November 30, 2009 My right hip was resurfaced with the Birmingham appliance/method; I am scheduled for the left hip in 5 weeks (12.29). I was "suffering" with hip issues for several years; but just counted it as normal pain from running and tennis; and racquetball before that. I was an avid racquetball tournament player for 20 years; and I figure that had as much to do with my hips "going away" as anything else. There was always pain after tennis and running but in the last 10 months; it caused a complete cessation of sports and other activity. For the longest time I was unwilling to think that it was my hips since the pain was in my groin, for the most part. I now know that it is common to come to that conclusion. However, an x-ray of my hips prior to getting my right knee scoped for cartilage again, confirmed the pain as bone on bone in both hips. My knee has no evidence of arthritis.

None of the orthopods in my area are trained in HR; and the hospitals are not setup with the equipment. My daughter is a GenSurg in Milwaukee and she "scoped" out Dr. Anderson as a "good guy".

My sense is that he has done a good job; but I time will tell. I had expectations about the recovery that have proven false though. It seems that some around here talk about loading the hip very soon; even though I’m in excellent shape, that will not be the case for me. They have been very clear in warning that I CANNOT load it beyond 50% for 4 to 6 weeks; very little rehab till I see surgeon on 12.09. Those restrictions may be specific to my case. My hips were more engaged that expected. I’m hoping my capsule and surrounding soft tissue which feeds the femoral head have not been compromised; so then I guess I’m hoping that the cautions are more related to muscle surgical intervention than expected/normal.

In my post op visit on the 9th I’d really like to be able to hear the "inner" discussions about how it all went; pros and cons. I would be comfortable with that discussion; but I really don’t know how to set it up so he would be. The incision is 10-12"; in an arc. I had asked and was told that he prefers posterior. Prior to general anesthesia I was offered and received (when it was explained that this is NOT an epidural) a spinal morphine (Duramorph) injection. For 36 hours after the surgery I had 0 pain; I felt like I could get up and do anything. There was very little swelling (probably due to the drain which was removed before I was discharged).

Since my 5th day I have considerable swelling; I elevate as much as possible; I ice the incision, even though the swelling is to my foot. I do only the simplest "exercises" (ankle pumps, heel slides, quad sets, and terminal knee extension); the terminal knee extension really "hurt" the upper quad; so I’m assuming some surgical work went on there.

It just seems to me that I’ve got a lot of recovery to make before Dec 29th rolls around; and this new leg becomes the dominant one.

The only other thing that really caught me off guard was the use of warfarin. I discovered that this was just standard procedure for Dr. Anderson. It just seems odd that patients with standard or lower risk for DVT are treated the same as those who are at high risk of DVT. Regardless I am taking the stuff as directed and going through the monitoring. This would not have been a deal breaker. So this is what a big surgery is like!

December 3, 2009  I'm 9 days post op now. It confusing when i'm asked about pain because it is certainly not in the joint or like it was before pre op. The only real pain I have is in the big thigh muscle above the knee and on the outside of the leg. It is very stiff and restricts movement. I think once the swelling subsides things will progress at a faster pace. Also, I am probably overly cautious about that "only 50% loading" restriction.

I didn't mention it but my age is 56. Had i been more sensitive to my body I would have been visiting these decisions 4 years ago; but then HR would not have been an option.

I meet with Dr. Anderson in 5 days. So, the exercises I've been allowed to do, what I do.

December 31, 2009 I just completed my 2nd BHR hip with Dr. Michael Anderson, Milwaukee. I was 5 weeks on my right and recovery was going very well. At two weeks I carefully switched to one crutch, being careful to walk w/o limp while supporting it. At three weeks I could walk for a couple of hours in the morning walking fairly normally; and by five weeks things felt pretty good; but I could tell there was and will be much strengthening yet to go. In fact it seemed every day was slightly better than the previous. Although I have been very active in racquetball and jogging; I have no intention of playing with the same abandon. I’m happy to take it a little easier with tennis and using other means than jogging to stay in shape. Obviously everyone has different expectations.

As far as I can tell 5 weeks out, I am very satisfied with the direction my progress looks to be headed. But going down again with the second hip, the end result will have to wait a bit. You can’t be stupid with the recovery or you will only set yourself back at best; or something more serious at worse.

I had not "researched" Dr. Anderson as thoroughly as I later learned I should have; but I have no regrets. I have had a very positive experience with him and his staff. I won’t bore you with what I learned of his technique unless you want to know; but he is well respected in this kind of surgery.

A couple of quick thoughts: 1. I underestimated the "energy" drain in in healing. I was able to go back to work at two weeks; network consulting (so not the most strenuous of jobs) and at two to three weeks I would wake feeling deceptively normal. HOWEVER, if I didn’t respect what my body was telling by the early afternoon; I paid a heavy price…. Talk about crashing! But if I stopped and rested for a couple of hours or the rest of the day… life was much more pleasant. The resting time has lessened but must still be respected (even 5 weeks out).

2. Read judiciously my comments and those of others; I selectively "listened" for what I wanted to hear. That is not fair to yourself. I think this is a bad mistake. It seems there are far too many variables to overstate another’s experience or make yours normative for others.

January 20, 2010 Had my 2 week post op visit last Wednesday; and am now 3 weeks on my LBHR and 8 weeks on my RBHR. Being very careful, I have been working since a week out this time (I take care of several client networks); and today is my first full day w/o a crutch (about the same as the first surgery).

I was really concerned that my RBHR would handle the stress of having the LBHR within 5 weeks; but I have to tell you that my RBHR never complained. I can't wait to rebuild the muscle loss in my thighs, though; it is amazing how fast the atrophy occurs. But I know it will be another week before walking with the LBHR becomes strong enough to be close to normal. Then I hope to come up with a workout in the Y pool. I'm going to be very careful in the early going.

I spoke with Dr. Anderson about the cementless femoral component; my procedure was cemented. He clearly says that after 10 years or so depending on my activity that it/they will probably fail due to micro fractures in the cement bond (not something I wanted to hear); but also that it would be 10 years before the uncemented procedure will be in use in the US. I assume because the testing is only 2 years out. However, the article by Dr. Gross seems to think otherwise. It does seem to follow that if the acetabular is not cemented to induce bone growth; that the stemmed femoral component would also benefit as well. If so, a little late for me.

However perhaps in 10+ years when the failures occur, some procedure will be available to "fix" the issue w/o a THA.


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