Have questions regarding thp bilateral??? - Knee & Hip Problems Message Board

mytake · 10-22-2006, 02:05 PM

I am 46 and have been advised by 3 ortho surgeons 10 yrs. ago that I needed bilateral thr. Well I was able to deal with the pain, but as we all know it just tends to get worse and now it is pretty bad. I still work fulltime and live alone so have no support at home for after surgery.

Dr. said he wanted me to loose weight quite alot before the surgery could be done. Well that was last year, went back to him about 4 months ago to get a cortisone shot in my hip joints. After he took new xrays now he tells me that there is not enough space in the joints to even give me a cortisone. Boy was that a big disappointment, after waitng 3 weeks to see him and I had so anticipated the relief these shots would give me.

He now says that losing the weight needs to be put on hold and he was wanting me to set up an appointment that day for the surgery. He said that both hip joints were completely bone on bone at this point.

My questions:

He wants to do the left hip joint and the right one 2 weeks later and said I should be back to work in 8 weeks total. Does this sound like it is too soon?

Is it possible to wait too long and the joint be so worn down that a replacement can't be done?

What is best metal or ceramic?

Gotta say I am terrified to have this done.

Please any advise/comments welcome.

Deborah

granny2billy · 10-23-2006, 07:42 PM

I am 10 weeks post bilateral thr. you can do it. I did mine 10 days apart. My hips were also bone on bone. It is the right thing to do, unless you want to be in a wheelchair for the rest of your life. that is the alternative.

ask you physician if he will do they at the same time, if i had to do it over, i would choose that. the initial pain in the first few days is bad enough to make you not want to have the second one done. I almost cancelled out 5 times in that 10 day waiting period. But my children kept reminding me that I wanted to play and walk with my 2 year old grand baby, so I did it.

The reasoning for having them done together or as close together as possible is that you only have to go through the trama once, you get the same pain medication, you have the same restrictions and you will be over and done with it all the sooner.

As far as going back to work in 8 weeks. that depends on the type of job you do. I am heavy, but athletic. I just started driving last week (9 weeks) and went back to work 2 days a week. it was exhausting, i found 6 hours was all I could take in one day. so I would say 12 weeks for complete full time return to work. This is major surgery and you do not want to risk damage to your new joints by rushing things.

As far as type of implant. go with titanium and ceramic ball. It has a 40 year life expectancy and who wants to go through this any more often?

The most important thing I can stress is take some pt prior to the surgery, work on muscle strengthing while you are waiting for the surgery. then afterward, KEEP MOVING. even when you dont think you can, keep the blood flowing in your legs, your recovery will be much faster that way.
Reduce your intake of pain killers as you can tolerate and substitute other over the counter mediations to manage the pain. the sooner you get used to the stiffness the better. It is a long recovery. but the pain you will feel afterward is a good pain, it is a healing pain and you know that it means the light at the end of the tunnel.

granny2billy · 10-23-2006, 07:57 PM

oh I forgot to say, I am 52 years old, and put off my surgery for 6 years until I could barely move. I had to wait 6 weeks for my surgery to get scheduled, so in that time I went to pt and worked on building my stamina, upper body strength and my leg and glute muscles. this was the single most important thing I did for my recovery, because my muscles are healing extra fast because they were all ready toned when I went in.

After the surgery In the hospital, ask them to leave the catheter in as long as you can, so you dont have to use the bed pan, with both hips done that is more than difficult. Also prior to the surgery, starting now, work with the pt to build the muscles in your arms and shoulders, you will need them desperately afterward.

Since you live alone, You will need help for the first few weeks, so if your insurance will pay for a rehab hospital post surgery, then definately go for that. Thankfully I had my husband home for the summer (he is a teacher) to help me get in and out of bed and cook for me etc.

I did go to the rehab hospital for a couple of days after I was released from the hospital to make sure that I was using all the equipment (walker, cane, toilet seat, shower, etc ) correctly. Having help is invaluable, so if you cannot arrange for someone to stay with you for a few weeks in your home, definately go to the rehab hospital.

After leaving the rehab hospital, keep up the pt on an outpatient basis, try to keep moving, I find that if i sit to long i get so stiff I can barely walk until the blood gets flowing in my legs. so keep moving.

rp_aust · 10-24-2006, 09:37 AM

Deborah

First, if you get a total hip replacement then whether you have bone on bone or not is irrelevant, as the top of the femur is amputated - does not matter what condition it is in as it is thrown in the waste.

At your age you should look at resurfacing, which does not amputate the bone. Whether you are a suitable candidate only an experienced resurfacing surgeon can tell, but they can tell from xrays, even ones emailed to them. If your surgeon does not do resurfacing then he is not the one to advise you on the possibility.

I had both hips resurfaced in the one operation last December (at age 54). I was bone on bone in both hips with cysts on the femoral head. I was cautioned before the operation that whether both were done on the one day depended on how I coped with the trauma of the operation. If there seemed difficulty then only one would be done at a time.

I am very glad that both were done, as the thought of two recovery periods gives me shudders.

If you decide not to pursue resurfacing (which would be a mistake unless you are physically unable to be resurfaced) then the next best option would be a metal on metal large head total hip replacement. The large head would significantly reduce the risk of hip dislocation.

Regards

Ross

mytake · 10-25-2006, 07:37 PM

Hi granny2billy and Ross,
I do have some things to think about and both of ya'll give me some very informative useful facts to consider.
I thank you both so much for taking the time to share your experience and knowledge with me.

Deborah