Today’s date Dec. 4, 2016 – Surgery Date Nov. 22, 2016. Background: I’m a 57 year old who has experienced hip pain and resulting limitations for about 3 years. I’m active and enjoyed running, working out, skiing, scuba diving and hiking before the hip pain showed up. Although my hip pain wasn’t debilitating, it was preventing me from doing the things I had hoped to do in retirement (last year) so I decided to go ahead and get the resurfacing done. I’m glad I didn’t wait any longer as I believe my recovery was aided by the fact that my muscle tone, posture and gait were still relatively normal.
Going into the surgery I was nervous. Despite a ton of research on resurfacing and on Dr. Pritchett, despite 3 years of hip pain and 3 doctor recommendations I still kept questioning whether or not I really needed to have it done. Fortunately, I guess, my hip was particularly problematic during that time reinforcing the fact that things were only going to get worse. The whole thought of the surgery and the fact that I was essentially going to be awake during it kind of freaked me out. I tried at one point to watch a video of the surgery that Dr. Pritchett has on his site, but couldn’t bring myself to do it.
One week before the surgery my wife and I got some sort of food poisoning or stomach virus. It was awful. 3-4 days of high fever and diarrhea then lingering recovery. But, it took my mind off of the surgery. I got my strength back a couple of days before. And at that point there were a number of things I had to get done before the surgery so I just kind of got into execution mode and focused on what all had to get done versus what was about to happen to me.
We live about 2 hours from the hospital and I had to report to surgery at 5:45 am, so we stayed overnight in a hotel close to the hospital. It was recommended by Dr. Pritchett’s office and was really excellent. We had an early dinner and then I took my first anti-bacterial shower before going to bed.
Day of the Surgery – I got up at 5:00 am, took my second anti-bacterial shower, had a cup of black coffee and headed to the hospital. After my initial preparation for surgery, Dr. Pritchett stopped by to see me. This was the first time that I saw him since my initial consultation and before I had decided to go forward with the surgery. He asked if I had any questions for him. Just to confirm, I asked him what device he was planning to put in. He said Cobalt Chromium metal resurfacing parts. That was a shock since he and I initially talked about Titanium ball and socket with a cross-linked polyethylene liner in between the two. One of the reasons I came to Pritchett was because he offered that option and that is what we had discussed in our initial meeting. I’m the kind of guy who carefully thinks through the major decisions in life. So, to make this change with no prior discussion an hour before surgery was not my preference. To Dr. Pritchett’s credit, he took a good 30 minutes answering all of my questions and talking through the pros and cons of both options. He didn’t rush me in the slightest way. He told me that he would install either option, but that he thought that the metal ball and socket was the better option for me. The reasoning basically came down to practical considerations since the metal bearing surface option was used predominately for larger hips and the titanium / poly was developed as an option for small hip sizes, mainly women. He expects that either would probably last my lifetime, but there is less evidence with the titanium / poly solution and less predominance of parts in my size, 50 mm. He also mentioned a recent study that showed the 10 year survival rate for those who had the Cobalt/Chrome resurfacing was better than those who chose not to have the surgery suggesting lack of negative effect and even possible positive effect of the Cobalt and Chromium particles. The studies show that the major risk for the metal parts is the same as other options – infection and femoral neck break. Metallosis with Birmingham resurfacing metal C/C parts is the cause of less than 1% of the failure. So, I decided to go with the new recommendation and feel good about the choice.
They then took me into the surgery room at Swedish hospital in their new Orthopedic Institute building. Everything, including the surgery room was impressive. The last thing I remember was the anesthesiologist having me roll over to put in the spinal injection. I woke up in recovery. My legs were numb for about 30 minutes or so. As soon as I could feel my toes, they sent me back to my hospital room at about 10:00 am. The day was pretty uneventful until the Physical Therapist and Occupational Therapist showed up in the afternoon. They had me get out of bed, walk around a bit, do some stairs, get in and out of a simulated car, etc. etc. I was amazed by how quickly I could move around. The first real pain I felt was when the OT had me try to put my socks on and I pulled too hard on my operative leg – holy crap that hurt. Doctor Pritchett came by around 6 pm, said the surgery went great and we left for home around 7pm.
The drive home was uneventful. We had to take a ferry ride on the front end of the trip and so I got out and walked around upstairs. The final leg of our trip was about an hour and we completed it without stopping.
At home our master bedroom is on the 2nd floor and so I decided to recover up there. Two things made that a little more difficult. One, my wife is a PTA and she wasn’t comfortable letting me go up and down the stairs alone for the first 3 – 4 days. So for that period I was dependent on her for anything I needed downstairs. The other initial problem is that we have a soft, memory foam mattress. For the first few days before I had any strength in my operative leg, getting in and out of bed was difficult. Other than that it worked out well.
We ended up borrowing or buying most of the assistive devices recommended including the higher toilet chair, shower chair, suction cup grab bars for the shower, hand held shower nozzle, walker, cane, foam wedge for the bed, reacher, sock device and long shoe horn. Between my sister-in-law who recently had knee surgery and the place in town that lends out medical assistive devices, we were able to borrow the majority of it. In hindsight, I probably could have done without some items, but I used all of them. I also borrowed a lawn chair with a zero gravity setting in case I had trouble sleeping on my back. I haven’t had to use that yet.
The recovery has gone well so far. From the first night I slept with my leg elevated on the foam wedge. I actually found it a comfortable way to sleep, or maybe it was the oxycodone. The PT showed me my exercises at the hospital and I started doing them 2-3 times a day at home the day after surgery. I iced my leg after each set of exercises. Elevating my leg and the ice must have worked well, because I really didn’t have any problem with swelling. At the worst my operative leg got to be about an inch larger in diameter than my other leg. I was surprised by how little strength I had in my operative leg initially and how quickly it came back with the exercises. The only movement that I still have trouble with is a straight leg lift lying on my back. Dr. Pritchett says it has to do with the tendon and it will recover soon.
I typically have been walking around 200 – 400 steps a day just in the house plus I end up going up and down the stairs several times a day. I have avoided sitting in a chair for the most part except for meals. I started transitioning from the walker to the cane after about 4-5 days. I was able to walk about 100 steps without the cane last Thursday, 9 days after surgery. Today I am walking mostly without my cane in the house and am starting to do a reciprocal pattern on the stairs. I took my first shower on the 4th day post op and was able to take my first standing-up shower on Friday. I started tapering off the pain meds starting on the 2nd day post op and stopped taking them all together yesterday.
I had my first post-op appointment with Dr. Pritchett Friday, 12/2. He was happy with how everything looked including the incision – the bandage came off for the first time on Friday. Looking at the X-ray he said it was exactly as it should be.
All in all the surgery and recovery has gone very well. I have been very impressed with everyone at Proliance, Dr. Pritchett’s practice, and the folks at Swedish. Plus, I have so much confidence in Dr. Pritchett that I know my surgery was done as well as it could have been done. He is so knowledgeable in this area having worked with one of the original pioneers in resurfacing and then pioneering additional improvements himself. Everyone we spoke to about him offered unsolicited comments of praise. He is a man of few words, but extremely capable and very much focused on what is best for the patient. He stands head and shoulders above the first two surgeons I consulted about my hip.