Rehab from Hip Replacement

[Hot Holster]

TGN, I just had a knee replaced and the day following surgery they had everyone who had a knee replaced or a hip replaced (12 of us) out of bed for a short walk, and then we had an in the hospital 1 hour PT session twice a day for three days, before they released us.

The lady who lives across the street from me had her hip done about the same time I had my knee done and her doctor is sending her to outpatient therapy. When your doctor comes in to see you, ask about therapy.

Good luck with recovery, I hope everything turns out good for you.

[PD Sgt.]

I had one of my hips replaced about two years ago. First, make sure you follow the post op protocols regarding limited ROM while moving around the first couple weeks, particularly while you still are taking blood thinners and your leg is swollen. This can be tough, especially in younger patients who are in good shape and active as it sounds like you are. Once the swelling went down, I could not believe how much better I felt so quickly. In days the distances I was able to walk increased dramatically. Listen to your body.

My doc gave me the option of doing my own rehab or structured, and I elected to do my own, knowing I could always go to PT if my results were not up to par. I was on a low to no impact restriction for six months due to the procedure I had done (Birmingham hip). I worked primarily on core and hip flexor strength in that time. I was in pretty good shape going in, so I pretty much did maintenance work for the other parts of my body in a manner that did not put strain on the hip. At six months I was able to resume running and more aggressive training. I still avoid putting undue load bearing on the hip, such as shrugs for example, and I only squat body weight for the most part. I use lighter kettlebells (<45 lb) for total body work and do more plyo. The one area I wish I had been more aggressive with is flexibility. I am catching up now, but I was lousy at stretching before, and this carried through after surgery.

To those who are not sure if they have a condition requiring replacement, see your doctor and find out. I put up with a lot of pain thinking I had IT band problems (which I did have as well). Once I did find out I was bone on bone arthritic, I delayed for years due to my age (40). Only you can decide when the time is right for the procedure, but I will say I felt better the day after my surgery than I did the day before. You do not realize how limiting the pain is on the rest of your life until it is gone. Also, research all your options ahead of time. My hip allows for a much greater degree of activity than most traditional replacements. My first ortho did not even mention this procedure to me. Weeks before my surgery I found this new procedure and a whole new ortho, made an appointment and cancelled the surgery. I would have been very upset to have found out after the surgery that there was a procedure available that would allow me to be more active.

[TexasGunNut]

PD Sgt.

Thanks. Two days post op and I can already tell that I'm going to have to watch my ROM closely. I feel so much better that I'm know I'm going to push the limits of what I'm supposed to do. I waited too long to have this done. I have a high pain tolerance and because of my age I ignored the signs until the Birmingham was not an option for me.
That's another reason I wanted to post on M4C. Hopefully some other hard head will read this and realize that pain is your bodies way of signaling to you that something is wrong. If your hip hurts I don't care if you're 40 or 30, find out what is wrong before your options get narrowed.
For us guys that played too many years of football or jumped out of perfectly good airplanes it's even more important to monitor our health.

[will_be]

I'll echo what a few others have said... Follow the hip precautions as laid out by your therapist. The joint capsule is disrupted by the surgery & not as stable as it was before & it will be some time before it regains that stability. It would not be good if that thing disclocates! Otherwise walking is probably the best thing you can do in the next couple of weeks. Outpatient therapy would probably be good at least at first to help guide you on your long term recovery. It's great that you're doing so well this soon after surgery. I worked on an ortho unit for seven years & some people struggled with hip replacement & others seemed to breeze through. Take care of that thing & it should last a long time.

[Abraham]

TexasGunNut,

Thank you for your response.

I hope you're getting all the PT you need and more importantly the specific PT you need.

What's a Birmingham hip as opposed to a ...?

Thanks!

[TexasGunNut]

TexasGunNut,

Thank you for your response.

I hope you're getting all the PT you need and more importantly the specific PT you need.

What's a Birmingham hip as opposed to a ...?

Thanks!

Abraham,

In a nutshell a Birmingham is a resurface as opposed to a full hip joint replacement. Depending on your age and the type of damage a resurface my be a more viable option. If I live long enough, which I plan on, I will probably have to get my replacement replaced. A resurfacing saves a lot more of your original bone and buys you more time until you have to get a new joint. I've grossly simplified the explanations and pros/cons but the bottom line is if you're having joint pain do your research, get second and third opinions.
Also, if you're in pain get it looked into. Don't keep swallowing Advill and playing iron man. Keep after it until you at least get an MRI to get a definite picture of what's happening.

[PD Sgt.]

While the Birmingham Hip is a resurfacing of sorts, unfortunately it is just as invasive as a traditional hip replacement. A simplified explanation is instead of cutting off the entire femoral neck and placing a spike or rod in the marrow channel with a ball on top (this is very simplified) as the ball of the joint, they chamfer away the arthritic bone from the femoral neck to make a cylinder shape. Over this they place a metal cap that looks a little like a mushroom. This now is the top of your femur, and is matched with a cup in the pelvis, pretty much the same as a traditional hip replacement.

The advantages are greater stability due to the larger diameter, less chance of leg length discrepancy, and the patient keeps their natural geometry. The hip is all metal, which can be an issue for some, but the durability is generally greater overall than some of the other materials used. These reasons are why you can generally be more active than with a normal hip replacement.

The downsides are it requires exact placement to avoid complications like stress risers in the bone if the chamfering is off. It is generally desirable to have a surgeon who is experienced with the procedure. People with cysts in the bone, or small bone structure are also not good candidates. There is a chance of femoral neck fracture in the first three to six months, which is why most orthos limit activity during that time. Also, the procedure has only been around since the early to mid nineties, so there is not as much long term data available. To date however, at similar time points the Birmingham has the same or slightly lower revision rate as a traditional replacement.

If a Birmingham needs to be replaced, it then requires a traditional hip replacement. One of the things that makes the Birmingham attractive to younger patients is it is then like your first hip replacement in regards to the amount of trauma to the femur.

[Inkslinger]

PD Sgt.
You mentioned IT band pain. Did that subside after the surgery? I recently got checked out for pretty bad pain in my knees that I've been dealing with for years. After x-raying my knees and hips the ortho told me that I had arthritis in my hips and would eventually need one, if not both replaced. He told me that's what was causing my knee pain via the IT band. I thought it strange because my hips bothered me sometimes, but nothing like my knees. I'm just trying to get an idea about what the future will be like. I'm 39 and didn't think I would be thinking about arthritis and hip replacements yet.

[PD Sgt.]

PD Sgt.
You mentioned IT band pain. Did that subside after the surgery? I recently got checked out for pretty bad pain in my knees that I've been dealing with for years. After x-raying my knees and hips the ortho told me that I had arthritis in my hips and would eventually need one, if not both replaced. He told me that's what was causing my knee pain via the IT band. I thought it strange because my hips bothered me sometimes, but nothing like my knees. I'm just trying to get an idea about what the future will be like. I'm 39 and didn't think I would be thinking about arthritis and hip replacements yet.

I don't want to take the OP's thread too far off topic, but I waited years after diagnosis for the surgery, and by then I was not able to run and my IT pain had disappeared.

I will say that post op I became much more aware of overtraining, and consciously made an effort to avoid my earlier mistakes to avoid damaging the work I had done. Take it slow and listen to your body.

[TexasGunNut]

PD Sgt.
You mentioned IT band pain. Did that subside after the surgery? I recently got checked out for pretty bad pain in my knees that I've been dealing with for years. After x-raying my knees and hips the ortho told me that I had arthritis in my hips and would eventually need one, if not both replaced. He told me that's what was causing my knee pain via the IT band. I thought it strange because my hips bothered me sometimes, but nothing like my knees. I'm just trying to get an idea about what the future will be like. I'm 39 and didn't think I would be thinking about arthritis and hip replacements yet.

If my situation relates, my hip pain translated into my knees. I've had knee pain for years that I never got checked and my Doc seems to think it was hip related. I'll let you know in a few weeks or a month if getting this hip fixed cures my knee pain.