Is it time for a hip replacement?

Miscellaneous and Personal Stuff I Must Share
1

The earlier threads on this topic are all more than 20 years old, so I thought I’d start a new one.

I’m looking for some guidance from those of you who’ve had this surgery. How did you know it was time? Did you have robot-assisted surgery? Did you have general anesthesia or a spinal block? How long did you have to stay in the hospital and how long was it until you could walk normally? If you could change your decision, would you?

My left hip has been getting more painful and weaker for about 5 years now. I tried to convince myself that it was just bursitis, and 3 years ago I had a cortisone shot that helped considerably, but then things got gradually worse and another shot last month didn’t help at all. The pain isn’t too bad (I’m not rolling around screaming) but it’s always there. It hurts to walk, so I’m gaining weight. I can’t sleep at night despite OTC NSAIDs. I’m slowly realizing that it isn’t going to get better & probably will get worse unless I do something.

My PCP will refer me to an orthopedic surgeon, but I’d like to know what questions to ask or red flags to watch out for.

2

Thank you for starting this thread. I’m sort of in the same boat, although my hip pain came on rather suddenly about a year ago, so I did see an orthopedist, who diagnosed osteoarthritis. Quality of life kind of sucks with this; not only walking, but getting in and out of my small car is also painful because of the way I have to twist my hip to get under the steering wheel.

I’d like to ask one question: how old are you, and for the folks who have had the surgery, how old were you at the time? I’m 76.

3

My only experience is with other people: relatives or neighbors. I’m not old / decrepit enough for new hips or knees. Yet; I have no doubt some of that is in my future.

But the the big takeaway I got from the folks I’ve dealt with was there is a combination of increasing age, increasing weight, and decreasing other aspects of health. If you cross that threshold, no operations for you. You missed your last chance and now must live with the increasing immobility and pain until the end.

OTOH, the people who did the operation(s) early in elderhood were spry into great old age.

I don’t want to be that first kind of person; I want to be that second kind of person. So I’m thinking to fix them as soon as they’re starting to become a problem. Not 5 years after they’ve been a well-established problem.

Good luck on getting this addressed ASAP.

4

Right there with you: I’m 77. When I get in my car, I have to put my arms around my left leg and lift it over the door threshold because it is too weak and painful to raise it. I am finally admitting to myself that this is NOT NORMAL.

Keep in touch with your thoughts/progress, OK?

5

I hear you! I’m merely “overweight” now, not yet “obese” but I don’t want to end up there! And I only limp when walking, don’t normally use my cane, but I don’t want to end up there either! So yeah, I think it’s probably time. My last xray (a couple of years ago) showed “moderate” arthritic degeneration of the joint, but I’m guessing the surgeon will want to take another xray and it certainly will not have improved since the last one.

Thanks for strengthening my resolve.

6

I had a replacement about thirty years ago due to ankylosing spondilitis, a fancy name for arthritis. Done with knives. Pain killer drug, I do not remember which. A long time recuperating, but I was walking with a cane in a week. A month out of work. The scar looks like a zipper.

My wife had one a couple of years ago, the surgeon let a robot do most of the work. She was walking right away. Lots of drugs, vitamins and supplements. Bandage changes. Much much easier than mine. One small incision to let the robot do it’s work. No problems.

My exercises to get muscles working again were at home. Hers were at a clinic. Most important thing is that I didn’t exercise enough, and it hurts when I stub my toes on that side. She has reported no problems or difficulties.

7

I didn’t - but my husband did it last year, when he was 62. He had the posterior approach - the anterior approach heals more quickly but my husband is very overweight and in his case, the anterior approach has a higher likelihood of infection ( due to the fat that would be hanging over the incision) which negates the benefits. He had general anesthesia and it was robot assisted surgery. He started walking the same day and was released the next day so that he could get a session or two of physical and occupational therapy before going home. He used the walker for a week, maybe two and then moved on to a cane. He had 2-3 weeks of PT at home and then a couple of months at a clinic. The only thing he regrets is not getting it sooner - what finally prompted him was a trip to Disney with the grandchildren where he was in so much pain, we wasted a couple of days tickets to stay at the hotel ( and if you knew my husband , you’d know how much pain he had to be in to do that). By eight weeks , he had no more restrictions. Now it’s almost a year later, and it’s almost like he never had or needed the surgery ( except he needs antibiotics before dental visits). The people he knows who did not recover so well didn’t do the PT the way they were supposed to.

8

I haven’t had surgery of that kind, but I know several people who have had hip and/or knee replacements. The one lament I’ve heard several times is, “I just regret that I waited so long to get it done.” In other words, it was inevitable, but they went ahead and suffered a lot of unnecessary pain before accepting the inevitable.

Yep, it is time!!

9

Yep^^.

The usual other comment is that the recovery sucked a lot, but was totally worth it.

Accepting that you’re not going to avoid the recovery process, so delaying it just adds to your lifetime misery score, not subtracts from it, is a key mental threshold.

Also as noted by folks upthread who’ve done it, the horror stories of long pain-filled recoveries are mostly from 20 years ago. Not this year or last year. The whole process is a lot better than it was not that long ago.

10

I had my right hip replaced in 2015, my left in 2021. Both times anterior approach and both times I was back to work within about four weeks.

In 2015, I was in so much pain that I preferred to get around the plant while supporting myself with any rolling stock available (usually a small cart). Eventually the plant manager told me to just start my sick leave and FMLA already.

11

I think I had a spinal block and general anesthesia.

That’s me. BUT, I’ve a friend that got two done (not at the same time) and she was going up and down stairs the next day. Took me a couple of weeks.

I don’t have anything for you to ask the doc, but make sure your home is ready for you.

What I did was move my bedroom to the first floor. We have a bathroom on that floor. But I did still need to navigate two steps.

To move my bedroom I bought an Aerobed twin mattress. Make SURE you get the one that is the double height, not just right on the floor. It’s similar in height to a regular bed. That makes it easy to stand. - /side note - These are VERY comfortable and great for guests. I slept on one nearly every weekend when I was taking care of my mom.

A walker helped a lot. I configured mine to be able to have a bag on it so I could get something from the 'fridge and wander back to the TV.

Buy a nice robe, and slip on comfortable shoes/slippers.

Stock up on comfort food. Food delivery service can help, but they are not supposed to come into your house. But, if you explain your circumstance, they may take the bags to the kitchen.

I ended up setting up my cell phone for reminders on when to take my pills. I also created a system so I could remember when I took what. There were lots of pills involved. Some ever 4 hours, some every 6 hours. It got hard to track. Prepare to be sleep deprived.

You’ll be doing a few weeks of PT.

Do you have a spouse, or someone to assist you?

12

Reading this with interest. I’ve been having hip pain for about a year, diagnosed as bursitis on both sides. I also have some arthritis. An injection did very little, and it mainly hurts when I’m in bed, sleeping on my side. A pillow between the legs really helps keep the hip from torquing.

I had a knee replacement a couple of years ago, which has held up well. I don’t relish the thought of going under anesthetic , but neither do I like the idea of eventually being unable to walk. The biggest issue is that I’m now 79 and if something isn’t done soon, it will be too late. At least I still have all my gear from the knee replacement, i.e., walker, cane, etc.

13

IANAD, but I thought the point of a spinal block is that you don’t need general anesthesia, which is more dangerous to the patient. Are there circumstances when both are used?

Thanks, luckily my house is all one level and all laminate floors. I am going to invest in a walker though – thanks for the tip! My son is close by in case of emergencies.

It’s hard to imagine being more sleep-deprived than I am now! I don’t think I’ve slept through the night in several years, between the constant tossing & turning to find a way to lie so my hip doesn’t ache & having to get up to pee. I’m looking forward to a more normal sleep pattern.

14

I think what confused me is that it’s possible to have both bursitis and arthritis. I had a cortisone shot about 5 years ago that pretty much got rid of all the pain, but I’m pretty sure it was mostly bursitis in that case. The most recent one didn’t do a darn thing. And I find not being able to find a comfortable sleeping position very hard to take. I’ve used the pillow between the legs trick, but it’s hard to shift around with it in place. If you decide to get the surgery, let us know how it goes, OK?

15

I donno. But I was not awake for the procedure. And I got a shot in my spine.

16

Same here. They started with the spinal, but I was apparently having breathing issues, so they had to intubate, which meant anesthesia, apparently.

17

Ya know, I think that’s it. I was breathing fine, but maybe it’s sometimes a precaution.

18

From what I’m reading on the intertoobs, they really don’t want you to feel anything at all that might cause a reaction to the assault being carried out on your body. An inadvertent twitch could cause a major “oh, shit” moment.

19

Mine was done a10,000 feet in elevation. So that may have something to do with it.

20

Hooo boy, how timely.

I had my first hip done in spring of 2018. Non-Robotic, posterior approach technique. Titanium-porous spike with aluminized ceramic femur head. Polycarbonate acetabulum.

Took several months before I was safe to put full body weight onto it. Pretty good recovery, pain-wise. Until I fell on it 9 months post-op. Didn’t do damage to the hardware but damaged ligaments and tendons. It is a source of pain.

The other side will have to be tended at some point. Both of my femur heads are formed as egg-shaped, opposed to roughly spherical. Born that way. I blame my parents. :grinning_face_with_smiling_eyes:

By comparison, my wife. She had her left hip replaced on March 5. Robotic surgery. Not anterior, not posterior. A technique that’s basically entering just along the median line of the body. She was off the walker within 3 weeks. Mostly off the cane. Zero pain post-op. 1 night in the hospital, light use of opiates ONLY in hospital. Zero use at home. Managed fine with Tylenol.

This coming Thursday she has her right hip replaced. No reason to think it won’t be just as successful.

8 years and a world of advances. Just remarkable. Both of us are very compliant clients re: P.T. both at home and at P.T. centers. Do ALL of the reps. Hydrate frequently, etc.

Both of us were in Twilight sleep. I remember my surgeon literally using the mallet to pound the implant home. ( That’s all I remember ). She has zero memory of the event.

Both of us used the Hospital For Special Surgery. Pun intended, they are THE cutting-edge bone joint in America. For 16 years in a row, chosen as the #1 place to have Orthopaedic work done. And it shows.

No matter where you’re having it done, ask many questions. Take paper or record the conversations with your Dr on your cell phone or an audio recorder. Surgery is stressful. Don’t assume you will remember things. Best case: bring an advocate. Partner/ Spouse/ Trusted friend etc. Have THEM take many notes. There’s no such thing as a dumb question.

During my initial visit with my guy in 2017, we were working our way through the questions. I was in amazing pain. Had been bone-on-bone for more than a year. At some point I asked the following question:

" Doctor, after the surgery, will I be able to play the violin? "

The guy roared with laughter. I wasn’t wasting our time. I needed to know that the person who held my personal and professional future in his hands wasn’t a crab. A stiff. An old-school dour jerk. I needed to know he had a bit of light to him. His response put me at ease. It mattered.

EVERYTHING matters. It’s your body.

A note about bone-on-bone pain. It greatly affects mental health. I’ve had to deal with chronic deep pain since 2000 when I fell and broke my L-3 wide open. So, I get what chronic pain is. The hip pain eventually became a dominant element of my life. Waking it was the thing that limited how many steps I had per day. It ruined a night’s sleep.

Don’t delay. A bad hip won’t get better through PT. It won’t slowly heal up. It will just decline and cause you more agony.

My two cents !

ETA: Wife and I both also had spinal blocks additional to twilight.