Was kann ich nach der rechten THR-Operation erwarten?

I’m originally from England, living in the Netherlands. I have OA and FM throughout. I also have OCD and a myriad of anxieties. I recently had a pelvic X-ray and MRI to determine progress of OA after 15 months of limited mobility, only to be told I need a right THR . It came out of the blue and I’ve been prioritised for surgery because it’s bone on bone and my leg keeps collapsing under me. I know what to expect surgically, but have no idea what I’ll be dealing with post-op…
All my docs and specialists are Dutch, with varying English language skills and I’ve been made aware of what will happen pre-op and during the surgery and been told I will be home the same day which seems crazy fast to me, after a major surgical procedure. I’ve scoured Google looking for more information but it all seems to be horror stories of pre-op deep tissue infections, which my OCD brain does not need to be over-thinking.

Q1. Coming home the same day would mean I would be able to walk again pretty much straight after the op.? I don’t understand how that can be. Has anyone else been on their feet again the same day.?

Q2. How much pain is there post-op.? I’m not good with pain, but I can endure it if I have to. I usually use 800mg Ibuprofen, but it seems like I’ll need something stronger, will I.?

Q3. The hospital gave me crutches to use, but I have OA and FM in my hands and arm joints, so I can’t use them. How easy is it to move about at home without aids post-op.? Or am I having a laugh at thinking I’ll cope with the stairs and using the bathroom alone.?

Lexi

Hip surgeons have classes before surgery to help hip patients prepare before surgery. there are some helpful pamphlets right here on patient that can help you adjust , just search.
i have had 3 replacement surgeries.and there are some things that can help you once you return home.
height of chairs, beds all need height adjusting important and toilet seat risers available. walkers, sock helpers all available in a hip kit available on Amazon. i highly recommend reachers. all drug stores have them.
read up on what type of hip your surgeon may use and or approach . also youtube has many doctors online that have all pre and post surgery information you may need from surgery centers.
the best thing that helped me were clothing that went over my head and slip on shoes. the first few weeks its difficult to lift leg and bending for dressing .
keep all things you need up on counters and easy to reach places. no throw rugs and pets that could trip you. safety concerns are necessary preventing tripping.
if your home with help that is a plus. if not you may need to go into rehab. there are many options available for care post surgery depending on patients needs.
pain medication will help you walk and do minor exercises when you return home. the doctor and nurses will assist you in the hospital before you leave to teach you how to use a walker , go up and down steps and getting in and out of a car. some restrictions may be applied depending on the type of approach the surgeon chooses. it will all be in a booklet for you when returning home.
any other questions will be happy to help.

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I had my THR as outpatient. They held an educational class prior to my surgery where the nurse and physical therapist went over everything. They showed us what exercises we need to be doing prior to surgery to get ready. We had to take a prenatal vitamin every day up until surgery. The following is what I bought/borrowed or prepared for :
Toilet seat Riser, walker, cane, Reacher grabber tool, Sock Aid, Flushable wipes and i had to adjust my bed height. When i got home that day the ohysical therapist came to my house and worked with me right then. I had to take ibuprofin and tylenol for 2 weeks straight no matter if there was pain or not. This helped with inflammation. I used a prescription pain pill too but only for a few days. I used my walker for the first 2 weeks and then went to a cane. The faster you get up and walk and do your exercises the better. I thought I would need help going to the bathroom but the toilet seat riser and using flushable wipes really helped. Sorry to be a little graphic but I would stand up after using the bathroom and used the flushable wipes which made it so much easier

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NO, you shouldn’t go home the next day, even with someone to help you. I’m 76 years old, very active and 3 months post-op from right THR due to advanced OA. It took me 4 days in the hospital and 10 days in rehab before I could even consider going home. The pain can be moderated with pain meds stronger than 800 mg Motrin. I was on IV morphine while in the hospital and the pain was tolerable. In rehab, I was on oral hydro-codeine. I was standing the evening of surgery (barely and with help). PT helped.

You will definitely need: walker, hi-rise toilet seat, grabber, sock assist tool all of which are available on Amazon. Slip-on shoes are a must. If you’re a side sleeper, you’ll need to put a pillow between your legs, but you’ll be sleeping on your back for a few weeks. Sleeping on your back is mandatory to make sure your new hip join stays in the right position. When I woke up after surgery I had a hip abduction wedge fastened to my legs. For the first few weeks, never get up from your bed or chair unless you have someone with you.

I am still stiff in my surgical area and somewhat swollen. Once your incision has healed, be sure to massage the area to prevent adhesions. My right leg is now 3/4" longer than the non-surgical left leg. Doctors and googled health care folks all say this is normal and I will “even out”. Baloney! I’m going to need a wedge in my left shoe. As a result of being “uneven” my back and knees hurt. I’m getting treatment by my pain doctor later this month.

Lastly and most important - Listen to your body.

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High there,

here in ENGLAND you would not be allowed home to be on your own after hip surgery .
and if you have stairs to climb you will need strong bannister support and possibly an aid such as a crutch.
If you are having minimal anterior surgery it may be easier , but if having posterior incision which is a much larger incision you will find it difficult as that involves cutting through muscle.
From your comments ( just checked) , you likely having minimal anterior , and you will be able to be discharged same day or next day as long as your stats are alright and no problems .
I was amazed how well i was following anterior hybrid hip surgery . i had spinal injection, no sedative and was wide awake during surgery and suffered non of the usual problems with anaesthetic . BE warned though, spinal anaesthetic does deaden you from waist down so its very normal you may lose bladder control for about 12 hours! … The nurses are well aware of this and were very understanding in my case.
AFTER 2-3 weeks i was walking around the house unaided and no pain, I was very pleased with the progress. Do be careful of sitting for long periods though , that can cause problems .
Just take it steady and do the basic exercises prescribed. And don’t run before you can walk.
However at five weeks the NHS PHYSIO had me doing resistance band exercises, now these were just too much for me and consequently have suffered much pain ever since.

I am now 5 months post surgery and am in so much pain still from my back , hip , knee and ankle , all brought on by the physio. I also have deep seated scar tissue formed and painful swelling around the top of my leg , and sitting is very painful as a result.
I am currently trying to get an mri scan to see if there is a problem that couldnt be identified by the x-ray or ultrasound. And hoping i can at least have a cortisone injection in spine to alleviate some of the pain im in.
I do hope my comments are of some help to you, i welcome any comments or questions regarding how well or not any one is doing after hip surgery. its good to know one is not alone .
Love and best wishes
Vanna.

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Hi Vanna
The scar tissue are adhesions. Nobody told me what to do to prevent this until a month after my surgery. The incision with adhesions was very painful, swollen and hard. A physical therapist told me to massage it several times a day (as firmly as possible). It worked!! I am still a bit swollen but no hard lump and no pain. I used massage oil and vitamin E oil which made the rubbing a lot easier and less painful. I am 3 months post-op and still a bit stiff. I’m going to a pain management doctor to help with back issues resulting from the THR.

THANKS JODI
Ive read about the massaging , i will give it a go. its amazing my surgeon has seen me three times over last few months and never suggested this !
My scar tissue is lower down than the anterior incision , figure that out,!
IM sill blaming the physio as it was only after the resistance bands i had problems . Did you have minimal anterior incision or posterior incision ?
My operated top of leg is two inches larger in circumference than my other leg, im surprised its not more as it looks so swollen in comparison to the other thigh.
im hoping for my surgeon to refer me for cortisone injection for my back issue too. as it would be much quicker than going through pain management . Has your GP organised pain management or your surgeon ? Going through your GP will take much longer to get any treatment . When i had my first hip done two years ago, the surgeon referred me for cortisone injection in Si joint for similar pain and it really helped the pain on the outside of leg and hip , i had posterior incision and it left my IT band tight and painful , i only waited about a month if that to get the appointment for CT guided cortisone injection . Ever thing is such a learning curve isn’t it?
im sorry you have ended up with the odd leg length, there was a discrepancy with my first hip done, and now it is better having had this last surgery as he has evened it up a little better but i think there is still a slight difference , but is better. I have never got a straight answer as to how they go about getting the leg length right , if there isn’t an exact science to it why dont they admit it and if there is why does it happen ?
It would be good to hear of your progress going forward Jodi dear , so hopeyou will post again here , all the best to any way .

Wow, no sedative? You are brave! I was told I’m having lateral hip replacement, so is that different from anterior or posterior? When were you able to shower?

Mostly I agree with what has been said. Maybe things depend a bit on your age. And your surgeon (and probably their age too!).

My THR was done here in England three years ago, when I was 74. I had four days in hospital, and couldn’t possibly have managed completely on my own for several days afterwards. (Dealing with the compression stockings etc - physically impossible.) I did walk, using a frame, the same day, in hospital - the physios insisted on that. My husband went back to work after a fortnight; I was fine by then and started walking round the block on my own on the first day he was not around (using 2 crutches).

My son had his THR in December, just before Christmas. He’s 47. He had had a serious cycling accident and shattered his pelvis a couple of years earlier. I think his operation was probably more complicated than mine (he’s also type 1 diabetic), but of course he’s younger. He was sent home by taxi the next day. He had no stockings, just tablets. He was totally on his own. In England. Covid rules didn’t allow visitors, and he didn’t want any Covid risks anyway. He also had to remove his own shower-proof dressing after a fortnight (which I thought was a big ask by the NHS). He’s using one crutch now (which I was told never, ever to do!).

No doubt that both of our surgeons are/were excellent. So:

Q1 Yes - with frame or crutch(es).
Q2 Yes - something stronger definitely needed, and for longer than we’d have liked (both me and my son). Both of us for 6-8 weeks in total. We were both told not to let the pain overwhelm us.
Q3 You can manage indoors very soon without crutches, grabbing onto furniture etc - but not stairs. Loo seat needs fitting beforehand - then that should be fine. Similarly shower. You will need to be taught how to do stairs. I only have two steps, and could actually avoid them completely (although the physios insisted I leant how to use them, in case). My son keeps one crutch at the top and one at the bottom of his stairs. Initially he lived upstairs and just went down a couple of times a day.

Perhaps one of your sides is better than the other for you to use a crutch just briefly?

Get a chair with a slightly higher seat than you normally use, with arms so that you can easily push yourself up out of it. I was measured for seat height as part of the pre-op check. I thought the chair was a luxury beforehand, but it was a godsend.

I made an excellent recovery, and my son is doing really well at the 2.5 month stage.

HTH

Joan

i just posted an outline of how my days have looked for the past week post op. im young and very healthy / in good shape but its still difficult and i require assistance. Everyone is different. My walker has been incredibly helpful for recovery.

Hi Vanna,

Sorry it took me so long to answer. I had posterior THR on my right hip and am experiencing quite a few of your symptoms. My right leg is about 1/2" longer than my left. My right thigh is a lot larger than my left. I had spinal facet ablation about two weeks ago but it didn’t seem to help with back pain resulting from being “off balance”. Dr told me not to get a shoe lift because my leg length would even out eventually. In the meantime, my back and knees are quite painful. My IT also made it painful to put weight on my left (good) leg. Going to see the pain management doctor next week. I contacted the pain management doctor directly. As you said, going through my GP would take forever. As far as getting straight answers, I found I have to be very direct and a bit forceful when dealing with doctors. Otherwise, they lump me in with “standard” patient problems and use the “standard procedure” rules rather than see me as an individual and possibly researching other healing methods. Generally, I feel that most health care providers follow a certain protocol and never consider outside the box. As I get older, the problem seems to worsen. OR, perhaps I’m just turning into a grumpy old woman

Hi Vanna - I haven’t been back on this site for a while, so sorry it’s taken this long to answer you. I am now 7 months post-op and my recovery was fairly normal. However, I am now experiencing hip pain again. It’s uncomfortable to sleep on that side. I had facet nerve ablation on my lower back about 2 weeks ago and now experiencing more pain than ever. I’m going back to my chiropractor as that seems to be the only relief I’ve experienced. My surgeon finally gave me an RX for a shoe lift. So, the THR was successful in many ways but has presented a whole new set of problems. I had posterior THR due to my weight. Even though I lost 40 lbs, my surgeon wouldn’t do the anterior approach. I’m still on the weight-loss regimen and, hopefully, I would be able to get an anterior THR whenever that’s required (which the surgeon said to expect). Trying to remain positive, stay active and eat healthy. I’m 76 years old, 5’4" and now weigh 239 lbs.

Update: It has been a while. Life has not been easy and there were a lot of post-op issues to deal with, while also coping with my left hip mirroring my right in terms of pain and immobility. I had thought once the TRHR was done, I would become more mobile. Sadly not.
I had the TRHR on 25/08/22, was up and out of bed as soon as I woke up after the op, walking down the ward corridor with a walker and up and down stairs with the aid of a crutch within an hour. Those first few steps hurt like a [disallowed expletive], but once I got going it was bearable. The x-ray afterwards was something else. I was taken down to x-ray in a wheelchair. Once in the x-ray suite, I was expected to get out of the chair, climb on the rock hard table and lie down on my right side, onto the fresh wound that had only just been stitched so they could x-ray me. Whoever thought that was a good idea needs to be smashed ‘a la Loki’ by the Hulk. There is absolutely no need to have that done lying down, it’s pure torture.! No instructions on how to get in/out of a car, so I figured that out ‘on the job’ when we left the hospital the same afternoon. That first night at home was a nightmare.! Everything was raised for me, which was great but they don’t prepare you for your body refusing to do a single thing you want it to. Don’t even think about trying to manoeuvre once you are in bed, which you will need a lot of help with. First you’ll need help to sit on the bed, then you’ll need support to shuffle back as gently as possible until you’re in a position to try to lie down, which you will also need help with. Once prone on the bed you will not be able to move. Your body will be in a state of shock that lasts for weeks so it will do nothing to help you find comfort. Pillow between the knees, so fricking uncomfortable. Pillow under the head, makes you feel like your neck is extended in a weird position, giving you a triple chin and gives you a headache. Every movement you do try makes you see stars and lying prone on your back hurts your hips, back, shoulders, neck etc, etc. Those first few days are awkward and deeply frustrating, for me because I am not good at being an invalid and not doing things for myself. I never sleep on my back and have never used a pillow anywhere but under my head, even when pregnant all those years ago. I didn’t sleep more than a couple of hours at night, mostly through exhaustion because of how deeply uncomfortable I was. I had muscle spasms and pins and needles down my right leg all night and then ‘dancing legs’ in my left because I was so tired. They don’t tell you this can happen. This is not for the faint-hearted. That first week I had three physio sessions of 15 minutes. Just a slow walk with the walker down to the front door and back and a few gentle leg stretches and foot wiggles. A week after my first surgery, my hip dislocated twice in the same afternoon while I was sitting down, the first time at home while eating lunch, the second in the Emergency room sat on the bed waiting to go home. I would rather have my fingernails pulled out than go through that again. My hip made a dull popping sound before pain exploded in my knee and my whole leg twisted to the right. I couldn’t put any pressure on it and once it had twisted, it would not go back straight again. My partner called the emergency doctor, who gave me a shot of morphine, which did nothing so she called for an ambulance. Over an hour later she gave me another shot of morphine, again it did nothing. Another half hour later the ambulance finally arrived and they shot me up with ketamine. I admit that I spent those two hours crying, howling and whimpering in agony. In the hospital they reset my hip, x-rayed it and took me back to the ER. Vitals checked, doctor signed me off and just as I was about to get down off the ER bed, it dislocated again. Thankfully they didn’t leave me too long but I still howled and yelled for a good twenty minutes in the ER before they knocked me out again and admitted me. I spent three days lying in a hospital bed with my legs hip width apart, having been told ‘do not move’ and had my second TRHR op on day four. Yeah, not fun. I have big bones apparently (thanks Dad) so the cup was not big enough and the ball was too big. So they re-did the cup. Two more days in hospital to make sure I could poop again before being set free to go home. In early September the nights are still hot, the mosquitoes still persistent and I could not move by myself. How I HATE summer. My right leg was now 4mm longer than my left, which was supposed to even out, but didn’t. The back pain was excruciating, especially at night.! After two weeks I just couldn’t bear it anymore and forced myself over onto my right side, enduring the pain of putting my weight on my hip, just for a few minutes. Yes, it hurt but it was a relief to take the pressure off my back. I might not have to deal with sciatica any more but chronic back pain is a thing. As is knee pain. Physio helps but it doesn’t cure.
Almost three years on and my mobility has not improved. My back hurts, my knee hurts, my scar itches like crazy especially in the heat, I can’t feel very much below the scar which is on the side of my leg and I still get muscle spasms in the early morning hours. I limp after 30 yards and stagger like a drunk after 100 because my legs are uneven and the pain is ridiculous. On top of all that, my left hip has been misbehaving for the past two years and my orthopaedic surgeon has refused to do anything about it because I’m too young, too heavy or just female, I forget which BS excuse is his current go to, BUT last month I saw a new surgeon. I guess the old one is sick of seeing my name on his patient list so palmed me off onto someone else, who looked over my newest x-ray, took into account my lack of mobility, poor quality of life and intense frustration at not being able to do something as simple as walk, while being fobbed off over and over again with rubbish excuses and agreed to do the surgery promising to take into account my uneven leg length. Hallelujah.!! I go through the usual pre-op checks in two weeks time and will be given a date by mail on the 28th of this month. We’ve agreed that the scar will be on the front of my hip this time to try to alleviate the muscle issues I had last time.