Hip Replacement Surgery: When to proceed

Posted by elliott1953 @elliott1953, Jul 13 2:20pm

While I am scheduled for hip replacement surgery in 3 months, I am having second thoughts and may defer the surgery to a later date when I am in more discomfort. I find it really difficult to make the decision for surgery and suspect others are or may have been in the same boat. Maybe the obvious time is when it reaches a point where you can no longer tolerate the pain and it just too interfering with your life and, for me, I just don't know if I am there yet or if I am deluding myself because of my fear of surgery. Anyway, I suspect I am not alone in this thinking.

Although my x-ray is showing severe osteoarthritis in the left hip, I don't think I am as debilitated as most people who undergo hip replacement surgery. I am a fit and relatively active 71 year old. Despite mild pain, soreness and stiffness, I can still go on my 50 minute evening walks. I can still function fairly well despite the soreness, mild pain, and stiffness. I've long thought that when the day comes when I can't put on my own sock that will be the decision point but maybe that's too extreme. The discomfort is generally worse at night while sleeping so the arthritis is affecting my sleep and I try not to take aleve or advil very often.

I know that osteoarthritis is progressive so surgery is likely inevitable down the road. The anterior approach was recommended for me but I understand it is still a relatively new method and surgical methods are always improving so that may be another reason to defer for now.

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

wmh9680 | @wmh9680 | Jul 16 11:45am

I've had 7 knee surgeries (right TKR and then shattered my femur above it 2 years later in my rt knee and a mcl repair and acl replacement in my left knee) and 2 shoulder surgeries (rotator cuff and then reverse replacement on the right-the left is bad but livable, the repaired one is the better of the two)and one back surgery. I'm much better after all. #1 find the best dr who has done hundreds from the best clinic/hospital and find the best PT and listen to both and do but don't overdure what they tell you to do. You can push more when you are better. I still do stretching and PT every day and it make a big diff (I'm 74) and feel pretty good for my age and surgeries, we ride our ebikes 17 miles or more a day when we can.

sue2020 | @sue2020 | Jul 17 11:03pm

Elliott - I had a THR - left side 2 years ago. I’m 69. It went well. The pain I experienced pre surgery (groin pain, hip pain, loss of flexibly, sleep loss) all went away. I remember the first night sleeping thru the night - first time in years. I had a TKR in 2019, also the left side. It did not go as well. I can’t bend the knee more than 100 degrees. My PT was cut short due to Pandemic.
My THR was actually delayed because of Pandemic.
Here’s what I have to say about waiting. For me it came down to disruption in sleep. When I could no longer stand being dead dog tired, I had the surgery.
But there is another thing that happens as we wait: de-conditioning. Think how much work it is to get in shape and stay in shape. As we get more and more pain, and lose more range of motion, we pull back from exercise (movement) and we de-condition. My goal is to continue to be able to walk for the rest of my life.
I met with my surgeon regarding my right hip/knee last week. I have intermittent pain on the outside of my right knee. I probably will never get that knee replace, so my hope was it was joint to joint pain from my hip. It was confirmed it’s my hip. But my surgeon’s advice is that it’s my timeline. I decide. I’m totally not there for another THR. But I am starting to need Tylenol to get to sleep - it pushes back the knee pain. And I’m careful in my Aqua Fitness classes not to do the exercises that exasperate the hip pain.
I’m not sure if this helps - but it is your call. You will know when you are ready. For me, Hip surgery was so much easier to recover from than knee surgery.

elliott1953 | @elliott1953 | Jul 18 9:18am

Thanks for sharing your experience. It really does help to learn of other people's experiences. I had been quite resistant to using arthritic tylenol or aleve often, saving it for when the pain is just at a high level but I started this week taking two arthritic tylenols before bed - it does work some.

I just don't think I'm ready yet for my scheduled September surgery. Besides the physical issue, one also has to be mentally prepared for surgery. And, in that regard, I've had some minor but annoying complications from cataract surgery a few months ago and just don't feel mentally prepared for another far more discomforting surgery such as hip replacement at this time.

jmalcs | @jmalcs | Jul 26 7:37am

Yes having surgery is frightening…. Something I think we all dread! Yes you will know for certain when you have to have your surgery as you will have difficulty moving… but where it’s affecting your sleep you should seriously think about doing it sooner than later. I waited too long. My hip would keep “popping out of place” after a seated position and I could no longer lift my leg to work my car pedals properly …. Hence I was very reconditioned going into surgery which I believe affected my recovery post surgery. Also, I had a posterior lateral incision, several muscles/ tendons were cut… I’ve had a long and difficult recovery still( am in PT intermittentingly 3 years later for chronic tendonosis of bilateral hips/ hamstring issues- did have a 1/2 inch leg length discrepancy). I wholeheartedly recommend the anterior approach- A muscle sparing procedure. Obviously it’s a discussion to have with your surgeon. Best of luck to you!

elliott1953 | @elliott1953 | Jul 26 8:18am

In reply to @jmalcs "Yes having surgery is frightening…. Something I think we all dread! Yes you will know for..." + (show)

Thank you for sharing your experience. I can't imagine the pain you must have endured prior to your surgery and the frustration of such a long and difficult recovery. Best wishes.

charn | @charn | Jul 26 8:50am

69yo. I had bone on bone in my hip. It didn't really hurt but kept collapsing.
Dr ordered 6 weeks pre-surgery PT. 2 days before I was susposed to start I fell and broke it. Please have surgery before it gets to bad. I felt 100% better 3 days post surgery. No complications, I only needed 2 weeks of post surgery PT.
I wish I would have done it sooner. 7 months later, it's better than the original hip.