About

Member has chosen to not make this information public.

Pages

Member not yet following any Pages.

Posts (32)

6 days ago · Anterior vs. posterior hip replacement (THR): How do you decide? in Joint Replacements

Hi, @JustinMcClanahan Thanks for moving my post to the proper category.

Basically, yes, what seems to be the situation is that ortho docs do the approach they like to use.
What I want is the approach best for me.
It would be refreshing to hear a doctor say: "You know. I think that with your situation, I would recommend you see a doctor that uses this approach."
Instead they are willing to use whatever approach they use to handle every situation. Can that possibly be correct?

The one who would use the anterior approach also does do posterior and has for about 14 years. He said that because of the fusing, he would probably have to open the incision longer than normal which could lead to it opening up, etc., later which would require a visit to the wound center. Plus I am overweight and that can cause problems with belly fat. Why even suggest that then?

The other only does posterior and has for 30 years. I worry that the posterior approach would injure my atrophied muscles — already seen as atrophied/fatty on an MRI and confirmed by other docs — but this doc says he doesn't think my muscles are as weak as others have told me. So what am I to believe?

Plus neither have mentioned — other than saying I would need a shoe lift, which I already use now — if they would have to cut off any more bone before inserting the femoral stem — making my leg even shorter. Depending on which doctors I believe (2 say no/3 say yes) I do or do not have idiopathic avascular necrosis and can mean weakened bone.

I've also read that it is important to find a doc who does a lot of hip replacements.
So the one who would do anterior hips also does shoulders — about 150 surgeries a year.
The one who does hips also does knees — about 60 hips and 140 knees a year.
Are those enough? How do I choose?

I know there are no promises in surgery but it sure would be nice if the docs themselves really looked at each case and brought up the various points instead of a patient having to try to remember what to ask — so they aren't surprised at the outcome. It all seems so much like an "assembly line."

Mon, Jul 15 11:23am · Anterior vs. posterior hip replacement (THR): How do you decide? in Joint Replacements

Hi, I understand that "supposedly" most hip replacements go well and that is why those people are not on forums. However, I do wonder if those with less-than-good outcomes just suffer in silence and are not counted. So basically I am nervous about how to proceed. I have a femur head that is collapsed and has been for about 6 years. It is fusing onto the socket that it should be rotating in. The ortho doc I went to back then because I was having a problem walking took X-rays to ID the problem and told me that, since I had no pain in it, he would not replace it.

Since then, my hip continues to NOT hurt. However, because it is locked in place, my back and my knee must do the movement and pain has developed in those two parts. My glute muscles also have atrophied. I did seek other opinions – one said it was too complicated for his approach, another said he would not do it because I did not have hip pain, and another said his approach could leave me in a wheelchair. I gave up for several years but, because of pain in knee, decided to get more opinions and see if knee could be fixed.

Now I have two ortho docs who say they can replace my hip. Both say I will probably still walk with a cane, probably still need a shoe lift, but I should get back "some" ROM — I have no sideways ROM at all — and that should help. Both say the operation will take about 2x as long as typical hip replacement and the scar will be much larger. My concern is that one says, for my situation, it has to be done from the posterior. The other says anterior. I know each doc has his/her preferences, but I would like to know what is best for MY situation. Surely not every approach is good for each situation, right? I don't want to endanger my already atrophied muscles, or get an infection from an incision that is very long, etc.

Any thoughts anyone cares to share? Thanks.

Fri, Jul 12 5:06pm · Leg length difference after TKR! in Joint Replacements

Hi @lturn9. I've only been visiting the forum on occasion but saw your post about your situation. Have you considered talking to anyone about bone lengthening to regrow some of the bone lost? I was looking at the website for the Hospital for Special Surgery, which apparently is the top site for orthopedic surgery in the U.S. and saw this information: https://www.hss.edu/limblengthening-about.asp
Perhaps you could ask your surgeon about it or find someone there to communicate with you to see if that is a possibility for your situation. Or perhaps someone at Mayo is familiar with the process. Best wishes!

Oct 19, 2018 · Femur perforation during anterior hip replacement? in Joint Replacements

My 60+ sister always seems to get the odd outcome for surgeries and it has happened again now with her anterior hip replacement. Her board-certified surgeon informed her that, as he prepared her joint, an instrument he was using punched a hole about as big around as his little finger through her femur. Now she is on less than 50% weight bearing on that leg for the next 4-6 weeks with the hope that it heals well and does not cause a fracture. Needless to say, she is depressed and it makes her return home (single with an active pet) more problematic. Has anyone else experienced this with anterior (or other types of) hip replacement? I’d like to give her some reassurance and hope.

Sep 24, 2018 · Leg length difference after TKR! in Joint Replacements

Hi, @lturn9. I am so sorry to hear about the problems you are experiencing. It's so baffling to think that orthopedic surgeons can do such things as shortening the bone without realizing how that would affect the patient afterwards. It's as if they are operating in a vacuum without awareness of the aftermath.
My sister was convinced that her leg length discrepancy brought on groin pains. But the ortho docs she consulted attribute those new pains to the need for another replacement — this time her hip.
She also was told that what one doc measured as leg length discrepancy is actually just "perceived" since she has knock knees. Very confusing. But she has signed up for hip replacement next week.
For your situation, have you looked into MLS Laser Therapy for your neuropathy (that is if you meant diabetic neuropathy in your feet). Apparently the laser made by that company has shown that it improves that condition — at least that's what its literature says:

http://www.celasers.com/medical/mls-laser-therapy/research

I have been getting MLS laser therapy from a chiropractor near me. It has helped pain in various areas because of my deteriorated hip. He also uses it to hit trigger points where my muscles are bunched.
As far as your leg length problem, have you looked into Feldenkrais? It's a way of movement that rewires your brain to allow your body to compensate and move differently.
Also, would stretching those muscles on the shorter leg – under the guidance of someone who might know specialized PT (perhaps for folks who have muscle diseases) help?
I wish you HOPE. Don't despair.
So far I am putting up with collapsed hip joint (which still does not hurt) but having more problems with all the compensating parts (ankle, back, knees, etc,)

May 19, 2018 · Taking care of bones before the terror of more serious conditions. in Bones, Joints & Muscles

Hi, @otherwaytolive That's great that you can walk uphill on a treadmill for 5 minutes a day! Have you looked into exercises by Peggy Cappy (She has videos with exercises for folks with arthritis, etc., or by Pete Egoscue? I have two Egoscue books Pain Free and Pain Free Living — he also has others — which help. Best wishes.

May 15, 2018 · Leg length difference after TKR! in Joint Replacements

Thanks, @gailfaith, for your comments. I am happy your bilateral TKRs went well and saddened that you now have to use a walker after your accident.

Yes, my sister, who is in her early 60s, is having back problems because of the great difference now between the length of her legs. Is anyone aware of what leg length discrepancy (LLD) is below what could be considered the standard of care in a TKR? I've searched online for those who have had TKR and no one seems to come close to 1.6 inches. Almost all seem to have a half inch, with 1 inch seeming to be the largest LLD.

It's unfortunate that doctors don't seem to be held accountable for their mess-ups. Possible problems are never mentioned in all of the TKR marketing, nor did her doctor mention it when she made the customary one-consultation appointment to see if she needed a TKR.

Apparently you can't even build a shoe up that high with custom orthotics and why should she have to seek out and pay for custom shoes for life? She is devastated. If anyone has any information on what she could do to help herself, please post. Thanks.

May 12, 2018 · Leg length difference after TKR! in Joint Replacements

My sister, who also has chronic venous insufficiency, had a total knee replacement at the end of February. Has been doing exercises, going to PT, but after more pains, her PT suggest she start using a cane. Pain in legs and lower back. Finally PT measured her and said her “new knee” leg is 1.6 inches!!! longer than the other one. She is devastated that she is now in worse pain than she was before TKR. She was told to build up the shoe of her shorter leg and find someone to add to the bottom of the shoe as well. Now she can’t walk around barefoot anymore but has to put on shoes to ease the pain even a little. What can she do? Any suggestions?