This My Take is an account of my total hip replacement.
I have suffered with osteo arthritis for over two years. It interfered with my sleep and after working all day sometimes I would just go home and sit with an ice pack. Towards the end I had a permanent limp and my other hip was beginning to hurt as well since I was favoring it. Finally it got to the point where I could not put any weight on it. My doctor prescribed steroids which really worked well but the downside is that they have a lot of side effects and you cannot stay on them for the long term. It was finally time to consider getting a total hip replacement.
Starring Role
The choice of surgeons is very important. You can consult your personal care physician or if you know somebody in healthcare they may have recommendations. There is lot of information online about specific surgeons as well.
Lucky for me I have a live in Physical Therapist who deals with hip replacements on a regular basis. My wife has been working with hip replacements for over 25 years. Actually, we knew this day would eventually come so she was familiar with a group of surgeons and one in particular she knew did excellent work. We booked an appointment to see him.
The pandemic had put a hold on most elective surgeries for months. I waited until I got the two dose Moderna vaccine before making an appointment to see the surgeon. I expected to have to wait several weeks or maybe more than a month. My wife was able to speak to the surgeon directly and I was booked to see him in two weeks.
This X-Ray shows a normal hip. The white outline around the hip is the cartilage which acts as a cushion in the joint. When this cartilage wears away the two bone surfaces wear against each other causing pain and inflammation. In my case, the ball part of the joint was becoming deformed. It was becoming more egg shaped and there was no cartilage around it. It was bone on bone.
When I had my initial visit, it was determined that the left hip needed to be replaced but the right hip still had some cartilage around it so the surgeon told me I was “one and done”.
Since my wife knew the surgeon, I was to be admitted in less than three weeks.
The Hardware
I had a friend that had this procedure done 30 years ago. He had a titanium hip. Both surfaces were made of titanium. These hips were very durable but the downside of them is that when the two metal surfaces rub against each other, minute amounts of titanium wears away and this metal gets into the body, sometimes with toxic consequences.
These early hips also were very prone to dislocation. The ball would pop out of the socket and would require painful surgery to repair it.
My surgeon explained the reason why he uses the hardware that he wanted to implant in me.
Figure 1The Stem
This artificial hip joint is designed to be used as part of a system that uses computer imaging to assure that the hip is installed at the correct angle and position. The stem part is titanium and has a special coating that once it is inside the femur it facilitates bone growth around it, making for a more stable joint.
Figure 2Ball and Socket
The ball part of the joint is made of plastic. It has been tested and it is shown it is very durable. It also will prevent metallosis . Notice there is a smaller ball and socket inserted in the larger ball. This will increase the range of motion of the joint which prevents dislocation. The surgeon informed me that he does about 14 of these surgeries a week and in the 3 years he has been using this product he has only had 2 dislocations.
Prep Work
Preparation is important. I had two weeks to prepare for this. Besides getting a lot of household chores done I needed to get ready for my convalescence.
I installed several grab bars in my shower stall and a hand sprayer. I purchased a commode and a tub seat. I was able to get a walker and I ordered a cane. I got a couple of tennis balls and cut holes in them so they would fit on the walker preventing my floors getting scratched.
There is a kit made for these kinds of surgeries. It included elastic shoelaces, a grabber, and a device that helped you put on socks.
I had been doing extra cardio at the gym and I lost about 5 pounds. Losing weight, even just 5 or 10 pounds will reduce stress on the joints.
I got a haircut and cut my toenails. I did not know when I would get down there again.
D-Day
The days went by fast and before I knew it, it was 6AM on the day of the surgery. I was to be the first of the day. I was processed and brought to the orthopedic floor. A nurse started an IV and got me changed and ready for surgery. The surgeon usually uses spinal anesthesia instead of a general anesthetic. They assured me I would not be awake during the surgery.
My wife came in and sat with me and when the surgeon came in, she spoke to him briefly with a few questions. The surgeon was very forthcoming with information during the whole process.
I was wheeled off to the operating room and the next thing I knew I was back on the orthopedic floor. A nurse assured me that everything went well. My wife sat by my side and spoke to me. I was still groggy, but I do remember the surgeon coming in and sitting at a computer and inviting my Physical Therapist wife over to see the X-rays. Even in my limited capacity I reasoned that if he was willing to show her the X-Rays, it must have come out good.
After a few hours I was wheeled into my hospital room. At about 5 PM my wife took me for a walk in the corridor. I used a walker, but I was amazed at how pain free I was. I found out later it is because during the surgery I was given large quantities of pain medication.
I was home the next day after lunch time. I had exercises I did very few hours. Mostly standing at the kitchen counter and moving the leg around.
After a few days I was using the walker to go up and down my driveway. Soon I was using it to walk to the next-door neighbor’s driveway.
I was sent home with Tylenol and Oxycodone. I never needed the opioids.
Within three weeks I graduated to a cane and walked twice a day in increasing distances.
Three weeks after that I retired the cane.
Eight weeks out and I began outpatient Physical Therapy. I am finishing the fourth week of Therapy and will have four more weeks.
The process has not been seamless. I have had days when I was sore and some days it was painful to walk. This is attributed mostly to me overdoing my exercises.
It will be a long rehabilitation period. Perhaps as long as a year. The surgical process is very vigorous and involves tendons and soft tissues as well as a 3-inch incision. A lot has to heal.
My new Best Friend.
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