Dean's Bilateral Hip Resurfacing with Dr Gross

[JHippy]

I noticed the toe-in also, in the beginning. I don't think it's there now, if so its very minor (I'm 6mos+). I'm guessing it's weakness in the external rotators which were cut and reattached in surgery.


Please let us know what Lee says.

[Snowbound]

I noticed the toe-in also, in the beginning. I don't think it's there now, if so its very minor (I'm 6mos+). I'm guessing it's weakness in the external rotators which were cut and reattached in surgery.


Please let us know what Lee says.

I had the opposite problem. When I went to rehab after surgery the therapist said that I was standing with my foot angled out, which she said was compensation for my bad hips. I'd probably been doing it for years but once I was aware of what I was doing and with the new hips it wasn't difficult to correct.


I'm about 5 months post bilateral, and since the surgery I've noticed that I'm somewhat knock kneed. I assume it's from years of extremely tight adductors. It may also be from correcting my walking/standing with my toes pointing out to having my toes straight ahead. I'm hitting the gym every day and riding frequently so I'm hoping I can correct this over time.

[djganz]

L post op day 14, R post op day 12


Hi,


Just wanted to let you know what Lee replied. Here it is:


"As you gain strength in your leg, this will correct itself. Don’t try to rotate it, just let the hip go where it feels most comfortable. Work on your exercises and walking, the muscles will respond but it takes time."


Thanks for your input. I'm going to just let it be for now.


Take care,


Dean

[JHippy]

Awesome. Thanks for posting her response.

[DeviceGuy]

Thanks for response.  Good to know that it should self correct.

[djganz]

Hi,


I also asked for clarification on just how much we should be walking, total, per day in the first 6 weeks. Here is Lee's response:


"You should max out at 1.5 miles at 6 week total per day. Best advise, listen to your body and do not overdo!"

Take care,

Dean

[djganz]

L Biomet (56 mm) post op day 17, R Biomet (54 mm) post op day 15


Hi,


I had a set back this week which has slowed me down. But it looks like it was not serious and I hope I've learned to be more patient and ask more questions.


Last Thursday as I started my outside walking program, at post op days 10 and 8, I noticed that my left foot was a bit toed in. I had been told in the hospital not to let my foot curl in, but to straighten it out.  My right foot alignment seemed perfect and I was concerned that maybe something was wrong with my left side. I straightened my foot out as I walked, so that my toes pointed straight ahead, but this but a strain on my lateral knee cap and lateral left hip. It wasn't a severe strain, but my left leg definitely felt different compared to my right leg which felt supple and strong. The next day I decided to try a gentle stretch aimed at the internal rotators of my left leg. But I also started an isometric strengthening exercise for the external rotators of my left hip, not knowing at the time that the external rotators are cut and then repaired during the resurfacing operation. (I still don't know the details of what is done with them.) I also continued to externally rotate my left leg as I walked, so that my left foot would point straight ahead. The strain on my left knee resolved and I was feeling pretty good except for a mild strain at my left lateral hip. I sent an email to Lee, but not soon enough for it to be answered until Monday. Over the weekend I advanced my walking program so that I was walking about 1/4-1/3 mile up to 3 times a day. On Monday morning I was feeling good enough that I walked perhaps 1/2 mile with 2 canes instead of crutches. My walking felt easy except for a mild strain in my lateral and sometimes medial left hip. My leg swelling had largely resolved by post op day 10, but I still had some persistent ankle and foot swelling which was moderate on my left and mild on my right. Then I read an email from a hip surgeon, saying that there was little to gain and potentially much to lose in being active too soon after surgery. He said that too much activity could turn the perfect resurfacing into a THR. This got my attention. Soon after, I got Lee's response that I should not rotate my leg, but just let it go where it feels most comfortable, and that the alignment would improve as the muscles got stronger. I had stopped using pain meds on Monday (of this week) and my left lateral hip definitely felt irritated. I was also concerned that the persistent left ankle and foot swelling was a sign that I had injured something in my left hip. I wondered if I could have caused a stress fracture in the femoral neck or torn the external rotator repair. This was a bad feeling. So I changed what I was doing. I stopped my walking program and spent the next 3 days mostly on my couch with my feet up above my head and the polar care going every other hour. The pain in my left lateral hip resolved but my hip feels a little sensitive like it was stretched or messed with.  The swelling in my left ankle and foot was stubborn, but today it's been reduced to some slight to mild swelling behind the malleoli.  Lee sent me an email that it would take a major injury to disrupt the external rotator repair, and I've heard that femoral neck fractures are not common these days. This is encouraging, and I feel fortunate that it looks like things will be ok. But I'll tell you, I'm in no hurry to advance any of my activities anymore. What I mainly want is healthy, functioning hips. I hope there are no complications. The lessons for me from this are be patient, ask questions first before acting, listen to your body, and don't overdo.


By the way, I asked Lee for clarification on how much walking we should do, and she said to aim for a total of up to 1.5 miles/day by week six.  I was headed far beyond this at the pace I had set.


Thanks very much for reading and for all your help.


Dean

[MattJersey]

I think we must all of had similar panic situations, doubts, and worries ... Elsewhere in the site there is talk of the emotional roller coaster. I didn't feel anything that I would consider "emotional" other than my worrying about (a) have I made the right choice (too late now, but it is all good so far) and (b) oh my gosh, it just twinged, or whoops/ouch, I shouldn't have twisted like that.


I tried external rotator exercise (clamshell) after my six week check, and it was sore! So heaven knows what yours was like at ten!


All the twinges I had, all my micro worrying, here I am at ten weeks and it is in perfect shape. Unnecessary worrying. I expect you'll feel much better after your six week X-ray and check up. Best wishes.

[JHippy]

Yea I remember those types of feelings. Don't worry, you'll get there. It's a healing process. I think of it as recovering from a broken bone + torn ligaments + pulled muscles all at the same time.

You're smart to check with the Doc when you're unsure or worried about anything. That's what they're there for.

[djganz]

L Biomet (56 mm) post op day 20, R Biomet (54 mm) post op day 18


Hi,


I spent most of the last 6 days on the couch with my feet over my head and the Polar Care unit going every other hour. The swelling in my right foot and ankle looks gone, and my right hip, leg, and foot feel great. My left foot and ankle still have mild swelling, but it's improving each day. It's surprising how long the swelling can improve a little each day, but still leave a mild amount left. I asked Lee about it, and she said that "swelling is normal following hip surgery for about 3 months."  I feel some stiffness in the left ankle (when I do ankle pumps), left anterolateral thigh (when I bring my heel towards me during heel slides), and in the lateral left hip, over the trochanter (when I'm standing and walking). But I don't feel pain in the hip. Perhaps the stiffness is because of the residual swelling.  An ice pack over the trochanteric area is particularly good at relieving the feeling of stiffness there. I still had some lingering concerns about possibly having hurt my hip with my effort to correct my left foot toe-in. But Lee didn't think my activity would cause a stress fracture of the femoral neck, although she stressed she couldn't say for sure without looking at an X-ray.  She thought that as long as I could bear weight with no pain in the hip, that most likely, there was no problem.  She thought I should progress my activity during the day, ice and elevate at night, and see how I do.  So I'll advance my activities again, but gently.


Take care,


Dean

[Paul_D]

Hi Dean,


I am following your story very closely as I am due for bilat next week with Dr. Bose.


This is my first time in hospital and I am nervous as hell but this forum is helping me ease these thoughts. What did you do to prepare for the operation? Did you do any exercises? How did you mentally prepare?


Regards,
Paul

[djganz]

Hi Paul,


I'm sorry you're nervous. Going into surgery can be a little anxiety provoking. I tried to follow my exercise routine as much as I was able. For me, this was riding an exercise bike or using a Stair Master at a comfortable setting. I found stretching after I exercised helpful, and I actually spent 60-90 minutes stretching (The time gradually crept up in recent years as my hips worsened, from a baseline of 45 minutes.) I know stretching isn't for everyone, and it felt as if it were taking over my life, but it did help me maintain my hip function. I also did some general strength training. It is helpful to have arms strong enough help lift you out of sofas, and strength in your core muscles helps too. My triceps are probably getting the most work.  I don't have any specific exercises to recommend. You might consult with a trainer.


As for mental preparation, I was just ready. After years of struggling to maintain basic function, I was ready for someone to relieve what I was feeling and do something about it.  I knew there was nothing better that I could do. I couldn't really wait any longer for some miracle hip regeneration cure, and resurfacing seemed like the best option.  I'm a former physician and I've had previous surgeries, so I was familiar with the hospital setting and procedures (like starting iv's, drawing blood, anesthesia, and post op recovery). Everyone who does these things in a surgical setting is pretty good at what they do, so I wouldn't worry about these things. You'll be well taken care of.  You've chosen a successful surgeon to take care of you. Try to trust him. Pain postoperatively hasn't been an issue, and every day gets a little bit better.

The things that you do and experience prior to surgery are pretty simple. You may need to register at the hospital. After that you'll wait to be called back. You'll be taken to a preop area where you'll change into a hospital gown (with the opening in the back).  You'll lie down on the bed and a nurse will ask you some questions and take your vital signs. He or she may connect you to monitors which measure your heart rate and oxygen saturation. Either the nurse or perhaps the anesthesiologist will start an iv, and labs may be drawn from the iv line when the iv is started. (This saves you from having to get stuck again to take the labs.) Someone may come later to draw a separate blood sample to make platelet rich plasma for use in the operation.  The anesthesiologist will come to see you and the surgeon (or someone who assists the surgeon) will also come to see you. Around the time they bring you to the operating room you may be given a sedative through your iv line which will relax you. You'll arrive at the operating room, meet some of the operating room staff, and transfer from your bed to the operating table. Soon after that the anesthesiologist will begin administering the anesthesia, and you'll go to sleep and wake up in the recovery room. Your job, thankfully, is pretty simple. You've chosen a highly trained, highly successful surgeon. Trust him.

I hope that helps some. Good luck with your operations!


Take care,


Dean

[djganz]

L Biomet (56 mm) post op day 24, R Biomet (54 mm) post op day 22


Hi,


My hips seem to be recovering at different rates. My right lower extremity swelling has resolved and doesn't return, even when I leave my feet down. My right hip has very little pain within the incision. The hip doesn't get sore from prolonged standing or extended walking. I don't really even notice my right hip. It just works, and it feels like it's ready to go, although I know it needs time to recover.


In contrast, my left hip has more pain (but still not a lot) within the the incisional area. The swelling was greater in my left leg and still persists in my left ankle and foot, and it increases if I leave my foot down. There is more stiffness in my left ankle, thigh, and hip than on the right side. When I walk, my left hip feels swollen, and I can feel a mild strain across the trochanteric area. Prolonged standing (an hour or more) can cause my left hip to ache across the trochanteric area.  Reducing weight bearing, rest, elevation, icing, and the hip exercises help it feel better. It feels like my left hip is recovering from more trauma than my right hip is. I'm beginning to think that my efforts to correct the toe in of my left foot may have added some to the irritation of my left hip, but that the large majority of it was already there. It just seems to have more to recover from, and it's taking longer to do so. I've communicated with Lee, and she says that this is normal stuff. She says it can take 3-4 months for swelling to resolve and up to a year to fully heal.


I've begun to limit the amount of time that I'm on my feet to no more than an hour at a time. (I don't usually spend an hour or more on my feet, but I can if I'm cooking and cleaning up.) I've also begun to ice with ice packs (bags of ice) which I put on my left hip where it is sore for 20-30 minutes. Then I wait an hour and ice again. I've been doing this throughout the day for the past 2 days and it's made a significant improvement in how my hip feels. The right hip doesn't really feel like it needs icing right now, although I could go back to using the Polar Care if I need to do both. But I like ice packs better.


I take one walk a day which is 0.6 miles right now (using 2 crutches), but I'm in no hurry to push it. I mainly want the swelling and achiness in my left hip to resolve. It seems to be improving.  That's all for now.


Take care,


Dean

[China Lady]

For me it was similar. Left and right side have had a different healing speed. My right hip was always 14 day ahead from my left. After, roughly, 3/4 of the year post surgery they became equal.
Dont worry too much....

[djganz]

Thanks China Lady. That's reassuring. I hope your hips are feeling good and you're doing well.

[Paul_D]

Hi Dean, how is it walking without crutches now after 24 days? How long do you think you will need walking aids?

[Snowbound]

Similar for me, although the swelling didn't last that long. For the incision my right side healed faster. The pain subsided sooner and numbness went away quicker. I still have a fair bit of numbness on the left side, but the right is now isolated in the area of the incision.


Internally it was the opposite. My left hip has been good right from the surgery, but I've had pain in the adductor and hamstring on the right side (which was my "bad" side). I'm not surprised it was the adductor, they were very tight prior to surgery. The surgeon said the pain was normal. At first it radiated down the inner leg to the knee but gradually improved over the weeks. It then moved more to the hamstring.


I did a few sessions of massage on my hips at about 4 months. It help relieve the tension.


I'm now at 5 1/2 months and the pain is almost gone. I still sometimes feel minor discomfort at the top of the hamstring, but very minor. I'm going to the gym every day, doing yoga, riding my bike and it feels great. These are the best hips I've ever had.

[djganz]

Thanks for letting me know about your recovery, Snowbound. It's nice to know that my situation isn't unusual. Paul, I can take a few steps without crutches with sort of a waddling gait. I'm in no hurry to give them up. I tried 2 canes about 10 days ago, and that worked ok, but I went back to crutches. I want my left hip to be able to rest and recover. And I want to protect my femoral necks. Something I read by a hip surgeon on the Surface Hippy Yahoo group gave me a scare.  I think he wrote, "A stress fracture of the femoral neck can turn the perfect resurfacing into a THR."  I don't want that to happen.


Thanks for your support.


Dean

[Paul_D]

Well I am about to find out, surgery scheduled in t -12 hours and I finally feel ready.

[John C]

Hi Dean. I had some thoughts on your feeling of the foot being toed in. Sorry I am so late in coming across your topic. I definitely had this after my surgery. My understanding is that the external rotators that turn the foot out are the ones that were cut in surgery, so they are now weak which leaves the leg with a natural tendency to turn inwards. It should go away with time as those external rotators get strong and firing again. Do your rehab with awareness of which exercises work the external rotators, and be aware of how your feet are tracking whenever you walk. My experience was that it was not a problem at all long term, but it did require some attention at first.