Dean's Bilateral Hip Resurfacing with Dr Gross

[djganz]

L Biomet (56 mm) post op day 31, R Biomet (54 mm) post op day 29


Thanks, John, for your post.  That's reassuring.


My right hip is feeling great. It doesn't get tired or sore.  Even after spending several hours on my feet, my right foot will only get slightly to mildly swollen. I can walk as far as I like on it. Most of the time I don't notice my right hip.  It just feels like a normal hip.


My left hip is different. I feel tightness and irritation over the lateral, trochanteric area, like tissues are rubbing together, or like a tendon is rubbing over a boney prominence when I walk. It will warm up after about a 1/2 mile, and feel better, but I'm using 2 crutches for my outside walks to protect this hip. It doesn't feel ready to go with less support. I'm walking about 1 mile now at a relaxed pace. My left hip will also get sore at the end of the day if I've been on my feet too long, and my left foot will end up moderately swollen with 2-3 plus pitting edema. Although, most of the swelling resolves overnight when I'm sleeping. 


I  spent the last week icing my lateral left hip with ice packs.  I iced for 30 minutes, waited an hour, then iced again, about 6 times a day. I'm icing less often this week, about 3-4 times a day.


Lee has said I'm within the normal range for recovery. I hope so. I look forward to my 6 week follow up, Aug 4, so I can see what Dr Gross thinks.


Take care,


Dean

[John C]

Hi Dean. You made a pretty accurate description of trochanteric bursitis. There is a bursa that cushions soft tissue that rubs across the greater trochanter, and that bursa can become inflamed. Mine was a little sore for the first month or so, and I had temporary flare ups over the first 18 months when I had a big increase in activity level or type. Many of us found relief for this by using a foam roller on the IT band that runs up the outside of the leg. Dr Gross offered a steroid injection if it did not get better, but I think the need for that is really rare if a person is willing to use the roller. You will find lots of references to using the foam roller on this site.

[djganz]

Thanks again John.  I've got a foam roller. I look forward to using it when Dr Gross says it's ok. Thanks again!  Dean

[djganz]

It's been 5 weeks since my surgeries. My left hip continues to recovery slowly compared to my right one, but I think there has been some progress since last week. I think there is less stiffness and soreness across the trochanteric area, I can stand longer without my lateral hip starting to ache, and there is less swelling in my left foot and ankle. Sometimes I can stand as long as I want (a couple hours) and sometimes it's more sensitive. Sometimes I don't feel much stiffness/soreness at all, and sometimes it's a bit more.  I've also noticed that there is stiffness posterior to the trochanteric area whenever I take a step up with my left leg. And I've begun to have some soreness in the lateral hamstrings where they insert into the knee. It's hard to be sure exactly how things are going because I need to compare how I feel now to how I felt several days ago. There's not a dramatic change from day to day.


I'm walking 1.5 miles/day with 2 crutches. My left hip feels like it needs this support. Inside the house I'm comfortable using 1 crutch, and I use 1 crutch outside for short distances like walking around our cul de sac.  My hip will warm up after about a 1/2 mile and feel better. I can walk a few steps without crutches with sort of a waddling gait. I tried walking (about 1/2 mile) 3 weeks ago using 2 canes, and that felt ok, but that was before I became more concerned about the stiffness and soreness in my lateral hip. Since then I've stuck to crutches.


My right hip feels great. I have a follow up appointment next week. I hope to find out what's up with my left hip. If they tell me it's ok, then I'll feel better about challenging it more. That's it.


Take care,


Dean

[JHippy]

Dean, don't hesitate to contact Nancy at the office if you have questions/concerns. I did a few times myself.

[djganz]

Hi,

I had my 6 week follow up with Lee and Dr Gross today. They thought I was doing well. There were no problems seen on the x-rays. That was nice to hear. They said it's normal to have differences in the recovery of the right versus the left hip.  Lee agreed my left hip was a little slow from a single hip perspective, but she thought overall I was doing well for a bilateral patient. Dr Gross thought my right hip was doing well and making my left hip look bad.

I found out when Lee was showing me the next set of exercises, that my left hip was considerably weaker than my right hip, particularly on the straight leg raise.  It was also the poorer functioning hip before the surgeries. Perhaps that's why it's taking longer to recover. I look forward to working on the next exercises and strengthening the left side. I also look forward to walking more and beginning to stretch.  It's so nice not to have to worry about something being wrong with my hip.  I apologized to Lee for besieging her with worried emails for the last 5 weeks. I think I can finally leave her alone.

During this trip, I was able to use 1 crutch, on the right, while walking around the airport terminals.  I also drove for the first time since the surgeries. I've begun to take baby steps in the kitchen, bathroom, and bedroom with no crutches, with a more normal, less waddling gait.  And tonight I tried using one cane, walking slowly around the house which felt ok. I still used 2 crutches for long walks through the airports today though.

Take care,

Dean

[Paul_D]

Hi Dean,

I think I am having a very similiar recovery to you. For me its now 13 days right and 8 days left post op.

My right leg feels perfect but my left hip feels like there is a "bubble" around the hip region. Is this the same feeling you have/had?

Regards,
Paul

[djganz]

Hi Paul,

Yes, I think that's a good description. If it helps, I had that sort of feeling, and it turned out that nothing was wrong.

Take care,

Dean

[djganz]

Just wanted to say, having my follow up appointment this week seems to have freed me up to move on with my rehab. I've been using a single cane for all my walking since the day after my appointment, and I'm starting to pick it up for a few steps now and then. It's great to look down and see myself walking with no support.


Dean

[JHippy]

awesome, Dean. I breathed a big sigh of relief at my 6-week as well.

[djganz]

Hi,

I'm now 8 weeks post op. I'm still using a cane, but I've begun transitioning away from it.  I do without it for at least half of my indoor walking. During my outside walks, I frequently pick up my cane and walk 10-40 yards  without it.  It doesn't feel like I'm hurting my left hip to walk on it for short periods, but I have a slight limp.  The left lateral stiffness and pain have improved. The left lateral hamstring aching has resolved. My left hip flexors are very weak and painful when I try to do the supine straight leg raise. I still can't lift my left leg into the air without significant pain, so I do this exercise in the standing position to make it easier and avoid aggrevating what's hurting.  Dr Gross gave us 2 strengthening exercises to do: straight leg raises in the supine and sidelying positions. The sidelying leg raises have helped my left lateral hip feel better.  My right hip continues to feel great.

The stretches Dr Gross gave us (reaching for our feet while seated in a chair with knees apart and feet together, hip flexor stretch-which I've modified, adductor stretch-which I've modified, and quadriceps stretch) are helpful in reducing stiffness and pain.  I've also been doing hamstring stretches. My left (lateral and anterior) hip is still achy when I get up from having sat for a while, and my left adductors ache too. But this improves after I've walked a little. I still use my arms to stand up from a seated position.  I try to ice my left hip (lateral, anterior, and adductor origin-not for the squeamish) 30-60 minutes a day, which helps reduce pain and stiffness.

We're allowed to flex our hips past 90 degrees now. The main restrictions we have are no extreme hip flexion (such as squatting), no crossing the legs at the knees, no running or jumping, and no lifting more than 50 lbs routinely.

My left hip is improving, but more slowly than I would like. Still, I can imagine weaning off the cane in the next 2 weeks, and moving on to things like walking up stairs foot over foot and riding an exercise bicycle.

Take care,

Dean 

[djganz]

Hi,

I'm now 9 weeks post op, and today I went out to do some errands and left my cane at home.  That felt good. Walking around the store and parking lot, I may have looked like someone with a sore back. My gait is steadiest when I'm out for an extended walk. Most of the time I don't think I have an obvious limp, but I still do some hobbling after getting up from sitting or laying down for a while.

I can walk upstairs foot over foot for 3-4 steps without a rail, but I haven't tried it for more than that. My left leg is still stiffer and weaker than my right one, but it is improving. I continue to do the stretching and strengthening exercises. I've also tried standing just on my left leg, and that seems to have helped.  It's getting easier to get dressed. I look forward to trying out a stationary bike.

[djganz]

Hi,

I'm 10 and a half weeks post op now. I've been able to walk without a cane for about a week and a half.  But if I walk, use the exercise bike, or do my leg raises too much, the lateral (and anterior) left hip pain and limp come back, and I end up using my cane some more until the pain resolves, usually within a day.

I'm still limited to doing my left supine leg raises in the standing position. In the supine position, I can just barely get my leg off the floor and it hurts (as if I'm aggrevating it) about 3 finger widths below the anterior superior iliac spine. I also have  weakness in flexing my left hip with my left knee bent (I need to help lift my left knee up to put on the parking brake in my car.). If I walk for 45 minutes (about 2 miles), my lateral left hip will hurt afterwards for a day, so I'm doing less than that at any one time. I've been using the exercise bike, but mostly with no resistance. 

Last weekend my left hip felt good and I increased my walking, exercise biking, and leg raise work all at once. Then my left hip got sore, and I've been spending the last 3-4 days trying to sort out what caused the flare up. It seems overdoing any of these can cause problems, so I've cut back on all three. My right hip continues to feel fine.

I've been doing a stretch for the internal rotators of the left hip (standing with my left foot pointing straight ahead, my right foot behind, and rotating my shoulders about 90 degrees to the right), which seems to help my left foot point straight ahead instead of toeing in.

I still can't put my socks on, but my flexibility is improving.

Take care.

Dean

[djganz]

Hi,

I sent a note to Lee Webb, describing what I wrote in my last post, and asking the following questions:

Does this sound normal?
Can you tell me why my left hip flexors are so weak?
If I use a foam roller for my thigh, how far should I stay away from the hip?
Is it ok to roll on my anterior hip, under the ASIS, where it hurts when I do the supine straight leg raise?

Here is what she said:
"It takes a full year to heal from the surgery. At 10 weeks, you are going to have pain and weakness as you are describing. Listen to your body and back off when you have pain and limp. Use the cane as long as you need it. Try increasing your walking distance first, then add bike and leg raises. All of this sounds normal. A foam roller is fine. I would not roll over the incision. If something hurts, avoid that. You should see gradual improvement with time."

Take care,

Dean

[Juno]

Dean -- I agree and would say at 10 weeks you are doing great. I'm 2 years post op and am still making strides with the small external rotators of the glute. I hate to put it like this, but don't expect too much right now.... You are pain free and walking... It's a win!! It takes time to regain that range of motion, and even now, every day feels different. I can now do some pretty extreme yoga poses that I be ever thought I'd ever do again, but still some of the basic stuff involving my psoas and adductors are still a challenge. I seriously see improvement week to week right now. I hardly ever think about my hips until I'm trying to squat (still can't do a full catchers squat with my heels of the floor, but I'm close) or try to do full splits (not there yet, but maybe in another year)!  I think alot of it has to do with how long you were compensating before surgery and how jacked up some of the muscles were before surgery.


You're doing great!! Keep it up.
Juno

[MattJersey]

No experience of bilateral, but can only imagine how much more challenging.


It must be a little frustrating, as if I think about my pre op situation, after all the research I conducted, despite trying to think long term and the need to be patient, I still quietly hoped for more and to be one of the super hero type recoveries.


Now with hindsight, at just over four months, I think those recoveries are a rare breed. Or, they are a matter of "good perception" and better expectation management on the part of the patient concerned (and maybe a little bluster too).


By this I don't mean I feel misled but that perhaps the wrinkles that, surely, even the super heroes have, get smoothed over very easily when writing about them in the past tense having achieved some "level" of progress.


So myself, if I could have understood and felt what it feels like now, at four months, pre op, and have known all the wrinkles and ups and downs, and discomfort I experienced, still I wouldn't have changed my mind as it has been so worth it.


Continue to work sensibly as you are doing, I admire your patience, and once you reach that "level", and you will know it, the challenges you are over-coming now will take on a very nice rose tint, I am sure!


Best wishes!


Ps. The rose tint in my spectacles was further enhanced yesterday when I shot my best golf score for 18 months, six over par that included four double bogies. I love my new hip.

[djganz]

Hi,


Thanks Juno and Matt for your kind and thoughtful replies. I appreciate them.


I'm now 12 and a half weeks post op. It's taken 2-3 weeks for my left hip to feel strong enough to support me without pain and without sagging to the outside when I step onto my left leg. The last time it felt this good was at 9 and a half weeks post op, just before I added stationary biking, increased walking, and increased straight leg raise work. Today it feels pretty good.  But I'm taking it easy.  I don't want it to feel sore and weak again.


Since my last post (at 10 and a half weeks post op), I stopped riding the stationary bike, and, after holding off for a while on leg raises, started experimenting to find the optimal amount of leg raise work for me. I also stopped the extended 2 mile walks I had started, and substituted instead shorter stop-and-go walks (like walking my dog). I tolerated the shorter walks well, so I restarted nonstop walks, but at a shorter distance. I started walking for 20 minutes at an easy pace (about 22 minute miles), and I'm increasing the time by one minute every 2 days. I've also continued with my shorter stop-and-go walks, and that's been fine. With the leg raises, I've found that it's very easy to overdo it, and the pain and weakness that results from overdoing it, which I don't feel until hours after doing the leg raises, can last for days. Right now I'm limiting my leg raises to 3 sets of 10, raising only about 8 inches, with my supine raises being done in a standing position to make them easier, and my side lying raises being done on my side, like normal. With walking, anytime my hip left hip starts to feel tired, I ease up and stop soon after. Using a cane sometimes also helps if my hip is tired or if I think my hip may get overworked.


I continue to stretch about 90-100 minutes a day, which is down from what it was, and my flexibility is improving. By sitting in a very low seat, I was able to put my socks on this week without an assistive device for the first time since the surgeries. I can get dressed without assistive devices, although I need to lean on something or sit. I'm still icing my left hip. I experimented with ice massage for anywhere from 15-45 minutes and that worked well. I'm currently using ice packs again for about 60 minutes so my hands can be free.


I look forward to increasing the length of my extended walks, but I'm going to do my best not to overdo things.  My main goal is for my left hip to continue to feel strong.


Thanks for reading and take care,


Dean

[djganz]

Hi,


I'm 13 weeks, or 3 months, post op this week. After writing my last post, I thought I still might be doing too much, so I decided to hold off on the leg raises. I've just been walking, stretching, and icing since then.  I walk my dog about 0.8-1.0 miles in the morning, which is a stop and go sort of thing. I tolerate this well. Then I go for a walk by myself. I've been increasing the duration by one minute every two days, but I might slow that down a bit. Right now I'm walking 27 minutes at about a 20 minute mile pace, which is faster than my pace last week (22 minutes a mile).  That makes about one and a third miles. In the afternoon, I usually walk around our cul de sac slowly for 15-20 minutes while I'm out with my dog.


The soreness that I was feeling in the front of my left hip has resolved since I stopped doing leg raises, and last night I finally could sleep on my stomach without pain in my front left hip. I still get some temporary soreness in that area, as well as temporary stiffness and pain in the lateral left hip, but it's less than it used to be, and not enough to cause me to limp. My left hip has stayed strong this week, although sometimes just barely. I can feel that it is weaker than the right hip, and on my longer walks it can get fatigued in the front hip flexor region.  Carrying too many groceries can cause it to ache a little, laterally. I can still hobble/waddle a bit after getting up in the morning or after getting up from sitting. But that usually goes away in about 30 seconds. My stretching has decreased to about 80 minutes, and my icing time (for the left hip only) is 30-45 minutes.  I've been stretching the internal rotators of my left hip/leg with a stretch that looks something like 3rd position in ballet, and it seems to be improving the mild left foot toe in I have. I'm able to walk without a toe in, but it's something I need to consciously think about.


My walking is definitely better now than it was before the surgeries. Walking is fun again. My legs swing freely and easily straight back and forth from my hips instead of whatever was going on before. I can walk further and faster (although I'm not trying to push for speed) than I could before, when walking had become something I just tried to bear. My right hip continues to feel great, with an occasional twinge in the lateral or front areas.


I think that's it.


Take care,


Dean

[djganz]

Hi,


I'm 14 weeks post op. and my left hip is starting to feel like a real hip, like it really supports me.  I still may hobble a bit after getting up, and I still have times where there is stiffness and soreness, but I also have times where I don't feel any pain or stiffness, and where I actually feel somewhat agile and strong. I was turning and changing direction in the kitchen one day this week, to the right and left, and felt no pain, weakness, or limitation at all.  It reminded me of how I used to feel prior to the onset of hip pain.  I put on my parking brake (once) without lifting my leg up with my hands, and I went grocery shopping and could move normally and independently of the cart. (I still used the cart to help me get down to the lowest shelves and then get up again.) For the first time since my hips started hurting, my left hip has started to feel soft, cushiony, and comfortable again around the joint.  I'm also starting to use my legs more when getting out of a chair or sofa, and I was able to put my socks on (with some difficulty) while sitting on the sofa or bed (instead of on a low seat).  Another thing that's getting easier is turning from face up to face down when I'm on the floor. I don't have to be in an extended, lying down position. I can turn while my hips are flexed by putting my weight on my hands.


I'm still just walking, stretching, and icing. My continuous walks are now 30 minutes (at a 20-22 minute/mile pace). My stretching has ranged from 70-100 minutes, but is usually 90 minutes or less, and I'm icing my left hip for about 30-40 minutes.


Take care,


Dean

[djganz]

Hi,


I'm now 4 months post op, and I continue to make gradual improvement.  I routinely set my parking brake without using my hands to help lift my leg up. I can carry 2 heavy bags of groceries without hurting my left hip. My left hip no longer gives way and sags to the side, ever.  I no longer hobble. I went through a phase where I sort of rocked from side to side for 10-30 seconds after getting up, but that has decreased. Now I'm stiff when I get up, but I loosen up within 30 seconds.


My sustained walks are up to 45 minutes now. My estimate of pace is rough because I measure the distance using Google Maps, but I've calculated it from 17 minutes/mile (for 0.8 mile) up to 22.5 minutes/mile.  I can walk at a sustained medium speed, and even at a slightly quick speed for a short distance, although my gait gets stiff at this quicker pace. 


My left anterior hip doesn't usually get fatigued on my walks anymore, although I still get aches in my left anterior and lateral hip, off and on, as I walk. I've begun to feel some aches in my right lateral hip, off and on, so maybe my hips are starting to even out. 


Getting out of chairs/sofas is easier and requires less arm assistance. For a deep sofa, I might use 50% arms and 50% legs. I honestly can't remember what the ratio was before I had hip trouble.


It's still hard to put my socks on. Bending over to pick up dog poop off the ground is still challenging. I need to spread my feet out to the sides and reach down between my legs. When I'm not warmed up, I can just barely reach the ground with my finger tips. But if I hold onto something for support, it's easy to reach the ground. 


I'm still just walking, stretching (75-90 minutes), and icing (both hips now) for 35 minutes. As some stretches require less time, I've been adding others. So my stretching time has remained about the same. Last week, I tried and was able to do one set of 5 repetitions of supine left straight leg raises, lifting my heel about 6 inches off the floor, without hurting myself. So my left hip flexors are getting stronger. But I still have soreness at times in the left hip flexor area, though it has lessened.


I'm ready to add something like riding a stationary bike. That's what Lee suggested. Then after that, strengthening exercises, the supine and side-lying leg raises.


I hope you all are doing well. Take care.


Dean