New Hip.

[priapism]

Just checking in. Here is where I am at: R hip done in mid June, L hip done in early August, roughly 6 weeks apart. Before the first hip, I was not sure if I was making the right call with the R side, because L side was causing pain while sitting and standing, while R was giving me functional limitations (reduce RoM, could not go up stairs/bend easily etc). But went through with it anyway

Post-op R hip was very painful the first 1-2 weeks, gradually reduced after week 2 (just sore and achy). Surprisingly the L side got less painful, probably from a combination of pain meds and reduced load bearing. At the 6 week mark, it felt premature to get the L side done but L side pain was coming back and the next open slot was in another 6 weeks so I just went for it. I must have had a different anesthesia on the 2nd hip because the pain kicked in sooner after surgery, but similarly it was bad the first 2 weeks, with aches and soreness now at weeks 3-4

Turns out L hip was way stronger than the R hip, so I already have faster progress on the 2nd hip relative to the 1st. Gains were very quick in the first 1-3 weeks, timescale now is slower so gains are weekly instead of daily. I am now 10 weeks from the 1st and 4 weeks from the 2nd. Looking forward to a ski season this winter

So far I do not feel I am missing out on anything by opting for THR instead of Birmingham. I feel I am benefiting more from the peace of mind (lower risk) and quicker recovery. But have not pushed intensely yet, mainly PT and the stationary bike

[Full Trucker]

Nice, man. Stoked for you.

Follow-up on some of my stuff:

First of all, the new hip is killing it. It's been 17 weeks, I'm at "full recovery," and life is getting back to normal. I can bring my knee all the way to my chest now where I couldn't before, I can touch my toes easier, I'm back on the mountain bike and feel way more dynamic in all regards. My climbing fitness on the bike needs work, but it's getting there. I'm charging on the descents that are less technical, getting back on the bumpy stuff is the plan for this week. Additionally, prior to the THR I had 15-20 years of lower back pain that I always attributed 100% of the cause being that I broke my back within a year or two of the initial hip injury. Starting immediately after hip surgery all the way through now I have zero back pain. So that's a huge win.

But no surgery is without risk.

Early on, within the first week or two, I started noticing some pain, weakness, and limited ROM in my left shoulder. The symptoms got worse, and soon included my right shoulder as well. During this time I was also experiencing bilateral hip and glute pain, which I've mentioned in this thread and was attributing to my body "rebalancing" now that my legs are the same length and my pelvis is level. I assumed the shoulder pain was from being in a weird position on the operating table, and that it would eventually resolve. I didn't associate the two as being the same thing for a long time. The pain got worse, and eventually started involving carpal tunnel like symptoms in my right hand. The hip/glute pain started correlating with days I had more intense shoulder symptoms, and I started making the connection. Several theories emerged including Parsonage-Turner Syndrome, nerve impingement, joint or bone encapsulation, Polymyalgia Rheumatica, or some other auto-immune or nerve issue. I had a bunch of bloodwork done, a cervical MRI, an EMG / nerve study, PT evaluations, a short course of oral steroids that was as much diagnostic as it was therapeutic, and probably some other stuff. The current working diagnosis based on testing and symptoms is Polymyalgia Rheumatica (PMR), which is an inflammatory auto immune condition characterized by bilateral shoulder and hip/glute pain without swelling, and can often involve symptoms similar to carpal tunnel syndrome. Or maybe it just causes flares of CTS? It can be (and for me was likely was) triggered by a major surgery. More specifically, I think mine was triggered by 12 months of fairly intense mental and emotional stress, topped off with the hip surgery.

June and July were pretty challenging both physically and mentally. As quickly as I ramped up my activity level, the pain from the PMR limited that. I was off the bike for a couple weeks, back on gradually, then off again, now back in. Early August I was able to get to a reasonable spot with it, using a mid level dose of prednisone plus some light PT to manage symptoms. Trying to keep mental track of factors like sleep, exercise level, how many beers I have on a Saturday evening, etc. to see if there’s correlation to severity of symptoms. I have an appt a rheumatologist in early October to ensure it’s not something else. I’ve also talked with a dietician, and may explore how I might help manage the symptoms with diet and supplementation. The good news is, PMR does usually resolve and recurrence is probably very low. But until it resolves, it’s less than optimal. Fortunately, my good days are getting better and the bad days aren't as bad. I'm about to start a LONG taper off the prednisone (reducing dose by 1-2mg every 2-4 weeks) to see if symptoms return. Fingers crossed.

Despite this issue, I am still very happy that I made the decision to have the hip replacement. "No ragerts" as it is said on the internet. Having such an intense response / reaction from a surgery is very rare, from my understanding, but the chances aren't zero. And it could have been so much worse, e.g. an infection that spread to the implant requiring the removal eventual replacement of the implant would be many times over crappier. I'm still enjoying smooth range of motion, no arthritic pain in the surgical hip, and a lower back that is the most pain free it's been in over a decade.

FKNA

[MotoBeak]

I have a full replacement scheduled for early January. Colorado can thank me now for the good winter that I will miss. I broke my left hip 28 years ago, and the surgeon did a good job of putting me back together. No pain, slightly limited ROM that didn't affect any activity. Then this past January I started having some random sharp pains and my left leg didn't work right when I was skiing. It kept getting worse, but I was stubborn about it. My Chiropractor took some x-rays and I forgot how funky the joint looked after it healed. I finally got an appointment with a good ortho, hoping it would be a relatively easy fix. He took one look at the x-ray and said "That's not worth trying to fix, lets get you a new one." Shit. I knew that this would be in my future, but not what I wanted to hear at the tender age of 48. He explained everything very well and put me fairly at ease with the situation. He even said that I could be skiing by late spring! Obviously I should have seen him sooner, but I think it will work out just fine. I will be having flashbacks to recovery from the injury, but this should be easy in comparison.

[plugboots]

I don’t know if this helps anybody with the decision, but I had the resurfacing instead of the full and last week I had my six month follow up, (which of course I did eight months but anyway)… He was saying that you need to be strong and have really good bones to do a resurfacing they would never suggest a resurface on somebody who has what he called it “butter bones”, not saying you guys do, but he was talking about people like my 90 year old Mom. He also said recovery is harder with resurfacing because they leave more, (everything), intact and they can’t get in there as easily, so they have to pull all your muscles apart with hooks. If I use the drops on my bike, sometimes there’s clicking, and I asked him about that, and he said the ligaments are moving back-and-forth on areas that they hadn’t for years and so that may continue.

[priapism]

I don’t know if this helps anybody with the decision, but I had the resurfacing instead of the full and last week I had my six month follow up, (which of course I did eight months but anyway)… He was saying that you need to be strong and have really good bones to do a resurfacing they would never suggest a resurface on somebody who has what he called it “butter bones”, not saying you guys do, but he was talking about people like my 90 year old Mom. He also said recovery is harder with resurfacing because they leave more, (everything), intact and they can’t get in there as easily, so they have to pull all your muscles apart with hooks. If I use the drops on my bike, sometimes there’s clicking, and I asked him about that, and he said the ligaments are moving back-and-forth on areas that they hadn’t for years and so that may continue.

Yeah avascular necrosis (which I had) can be a contraindication for resurfacing, because even with the femoral head shaved for the cap, there might still be necrotic bone which weakens the prosthetic. I was cleared for it but it puts me at higher risk for failure, and I was just happy to move on.
I have 36mm femoral heads now (I had asked about 40mm) which is nothing compared to the 52/54 I would have had with resurfacing, who knows maybe there will be no noticable difference.

[plugboots]

I have 36mm femoral heads now (I had asked about 40mm) which is nothing compared to the 52/54 I would have had with resurfacing, who knows maybe there will be no noticable difference.

And there’s no way you’d be able to know anyway.
I’m gonna need a new left knee probably sooner than later and I hate surgery so much but…new thread for me I guess.

[goldenboy]

Dang full trucker, that's quite a story. Hope the weird shoulder symptoms go away.

I'm at 16 months and would still just give the surgery a "meh". I don't quite regret it, but I'm not that impressed by the outcome either.