Hip replacement. Dammit.

Hi all you good folks.

It’s looking like I’m going to have my right hip replaced (it feels odd to even say that).

I have had some experience with it as my Mom has gone through it (with poor results). I do know that it’s pretty common now, and most people have great results. But I’m naturally a bit concerned.

A bit about me. 58yo male. Woke up two months ago with some hip pain, never got better. I’d say at this point I’m at about 50% capability of what I used to be able to do (stairs are a bitch etc.). Diagnosis after x-ray, MRI and Physical Therapy is “Significant Osteoarthritis”. It sure did come on fast, never had hip problems in the past.

The good is that I live in the Colorado Mountains, and the Surgery group I’m using is one of the best in the country. Skiing causes lots of joint problems. My doc is a doc for the US Ski Team, and specializes in hips.

Living in the Colorado Mountains is also the bad news though. We get a shit ton of snow where I live. So, I’m planning on contracting out plowing for perhaps the whole season instead of doing it myself. It’s not easy to get into my truck even on a good day.

Anyway, if anyone has experience to share with hip replacement, I would love to hear them. The more you know and all that.

Coupla caveats. IANAD. IANAL. Personal medical experiences are just that. Anecdotal.

That said,

I’m 57. Had a right hip replacement in Feb 2018. I chose the posterior for a variety of reasons. The anterior is supposedly a quicker heal. Coupled with a good cement job, it allows patients to get back to their lives faster. My surgeon at HSS ( Hospital for Special Surgeries in NYC ) is old-school and does not perform anterior. My trust level with him was more important than my desire to try out a relatively new technique. Not saying it’s bad or dangerous. Just not what I chose.

Also- like you at 58- I’m relatively young for a replacement. I did NOT go with the cement job. Instead I went with the porous titanium implant. It’s a terribly complex and attention-heavy method in terms of recovery. Every single step for the first few months could NOT be more than 50% of body weight. No matter what. The bone matter within the femur ( more accurately marrow ) slowly grows into and through the implant, making it an embedded part of my body. No concerns that I would outlive the cement. This is a serious concern. Better to struggle moment to moment for a few months and then know the implant is a part of me than worry that in 15 years, the cement will degrade and the entire implant will have to be removed, the femur reamed out and a fresh implant cemented into place. No thank you !!

The recovery went exactly as planned. Zero infections. The bone slowly grew into the implant. I was home after 3 days/ 2 nights. Twilight sleep, no general anaesthesia. Careful application of heavy narcotics in the hospital, and a managed and tapered regiment once home got me off of them after roughly 12 days with no after-effects.

Visiting Nurses came. PT people came. They were utter professionals and understood my particular concerns regarding being so protective of the weight-placement issues. ( The first Visiting Nurse was mortified that I was still on the walker after a week, and demanded that I set it aside and start working that hip. That was an ugly moment, but she called her office, and they called my surgeon- right from my living room- and she apologized for her instructions to me once it was all cleared up. And, gave me superb treatment. )

Learning to walk without a limp, controlling weight distribution and gait was a bitch. I went from walker to a new design of crutches that worked for me. I chose them because once able to be on crutches, I had to get to the NYC subway system and negotiate stairs. I felt better about the ergonomics and workability of these opposed to the classic design. There are even smarter ones out there too, but I didn’t find them before ordering the ones linked above. A good choice.

The cane lasted a LONG time, and as I said, weaning off of the cane and learning a smooth gait was a force of will. Being sedentary for a few months robbed me of a lot of muscle density in the legs and lower back. I’m 5’10 and 250+ lbs, so the added weight was an added burden. Listen to your PT. Do all of the leg lifts and hip rotation work you can possible endure at home.

Get a notebook. Make regimen pages. Force yourself to do the workouts as proscribed. Post-Op, early days and weeks, some of it is bed-ridden work. After that, standing and doing. Do every rep. I’m not a gym rat. I detest working out- but knew this was my path to a normal life Post-Op and forced myself. My legs are healthier for it.

One huge issue is infection control. In the hospital and once home. It sounds like you’ve found a superb facility. Ask them- not on the day, but now- for their documentation on infection control percentages. My surgeon is a zealot about this. As is the case with most surgeries, a successful O.R. day doesn’t necessarily translate into a successful outcome because of infection risk.

HSS is pretty infamous for the work it’s done on infection control globally not just in the O.R. suite. Again, not taking a dim view of your hospital. Just encouraging you to do EVERYTHING you can to avoid infection. Silly little things. Like not taking a suitcase with you to the hospital for your short stay.

Why? Cause sidewalks and hallways are unspeakably filthy places. Dogs shit on the sidewalk. Rolling suitcases roll on the sidewalk. Hospital hallways are sometimes not so clean, on the bacteria level. So, HSS insists that you bring your stuff in a plastic bag. They even give you one or two Pre-Op to use. Just one significant angle of infection, well-managed.

Does your surgeon lay out all possible outcomes? Does she/he explain the full arc of processes? Complete success, partial success. What level of pain might you have Post-Op after the implant has healed and/ or cement is set and good? In my case, I face pain daily. The implant is snug as a bug in a rug. But I have femur bone pain because of the limp I’m managing due to a left knee injury. It alters the downward pressure of the femur as I step, and that presses the implant to the outside of the right femur. And so on- ask tons of question. Take notes at home. Every stupid question you think to surgeon will roll her/ his eyes at? Ask them. They occurred to you. It’s your corpus. Ask them. If the surgeon isn’t suffering too much from the classic M-Diety Complex, they will be respectful of your concerns and will encourage tons of questions.

Likely there are hand-outs/ booklets given before hand. I read mine through at least twice. Plenty of my questions were answered. Also, Pre-Op group classes are a requirement at HSS. You attend one. It goes for a few hours. The entire process of arrival, admission, Pre-Op, Surgery, Recovery, Post-Op, hospital room, etc are gone over by a senior nurse on staff. Again- I would assume any top-drawer hospital doing this surgery has similar programs. If your place has a great rep but doesn’t do a lot of formal prep for patients, go poking around to get info from other places. ( I don’t think I have my booklets from HSS any more. If I do, I’ll be glad to send them your way. )

Positive attitude ! Indulge yourself with food when needed ! ( If you’re diabetic, well…you know. ) I reduced my alcohol intake to zero before the surgery and a few months after. Nothing to interfere with the bone growth in any way, and I didn’t want to be any more unstable on my feet.

Looking forward to your input in this thread. Feel free to PM me if you wish if you’ve questions you’d rather not put in the public thread !

And, as they say in the theater, break a leg !! :smiley:

ETA: The phrase " bone-on-bone " is one of the most frightening phrases in the English language. I’ve SO much understanding and respect for people who live for years, decades with chronic very deep pain. Been there, suffered that, no longer dealing with it.
I get opioid addiction now. I really do. Don’t touch anything like that. But man, you live bone-on-bone pain long enough, you’d do ANYTHING to be shed of it.

Steadman Hawkins (or whatever they call themselves post split) are an awesome group. I’ve had two shoulder replacements by them and they are one of the top orthopedic groups in the world.

I haven’t had a hip replacement so I have no direct knowledge. I will say from my experience that rehab is critical and doing all of your exercises and then some is what gets you back to normal. One of my friends dads had a double hip replacement shortly after we graduated from high school in the early 2000s. He was surfing 6 months later. I wouldn’t expect your parents operation to have any bearing on how your surgery goes now.

Guy in one of my boat clubs had both replaced a few years ago. Did one, then the other was like 8 months later. Post-surgery pain was about as much as you’d expect, but after that subsided his quality of life improved tremendously.

Thank you so much Cartooniverse. You brought up things I need to think about. I do of course want something that will last for ever, so you have given me some more things to ask my Dr. about.

I have not see the ortho surgeon yet. I’m just making sure I have my ducks in the row and proper questions to ask. My primary care doc is saying I probably need the replacement.

My mother fell at 82yo and broke her femur right near the socket. They basically pinned it back together. Well, that didn’t last but a few months, and they did the full on replacement of the top of the femur. This type of deal. It was a glue job. Didn’t know there where options. I always accompany my mom to her doctor visits. She needs a bit of back up, and it’s always good to have another set of ears, and someone to write things down. I’ve learned a lot from those visits.

I’m a programmer, so desk job. But where I live brings up many challenges. We can get 30 feet of snow a season (no that’s not a typo). My Wife is very healthy and supportive. I’m a little overweight and a big guy at 6’3" my Wife is on the smaller side at 5’2" but tough as nails (She has completed four 140 mile IronMan races).

We live in a two story house with the bedroom upstairs. But we have a very good set up for me to stay on the first floor. A few years ago I remodeled the downstairs bathroom and put in ADA grab bars for the tub (I followed the specs given by ADA). I did that because ‘ya never know’. Glad I did.

About 4 months ago, in a meeting with my bosses boss, I suggest that we look into opportunities for people to work from home in such circumstances (way before this happened, I wasn’t even thinking about myself). He’s all over it and approves, but, well, he has bosses too. I wouldn’t want to try to do much in the way of real work, but if I need to get into a server and look at things, I think it could be set up pretty easily.

I have over 600 hours of sick time saved up, and short term disability and stuff. So I’m good there.

All in all, things are going to work well I think. And I’m very fortunate to be in the position that I’m in.

Dr. Hacket (bad name for a doc) at Steadman Hawkins did an orthoscopic surgery on my shoulder 8 years ago to remove a bone spur. Small world. They are very, very good. If I feel I need a second opinion, that’s where I’m going. Fortunately, both Vail Summit Orthopedics, and Steadman Hawkins are in the same medical office building not more than 5 minutes from where I work. Thanks for your reply.

A coworkers father has had a hip replacement and at 77yo still skis and bikes. I am feeling a bit better about this.

On the other hand, another fellow through a friend of a friend type of thing was out of work for 6 weeks. But he has more of a field job as a building inspector. So I suspect that’s to be expected. Building sites are tripping zones.

Sorry, missed this part. Yeah, I don’t want to go there. For now, I will do ibuprofen if I know I’ve got to get something done that day. I’m trying to get things ready for/when/if I have surgery. I installed an extra hand rail on our steps to the second floor a few weeks ago. Well, it’s just for the last 4 steps that where not covered adequately. What would normally have been an easy job was difficult because of my hip. I need to be able to do this stuff, I’ve been a ‘handyman’ all my life.

I want to be ready. I need to be ready.

(I did a lot of this type of stuff in my Mom’s house while she was recovering from her hip replacement).

Currently, I can walk maybe 1/4 mile without real, real pain. I wouldn’t dare try to go further. There is no point in putting this off.

Thank you all. I never pretend to know just what you might face. There is always one thing you forget that will ruin your day. Best to be as prepared as possible so that, hopefully, it’s only one thing. That’s why I started this thread.

What am I missing?

There are little “stupid” things you can do to perhaps stack a few more cards in your deck.

If you are a coffee drinker, give serious thought to switching to green tea. Green tea is supposed to have flavinoids or whatever, yet still contains a modicum of caffeine. I personally need my AM caffeine so I don’t kill people.

Mention has been made about infection. This is always a concern in ANY surgery, but moreso when bones are involved. Once bone gets infected, you throw it away. Bad news entirely. While the world is indeed a dirty place, and hospitals specialize in huge, ugly, vicious germs, the biggest source of germs for most people is your skin. Pre-op consists of lots of scrubbing your involved body parts with disinfectant. Skin contains teeny-tiny booby traps, known as hair follicles. Skin germs like to hide in hair follicles and plot world domination.

A week or so before surgery, get so heavy duty disinfectant like Betadine* and shower daily, scrubbing your hip and adjacent area with the Betadine. It’s a small thing, but as the old joke goes, “Every little bit helps, says the woman who peed in the ocean.”

*If you are allergic to iodine or shellfish, omit Betadine. Hibiclens or even Listerine can work instead.

Disclaimer: I’m not a doctor, nurse, or other health professional.
~VOW

I’ll have Coffee when out to breakfast once or twice a month, otherwise I drink green tea at work. So I’m good there.

I make note of your infection risk. I shower every day. I suppose that will be way different after surgery. I will look into Betadine pre-surgery. Hmmm… I guess I’ll be doing some bird baths after surgery.

I think, really, my biggest concern is what we are facing with winter. My part time neighbor contracts out plowing, and I suppose I will need too as well. My driveway can be real, real difficult. It it’s not plowed out after every storm, you’re pretty much screwed. I’ve a plow truck and a chained up 4x4 Kubota tractor, but that’s not something I’ll be doing for a while after surgery.

Crutches, walkers, and canes in winter would freak me out. Is there any chance you can postpone the surgery until after Spring thaw?
~VOW

Spring thaw is ~ mid May. That’s a long time limping. I’m used to winter, and think I can manage the snow issue with help. My Wife knows that this puts a greater burden on her, but would prefer to get this fixed ASAP. I agree. I would rather be fixed sooner than later. If I get this done (of course depending on doctors recommendations) sooner than later, I might be ready for our worst part of winter snows that typically happen in March. Don’t know but am ready to hire help.

Snow is sort of a way of life on the continental divide. We live at 11,200 feet. Winter is the time that I can draw in a bit, because there is little I can do about it.

I’m trying to learn guitar, I love to read, and my Wife and I play chess. So I’ll have no problem being entertained while laid up while winter blows through. In Summer, it would drive me nuts.

And, I might then be able to enjoy the upcoming summer if I get this fixed sooner than later. No point in waiting. Life happens.

Thanks for the thought though.

Glad to help !

Your Ortho will very much appreciate that you come in with a lot of questions. An engaged informed patient is what all doctors wish for. An angry silent withdrawn one- and high-pain patients like us can certainly fall down that path- make their job harder.

MY bolding. Your Mom is 82? Good on her ! :slight_smile: She got the glue because- and I mean no disrespect- most patients at 82 will not outlive the lifespan of surgical cement ( 10 years: Assumed. 15 years: Average. 20 years: High end ) They did the right thing by her.

Sounds like you’re looking ahead pretty well there.

I’m frightened of your wife. :smiley:

Keep us posted !

Had left hip done at age 57. My layman advice would be follow the post op exercise regimen verbatim. Sitting around is the worst thing you can do. First couple of weeks is understandably challenging, the worst part was the drugs that supposedly were going to help. The drugs made for weird sleep and really weird dreams. Also I was given anti-coagulant for a month which meant no alcohol.
Today, ten months later, better than before the injury that required the surgery. I was in hospital only 33 hours. You will be happy that it’s behind you and that’s it’s done. Worst part is metal detectors which are a daily part of my work. :rage:

I had my right hip replaced about 4 years back. Incision on the outside of the hip, I think that’s’ anterior.

In hospital two nights. Nurse visited the next day to check on me. In home physical therapy for about 3 weeks, every other day.

Only took light opioids for 4 days, then acetaminophen.

Used a walker around the house for about a week and a half, then a cane for another month or two.

No issues, no pain, very satisfied.

Hey, thanks everyone for support and suggestions. I will keep this tread updated as things move forward.

Left hip replacement at age 59 (2015). Anterior approach. Six weeks of medical leave. Cyanoacrylate closure on the incision, and no restrictions about getting in the shower once I could perambulate.

Good to know about the Cyanoacrylate. I guess the docs choice.

I’ve been looking at recovery times, and yes even though it’s a big procedure, I’m surprised that it may be 6 weeks away from work. Or three weeks before driving. I’m kinda a home body, but that’s a long time it seems.

We also live kinda remote, so I wonder what that means for PT. I mean if I can’t drive…

I had a PT fellow coming to the house about 3-4 times a week for a few weeks. I’m sure arraignments can be made.

A friend of mine in his early 60s had a hip replaced last spring. He was told the same times as you (6 weeks for work, 3 weeks for driving) but he was back at work (a desk job) in a week, using a cane. He followed the 3 week driving restriction, but that was more so that he could have his wife chauffeur him around.

According to him, the surgical recovery was a bit rough the first few days, but after that “it was nothing”.