Moderate hip arthritis/Steroid injection failed

joanie

Hello all.

Thank you for letting me join your community which is a fabulous source of help and information.

My story is this:

I am a very active 72 year old. Still riding my horses and working around 2 others. In December (2021) I was diagnosed with moderate hip arthritis (pain radiates in the hip down to the knee and below). My GP was of little help other than prescribing Co-drydamol and Ibuprofen and suggesting physio. So I went to a private Specialist (who arranged X-ray and MRI). His recommendation was a steroid injection which I had done a few days before Xmas. Unfortunately, the effects of the jab wore off 7 to 10 days later so I'm back where I started. I talked to the Consultant and he said the next step would be a total hip replacement but he was reluctant as, in his words, its an operation which carries risks, just like any other major op.

Problem is, I CAN ride my horse but I can't dismount because my right leg wont swing over the back of the saddle. I can't do any heavy lifting (hay bales, water buckets etc). I can't walk without pain and sometimes use a stick. I am taking pain relief every day (which I hate to do!). Some days are better than others. Its also disturbing my sleep. My poor husband is having to help out a lot (putting on and taking off rugs, leading horses in and out of the field etc).

So the question is: should I push for a total hip replacement - even though its 'moderate arthritis'? The thought of having to wait more time (maybe a year) for it to progress to advanced arthritis is not something I want to do.

I have researched a lot of information on the internet and the general view is that a hip replacement is supposed to be transformative. Would I be jumping the gun with a TRP? Any thoughts?

anneb82

Hello @joanie

Welcome to the online community and thank you for sharing your story with us all. I hope that you will find this a safe and friendly space for you to continue to share with us and join in other discussions that you have an interest in.

So you were diagnosed with moderate hi arthritis in December 2021. Your GP prescribed general painkillers for the pain and suggested you have physio. You decided to see a private specialist who arranged a xray and MRI, and then suggested that a steroid injection would be the best course of action which you had a couple of days before Christmas. Unfortunately, the effects of the steroid injection did not last very long, and when you went back to the private consultant, they suggested that the next course of action would be a total hip replacement but he was reluctant to do this due to the risks involved. The pain and problems that the arthritis is causing your hip is affecting your day to day life, including sleep and normal activities. You would like to know what other think, whether you should push for the hip replacement or try to carry on how you are for as long as possible.

It really does sound that you are suffering with the pain and that is impacting on your day to day activities. Obviously hip surgery is a major operation so your consultant is right to advise you of the risks but its whether those risks are worth it in your eyes. Unfortunately no one but you can make this decision for you. I sounds like from what you have said though is that you are doing the right thing by researching your options and looking into what the operation entails. That way you can make an informed decision. I personally don't think it matters whether you have been told your arthritis in your hip is moderate or severe. Clearly the pain you are experiencing is effecting your mobility and we all feel pain differently.

I've included some information below that I think will be of use to you. Information on hip replacement surgery may be very similar to what you have learned but the managing your pain link can be very helpful to you in the interim while you are deciding.

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

https://www.versusarthritis.org/about-arthritis/managing-symptoms/managing-your-pain/

Please do keep us informed over what you decide to do and if you have any other questions then don't hesitate to ask.

Good luck and take care

Anne (Moderator)

joanie

Thank you Anne. I agree that pain is subjective and I am rapidly coming to the conclusion that if its affecting my quality of life maybe a THR is the way to go. 🙄

Coddfish

Hi @joanie I had my right hip replaced aged 64. The arthritis as seen on X-ray was pretty severe, but I had never described what I was experiencing as pain. Just stiffness, difficulty moving from standing to sitting and vice versa, and the gradual eroding of my ability to do things I love. The crisis point for me was when I could no longer run. I had my operation privately. NHS lists were excessive, and without pretending about pain, it would have been hard to be a priority. Just over £13k for a fixed price package with aftercare. Yes, it was transformative and I am running again, coming up to 5 months post surgery. The fitter you are going into surgery, the easier the recovery is likely to be. I should probably have presented a year earlier and if something similar happens to my other hip, I would not hesitate. The first couple of weeks or so are not much fun, but you are soon in a better state than before. You only have one life.

Lilymary

Hi @joanie , I’m an ex rider who would love to be able to sit on a horse again one day, some of my happiest memories are on horseback. I had THR in April 2021 when I was 61 but was one of the unfortunate ones where recovery has been very slow and at times painful. I also have a lot of muscle weakness in my operated leg, which I’m still working on with my physio, but this means there’s no way I’d be able to grip evenly, or well, with my thighs, and I’m pretty sure I’d struggle with much more than a sedate walk at the mo. I definitely wouldn’t be able to mount in the normal way. Even my surgeon doesn’t know why i’ve Had these problems, but all he could say was “it happens sometimes, and it does get better eventually”.

However, I have also heard of some “new hippies” who were back on horseback 7 weeks later! I’m guessing their muscle tone was so good it aided a fast recovery. I gather there is a Facebook page for riders with new hips, and you may find that helpful, and I think Horse and Hound ran an article on it a while back.

The problem for you, and your surgeon, is you don’t know which camp you’re going to end up in post surgery, the duffers like me (and I was previously fit and only slightly overweight) or the star patients. If you’re just about managing at the moment , I would stick it out for as long as you can. Given how active you are, and the demands you make on your hip both working with and riding your horses, that’s asking a lot of a new joint (although my sister has ridden occasionally with two new knees). Your surgeon may also have mentioned that they can only replace joints twice. It’s a tough call really. It’s a shame the steroid injection wasn’t more successful (it didn’t work at all for me, not even fleetingly), but I got through literally crippling pain in a very physical job on cocodamol and naproxen for an awful year during lockdown before I caved in and went private, as I couldn't stand it any longer. No one likes to have to take pain killers, but it was a means to an end, ie kept me mobile for as long as possible, although never pain free, until surgery was the only viable alternative.

I’m sorry I can’t offer you more consolation, I’m afraid your joint will continue to deteriorate, although exercises can slightly reduce the rate by strengthening muscles that support the joint, but I’m guessing your leg muscles are pretty good anyway. You will probably have to adapt how you do things, (and you seem to be working on that already) and get a regime of pain relief meds that works for you, then keep reviewing with your surgeon until you both feel the time is right for surgery.

sunnyside2

ok haven't ridden in years but an idea.. can you train your horses to be dismounted from other side? I know it would be hard for you to relearn dismounting technique from other way round but might work

joanie

https://community.versusarthritis.org/discussion/comment/689797#Comment_689797

Hi, thanks for the suggestion. I had thought about that but then a friend said why not try to to get off as riding side saddle - so coming off that side but facing forward. I will try both - wish me luck!

joanie

Hi Lilymary,

Thank you for sharing your experiences of riding and the eventual hip replacement. I think I will, however, go for a THR as I hate the limitations placed on me by this awful condition. However, I went to see an Osteopath today who encouraged me to go for it and get it done. He said having an anterior hip replacement is better because they go through the front of the hip and not the side (going through the side means they have to cut muscles) which means there is a quicker recovery. So I am now researching this idea to try to make a good decision. Thanks again.😊

joanie

https://community.versusarthritis.org/discussion/comment/689775#Comment_689775

Hi Coddfish, Its good news that you have had the op and are doing well. Some people have transformative results and others are not so lucky. I'm hoping I will be in the first group since I am relatively fit and slim! Cheers.