are about poor results because people are searching for answers, and those who had good results don't need to find solutions. I hope we can generate a balanced conversation here with success stories as well as the reality that surgery always involves some risk. Talking with other members of Connect who have had and are considering a THR can also help you to make of list of good questions to ask your surgeon. Did you ask any of the surgeons that you consulted about infections and how or why they occur?
Thanks, @colleenyoung. No, I did not think to ask about infections. No one seemed to really offer much information but just answered what I brought up. It was all about looking at Xrays and looking at my ROM and little talk about much else. I've been learning as I explore online. Apparently with the stiffness of my collapsed joint, it seems that the posterior approach is the best with the least amount of cutting and best view. Does anyone know if there are two posterior approaches: mini and regular?
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2 ReactionsHello. My name is Robin. I'm a 52 y.o. female who started having hip pain about 2 years ago. 7 years ago I had a total knee replacement that was textbook perfect. When my hip started hurting I went to Dr's that had me start with PT, then cortisone shots and was told that I needed a THR. I had to wait 3 months to get a surgery date and was having terrible pain that I thought was the worst pain I'd ever experienced. I was wrong. You may have read my story on this forum so I'll give you the short version. Sept. 2016 I had a THR followed by 2 dislocations,a revision where I got a staph infection then had the hip removed for placement of a temporary hip while doing the IV antibiotics for 7 weeks, had the picc line removed and 5 days later was back in the hospital because the infection wasn't gone so they had to remove the temporary hip and left me with nothing but 7 more weeks of infusions. I'm done with surgery and if I new then what I know now I never would have done it at all. At this point I would never have another surgery of any kind, I'm far too scared.Hospitals are dirty places and despite knowing about the risks of getting a staph infection, nothing has changed. There should be a bio hazard team that cleans ORs top to bottom after every surgery! They book 5 or 6 surgeries a day and there's about 30 minutes between patients. That is not enough time to get those rooms disinfected well enough to get another patient in there 30 minutes later. If the previous patient got or has a staph infection you will get one too. All these people I read about having 6,7,8,10 surgeries are crazy. I had 4 and I'm done! I had to teach myself to walk again 4 times, deal with 14 weeks of IV infusions every 8 hours 3 times a day and unbelievable pain My surgeon said he could "attempt" a 2 stage and I passed. There are no guarantees. If you don't have any pain I would leave it alone! There are far too many risks involved. This is not an issue to take lightly. Make sure you read and understand every single thing that could happen. It could make your life miserable. It was the worst decision I've ever made!!!!! It's hard not having a hip but it beats the alternative. Good Luck whatever you decide. Robin ALSO, any surgeon who tells you the surgery would be a success is a liar and a fool. And looking you in the eye and telling you that is beyond irresponsible!
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4 Reactions@mamie, by chance I saw a report on the national news a few days ago about anterior approach to hip replacement. Your posting prompted me to track down some Internet reports on the technique. You may have seen some (or all) of them, but just in case, I thought you'd find them instructive. What was most interesting to me is that -- unlike the old-fashioned operation that cuts across muscles to access the hip joint -- the anterior approach avoids cutting across muscles whenever possible, and this reduces healing time and complications. I have three Internet links you might find helpful. The first is https://www.youtube.com/watch?v=5NqJa_J2dfw. The second is https://www.youtube.com/watch?v=CWccnIGKnRU. The third is https://www.youtube.com/watch?v=SJQDWkwWzTY. Perhaps you'd find it helpful to watch one or more of these with a surgeon who has a record of successful anterior-approach hip replacements. Let me know how else I may help. Martin
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1 ReactionHi, Robin @froggy1 I am so sorry you had to go through all that and continue to suffer the after-effects. Your experience sounds horrible and is one of several on this forum that have made me ask questions. What's confusing is that I also hear stories about others where joint replacements went well -- like the case of your textbook-perfect knee replacement. It so much seems to be a throw of the dice. I've been checking out sites that let you compare surgeon complication rates -- surgeon scorecard and surgeon ratings -- to find someone who has a good track record. Was your surgeon someone who was very experienced and in a hospital that was well rated? If you had not tried the surgery, would it have continued to deteriorate anyway? Have you considered a different surgeon with lots of revision experience? Thank you for sharing your story and information.
Hi, @predictable Thank you for your information. Yes, I've checked into anterior and have already seen a surgeon who specializes in the anterior approach. However, that doc said that because my hip joint was so collapsed and stiff, that approach would not work well because he would have to cut a lot of tissue, crank my leg around a lot, etc., and he normally would not. I guess that anterior approach works for joints that are not yet stiff and collapsed. My confusion about all of the approaches is alarming. One doc said posterior would be worse and cut major muscles. Another doc said posterior only splits a big muscle and is more muscle saving. And I still don't understand if posterior is the same as mini-posterior. It's so confusing! The questions and worries make me want to go to bed and forget about it all.
Hi Mamie, My surgeon was one of the top 5 doctors at the University of Washington Medical center. He is not the same one who did my knee but they work out of the same office. Although my surgeon came highly rated I still had 2 dislocations. Did he use the wrong type or size of replacement? I don't know. I'm looking into that. My concern at this point is staph infection. Why are they so common in hip surgeries? I believe that there is a big problem with the sanitary conditions in hospitals. Every hospital. I've read stories from all over the world. Why is everyone getting Staph? And why hasn't there been a serious investigation - study on why this happens so often. If it was a known fact that people that have open heart surgeries came out with staph infections as often as people who have had hips, knees and shoulders, something would have been done by now. This is not new, this is very common and i'm very surprised that none of the surgeons you spoke to said anything about staph infections. Again, hospitals make money by getting as many surgeries done as possible in a day. I'm certain that it has everything to do with the poor standards regarding cleaning. Hospitals don't care if you wake up with a staph infection. I spent all of Christmas week last year as well as the last week of Feb. this year in the hospital being treated for staph. It doesn't even phase the nurses, they see it everyday. I believe the joint was pretty much gone when I finally had the surgery so I don't know what would have happened. But if I wasn't having any pain I would definately leave it alone. Something else I forgot to mention is all the restrictions you'll face with that new hip. No bending, crossing your legs, leaning to grab something, picking something off the floor etc. I'm only 52 years old and very active. It is extremely difficult trying to go through life remembering not to do this and that because you'll always be at risk of dislocating. And you wanna talk about the worst pain ever? Dislocate a hip and your leg feels like it's on fire and you'll think you're having a heart attack. I spent 6 months worrying about every single move I made after those dislocations. It was exhausting and depressing. When they pulled the final hip out and sent me home they said "you have no restrictions at all". I was floored how could that be? Because there's nothing in there to dislocate! So I walk with a limp and a walker but I can bend, reach and cross my leg. I'll take that over another staph infection. And NO I would never consider another surgeon with more revision experience, it's not the surgeon I'm worried about, it's the filthy conditions in the ER where I contracted the infection that I'm worried about. Please, please,please make sure you have all the facts before you do anything! If you would like to contact me directly you may send me a personal message here on Connect. I would also be happy to talk with you on the phone if you like. Just contact me through a personal message. Robin
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2 ReactionsHello @froggy1, you may notice I changed your email to say send you a personal message here on Connect. We remove personal emails for the protection of the community and its members from unwanted solicitors who may find your email. We try to protect your privacy as much as possible. If you wish to share your email with some of the other members, we reccomend sharing email addresses and contact information via the private message function. If you have any questions on how to do this, please do not hesitate to ask.
I can't give someone my email address for the protection of the community? I have no idea how to send or receive a personal message. Can you walk me thru it?
Hi Froggy,
Connect is a public website and we recommend not sharing personal contact information, such as emails or phone numbers on the forum. We don’t want you to get unwanted spam emails or phone calls. You can share personal contact information safely by using the private message function. Here's how:
1. Click on the member’s name.
2. Click on Send Private Message.
3. Write your message.
4. Click Send message.
However, we encourage continuing this discussion with the group here. There are many people considering hip replacements or who have had one, who would appreciate connecting and sharing experiences with both you and Mamie. By replying to her in this discussion, you form a support group.