THR I need a new hip GRRR

[Campervan]

Well, I'm back. I knew I would be one day. I had RTKR 2011 and LTKR 2015. My right hip started playing up in 2014 after I fell off an office chair, but since then has been great. About 6 weeks ago I started with pain in my buttock, groin, outside of hip, down my thigh and around my knee. XRay has shown various issues, with basically moderate osterarthrosis. Its going downhill so fast that I can't survive the day without pain in every step I take unless I've taken diclofenac 75SR. Keeps me awake at night.

My physio and my GP both say its time to get it replaced. I'm ok with that but wondering which surgeon to use. My knee surgeon, who is absolutely marvellous in my opinion is around 3.5 hours drive away and like me is advancing in years being mid 60's. He is so meticulous. There's a surgeon recommended to me by my physio that is only 1.25 hours away and is in his late 40's I think.

Do I go to the tried and proven surgeon or risk the younger guy?

 

[djklaugh]

@Campervan Welcome back to BoneSmart! I'm sorry to hear you are having so much pain! But it does sound like getting a new hip is the thing to do. As for surgeons .... check out the closer younger guy and see if he does lots of hip replacements. I hear you like your knee guy but if he is not doing lots of hips then IMO it would be better to find some one who does do lots of hips. The techniques and skills needed for knees are not the same as the ones needed for hips.

Here's our hip pre op list of articles and suggestions:


Hip: pre-surgery considerations

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:

Score Chart: How bad is my arthritic hip?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?
If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:

Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?
And if you want to picture what your life might be like with a replaced hip, take a look at the posts and threads in stories of amazing hip recoveries

 

[Jaycey]

@Campervan Welcome back to BoneSmart! So sorry it's due to more joint replacement!

Do I go to the tried and proven surgeon or risk the younger guy?

The younger guy isn't necessarily a risk - just an unknown. Have you asked how many THRs he does per year?

And your knee surgeon is probably focusing on training his replacement. Frankly age should not be a factor at all.

For me the surgeon choice was all about gut feeling. Can you work with the surgeon and is there trust.

 

[Campervan]

Thanks Deb for the links and great guidance. My guy does a lot of hips, knees and shoulders. He's a hip revision specialist and one of the major shoulder surgeons in New Zealand. The closer younger guy also sounds good but I guess I'm hesitating because I don't know him and don't know anybody who's used him.

 

[Campervan]

And your knee surgeon is probably focusing on training his replacement

I spoke to his Secretary today and he's not retiring anytime in the near future. That was my concern. I most definitely can work with my knee surgeon and have absolute confidence 100% in his ability. He has a very individual caring relationship with his patients. The closer guy is part of a bigger centre with about 10 surgeons and I've been there for an issue with my foot and it does feel quite impersonal, but I'm trying not to let that influence me.

 

[Jaycey]

I've been there for an issue with my foot and it does feel quite impersonal, but I'm trying not to let that influence me.

I would be influenced by this. If you have a good relationship with your knee surgeon I would tend to stick with him. Yes, it's a longer drive. But you already have a relationship and confidence in him.

 

[Campervan]

I have an appointment this coming Wednesday with the closer surgeon. I found out he has an excellent reputation. He mainly uses the anterior approach which I'm happy about. But I have read somewhere that the knee gets put under a lot of pressure. So I'm concerned about how my TKR will cope. Any advice gratefully received always.

 

[Jaycey]

Well done for finding another surgeon. Fingers crossed you get good vibes at the appointment.

But I have read somewhere that the knee gets put under a lot of pressure. So I'm concerned about how my TKR will cope.

Yes, the op leg is grabbed aggressively to dislocate the hip joint. Discuss this with your surgeon. Many of our members have had both TKR and THR and I can't remember anyone reporting a problem post op.

 

[Campervan]

I had my appointment today with younger surgeon closer to home and felt very comfortable with him. He explained everything really well, answered all my questions patiently and I didn't feel he was rushing me to get onto the next patient. And yep I definitely need one. He will use Direct Anterior approach with fluroscopic xrays during surgery. He plans my surgery/implants using computer software. I have to have a marker xray before my surgery.

Hopefully it'll be done in the middle of May. There's one hurdle to go through first regarding who's paying. He has to apply for me to ACC (Accident Compensation Corp - cover for accidents in New Zealand), wait for them to approve or decine and if decline then my health insurance will pay for me to have it done. Either way, it'll be done in the next few months.

 

[Jaycey]

@Campervan Great news on finding your surgeon. That's a major milestone. Hope the wait isn't too long!

 

[Campervan]

As expected the NZ ACC (insurance cover for accidents) declined my surgery. So now I'm waiting for the pre approval from my personal health insurance. Surgery is scheduled for 13 May but I've declined further in the last few days - I seem to get a flare up for a few hours, recover somewhat but never get back to where I was. I saw my physio today and advice is to get it done asap so I've messaged the surgeon's office to see if there's an earlier date. Today I've bought a walking stick to see if that helps when I get flare ups.

 

[Jaycey]

Today I've bought a walking stick to see if that helps when I get flare ups.

Use the stick as much as possible. This will help keep the weight off that sore hip. Fingers crossed you can get a surgery date soon!

 

[benne68]

Surgery is scheduled for 13 May but... I've messaged the surgeon's office to see if there's an earlier date.

I've added this date to your signature. Please do let us know if you get that earlier date so we can revised it.

 

[Campervan]

My hubbie has hit the nail on its head - he said every time I flare up its after I've been water walking/water cycling in the sea. And he's right, it is. I was told getting in the water would be really helpful. And the physio said to get into the sea as its all around, very calm bays not big waves. When I use my exercycle it doesn't cause a flare up.

 

[Jaycey]

Any activity in water can easily lead to over activity. You are weightless in water so movement seems easier. Do half of what you think you can do. Easy does it for now. Baby that sore hip.

 

[Campervan]

Not looking good for earlier surgery date. So 13th May it is. I note date added to my signature and May Marvels says 14th May, but its Mon 13 May.

I'm OK waiting till then as I'm much improved since I haven't been in the sea again.

 

[Jaycey]

@Campervan Surgery dates fixed for you! Sorry your wait is so long!

 

[Campervan]

Is it more likely that I could need a blood transfusion during hip replacement than it was for knee replacements?

 

[benne68]

Not sure if my experience is the norm, but I lost very little blood and didn't require transfusion during either my hip or 2 knee surgeries, @Campervan.

 

[Campervan]

Well, I wasn't sure whether to post this in hips or knees. As above my hip replacement is 13 May. Just over a week ago physio added an exercise to strengthen my hamstrings using a resistance band tied to a chair, sit on chair with band around ankle and raise to straighten leg. Then sit on another chair opposite the one with the band and again band around ankle and pull it back towards me.

All good until last night when my knees feel like they've got the tight rubber bands them that we get post TKR. Not good. Right knee I think could the referred pain from my hip. I'm using my crutches to get around the house because if I don't the pain is so bad I stoop forward when walking.

I've also lost ROM in both knees and they look swollen although not massively. They're definitely weak as I struggle to get up off chair and toilet. Also can't put my feet on breakfast bar stool footrest but I usually can.

So I stop the new exercises and see how it settles. Any other advice?