Hip replacement tips

RogerBill

Now four weeks from my hip replacement operation so time for an update. I think it was @Coddfish that said something like day to day progress is almost unnoticeable but that there's definitely a longer term trend of improvement. I feel exactly the same. Over the past two weeks sInce my last update I've been disappointed by my really slow progress. But I'm keeping a record of my twice daily walks using a free app, Viewranger on my phone. This shows a gradual longer term improvement in the distance and speed I'm walking although stops for a gossip with friends sometimes mess up the timing (I must remember to pause the timer)! I'm now doing 0.89 miles twice daily at 1.3 mph which isn't as good as I'd hoped but I am encouraged by the fact that it is somewhat better than two weeks ago.

I've not missed any of the exercises I've been given. One occasionally causes cramp like pains in my inner thigh so I stop and return to complete the number of reps after doing a couple of the of the exercises. Doing the exercises is a tedious chore but I'm sure very necessary.

I haven't taken any painkillers for a week and a half except for one bad day when I just took a couple of paracetamol for back pain after my second walk. I still find I need to get up for a potter around every hour or two during the night to ease the aches and stiffness. This is wearing but hopefully I'll be allowed to try sleeping on my side after my six week followup appointment with the surgeon. Generally the aches, stiffness, etc in my thigh, hip and back are all perfectly manageable. I'm a little concerned about my back because for many years I've had occasional problems and used to do exercises for this which due to the hip op movement restrictions I can't do at present.

When getting up from bed or, to a lesser extent from a chair, I definitely need the support of a crutch until I've flexed the hip, knee and ankle to ease the stiffness and numbness. I'm carrying one crutch around the house and two outside but mostly I don't really need them. I'm trying to build up confidence walking without aids indoors and trying to improve my gait to avoid any limping. Before the op the leg on my operated side had definitely felt shorter for a number of years. The op seems to have cured this and I read somewhere that it takes time for the brain to relearn where your feet are and to properly regain your balance.

I injected the last of the blood thinners yesterday. I've still got bruising especially around my ankle, but the surgeon said this is normal. The swelling is mostly disappeared.

All in all, nothing significant to report just slow gradual improvement.

Coddfish

Sounds good @RogerBill Bet you are glad to see the last of the blood thinners! I found 4 weeks marked a big change in my level of dependency on crutches, hopefully you will find the same.

LizB12

Sounds like good progress even though slow @RogerBill. It certainly pays to keep records as you go. You will be relieved when you are rid if your crutches and when you can sleep through the night.

ET63

Hi Bill and all.

Good to read your about your THR and how your recovery has been. I too wrote about my recovery which was very quick. . I am now 14 weeks post op and have resumed normal life.

i learned two new things today. I didn't know the theory behind weight bearing and uncemented hips, thank you Codfish. And second, I am not the only one that can feel my new hip, which sticks out quite prominently. Thank you Bill i wondered if i had made a wrong turn and moved it out of position. Glad to know it’s common

My physio told me only walking for 3 months , then I could go back to all my usual activities. I was walking crutch free by week 3 outside. I felt very stable and secure. I have an imbalance in leg length which is annoying but when i mentioned that to my surgeon , he was quite indignant! He showed me all the pelvic measurements which lined up beautifully but there is an inch somewhere in my leg that has contributed to the difference. Hence, walking tires me out so haven't done too much of that. Referred to the Orthotic department but haven’t heard a beep from them yet.

LillyMary, your friend at Pilates, how far along was she? I do Pilates and although very cautious, I do wonder how far I can go. Your comment made me sit up! When do dislocations stop being a worry?

RogerBill

Hi @ET63 On the fourth day after my op I did move suddenly and awkwardly and heard something crack which was worrying but it doesn't seem to have caused any noticeable damage. I've read elsewhere of others reporting their new hips stick out more. Some say it's due to swelling which can take weeks to resolve. It's obviously not the mechanical bits that have moved because I'm sure that would cause excruciating pain. It might be muscles that are wrapped around differently than pre op. Not having any medical training I've no real idea I'm only theorising. But as they say we know our own bodies better than anyone else and if we're pain free, except for a few aches and stiffness and can walk and move reasonably OK I guess there's nothing much to worry about.

Sounds like you're doing really well but very sorry to hear about your leg length discrepancy. I was extremely fortunate to be able to afford an op assisted by a Mako robot. One of the main benefits claimed is accurate placement of the hip components. This is done by reference to a 3D computer model constructed from a preop CT Scan of the hips down to the knees. The op is planned to equalise the lengths between the hips and knees. But even my surgeon said he had sufficient experience to achieve accurate leg lengths within a millimetre or so without the use of a robot. But even highly experienced surgeons can get it wrong and leg length discrepancy was one of the risk factors on the consent forms I had to sign preop. Sorry @ET63 none of this is of any use to you but wanted to share these thoughts should they be of interest to others thinking of having a THR.

I share your concern about dislocation. A friend's wife suffered one which was extremely painful and is certainly something I want to do everything I can to avoid that problem!!!

RogerBill

@ET63 Another thought or two about dislocation. I've no medical training so this is just my understanding based upon what I've read.

It's the muscles, ligaments that hold the ball and socket of the hip joint together. The post op exercises and walking I've been advised to do I think are intended to build up the muscles, restore flexibility, resilience, etc. This must surely be the best thing we can do to reduce the risk of dislocation whilst taking care not to overdo things. As I've been told, recovery from THR is a marathon not a sprint!

It's four weeks since I left hospital and I'm spending about 1.5 hours per day on three sessions of exercise plus two half hour walks, which I expect to gradually increase. (I've missed the occasional wslk due to weather or other commitments.) Plus I potter around home for a few minutes every hour or two day and night. Just wondered if others are investing this same sort of amount of time in their recovery?

A friend who is much younger and fitter had his THR a couple of years ago and he's still doing his exercises, although I'm not sure whether they're the same as mine or whether he does them all.

Abigail

Hi I had my new hip 4 October can’t put my foot down yet as got no glue or what thay use doing ok . Since I had plaster of on Tuesday it is sore to touch but doing ok I think

Coddfish

The risk of dislocation is a sort of reverse exponential curve. It’s at its highest immediately after surgery and declines over time. I am starting not to worry about it. Obviously it’s helpful not to have a fall in the early days. My niece is a paediatrician but often does locum shifts in A&E and says she has seen many post-surgery dislocations. Usually frail people, and people who have had surgery because of previous falls, rather than people who have been too active.

Abigail

Thanks for that I had my hip done on 4 October . Didn’t take pain killers larst night so doing better . Can’t put my foot down for 4 weeks so getting there it is so hard on crutches as my other hip is bad as well got have done later but thank you for this it help to no this thinks

ET63

Thanks RodgerBill

It’s all a learning curve, isn’t it? The surgeon said , at my last appointment, be careful and don’t dislocate your hip! 😂

As if…..!

RogerBill

Now six weeks since my hip replacement operation. After a couple of weeks when I felt my rate of progress was slow, the last two weeks have been more encouraging.

I’ve started driving. Because it was my left hip and my car has an automatic gearbox I was allowed to drive before the normal six week guideline. Although it’s a bit of a performance getting in and out, driving was easier than I’d imagined. I’ve a saloon car and I had thought I’d need to change to a higher car but I now think that can wait until my car actually needs changing.

I’m now doing a 1.4 mile walk at an average speed of 1.9mph twice a day. Two weeks ago I was only managing 0.9 miles at 1.5mph. Also I’ve changed from crutches to a walking stick outside and use no walking aids indoors. I’m trying to ensure I walk without limping, waddling, etc. Still a long way to go to get back to the ten mile walks I used to enjoy but very much better than during the six months before the operation when I could only manage 15 minute walks or standing.

However, I’m still being careful about bending so continue to use an easy grabber for some things and I’m not yet comfortable sleeping on my sides. Also I feel a little at sea with regard to what I should now be doing and not doing. For the first six weeks I had clear written guidelines and an exercise plan. I accept everyone is different but at my last physio appointment next week I hope to get some guidelines based upon her assessment of me relative to her wealth of experience with other patients.

Coddfish

Hi @RogerBill The advice I got at 6 weeks was to continue to avoid crossing legs but that it was ok to bend so long as it didn’t hurt. The surgeon advised when bending down to do shoes to bend the knee out if necessary and reach down inside the leg. I still prefer a pillow between my knees when lying on my side

RogerBill

Something else which I've found helpful post op are a pair of Skechers shoes. Because these have more cushioning in the soles than the shoes I was wearing, they seem to absorb some of the impact when walking. As they're slip on they're also easy to get on and off without having to bend.

I'm also trying to ensure I'm walking with a good gait. Heel down first, knees slightly bent, even steps, equal step lengths, no wobbling or limping and all with an upright posture. I think I'm generally doing fairly well but it's interesting how slopes and uneven paths are much more noticeable.

AndrewDunn

Not sure if I am posting this in the right place. However I had a THR op three weeks ago. It was a lateral/posterior op under spinal with some sleep inducing drugs . It was amazing. Home the following day, off the oromorph within 2 days, dropped the coedine the day after and the paracetamol within 10 days. I was walking a mile and a quarter with sticks after 10 days and half a mile without after 2 weeks. I did a couple of miles yesterday and a total of 10,000 steps and have no pain in my hip. I do however feel the need for a lie down and a sleep most afternoons. I have two questions: is the sleeping normal and how long will it go on.?

jeddison1985

Hi @AndrewDunn firstly let me welcome you to the forum I hope you find the information and support you are after from our wonderful community.

I can see from your post that you have had a recent total hip replacement and doing well with the recovery but questioning about the need to sleep.

The site is full of information and conversations, one of which you have found here and posted to. This will help you connect with people of similar experiences and aid you getting answers.

I wanted to signpost you to some information las a starter on total hip replacement.

https://www.versusarthritis.org/about-arthritis/treatments/surgery/hip-replacement-surgery/

Please feel free to search the forum for others with similar experiences and I am sure that some of our community will be able to help offer some useful suggestions.

Take care and I hope you get some answers soon.

Thanks

Joe

RogerBill

Hi @AndrewDunn Congratulations you're doing really well. I lie down most afternoons partly because during the night I'm getting up every two hours for a walk around to flex the muscles. Also in the guidelines I had from the hospital one or two rests lying in bed during the day was recommended for the first six weeks.

AndrewDunn

RogerBill, thanks for that . It is really difficult finding anything definitive about how long the recovery will take. I am not sure if my wife is right or not when she tells me I am doing too much. It is nearly impossible to find anything about how long muscles take to regrow and strengthen nor what is causing the fatigue: the operation: the interruptions in sleep : the exercise regime.

great to chat

Andrew

Lilymary

Hi @AndrewDunn , congrats on your new hip and rapid recovery! While you may be pain free and mobile again, your body is doing a lot of rebuilding in the background, which drains energy, and the anaesthesia can take a few weeks to wear off. Soft tissue takes longer to heal than bones., Six months on my incision is still tender. My recovery was epically slow, for no obviuos reason, but even so it sounds to me like you may be overdoing it a bit. Listen to your body, if it needs to rest, let it.

RogerBill

Hi @AndrewDunn

I am not sure if my wife is right or not when she tells me I am doing too much. It is nearly impossible to find anything about how long muscles take to regrow and strengthen nor what is causing the fatigue: the operation: the interruptions in sleep : the exercise regime.

I agree about the near impossibility of finding reliable and consistent information on the internet. I think this is partly because there are various different types of THR operations. But also the surgeon and physiotherapist at the hospital seem reluctant to commit themselves to definite answers even though they know I had a posterior op assisted by a Mako robot, the stem is cemented and the cup is held with a screw. All too often their answer is a frustrating 'everyone is different'. Obviously this is true but as so many THR operations have been performed there must be a wealth of information and experience from which you'd think some reasonable guidelines could be developed. Maybe this is a role Versus Arthritis could fulfil possibly by circulating a questionnaire to people in their contact database? I'd be happy to volunteer to assist with such a project. Dislocation of replacement hips is something I'd like to see investigated. For example, were people who suffered dislocation more likely not to have done the exercises or walked much after the op, what were they doing when dislocation occurred, how long after their operation did dislocation occur, etc.

Ellen

@RogerBill

Thank you for your suggestion I have noted it and passed it upwards to see what they think👍️

Best wishes

Ellen

AndrewDunn

Thanks fir the feedback. I guess I an beeing jeen to get back to “normal”. But i an beginning to realise that in truth my hip was wrong for about 4 years and pushing too quickly is possibly counter productive . In reality a few weeks extra weeks of patience is neither here nor there in relation to the years of pain.

thanks

Lilymary

@RogerBill , @AndrewDunn , the info on the Internet about recovery times after THR is “unreliable” because everyone heals at their own rate. This has been reinforced to me by my physio, by the surgeon, the ortho nurses in the hospital, my GP, other hippie friends, just about everyone “in the business” really. It’s not just about what type of surgery you had, there are countless other variables, eg age, fitness, underlying health conditions, exercise opportunities (possibly depending on where you live), bone density, diet, etc etc etc. It’s actually impossible to give guidelines that will be applicable to everyone.

I’m relatively young, was fit and active up to a year before before THR, only slightly overweight, no problems in surgery, live in the country so lots of walking opportunities, have a great physio, etc etc, but my recovery was hideously painful for the first 3 weeks and very slow thereafter. I developed Trendelenburg gait, and could only ditch the crutches for a stick after about 8 weeks, and only ditched the stick (except when on rough ground) after about 4 months. I’m still slightly wonky and have a slight limp, and occasionally suffer a variety of muscular pains, sometimes requiring pain relief. I can manage walks up to around 4 - 5 miles on the flat, even managed some 6 - 8 mile walks on the beaches in Northumberland last month, but hills are still a problem. The incision site is still slightly tender when I press on it. Even my surgeon doesn’t really understand why it happened, other than that some of the bone formations round the joint indicated long term muscle irritation (that I had been blissfully unaware of prior to surgery) that were set off by the surgery. All he could say was “it does happen sometimes, and you will recover eventually”.

I’d advise to stop trying to work to some notional target, listen to your body, don’t overdo it (I have several friends who dislocated their hips multiple times that way), and let your body heal at its own pace. It’s not a race.

AndrewDunn

Thanks , I think I need to accept that this is a marathon not a sprint ,whilst accepting that progress so far has been good. Maybe my impatience is being exacerbated by not being allowed to drive and having a long held view that sitting watching daytime TV is somewhat indolent . 😊

Lilymary

@AndrewDunn I was lucky that I had surgery just before a long spell of great weather, so lots of opportunities for gradually building up my walking - oddly walking hurt much less than sitting or lying down, so there was an incentive to get going again. But my leg tells me every time when it has had enough, which on one occasion meant Mr LM trotting home to get the car to rescue me! But it's much harder to keep it up when the weather's bad and days are short.

Abigail

Yes 5 weeks for me can drive on 15 so not long . It is hard not being able to drive jest want go up town and get out every day. I can get about in doors ok but nead stick for out but getting better every day