Clunking at 3 weeks post op

[Wannahoop]

I am 46-year-old male, three weeks three days post op with my first m-on-m resurfacing and I just called my surgeon because I have been feeling the clicking or clunking (new member, gotta get the verbiage right) when I move certain ways or do the bed (and now also standing up) exercises. No pain whatsoever, though. My physio couldn't say what's wrong and my surgeon hasn't called me back, but it seems like the good people on this website are saying I shouldn't worry because it's normal.  That sound like a big relief!  I also have been fairly mobile since I got out of the hospital 4 days post op but I still can't weight bear for another three weeks. Is it normal that I still have some quad swelling, stiff ITB/outside knee area?  And am I pushing it too much by crutching around coaching basketball and sitting in a lot of bleachers?  I am still a little scared because I often sit at 90 degrees (by accident) and don't lie down three times a day to do the exercies (I do them in the am and pm and in a chair during the day).  It's kind of isolating when you have no feedback, and I have "slipped" a couple times and landed on my bad foot.

Anyway, this website is great and I look forward to comments and reassurances, or warnings, especially since I need my other hip done after rehab and I want to get back on the bball court!  Regards,

[Pat Walter]

Hi

Welcome to Hip Talk.

Clunking is very normal.  It normally is because your muscles are still very lose and not holding the 2 bearing surfaces of the cup and cap tightly together.  It will get better.

I will say that I am somewhat taken back that you would be crutching around to coach and sitting in bleachers!  You do realize what major surgery you had and how you can cause injury to your resurfacing and surrounding area if you push it or overdo?  I think if you are a coach - you should realize how the human body works and heals.  It takes time, no matter how hard you push.  Sitting on a hard surface at 90 degrees is one of the worst things you could do.  Breaking all the rules.   Why don't you at least get yourself a lawn chair to sit in instead of climing on bleachers and sitting on hard wood..  I don't see how you can even do that if you had the posterior approach. My butt would really have been hurting.  

If you have swelling - then you are on your feet too much.  Rest and keep your leg up and ice.  Too much crutching around too early.  Listen to your body.  If it hurts or swells - stop doing the things to cause that.  You can cause a lot of problems early on by not taking it easy.

I don't know why you are not weight bearing for 6 weeks - but that should be a tip off that your surgeon thinks you should be taking it easy.  I would rather be cautious and not face another surgery to revise my resurfacing.  Slipping could cause a femur neck fracture or any other number of problems.  I think you need to rethink what what you are doing and start to become more cautious and let your body heal.  I am sure you would never force a student to return to play until they have healed  - be a good coach to yourself and ensure you will have a complete and sucessful recovery.  Caution and patience are your friends for a long time.  You normally are not allowed to return to heavy activities for 6 months post op and your body does not heal completely until one year post op.

Pat

[Wannahoop]

Hey Pat,

Thanks for your prompt response and your very sensible input.  The swelling in the quad is slight and only after I have been up on crutches for a while, so it hasn't worried me much.  I have had no pain whatsoever associated with the hip, even immediately post surgery, although I have been entirely off painkillers for a while so i do have stiffness ususally at night or in the morning.  I never consciously let myself sit at 90 degrees, and I always use my wedge cushion and have my leg out when in the bleachers or on a chair (I have only had to sit in bleachers for a few bball games, although I sat in a chair for 5 hours yesterday, with some standing up breaks, because I had to).  I spend my bball practices (three a week , 1.5 hours each) standing on one leg, with crutches, often doing hamstring "curls", which my physio said would be okay.  I did have the posterior approach (nice scar on the bumcheek) but the scar has healed up fast and very well and it has not hurt me to sit on my butt.  I also have driven myself in the past two days and am very careful getting in and out of the car.  I guess I have tried to be active because my physio said let pain be a guide (she did warn about swelling but like I said that has not been extreme).  The surgeon (Dr. Emil Schemitch, St. Michaael's Hospital, Toronto) was great, and said I need to be non-weight bearing (or touch only so I could "rest my foot on an egg without breaking it") because of the way the bone needs to integrate into the metal.  I hear about others with the same procedure walking with a cane after two weeks, and I am committed to staying OFF the foot for another three weeks, so I was hoping he is just a conservative doc, which is fine.

Also, I am a former elite athlete (okay, 9 years of bad bilateral arthritis took care of that), and for five months pre-op I rode the exercise bike pretty hard regularly to get my quads and hams strong.

Maybe my question should have been:  "Am I being an idiot?"  But I tell, you, the hip feels great (except for the aforementioned clunking, which doesn't hurt, and stiffness, which disappears after I do my a.m. bed exercises).  And I am not doing more ROM-wise than my physio and doc recommended.  So Pat, am I being an idiot? 

Looking forward to your sage advice.

[Pat Walter]

I could just say YES - but I don't think you are.  You are just happy to have a new hip and need to be more cautious.  Better to be cautious than sorry.

I was on one crutch 4 days post op with 100% weight bearing.  No crutch at 3 - 4 weeks and only outside.  No pain meds after leaving the hospital, sight seeing 5 days post op and walking over a mile a day at 10 days post op.  I was in Belgium.  I had no swelling or bruising.  If I were to push it too much or sit too long, I would start be be uncomfortable and could have had swelling - so I took it easy.

The US and many doctors are very conservative.  The overseas doctors normally less conservative with recovery.  My doctor allows patients to be 100% weight bearing immediatlely. You can't really do that for a few days. Althought you are weight bearing, you don't have much control over the leg and need the walking aid for balance.

All doctors approach the recovery different.  It is always best to listen to your own surgeon since they are responsibe for you and know your personal condition.

I would suggest you do take it easy and don't play basketball until at least 6 months post op and don't do a lot of jumping and running until far after that.  You will have the rest of your life to use the hip - so let it heal.  Remember because your hip feels great - you were just cut wide open only 3 weeks ago and you have to give your hip time to heal.  Be glad you are so painfree.  I was too, but many are not.  Enjoy your easy recovery and take it easy.

Over that past 5 years, I have read thousands of personal stories that included some nasty revisions.  Some from surgeon error and some from people doing dumb things.  Don't do anything dumb 

Stay in touch and take it easy.

Pat

[Wannahoop]

Pat, you're great.  Thanks so much for the input.  I am not so worried about the bball - I can wait on that - but you have reassured me re: the clunking, and reaffirmed my need for caution.  I will follow your advice, and check in periodically to let you and the readers know how it's going.  Thanks again for the feedback.
Regards,   

[obxpelican]

I think the reason you are clunking so much is that your muscles have not been strengthened enough, most people by your point in time are doing a lot more physically. 

We hear a lot of people with the clicking and clunking, sometimes so many sometimes I think Pat should have that on her front page "don't worry if you are clicking and clunking as long as it's not associated with pain"  ;-)

Your doctor sounds real conservative, but that's not a bad thing, listen to him, do your time and keep doing your excercises.  I'm wondering if your doctor felt that maybe your bone was not hard enough or maybe you had some other issues during surgery.

Like Pat said, ice an elevate if you get some swelling.

Don't worry about that 90 degree rule thing, I broke it many times by accident, try not to do it, but you are going to end up breaking that rule sometimes by accident, it's like speeding, I speed, most times I do not get caught, when I do it's bad.  Same thing applies to the 90 degree rule, at some point it may cause issues breaking that rule.

Keep us posted and good luck.


Chuck

[Wannahoop]

Thanks Chuck,

I can say that I have had a fair bit of muscle wasting in the leg because I have been off it, even with the bed exercises.  It makes sense that the muscles are weak.  I'll step up some quad exercises.  My support leg quadricep and calf, however, are in great shape although the hip joint is suffering.  I am looking forward to resurfacing the other side! 

Thanks again for the input.

[pfhuntley]

Hi,

I am 4 weeks post op today, and I just started clunking a lot too. I had a bit of it early last week, but now that I am more active it is more noticeable. I was getting pretty worried about it today, until I read these posts. Thank you all for helping me out. I was told by my PT guy, that as my muscles get stronger, they will hold the hip in place and the clunking will lessen or go away. That is good, because it kinda freaks me out.....

I am doing my recumbent bike 1 mile every other day and my exercises 2 times per day. I walk with my cane now and NOT the walker, which I was using until Friday. My leg says 1 mile is enough for now so will add time and distance slowly. I want to walk a lot, but my hip is not strong enough to walk too much yet. The muscles are wayyyyyy sore yet. Icing makes them feel better and I do that all the time. I can't wait to be able to get into my bubbletub soon!

Good luck to everyone who is going through the same as I am, it WILL get better quickly, as I am learning.

Pat, you are awesome!!!

Thanks all!

~Paulette

[smdmf]

wannahoop, im a bball addict too. im 47 and im in need of a BHR in my left hip. im trying to make it till next year but im not sure if i can make it. the thought of taking a year off of bball is killing me but i have no choice. do you know the cause or your arthuritis? im down to one day a week, half court. even that is getting to be too painful. i hope you get back on the court soon. i hear it takes at least a year so take it easy and good luck,

                                                         mike