Four Years After My Total Hip Replacement

A Total hip replacement (THR) is a surgical procedure that reforms the hip. Total hip replacement is also called arthroplasty. Its main purpose is to relieve pain and restore mobility to the individual.

When an individual gets a THR; the head of the femur (bone that extends from the hip to the knee) is removed. The surface layer of the socket in the pelvis (two large bones that rest on the lower limbs and support the spinal column) is removed. The socket is replaced with a plastic or metal and plastic cup. The head of the femur is replaced with a metal ball and stem, with the stem fitting within the shaft of the femur.

In the normal hip; the head of the femur moves within the cup-like socket (acetabulum of the pelvic bone). The acetabulum (cup-shaped socket at the base of the hip bone where the ball-shaped head of the femur fits) and the femoral head are covered by the articular cartilage; which allows smooth and painless motion of the hip joint.

It's been four years since I've had THR and I've been pain free every since. My mobility is back to where it was before I started having the hip problem. I am happy that I had this surgery. My regrets are that I didn't have THR sooner. I suffered severe pain for over three years before the problem was diagnosed. My hip was gone; leaving a bone to bone interaction. For years my doctor treated me for arthritis. The medication didn't work. The pain got so bad I was forced to use a cane for support and to prevent me from falling down.

Finally, I went to see a hip and knee specialist and found out that I was in need of THR. Surgery was scheduled for three months from the date of the diagnosis. Surgery lasted approximately two hours. Around twenty four hours after surgery; physical therapist assisted me in short walks, using my walker. I was released to go home the third day after surgery. Some patient's hospital stay is longer than three days. After my many staples were removed; I started physical therapy. I was in therapy for approximately eight weeks. For me therapy went smoothly; it wasn't bad at all. I walked without the support of a cane or walker four weeks after surgery. I was driving my car in six weeks. At first, I only went on short drives.

Around six weeks, I was doing light house work. Soon I graduated to regular house work. I exercise on the stationery bicycle for 30 minutes three times a week. I walk two and a half miles, five times a week on the high school track field.

The doctor doesn't recommend jogging. High impact aerobic and things like football; basketball is a no -no. I can golf, not that I'm any good at it.

Other restrictions; in the first six to eight weeks after surgery, are to avoid bending the hip beyond 90 degrees; keep the knees below the hip when sitting. Sitting on a small pillow or higher chair will help.

Avoid crossing the surgical leg over the non-surgical leg. Avoid turning the surgical leg inwards (pigeon-toed). Avoid bending over from the hip to reach the floor. If the individual is not being compliant with the postoperative restrictions; it can result in loosening of the implanted hip joint. And the patient could end up in need of revision surgery. Revision surgery is more complicated than the first surgery.

The three years that I was in pain (24/7); I never thought I would see another pain free day. I started training myself how to live with the pain from day to day. I told myself that if I had to live with this much pain for the rest of my life; I wasn't going to let it take complete control. I was going to be in control.

Along came hip replacement. I remember struggling from the preparation room to the operating room (OR); with the use of my support cane. I really didn't believe THR could take away all that pain. The OR was next door from the preparation room.

I was allowed to walk to the operating room because in THR surgery; I had the option of being put to sleep or having a block and staying awake during the procedure. I choose to stay awake. I, also, choose to walk to OR. So, I was given a local anesthesia, and the anesthesia doctor walked with me to the OR. There I was given the block. Anyway, I was knocked out; even local anesthesia knocked me out. From the time I woke up from surgery until this day; I had no need for pain medication for my hip. I seriously didn't feel any pain during my stay in the hospital.

Four years later, I am still getting around very well and exercising and doing a lot of daily driving in my car. I remind myself of what I'm not supposed to do like lifting things over 40 pounds or Jogging, etc.

My THR was the results of injury. I was rear ended in my car a couple of times and I was hit on the hip by a small vehicle; these accidents occurred back in the mid 1980s; the doctors thought I sprained a main muscle, when the vehicle hit my hip. There were other problems like my L4-5 disc and the C4 disc. I had serious problems with my right side after the accidents. My hip never completely recovered. The doctors still thought the problems were from the disc and a sprained muscle. Later, I was told that I had arthritis. Three years before surgery I was in daily pain. My THR was the results of hip injury, however, a variety of disorders can result in hip disease.

Disorders that can result in hip disease are:

Osteoarthritis: A specific form of degenerative arthritis caused from overuse or from aging.

Avascular Necrosis: the results of loss of blood supply to the ball or head of the femur bone. (Femur is the bone that extends from the hip to the knee.)

Rheumatoid Arthritis: Causes inflammation of the joint lining and destruction and deformity of the bone.

Traumatic Arthritis: A type of arthritis resulting from a hip injury. A tear can occur in the articular cartilage; increased friction and accelerated degeneration of the joint can occur.

Hip replacements are most common in people in their 60s and 70s. However, people as young as the late teens and as old as the 90s can be candidates for THR replacement surgery. Approximately 150,000 surgeries are performed in the United States annually. The success rate is over 90%. Up until the 1960s THR outcomes had been unreliable.

Total Hip Replacements (THR) last any where from 10, 15 to 20 years. My surgeon told me that my THR should last 15 to 20 years. The chances of THR to last 20 years is 80%.

Complications can occur with all major surgical procedures. Some of the most common complications following THR are:

Deep Venous Thrombosis (DVT); this occurs when the blood in a large vessel of the leg forms blood clots within the vein. The surgeons usually prescribe a blood thinner medication; activity as soon as possible and a pressure stocking immediately after surgery, to keep the blood in the legs moving. When you leave the hospital you will probably no longer need the pressure stockings. Some people wear it a few days after leaving the hospital.

Infections, is another complication; however the chances of getting an infection after THR is less that 1%. In case of infections; some may show up very early, others may not show up for years. Infections can spread into the artificial joint and cause the joint to loosen. The surgeon will advice you to take antibiotics if you ever undergo bladder or colon surgery or any time you have dental work done.

Loosening of the joint implants may lead to total hip revision. One must be extremely careful, during the first few weeks after surgery to avoid positions that could dislocate the hip. As time pass; the body will make enough scar tissue to stabilize the hip replacement.

Dislocation may result from muscle imbalance and tightness around the hip joint. Chance of dislocation is 3%. Dislocations may also occur because the patient does not follow postoperative instructions and restrictions.

Loosening of the implants is the most frequently cause of failure of a THR. If failure occurs, the individual may need a revision surgery.

Although quality results can be achieved; revision surgery is technically more difficult for the surgeon and the patient.