Smith & Nephew BHR Brimingham Hip Resurfacing

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Jake

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8 day update
« on: March 31, 2015, 04:19:27 AM »
Thanks to all that have posted on this site.  It has been a great resource for me while taking this journey. 

I am 40 yrs old and 5 days post op from HR on right hip with Dr Gross.  After reading through the site I realized that everyone has different recovery's so I really didn't set any expectations for myself.  Surgery went well, doctors, staff  and hospital were excellent.  I was in the 12:00 slot so I was in the hospital bed until 9:00am the following morning when the nurse came in to get me up, walk around and take a shower.  I can honestly say  that getting out of bed for the first time was probably the worst part of the whole process so far.  I say that because I really didn't know what movements would hurt, the pain killers were in full effect and I hadn't really moved for 24 hours at that point.  Once I took the first few steps I felt much much better. 

The first day out of the hospital it was hard to get around.  Getting in and out of the car was difficult, sitting and getting up was hard and sitting on the toilet was scary.  Getting in and out of bed was probably the worst, I didn't sleep well but managed about 5-6 hours. 

The second day I felt much better, I was able to manage unassisted for most things like stairs, bathroom, shower and walked without pain on crutches around the house.  I did take a trip to the new Cabellas and tried to walk around the store but realized that wasn't working out so well so I sought out a zero gravity chair and took a break.  Then I got myself one of those little scooters to finish up my experience.  Once I returned to the house I was feeling like I over did it a little.  Taking the normal regimen of pain killers.

The third day I took it easy. Went for a couple of short walks up the street, iced and rested.  I felt better than the day before.  No pain in the hip joint only muscular pains. No ROM...log leg.  Taking normal regimen of pain killers.

The fourth day I traveled back home by plane solo.  Once getting to the airport the wheelchair was ready and they took me through security and to the gate.  I walked down the jetway to my seat for my first leg of the trip.  Another wheelchair was waiting to bring me to my connecting flight.  Again, I walked down the jet bridge to my seat.  During my layover I was able to get some food and walk around a bit and felt pretty good.  I was very happy to finally get home to my family (I was at my brothers house in North Carolina for the last few days) and get set up in my recliner with wife and polar car machine.  I slept like a baby and woke up feeling great.  Taking normal regimen of pain killers.

The  Fifth day my hip was a little more swollen and I had some pins and needles on the top of my right foot for most of the day but it's gone now.  My stitches are really itchy as well.  I only took a couple of pain killers today and I probably didn't need them.  I am walking much better and have used one crutch a couple of times because I needed to carry out some water and a bowl of soup.  It feels fine but I'm not sure if I should be doing that. 

Tomorrow (6th day), I may try to get off of the pain killers and take a drive.  We will see how that plan works out.  To be continued.....

8 day update and answers to your questions

-Yes, Ice and Polar care are my best friend!  I ice whenever possible.  Only stayed one night in hospital.  I took pain meds for 5 days and only had 5 extended release pain and 25 short acting pain meds left. 

-The status of my hip before surgery... I was in minor pain while walking and as activity increased so did the pain, always walked with a limp, ROM was horrible, work outs were a joke and was limited to mostly upper body stuff, hard to get a good cardio work out either on stationary bike or elliptical, hard time tying shoes and bending over to pick stuff up.  The worst part was not being able to run around with the kids, my 6 year old daughter could outrun me handily.  The deciding factor was when I was at a convention in Vegas walking to and from the classes and back to my room, basically limping for what seemed like miles over the course of 3 days and coming really close to renting a little rascal scooter.  Oh, my wife was changing jobs and had to sign up for Obama Care so that was another good reason to get it done before that nightmare.  I was definitely not confident that I was making the right decision in getting the surgery and I guess time will tell.  As long as recovery continues to go well and I'm able to walk without pain and resume most activities (skiing, golf, motorcycle) and run around with the kids I will be happy I did it. 

Day 6 - I went off of the pain pills cold turkey, only taking a few Tylenol today, I'm not in  pain  unless getting in/out car and bed if I move the wrong way.  I was planning on going for a short drive with me behind the wheel but decided against it.  Instead I had a driver and went into town for a walk around the mall, tried to figure out how much walking I did, probably a little less than 1/2 mile.  Feeling stronger but still a long way to go.

Day 7 (bandage removal day!) - Today I felt stronger yet again, was planning on taking a walk and relaxing but I was needed at work (self employed, needed the boss to make executive decision) so I took the maiden voyage behind the wheel and drove about 1.5 hrs round trip to look at a job, did some walking, went out to lunch and made it back to my lounge chair unscathed.  It did start to get a little uncomfortable sitting in the drivers seat toward the end.  When I got back I took the bandage off and that felt good, scar was healed nicely but it still looks ugly.  Went for another walk with the kids, really trying to walk "normal" and went about 1/2 mile.  It Felt like I was starting to get a charlie horse about halfway through so I turned around and went back to ice.  It was a good day.

Day 8 - Today I dropped to one crutch when not going on a "walk".  Went to a morning meeting at work then drove around for about 2 hours. Went home to ice and then out for a walk about 1/2 mile, it was a little further than the day before.  Charlie horse started just as I got back to the house so I figured that was perfect timing.  Again, feeling stronger but again still a long way to go. The Charlie horse is probably my IT band, I need to be careful to not lean into the IT band for support when walking.

Thanks for all of your comments and encouragement!  I wish you all the best in whatever stage of recovery you are in. 

« Last Edit: April 05, 2015, 04:52:45 PM by Jake »

MPH

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Re: 5 day update
« Reply #1 on: March 31, 2015, 08:30:05 AM »
All sounds good to me! The only thing missing is ice? I swear by it as do many others on here. I had very little swelling after two weeks of 24/7 icing! 
RBHR 13th Jan 2015 Andrew Shimmin, Melbourne AUS. 52mm head/58mm cup.

ecchastang

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Re: 5 day update
« Reply #2 on: March 31, 2015, 12:48:17 PM »
Glad to hear how you're doing.  I am 8 days from surgery with Dr. Gross.  Did you just stay the one night in the hospital?
Apr 8th, 2015 Biomet U/C Dr. Gross

oldsoccerplayer

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Re: 5 day update
« Reply #3 on: March 31, 2015, 02:34:34 PM »
Take a  drive? Do you mean you plan on driving yourself?
I'd recommend waiting a bit longer, maybe you can drive a short distance if it's necessary but if not then hang on a bit longer.
I understand wanting to get off the pills but only do that if you are pain-free. If it hurts take them for a few more days.
Sounds like overall things are going well but you might have a tendency, like so many of us, to try to do too much too soon. Remember, it's a marathon, not a sprint.
BioMet Left Hip Resurfacing, Dr. Gross, 07/2013

MattJersey

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Re: 5 day update
« Reply #4 on: March 31, 2015, 06:03:01 PM »
Very encouraging and consistent with the younger patients recovering more quickly consensus. Good luck with it, hope it continues smoothly.

I'm 4 weeks away today. Gulp. Had a day yesterday where I thought, because my hip somehow seemed ok on morning dog walk, maybe it is too early. Then I swam in evening and realised this morning, after a restless night and general "buzz" in hip all through despite paracetamol, that no, it is good timing.

Keep us posted on progress. What state was your hip in before you proceeded? Presumably a doubter like me and many others, not sure if too early?
28 April 2015, RBHR Mr McMinn

Miguelito

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Re: 5 day update
« Reply #5 on: March 31, 2015, 10:08:51 PM »
How many days/weeks of painkillers did Dr. Gross prescribe? I can't remember what he prescribed me. I'm gonna guess it was about 10 days, because I seem to remember both times I had surgery (both on his Wednesday) that on Friday of the following week I still needed the meds, was concerned about the weekend (and not being able to get any) getting a new prescription, and then only using like one or two pills (because Dr. Gross's painkiller regimen was so well tailored).

If my recollection above was true, I know that I would not have been able to stop meds at six days. The one piece of advice I generally always give on this site is to take the meds, and stay ahead of the pain.

I wish you well in your continuing recovery!

Mike

RHR April 2012.
LHR March 2014.

Both Biomet Magnum/Recap 54/48, by Dr. Thomas Gross.

JHippy

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Re: 5 day update
« Reply #6 on: April 01, 2015, 03:04:05 AM »
Congrats, Jake! Sounds like you're doing great. Heed the advice of others here to not push it. By the end of the second week you'll feel like a new man. And by the end of the third week even that much better still.
Left HR; Dec. 17, 2014; Dr. Gross and Lee Webb NP;
uncemented Biomet Recap/Magnum; 50mm/56mm.

Jake

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Re: 5 day update
« Reply #7 on: April 02, 2015, 09:42:41 PM »
8 day update and answers to your questions

-Yes, Ice and Polar care are my best friend!  I ice whenever possible.  Only stayed one night in hospital.  I took pain meds for 5 days and only had 5 extended release pain and 25 short acting pain meds left. 

-The status of my hip before surgery... I was in minor pain while walking and as activity increased so did the pain, always walked with a limp, ROM was horrible, work outs were a joke and was limited to mostly upper body stuff, hard to get a good cardio work out either on stationary bike or elliptical, hard time tying shoes and bending over to pick stuff up.  The worst part was not being able to run around with the kids, my 6 year old daughter could outrun me handily.  The deciding factor was when I was at a convention in Vegas walking to and from the classes and back to my room, basically limping for what seemed like miles over the course of 3 days and coming really close to renting a little rascal scooter.  Oh, my wife was changing jobs and had to sign up for Obama Care so that was another good reason to get it done before that nightmare.  I was definitely not confident that I was making the right decision in getting the surgery and I guess time will tell.  As long as recovery continues to go well and I'm able to walk without pain and resume most activities (skiing, golf, motorcycle) and run around with the kids I will be happy I did it. 

Day 6 - I went off of the pain pills cold turkey, only taking a few Tylenol today, I'm not in  pain  unless getting in/out car and bed if I move the wrong way.  I was planning on going for a short drive with me behind the wheel but decided against it.  Instead I had a driver and went into town for a walk around the mall, tried to figure out how much walking I did, probably a little less than 1/2 mile.  Feeling stronger but still a long way to go.

Day 7 (bandage removal day!) - Today I felt stronger yet again, was planning on taking a walk and relaxing but I was needed at work (self employed, needed the boss to make executive decision) so I took the maiden voyage behind the wheel and drove about 1.5 hrs round trip to look at a job, did some walking, went out to lunch and made it back to my lounge chair unscathed.  It did start to get a little uncomfortable sitting in the drivers seat toward the end.  When I got back I took the bandage off and that felt good, scar was healed nicely but it still looks ugly.  Went for another walk with the kids, really trying to walk "normal" and went about 1/2 mile.  It Felt like I was starting to get a charlie horse about halfway through so I turned around and went back to ice.  It was a good day.

Day 8 - Today I dropped to one crutch when not going on a "walk".  Went to a morning meeting at work then drove around for about 2 hours. Went home to ice and then out for a walk about 1/2 mile, it was a little further than the day before.  Charlie horse started just as I got back to the house so I figured that was perfect timing.  Again, feeling stronger but again still a long way to go.

Thanks for all of your comments and encouragement!  I wish you all the best in whatever stage of your recovery you are in.  Being a hippy isn't as bad as I thought ;) 

To be continued........

Pat Walter

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Mid-term Results of Hip Resurfacing Study by Dr. Brooks 2015
« Reply #8 on: April 02, 2015, 10:56:33 PM »
Alternative Bearing Surfaces (Hip)

Presented at AAOS by Dr. Peter J. Brooks on Tuesday, March 24, 2015 7:00 AM

Author(s): Carlos A. Higuera, MD, Bay Village, Ohio; Kurt P. Spindler, MD, Garfield Hts, Ohio; Gregory J. Strnad, MS, Lyndhurst, Ohio; Peter J. Brooks, MD, FRCS(C) Cleveland, Ohio

INTRODUCTION:
Hip resurfacing has been proposed as a suitable procedure for young, active patients. Given the concerns with metal-on-metal bearings, and the recall or withdrawal of certain devices, it is appropriate to review our results using a resurfacing device with a relatively good clinical record. As our experience and understanding of these bearings grew, we now describe changes to our preferred component position, and have used additional imaging to narrow our indications for this procedure, which we continue to perform in significant numbers.

METHODS:
We performed 1,333 hip resurfacing procedures, with minimum two-year follow up, at a single US institution following FDA approval in 2006. All patients were followed using a validated prospective observational registry, and an IRB approved database. All surgery was performed by a single surgeon, using an antero-lateral approach. The average patient age was 53.1 (12-84), and 70% (938) were male. Patients were seen at six weeks, then one, two, and five years after surgery. Our weight-bearing protocol was 75% partial weight-bearing for six weeks, then avoidance of strenuous exertion for one year, then unrestricted activity. Over time, and in response to reports of poor outcomes from other centers, we modified our target socket inclination from the traditional 45 degrees to 35-40 degrees, and introduced previously undescribed imaging strategies for patient selection. Metal ion levels and cross-sectional imaging using MRI were utilized only in symptomatic patients.

RESULTS:
The average femoral component size in males was 51 mm, in females 45 mm. Less than 1% of cases were < 42mm. Preoperative Harris Hip Score was 59.6 + 10.6, and postoperative  score was 98.7 + 3.3. Hip-related Physical Limitation score improved from a baseline of 2.6 to 6.6. There were no dislocations, no femoral component loosening, and one socket loosening (0.08%). We had two femoral neck fractures (0.15%), three deep infections requiring component removal (0.23%), and one late traumatic acetabular fracture requiring revision. One patient was revised for unexplained pain, and continues to be symptomatic.

There were three cases of excessive metal debris (0.23%), but no destructive pseudotumors. Two of these were attributed to socket malposition. The third was a small female (40 mm head) with dysplasia, accurately resurfaced, but with excessive femoral neck anteversion, and a pelvis which tipped backwards 14 degrees in the standing position. Retrieval analysis showed anterior edge loading. This case led us to modify our patient selection criteria and recommend new imaging protocols. In total, five males and six females required revision. Overall survivorship was 99.2%, at 2 to 5.7 years follow up. Aseptic survivorship in males under the age of 50 was 100%.

CONCLUSIONS:
To our knowledge, this is the largest US series of hip resurfacing involving a single device, by a single surgeon. Hip resurfacing can be highly successful in the mid-term with careful patient selection and attention to technical detail. Metal-related complications in our series were rare, and could be explained by either inaccurate surgical technique, or by patient characteristics which we would now deem unacceptable for resurfacing. We have had very few complications, but based upon this experience we have the following recommendations:

1.Aim for socket inclination of 35-40 degrees.
2.Avoid resurfacing patients with head diameters less than 44 mm.
3.Obtain CT scans of all females, and males with apparent hip dysplasia, in order to avoid esurfacing patients who have excessive femoral anteversion.
4.Obtain preoperative standing lateral pelvis x-rays, and avoid resurfacing smaller patients whose pelvis tips backwards, risking anterior edge loading.

Disclosure:  C. Higuera: 5 - KCI, Stryker K. Spindler: 5 - KCI, Stryker G. Strnad: 5 - KCI, Stryker P. Brooks: 5 - KCI, Stryker
Webmaster/Owner of Surface Hippy
3/15/06 LBHR De Smet

Jake

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Got Stairs?
« Reply #9 on: April 05, 2015, 04:47:20 PM »
When can you start walking up and down stairs with the operated leg.  I don't think I am able to do it yet but I could at least start trying.  Is it best to wait or is it better to engage those muscles.  I'm  10 days post op.
Thanks

Juno

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Re: Got Stairs?
« Reply #10 on: April 05, 2015, 09:29:46 PM »
I was using stairs the day I got home from the hospital. PT showed me how to use them while using one crutch for support. By day 10 I was probably just using the handrail -- just go one foot at a time and remember going upstiairs with the good foot first and when going down you using your operated foot first.

Good luck.
Right resurfacing, Dr. Gross, 7/11/13
Left resurfacing, Dr. Gross, 12/11/13

hernanu

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Re: Got Stairs?
« Reply #11 on: April 06, 2015, 02:47:39 PM »
I had PT at the hospital, they showed me the right way to go up and down stairs.

Matter of fact, they wouldn't release me from the hospital until I could do three stairs up and down.

Make sure you know the right way to go up and down before you do it.

Up with the good and down with the bad

http://www.upmc.com/patients-visitors/education/rehab/Pages/stair-climbing-with-crutches.aspx

So use the stronger leg to pull you up and to control things on the way down.

Be careful now, I'd practice with a home PT person or a friend at first.

At about ten days, I was walking and doing some steps up and down regularly.
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

petemeads

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Re: Got Stairs?
« Reply #12 on: April 06, 2015, 03:19:51 PM »
If you mean leading with the operated leg, it probably took me a couple of weeks so you must be getting close by now...
Age 66, LBHR 48mm head 18th Nov 2014 and RTHR 36mm head Zimmer ceramic/poly by Mr Christopher Kershaw, Spire hospital, Leicester UK

hernanu

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Re: Got Stairs?
« Reply #13 on: April 06, 2015, 04:21:20 PM »
If you mean leading with the operated leg, it probably took me a couple of weeks so you must be getting close by now...

Up with the non operated leg,

Down with the operated leg and the crutch(es).
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

OtterDriver

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Re: Got Stairs?
« Reply #14 on: April 06, 2015, 08:46:31 PM »
I presume Jake is asking about when one can begin using the operated leg in a normal stair climbing mode!?

Was about three weeks out for me this time around!

Jake

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Re: Got Stairs?
« Reply #15 on: April 07, 2015, 04:05:19 AM »
Yes, sorry for the vague question.  I meant walking up and down the stairs like a normal person using both legs.  I just wasn't sure if I had to wait a certain amount of time, it was never really mentioned in the post op packet.  Thanks for your comments. 

hernanu

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Re: Got Stairs?
« Reply #16 on: April 07, 2015, 05:02:06 PM »
Ah.

I don't think there's any set time or schedule. I waited until if felt right and strong enough, and did it with one crutch in hand in case I needed assistance.

I'd take all timelines off it and do it when you feel strong and confident with it. No need to rush anything.
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

Snowbound

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10 week post op - inner thigh pain
« Reply #17 on: April 09, 2015, 04:53:04 PM »
I had bilateral resurfacing 10 weeks ago. The left hip is doing great but I still have some pain in the right leg, which was the worse hip one prior to surgery. At first it was the groin that was sore, which is normal from what I was told.

The pain has moved lower to the adductor area (which was extremely tight prior to surgery) and also more recently the inner hamstring. It's mainly a problem after I've been sitting. When I'm up and moving around the pain lessens and/or goes away.

I've been going to the gym but taking it easy on the legs, not trying to push it too much. Is this normal at this stage of recover?

oldsoccerplayer

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Re: 10 week post op - inner thigh pain
« Reply #18 on: April 09, 2015, 05:32:46 PM »
Hi there,
you learn from this site that there isn't really a 'normal' recovery, everyone has their own variation. I'm too long past the procedure to remember specifics but I do remember that for a while I would have pain or discomfort in one place that would go away only to be replaced by pain and discomfort somewhere else. My non-professional opinion is that as long as it's not persistent - ie it only happens in some situations, you're probably OK and just need to give it a bit longer. As always if you are really concerned your best resource is the surgeon. Do you have a post-op checkup scheduled? Mine was at 12 weeks and was a good time to raise any concerns.
All the best.
BioMet Left Hip Resurfacing, Dr. Gross, 07/2013

livendive

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Re: 10 week post op - inner thigh pain
« Reply #19 on: April 11, 2015, 05:04:05 PM »
I'm about 6 weeks out from my second resurfacing (had right hip done in January, left hip in March) and have similar pain on the "inside" of the hip that's pretty persistent.  It feels like the groin and adductors and is worst when I first get up from sitting or lying down, but is always there to one degree or another.  I feel like I could mostly walk without a limp at this point after the first hip, but now I'm still swaying to the left when the left is my plant foot, to get my weight vertical over it rather than leaving it "offset" as in a normal gait. It's still early for me, so I'm hopeful it'll resolve over the next couple of weeks.
RBHR 5 January 2015
LBHR 2 March 2015

Hip Talk About Hip Resurfacing

Re: 10 week post op - inner thigh pain
« Reply #19 on: April 11, 2015, 05:04:05 PM »

 

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