Surgery Scheduled - Questions for group

[Philbrd]

Hi All,
I am also new to this forum and have seen similar questions as what I am about to ask.  However, I feel compelled to ask since each person is different.  I have seen Orthopaedic in Concord NH and the xrays show osteoarthritis in both hips.   They suggest THR at some point in time and definitely have not recommended Hip resurfacing.   I am 52 and up until a year ago was very active - running 20 mpw, hockey, hiking, skiing, etc.  I've pretty much had to stop running and hockey.  The pain is not what I would call terrible - most notably if I bend forward at the waist.  What is really challenging is stiffness.  If I hike, play hockey etc i am very stiff for what seems like days.  I feel I have also lost a lot flexibility - fairly rapidly in the past year.  For example, bending to put on a snowshoe is difficult.  Some pain but very stiff.  My wife notices a pretty continuous limp.   Ironically, I have the most pain at night - and not predictable.  I'll wake up with pain deep in hip - I cannot correlate what brings on the pain at night.  I did have a cortisone shot and that has helped.  I have spoken to Dr. Gross and he says I am a good candidate for Hip resurfacing so I am scheduled for Bilateral resurfacing, with a visit at his office for the bone test and current xray in a couple of weeks. 


So here are my questions for the group:
1)  Do these symptoms sound similar to other - particularly stiffness with persistent pain, but the pain is positional and not unbearable?
2)  I think I know the answer, but is there an advantage to putting it off.  I've tried stretching a program called FAI Fix, strengthening but nothing seems to improve.  I find symptoms do diminish at times, but seem to be progressively getting works (say over the past year). 
3) with hip resurfacing, can i expect to gain flexibility and range of motion back?


Thanks in advance for any insights,

[John C]

In answer to your questions:
1. Yes, those exact symptoms are very familiar to many of us, and are what lead us to choosing surgery.
2. Timing is very personal. I had my first hip resurfaced by Dr Gross 10 years ago after dealing with a painful hip for almost 10 years before that. At the time Dr Gross said that the x-rays of my other hip showed that it was also a candidate. I was not having any pain in the other hip at the time, so I just had the one hip done. About four years later the other hip started going bad, and I am having it resurfaced by Dr Gross at the end of this ski season. Why did I wait so long? When I measured the risks of surgery versus the limitations and pain that I was dealing with, I was still able to be fully (though painfully) active in all my sports so I kept putting it off until this year. If it comes out as good as my first hip, it will seem foolish to have waited and dealt with the pain. If something unlikely goes wrong, I will be glad that I milked a few more fully active, though painful, years out of my natural hip.
3. Yes, you should expect to get flexibly and range of motion back within a few months of the surgery, but I would expect it to be commensurate with a normal hip your current age, as opposed to making you feel 20 again.
Dr Gross and his team are outstanding, so the surgical experience will likely be better than you expect. The road to recovery is a winding road full of surprises and occasionally some setbacks, so be prepared for that.
Dr Gross made two key comments to me during the process. When he first examined my first hip, he said "I can make you a lot better". He was right. Shortly after that surgery when I was having some strange sensations in my new hip, he said "You have to expect some things like that, you have a metal joint." Reasonable expectations are good.

[Tri Hard Alan]

I would add, re question 3, is do not expect the full range of motion and flexibility you had before your hips started to trouble you. I only had one side done but was warned this one will never have the same ROM as my operated side. But to be honest this isn't a problem at all.


If you are patient after surgery, start and follow a strengthening program at the right time you will have reasonable flexibility and ROM and more importantly go back to all your previous activities.


Good luck.

[blinky]

I'll chime in to say my ROM has improved and is still improving since surgery, but I am sure I won't get back to the extreme limberness I had in my teens and twenties.


A symptom of my dysplasia was extreme flexibility. I could do all kind of splits and high kicks. It was an advantage for some sports and activities, but not normal. As my arthritis progressed, I lost that flexibility. Loss of ROM, not pain,  was the first sign of my arthritis. Pre op I could tie my shoes, but could no longer sit cross legged.


Everything tightened up post op. My strength and endurance came back pretty quickly, much to my delight. I went into surgery looking forward to being able to walk as much as I wanted and to move without a limp, hoping to run a little bit. Within a few weeks it became obvious that walking would not be a problem, and running was likely. Now I am eager to see how fast and far I can run.


ROM? It wasn't a priority so I haven't pushed it, but it has been coming back on its own. Tying shoes was never an issue, but after about six months I could sit cross legged again. I can do decently high kicks to the front, but don't have the lateral flexibility I once had. (I think my hips used to be able to slide out of the sockets to let me do some things I used to do.) I'd say now, at two and half years post op, I have better than normal, but not freaky, flexibility.


Best of luck. Your symptoms sound familiar. I let it go too long, until I had trouble sleeping and couldn't do simple daily activities.

[Quig]

I'll echo those above me, it sure sounds like it's time.


To answer your questions;


1. Yes, those symptoms make perfect sense. Many of us have experienced them. In my case I had certainly graduated to 'extreme excruciating pain' at times. And sleeping was really, really bad.


2. I don't see any reason to wait. It's clearly having a significant effect on your life. Around here you'll hear over, and over and over "I wish I had done it sooner...". I'm one of those. I suffered mightily for a couple years and since my surgeries have felt sooooooo much better.


3. Short answer; YES. Long answer; I'm a bilateral. My left hip had minimal symptoms (pain was minimal and ROM still quite good) but was bone on bone in the X-rays. My right hip was really, really bad and had terrible range of motion and flexibility. I mean TERRIBLE! I'm currently approaching 2 years post surgery and the improvement is beyond description and continues to improve. I marvel at the things I can do now... it really is remarkable.


And though it's probably not necessary, here's another vote of confidence for Dr. Gross and co. I just can't overstate how nice everyone is and how good they ALL are at their jobs.


Good luck!

[Joe_CA]

Hi Philbrd,

I have an answer to question number (2). Is there an advantage to putting it (hip resurfacing) off?

Surprisingly, I can actually think of one advantage. If you continue to wait, your pain will increase, and you will continue to have those miserable days and nights. As each year goes by, it will only get worse. So, when you finally get hip resurfacing surgery, you'll be even happier and more content in comparison!

Does that answer sound kind of dumb? Well, that's because it is. However, it's pretty much true in my case. I let my hips continue to worsen for many years. I'm sure I was a candidate at least 6,7 years before I ultimately had the surgery (bilateral with Dr. Gross in Dec. 2016). One of the main reasons I put it off was because I wasn't even aware of hip resurfacing surgery until 2016 (this website was key to gaining knowledge on the subject). So, because I was such a sad sack for the last couple of years, I'm overly happy with my results :-).

Is that one small alleged advantage worth putting it off? Of course not! Please consider getting it done. It's your decision. Continue to research and read the posts here. I too tried all the stretching and strengthening during my final year pre-surgery. I made one last push to try and overcome my plight. I truly think the attempt made my hips worse. Once you're bone-on-bone, there's not much you can do to improve your situation.

Good Luck.

[Philbrd]

Thanks for the insights!  I appreciate the info.
Dan

[karlos.bell]

 8) Hi Yes - No - Yes. Cheers K

[byebye]

I waited 5 years (until i turned 50).  4 cortizone shots, Hip nerve ablasion and unfortunately too much Ibuprofen.   I waited as long as could and probably beyond due to the fear of the unknown. It won't get any better or easier by waiting.

Always extremely active, but as the years progressed, I began limping, had pain every night and could actually feel my hip bones grinding when I stood and tried to put on a sock.  I waited too long. 

Only 9 weeks out now, but am so glad to be on the other side and ready to get back to life.  Not without a couple steps forward and one back and times, but in general each day better than the next.  Good luck to you- and your journey

[RebeccaT]

I had my right hip resurfaced by Dr Gross when I was 41 ... totally worth it. I had about the same symptoms as you ... the limp was what drove me crazy the most, but also the pain at night.

Like Blinky I had dysplasia and was super flexible (like crazy flexible). So while I haven't gotten back to that level of flexibility, I would say I do have better ROM than most people I know (like, I can sit on the floor and reach and touch my toes with no problem ... and I can pull my knees to my chest, etc.) ROM is WAAAY WAAY better than pre surgery.

My left hip is going now -- i will put it off until I start limping or can't sleep and then it will be back to South Carolina for me.

[tommyhip]

I will approach your question from a different standpoint. You're 52 years old. If you get a THA you can almost be assured that you will have a revision in your lifetime. Go on youtube or the like and watch that operation. It's horrific even though sometimes necessary. If you get an HRA and it doesn't last your lifetime you can always go THA as if you never had the original operation - at least as far as the femoral component is concerned. PLUS, you will have the benefit of the future technology and surgical innovations that are constantly evolving in this arena. Go get your DEXA scan done in NH where you live and forward the results to Columbia, SC. Dr Gross, unlike many other orthos who will only perform HRA's on the very best candidates, will likely still perform the operation even if you have marginal DEXA results. What changes mostly is the post-op protocol and safeguards for rapid or slow recovery. AND STILL, Dr. Gross's post-op published results are among the best anywhere. I chose Dr. Gross specifically for his experience and commitment to cementless prosthesis. I chose this specifically over HSS in New York. Finally, your limp is likely caused by a combination of worn/lost cartilage and muscle contraction and/or pelvic tilt. HRA cannot substantially effect post-op leg length (like THA) so don't wait too long. And finally you will have no permanent ROM restrictions as in ALL THA's. At 12 weeks post-op I don't even know that I had a new hip. The decision should be easy - for sleep's sake alone. LOL Good luck.