THR Success vs Problems

RogerBill

After reading about the experiences of many others I’m a little concerned the after effects of my THR will be worse than the current problems with my osteoarthritic hip. I used to enjoy regular 8 mile walks but suddenly five months ago I found I couldn’t really manage to walk more than five minutes or do much which involves standing. But when I don’t walk or stand too long I’m OK. I know osteoarthritis is a condition which usually deteriorates and the diagnosis of my x-ray was “severe degenerative change in the left hip with complete loss of the superolateral joint space”. I decided to have THR because I can no longer enjoy walking and I thought the operation might have a higher probability of success than it would if I delayed and the hip deteriorated more. From what I’ve read elsewhere the odds of a favourable outcome are good so I’m wondering if those who’ve had a successful THR are less likely to post on forums like this thus giving a less favourable impression?

Lilymary

Before my surgery all I heard was “oh, my uncle\mother/friend etc etc had hip replacement and they’re back out horse riding, climbing mountains, dancing the tango etc etc.” (Insert relative or activity of your choice). My only experience of new hips was two friends who had multiple dislocations. Then it turns out I’m a slow healer. Who knew? My surgeon assures me these complications are rare and unpredictable, but mostly fixable or sort themselves out in time.

But even those with dislocations didn’t regret the surgery, and nor have I, it’s just a rather longer road for us.But the big difference is that with OA, the only certainty is increasing pain and reducing mobility. With a new hip, the joint pain is gone (just soft tissues have to sort themselves out), but a certainty that however bad it is in the weeks post surgery, it will improve. Focus on that.

RogerBill

Thank you again Lilymary, that's a very good, well balanced view and a reassuring one. The probability of a successful THR outcome is favourable and the techniques are improving all the time.

https://reports.njrcentre.org.uk/ I've only very briefly scanned this report on the National Joint Registry website which contains a lot of statistics including data on 1.2 million of the primary hip replacement operations performed in the UK between 2003 and 2019. The probability of needing a revision within 15 years for my age group is quoted as 7.29% But again I suspect this percentage will reduce as techniques continue to improve. For example, the report says joints with 32mm heads are taking over from those with 28mm heads, the use of cement is changing as are the materials used in the joint. Also my operation will be assisted by a Stryker Mako robot which should improve accuracy and help avoid uneven leg length problems which I believe is one cause of dislocation. Was your operation robot assisted?

Lilymary

To be honest I’ve never heard of Mako robot assisted surgery and had to google it. Are you in the US? That was the only site I could find that discussed it. I went to a hospital that’s a centre of excellence for joint surgery, no robots involved. Just a lot of old fashioned carpentry tools. It seemed to work. I had the same surgeon as one of my dislocated friends (in her case because she’s an unstoppable trekker but kept falling over on rough ground). After one of her dislocations while on holiday she was taken to a local hospital who said her new hip was “a brilliant piece of surgery”. That was good enough for me.

RogerBill

I'm in the UK @Lilymary Because of the long and extending NHS waiting lists I'm paying for a private operation at the Nuffield Cambridge hospital https://www.nuffieldhealth.com/hospitals/cambridge/robotic-orthopaedic-centre-in-cambridge For many years I've designed and developed computer aided design software and although I've never worked in the medical industry I'm attracted by the technology - boys toys and all that! But, I agree a skilled surgeon is vital and as far as I can tell the one I've selected has a good track record and I felt comfortable with his professional manner during my appointment.

Lilymary

@RogerBill Aaah, now I see why you were attracted to this! Did you actually discuss your hip with your surgeon, or just the “boys toys”? 😏 It’s good that you have confidence in him though, I ended up changing surgeon as I couldn’t get any sense out of the first I was given, and very glad I did. It makes such a difference.

RogerBill

@Lilymary oh yes the whole appointment was spent talking about my hip and alternative treatments e.g. injections. As appointments are very short I go fully armed with a list of concerns and questions in priority order. I'd previously read a lot about the Mako robot and given my background I didn't really want anymore info except to ask how many operations he'd done and was doing with it. I'd also previously got a copy of my x-ray and it's report so was able to ask if he agreed with the diagnosis in the report.

Seven years ago I had a prostate cancer diagnosis and like you wasn't comfortable with the hospital and consultant I'd been referred to, so worked hard on my GP to get referred to our next nearest NHS hospital. One of the best decisions I've made as the treatment I received was excellent. As I understand the NHS system, everyone has a right to choose and to obtain copies of their x-rays test results, etc. which I think are always worth getting as they contain far more detail than you get in short appointments.

My prostate cancer operation was also robot assisted using a Da Vinci robot which is a very different sort of robot to the Mako.

Lilymary

Interesting that you got a copy of your X-ray and report. I never actually asked for mine, but during a consultation with one of the junior doctors I asked if I could take a photo of the X-ray on his screen to show my physio. He said “you’re really allowed to do that, but I might have to leave the room for a few minutes.........”, which he did.

i had asked for a specific hospital for my surgery, but hadn’t realised you could ask for a specific consultant. I might have saved a lot of time and heart ache had I known that.

I’m pleased to hear your cancer treatment was successful and a positive experience for you. I’m trying to fight my Luddite tendencies, but robotics does seem to be bringing amazing advances in medical care.

RogerBill

https://www.nwangliaft.nhs.uk/patients-and-visitors/patient-information/access-your-medical-records/ States:

>>The General Data Protection Regulation and Data Protection Act 2018 gives you the right to access information we hold about you. You can request a copy of your health records at any time. We are required to respond to you in a month. There is no charge to view your records, or be provided with a copy of them.<<

I filled in the form and submitted it but I actually got copies of my x-ray and report within a week or so by phoning and asking someone in the department at the hospital where I had my x-ray.

When I was going through cancer treatment having copies of all the test reports and reports on my operation proved invaluable. The medical jargon takes some online research to decipher but if you've an inquiring mind it can be interesting. Also I'm on the committee of a cancer charity at our local hospital and one of our initiatives is to encourage staff to address letters to the patient rather send them copies of letters addressed to their GP. It's early days but we've already had some GPs report that they find the letters more understandable!

Lilymary

Ah, thanks for that info. My surgeon does keep me copied in on all correspondence, and if it needs translating I just pass it to my physio, who lives a few doors away from me. At least having my bootleg X-ray on my iPhone, I can refer to it whenever needed.I might ask for a copy of my post op X-ray though, if only out of curiosity.

Thanks for your work with the cancer charity, I’m sure they’re very happy to have you on board.

helpline_team

Hi @RogerBill

I can see that you've been having some really interesting conversations on this topic. The major reason for this surgery is to improve long term pain, and overall the outcomes are very good.

As with all treatment it's really helpful to make your own informed choice, so that you feel that you've weighed up the pros and cons and come to a decision which is right for you.

If there's anything we can help with, do consider ringing us on our freephone as it's sometimes easier to drill down and ensure that you've obtained a helpful answer, and that we've understood your question correctly.

all the best

Guy Helpline team