Advice please

I am a 53 year old male and have worn out hips full of arthritis and labral tears. Today I was told by a hospital orthopaedic surgeon he is going to do a full hip replacement in the next 6 months. He doesn't use screws etc but does it by fusion...uses 3D tomography to get a good fit.  

I am a smoker and now limping and having burning searing pain all the time I am up ouit of bed so am on oxycodone twice a day. 

Can any one please give me advice on pre surgery ideas and post surgery expectations for recovery time, pain, hospital stay and what to generally expect.

The surgeon said I have moderate to severe arthritis on the x-rays but  usually when they go in it can be worse as it is hard to see the full extent of it on an x ray.

He said it would be a 3-4 hour surgery on average. Any advice I will take.

Dear Gavvy, 

Just curious, have you gotten another opinion?  But the it sounds, you might really need surgery.

Millie

Hi Gavvy in the UK you would be strongly advised to stop smoking as this seriously compromises healing. My operation thr was cancelled last September due to being diagnosed with Type 2 diabetes just the day before op and again for the reason of compromising healing. My op took place 4 weeks ago having completely overhauled my diet and in the process lost 3 stone in weight and am no longer diabetic. I think being as healthy as you can be going into surgery will definitely benefit you afterwards. Good luck

Can you tell me more about the type of hip he wants to use. I had 2 surgeons recommend different types of hip for me, so as I will need a replacement in the next 2 years I really want to get my information.

And yes, I agree with other comments, be healthy and try and give up smoking.

Yes, had 2  surgeons say I have hips with square joints trying to go into round holes and two doctors underplaying it all because of my young age.

I have cut back to 5 to 10 smokes a day for some time now but am unlikely to stop...but yes I am pretty healthy otherwise.

no knowledge of type but it has a titanium cup and non cement implant into the femur.

Strengthen your leg muscles if you can stop smoking and the pain after is nothing like your feeling now I was pain free immediately after op some muscle pain but nothing like before look forward to a new chapter in your life all the best for a speedy recovery 

Thankyou  Jean.     Will do for sure.   

I didn’t anything special before my surgery but I was swimming everyday though.  Except for some tingling and numbness my overall health is post op.  I’ve read that smoking is really not good and it will probably get in the way in your healing post op too.  Mine is ceramic top but I have no idea if the other parts.  Good luck , Gavvy !

Hi 

I too am 53. 

A Female who had  quickly advancing arthritis. Started with a hard impact injury in a race 2 years ago.  

Continually worsening. First CT scan dec 2016 said mild arthritis and surgeon was not sure why I was suffering so.  Started injections to relieve pain, first injection worked, 2nd and 3rd no relief.  MRI August 2017 showed  advanced arthritis.  Bone on bone and deteriorating quickly and they rushed for surgery.  Surgery March 15 2018

Was healthy active before injury.  

Worked through pain in general for all things 

I Continued race injuries.  Continued yoga and walking etc a few months till I needed a cane and eventually Tylenol 3 with coedine wasn’t helping me anymore  and switched to morphine and sleeping aides to function at anything in life , and trying to continue working. Lucky I  do lots of computer and driving not physical work as what I did was hard.  

Was getting weaker in my muscles.  Very discouraged as swimming biking I couldn’t do either.  Everyone said get fit stay fit etc.  

I did eat healthy kept weight down and went into surgery with aid of 2 nurses in awful pain.

Woke up numb and nervous but within hours I was up standing and d24 hours later walking around hospital ward with walker. Day 3 Home with crutches.

Bone in bone pain gone.

Swelling and sore from what is done but so much better right away.  

Recover is different for everyone but mine was ups and downs.  Ups you need to be careful you do t do more then you should. Downs don’t  be hard on yourself and let your body heal.  Do the exercises and rest.  I am 3 months post op and doing amazing, etc for sleep is still hard no other limitations in hip.  Planing on hiking to the top of some of our mountain trails this summer.  

Good luck. 

Best advice I can give is to quit smoking. Sounds like you need the surgery now and not later 

Gavvy,

everyone is going to tell you to quit smoking but of course easier said than done.   However, it is recommended that you cut down a week before and two weeks after the surgery because it impacts the healing and you may end up with a loose prosthesis.  Also, you will be in the hospital overnight at least one day so plan on how you are going to handle not smoking during that time.  Bring an Ecig or have them put a patch on you etc.

Arthritis is the biggest indication for hip replacements.  Its easy to see the joint space narrowing on xray,  However, it sounds like you had an arthrogram also which shows the labral tear.  What is more difficult to spot are bone spurs which are often culprits for a lot of pain, sciatica etc.  You simply won't have this issue anymore with the joint replacement.  3-4 hours for the surgery sounds like a long period of time.  They usually take about an hour and a half but maybe they were including your preOp and recovery room time.  They usually do a spinal with it and you will probably have a urinary drainage tube for several hours post op.  No big deal.  They will do the spinal after your anesthitized.   

There are two major approaches.  The anterior and posterio/lateral.  Most people have the anterior approach but I opted for the posterio/lateral approach because the prior femorplasty for a labral tear had reshaped my femur and I was concerned about the risk of femur fracture.  Anterior oftencomes with thigh numbness post op and possible femur fracture.  Posterio/lateral has to go through (separate) the gluteaus maximus and requires additional post op hip recautions to prevent disloaction.  Both can have length disparities but it is what it is.  Thats why getting someone with good experience can make a difference. 

There was one doctor I consulted with who uses a 3D scanner to get the prosthesis to be an exact fit.  Unfortunately I did not use him and the length of mine are uneven and I'm having bursitis as a result.  So my pain has not resolved as of yet and I am 10 weeks post op.

3 major companies make the prosthesis, smith and nephew, de puy and another.  There are modular and fixed.  Most people get the modular with nonmetal material in the cup (can't remember the name of the material) Its a hard composit.  When they were using metal on metal, bits of metal were shearing off with usage and people were getting metalosis and rejection.  However, that is resolved with the composit on metal.

They tell you you are going to walk out of the hospital.  Your walking for the first few weeks will be to the bathroom and back and thats pretty much it.  I had help come in for 5 days a week for the first 4 weeks for 4 hours a day. It was a god send and worth every penny (15/hour).  One thing that was great is that she changed my sheets every day.  I was spending a lot of time in bed initially, so it made me feel much better.  But meals, laundry etc all add up and it will do a world of good for your spirits to have the help and it will help you stay healthy.  

In addition, I got all my supplies, everything I needed post op from our local church.  They had it all, they let me use it for free and I've since returned them.  Shower chair, toilet riser, shoe horn, wheelchair, walker, cain, and more.

Hope this sheds a little light on what to expect.       

Thanks....great help ...very much appreciated and noted.  Hope the issues you have are sorted asap.

Sounds like I have some hope...looking so forward to being out of this relentless burning pain running down the back of my thighs causing me so much grief.