Newly replaced hip dislocated after 4 weeks.

Thanks Steve, much appreciated.

I think your surgeons' comment "do nothing for five weeks" sounds right. It does take time for the bone to grow into the implant (not relevant if the implant was cemented), and it takes at least that long for the joint capsule to heal around the new implant.

My surgeon used an anterior incision, and that allowed me to get back to spinning in a bit over two weeks, post-op. There were no complications from spinning. In fact, I felt better post-op.

I did have "hip snapping" - my IT band would "snap" over the outer femur (greater trochanter). It happened a lot putting on socks. It stopped after about two months. It was not serious, just unnerving.

I've had both knees replaced and just had my left shoulder replaced Aug 6th. The hip was by far the easier procedure to recover from.

As for the dislocation at one month, that was entirely my fault as I failed to follow instructions. I have an excellent surgeon and the new hip has healed well. I'm certain my other hip will need to be replaced in the near future, and it's comforting to have a surgeon I trust. He did both of my knees as well. And when it comes down to it, the skill of the surgeon is the most important, totally agree.

Thanks again Steve for your thoughtful comments!

Joe

Hi Joe I’m in the UK and came across this post following a recent dislocation. I had my left hip replaced in 2021 and until now never looked back. However in July I had a fall and dislocated the hip. I have followed a rehab programme but seriously underestimated the full recovery time for soft tissue and returned to Pilates. I had been doing lots of strength exercises including squats and lunges without any difficulty. I did a gentle pilates class on Monday followed by another on Wednesday evening. At the end of the last class whilst I was stretching my hip popped out. Lesson learned- I was overly optimistic about recovery and stability of the hip and should have proceeded with care. Won’t be doing anything too strenuous for three weeks as in a leg brace and will take things a lot more slowly this time around.

Hi HippyChick, and thanks for reaching out.

I'm sorry to hear of your hip dislocation. As you now know, those are very painful. I'm assuming a Dr. could pop your hip back in under sedation, but let me know if it required surgery.

And like me, it sounds like you got back to Pilates and stretching too soon. The dislocation would have damaged the joint capsule, and that will take some time to re-heal.

The best guidance - don't cross your operated leg over the other, and don't bend your hips more than 90 degrees. I was one month removed from surgery and feeling great. I did a stretch for my IT band where I bend from the waist and put my palms on the floor (I'm pretty flexible for an old guy!). The hip dislocated while I was bent over. It was so painful, and I had to wait 4 hours in the emergency room.

That was 5 months ago and all is fine. It sounds like you're in a leg brace for something other than your hip. The hospital should also have done xrays to make sure the hip is ok and nothing is damaged or fractured.

Well now I have a kindred UK spirit in dislocating a replaced hip! I wish you all the best!

(I'm reminded of a few business trips to London, in the late 90s, and I've been through Heathrow a few times. I miss London and I love the black taxis. Who needs Uber in London?)

Joe

@hippychick and @heyjoe415

Sounds as though you have experienced 2 dislocations? Please keep us posted on your progress in months to come.
Yes, agree after dislocation to take things slowly, your dislocation is traumatic. Months to heal, and dislocation risk is high after a first dislocation. I dislocated twice, and expect to be cautious a year, possibly forever.

I dislocated at 10 weeks and again at 15 weeks, more careful now for 4 months and no dislocation. Perhaps consult a physical therapist for precautions, as Joe mentions not bending at the waist. Possibly a sock aid or have others put your sock on. Avoid low chairs. Use a grabber to pick things up. Possibly get a "hip kit" with grabber, sock aid, and other tools to avoid dislocation. Research Google scholar or other search engine for "precautions after dislocation after hip replacement " and you will probably see multiple recommendations which I recommend considering.

Regarding the "leg brace", after I dislocated the second time I woke up from anesthesia with full leg immobilizer, which might be controversial, as follows. First, I had education on the leg brace while still shaking off anesthesia. Second, I couldn't get into a vehicle to go home because of the brace, I had to slide into the rear of an SUV and try to stay still going home. Third, I read a few reviews of braces after dislocation in the orthopedic literature and it seems evidence for braces use in orthopedics is weak with just a few strong indications. (My orthopedic surgeon authorized me to discontinue after a day.) Fourth, my insurance, which is fairly good and evidence based, sent me a letter months after the brace was issued, stating payment was not authorized and I should not expect to receive a bill from the ER/hospital! So, bottom line, you might want to check further on your brace with Orthopedics, although your situation may be different - in other words try to see if the brace is likely to help or hurt your healing in months to come.

Hope this helps.

The don't cross your legs and associated advice was for the oldest, posterior, approach to hip replacement. It may or may not apply to you.

My surgeon, the principal inventor of the new Superpath approach, met me in the outpatient room before surgery and he had the hospital's multipage instructions in his hand including the don't bend or cross your legs, etc. He tossed it in the waste paper basket and told me that the only important advice was to take my medicine (pain medicine and I ended up not needing it) and be a couch potato for five weeks because he can't make bones grow.

So for five weeks I was a couch potato. Three years later still no problems. But, alas, now I have a nonfunctioning right knee so the same surgeon is doing a TKR for me later this week. I know that recovery for a TKR is supposed to be tougher than for a hip but I have a lot of faith in my surgeon. I hope to be back on the golf course some time in November.

Most important advice I can give: use a surgeon who has successfully done at least hundreds of the procedure the way she is proposing to do it for you. For example, if you have a surgeon who has done thousands of posterior hips but is now using the anterior approach and has done twenty of the anteriors so far, I would not have a hip replacement from him at this time as he is not sufficiently experienced in the particular procedure you are about to undergo. I know some one has to be the early user, I just don't want it to be me.

Steveinarizona and others on the message

The discussion is about precautions after dislocation, not the initial hip replacement. It's true orthopedic surgeons disagree widely about precautions after initial hip replacement, but dislocation is possible with any hip replacement. (https://journals.sagepub.com/doi/full/10.1177/11207000221099862?casa_token=1ZKE2qCAUfkAAAAA%3ARXL-59tokXWnBBh6R4yilYheG5f3SRSkB3T4LRzItz7J7eZGgngIQNMvRR7O7A079KZuAwgPAHz1fQ has information on rare dislocation with Superpath, as an example).

If you were to fall after hip replacement and dislocate, or dislocate for other reasons, your doctor will likely advising precautions - I am guessing the ER will have precautions on discharge! The type of precautions may vary with the doctors assessment of whether you dislocated to the posterior or anterior, degree of trauma, fracture, signs of infection, how many dislocations have happened and possibly other factors

Best wishes

Good advice tailback. And yeah, I don't see the need for a full leg brace for the hip. Avoid crossing the operated leg over the other leg, and don't bend at the hip or sit at more than 90 degrees.

It works. I dislocated one month after replacement because I didn't follow these simple rules.

Joe

Agree completely own finding the right surgeon - for a hip or any other joint. What I look for:

1. A surgeon in their mid 30s to mid/late 40s. Why? They are still early in their career and very likely ambitious and current on the latest in replacement practice.

2. A surgeon with a good pedigree from a good med school and/or residency/fellowship. The best programs are very hard to get into. If a surgeon passes those hurdles, well it's a good sign they are very knowledgable, and have done their residency/fellowship under the best surgeons.

3. Once you've narrowed it down, look for references, and the number or procedures they have done. And to paraphrase your comment, all hip surgeons are not created equal. Older surgeons may only be comfortable with a posterior or lateral in incision. Unless they've done a lot on anteriors, look elsewhere. The anterior incision is the most challenging and imo requires the most talent.

4. Check references and reviews.

5. To prepare for the "down time" - I treated it psychologically as time off from the gym (I'm a 7x/week guy.). This advice is mostly for retired people, like me. But don't delay a surgery because you're concerned about "down time". Once therapy starts, that's your job.

6. If a joint replacement is inevitable, just get the surgery. Cortisone shots, gel shots are all band aids. Just do it. And a great surgeon will almost never recommend surgery. They present it as an option. Take it.

And that's about it. Steve mentions the SuperPATH method and I am unfamiliar with it, but it certainly sounds promising. The problem is that it is patented, so you may have trouble finding a hospital system willing to pay royalties for a relatively uncomplicated surgery, specifically referring to anterior.

Thanks Steve!

(FWIW I had my left shoulder replaced 7 weeks ago today. Surgeon is excellent. He did his fellowship and residency at the University of WI med school and associated Froedert Healthcare. Each year, UW only admits 6 students from across the world to its residency program. My shoulder guy met this hurdle, and he's just very good. And the recovery has gone better than expected!)

One last bit of advice - be in great shape ahead of the surgery, meaning normal weight, normal or close to normal body-fat percentage. This improves circulation, which in turn reduces inflammation and swelling. I dropped from 190 lbs to 155 lbs in one year, and took my PBF from 32% to 19%. Not easy, especially in my late 60s, but worth every moment spent.

Joe

Good catch tailback, thank you.

Joe

Good to hear about everyone’s experience and thoughts on recovery. I had my hip replacement in April 2021 and made a full recovery. The initial dislocation in July 2024 was due to a fall. My recovery was good but I did not appreciate the time it would take for soft tissue recovery and this led to second dislocation as I did not exercise enough caution in returning exercise. Use of brace seems to be standard protocol in UK following closed reduction. Currently taking a pragmatic approach and realise that sometimes things cannot be rushed!