Questions regarding total hip replacement

Posted by Mamie @mamie, Dec 26, 2017

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.

Interested in more discussions like this? Go to the Joint Replacements Support Group.

@pledges

Husband had original judet cementless hip replacement in 1981 at age 26. It went well. In hospital 3 weeks. On crutches for 6 mo. Recommended back then. In fall of 1982 in car accident. Passenger in vehicle hit by drunk driver. Hospitalized 2 weeks with concussion, knee wound. A year later started having issues with hip. Dr thought rejecting ball so he had revision surgery in 1984. Was better for awhile but never great. In 1996 new surgeon did a total revision replacement with cadaver bone, wire, screws and a plate over a cracked pelvis that he felt probably happened in that car accident. It never showed up on xrays/mri when standing
still. Surgery took over 11 hours to pull it all out and replace. Did very well. In hospital 2 days! 2 yrs
Later had other hip replaced. He did dislocate that one 3x before a different woman surgeon fixed. Has been good since. Over 20 yrs. The 1996 hip though is not doing well. Has loosened. His surgeon is partially retired and no longer doing surgery. He sent him to another surgeon who doesn’t want to do any more surgery. He told him to go on disability and get Medicare. No help with pain, no other solutions offered. We don’t think our insurance will pay for him to go to Mayo. Have read about a new procedure that cleans out hip area of any debris and using camera injects cement into loose areas. My husband is 63 and not 83. He doesn’t want to be in pain for rest of his life. Anyone else been told no more revisions?

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Hi @pledges - Welcome to the Connect community. There are lots of great, supportive people here with tons of experience. I haven't had a hip replacement - my issues are with my knee. But there are a number of people here who have had hip replacements. I'll tag some of them and maybe they can share some insight: @katepitt, @klouis, @beatricefay, Also, here is a thread you might find helpful related to the use of cement:
https://connect.mayoclinic.org/discussion/need-tkr-and-had-positive-allergy-testing-bone-cement-and-metals/
Is your husband having severe pain now? Also, I'm curious whether your insurance might pay for Mayo if your primary care doctor refers you. Is that something you might explore? I'm wishing you the best.

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Here are questions you can ask yourself when considering a joint replacement:

Is joint replacement the best treatment for me right now? What other treatments should I think about?

How well does this surgery work for someone my age and with any of the medical problems I may have?
Will I be able to walk without pain? How far?
Will I be able to do other activities, such as golf, swimming, tennis, or hiking? When can I do them?
Is there anything that I can do before the surgery so it will be more successful for me?

Are there exercises I should do to make my muscles stronger?
Can I learn to use crutches or a walker before I have the surgery?
Do I need to lose weight before surgery?
Where can I get help quitting cigarettes or not drinking alcohol, if I need to?
How can I get my home ready before I even go to the hospital?

How much help will I need when I come home? Will I be able to get out of bed?
How can I make my home safer for me?
How can I make my home so it is easier to get around and do things?
How can I make it easier for myself in the bathroom and shower?
What type of supplies will I need when I get home?
Do I need to rearrange my home?
What should I do if there are steps that go to my bedroom or bathroom?
Do I need a hospital bed?
Do I need to go to a rehabilitation facility?
What are the risks or complications of the surgery?

What can I do before surgery to make the risks lower?
For which of my medical problems (diabetes, heart disease, high blood pressure) do I need to see my regular provider?

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@abhilashrathore

Here are questions you can ask yourself when considering a joint replacement:

Is joint replacement the best treatment for me right now? What other treatments should I think about?

How well does this surgery work for someone my age and with any of the medical problems I may have?
Will I be able to walk without pain? How far?
Will I be able to do other activities, such as golf, swimming, tennis, or hiking? When can I do them?
Is there anything that I can do before the surgery so it will be more successful for me?

Are there exercises I should do to make my muscles stronger?
Can I learn to use crutches or a walker before I have the surgery?
Do I need to lose weight before surgery?
Where can I get help quitting cigarettes or not drinking alcohol, if I need to?
How can I get my home ready before I even go to the hospital?

How much help will I need when I come home? Will I be able to get out of bed?
How can I make my home safer for me?
How can I make my home so it is easier to get around and do things?
How can I make it easier for myself in the bathroom and shower?
What type of supplies will I need when I get home?
Do I need to rearrange my home?
What should I do if there are steps that go to my bedroom or bathroom?
Do I need a hospital bed?
Do I need to go to a rehabilitation facility?
What are the risks or complications of the surgery?

What can I do before surgery to make the risks lower?
For which of my medical problems (diabetes, heart disease, high blood pressure) do I need to see my regular provider?

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what Jt is being replaced?age? Have you looked at options?

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@cobweb

what Jt is being replaced?age? Have you looked at options?

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@cobweb, I believe that the new member was providing a list for people to use when considering a joint replacement. Are these questions you asked? Would you add any?

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I'm 68 and my sentiments about total hip replacement match exactly what you wrote. I'm wondering if getting my core muscles super fit will help with my groin pain. I'm scared to get the surgery too after reading what others are writing.

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@jfsherley

Hi ! I had total hip replacement about 4 years ago and just sailed through it without any complications, took me about 2 months before I went back to work.

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Did you get your surgery at Mayo Clinic in Phoenix and if so what was your surgeons name?

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@itnoc

I'm 68 and my sentiments about total hip replacement match exactly what you wrote. I'm wondering if getting my core muscles super fit will help with my groin pain. I'm scared to get the surgery too after reading what others are writing.

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Itnoc,
I had total hip replacement 2 1/2 months ago. I was in a lot of groin pain and that was causing me to limp which then gave me back pain.
I chose to have the surgery because of that.
I had a great surgeon and a really good hospital experience. I had the surgery on a Monday and went home Tuesday and went to physical therapy on Thursday. The first week was challenging, the second week was also. I did return to my job the second week, though. I work from home and was able to work part time the second week.
Week three, I saw a significant improvement in mobility and began reducing pain meds.
I am very happy that I had the surgery and I am 90% recovered. When the weather cools off, I will be able to resume outdoor activities that I had not been able to enjoy prior to hip replacement.
It is major surgery- make no mistake. I watched a video of a hip replacement.
My vote is:
Yes to the surgery
No to watching the video

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@itnoc

I'm 68 and my sentiments about total hip replacement match exactly what you wrote. I'm wondering if getting my core muscles super fit will help with my groin pain. I'm scared to get the surgery too after reading what others are writing.

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I would not make a decision on joint replacement based on what is written here. Most posters here have had bad experiences - IMO because they didn't do enough pt both pre and post surgery. There are a few who have had genuine complications. Joint replacement is common now but it's still a lot of trauma.

Talk with your surgeon and ask a lot of questions. Be aggressive about pre and post surgical physical therapy. Most people are very happy with the results. Just remember the patient has to do most of the work!

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@itnoc

I'm 68 and my sentiments about total hip replacement match exactly what you wrote. I'm wondering if getting my core muscles super fit will help with my groin pain. I'm scared to get the surgery too after reading what others are writing.

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I'm sorry to hear you have groin pain, and I can tell you I lived with it for years, with lots of exercise, injections and PT to try to fix it without surgery because I was only in my early 50's. It was not a fulfilling way to live. Please read more closely what @susanfalcon52 and @heyjoe415 have to say. They are the most typical of hip replacement recipients.

A very small percentage of hip replacement patients have serious or long-lasting complications. A greater percentage are upset or disappointed because they don't understand that this is major surgery, and healing takes time. Or that they have to do therapy right after surgery, every day, even if they hurt. Or they forgot how badly they hurt before surgery, asnd are surprised that the relief is not instant.

Often when people hurt after surgery, they are upset with the surgeon who said at the pre-op appointment "healing takes 4-6 weeks." What the surgeon should say is "The incision is fully healed in 4-6 weeks and the implant is joining with the bone - but full recovery takes 4-6 months for most. You need to do your exercises and get up and walk every day even when it hurts."
Or at follow-up appointment they say "there's nothing wrong with the new joint." When what they should say is "the implant and incision look fine, now you need to start a program of exercise and get everything strong again."

My story began when I was in my early 50's and could no longer run, get onto my bicycle, or jump to hit a volleyball. One day a much older acquaintance who knew nothing of my medical history took one look at me limping up a slight incline and said, "When are you going to get those hips fixed, anyway?" The next week, my Mom asked me the same question.

That led me to clear my work calendar, call the surgeon and schedule 2 hip replacements just 6 weeks apart. Within 4 months, I was pain-free, able to walk, dance, hike, bike, travel and garden again. Several years later I needed revisions for an unrelated problem, and did it all over again. That recovery took a little longer.

Now, 18 years after the initial surgeries, 12 years after the revisions, I can tell you that I would do it again in a heartbeat. I went into surgery as strong as I could be, then did my therapy faithfully for months afterward. But now I am able to walk for miles, travel, garden & bicycle some (my lungs limit me) and go on adventures with my little grandsons.

So, yes, stay as strong as you can for as long as you can. But, when the pain interferes with life...seriously consider joint replacement.
Sue

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@itnoc

I'm 68 and my sentiments about total hip replacement match exactly what you wrote. I'm wondering if getting my core muscles super fit will help with my groin pain. I'm scared to get the surgery too after reading what others are writing.

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I went to PT for several months because of my groin pain. I had my left hip replaced July 5 and it is better. Still have pain in right hip, which will be replaced in November.
I do think trying to be fitter is a good start toward recovery after surgery. Best of luck.

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