3/20 Biomet Uncemented Left Hip Resurfacing- Dr

[SW27]

 I'm about 2.5 weeks post op ahead of you on my left side (right side was done 1/4/19) , I did tons and tons of the first series exercises he gave. My problem was regular leg raise, inside quad up by the groin which is still a little bothersome. I started PT at week 6 , 1-2 times a week. They gave me a bunch of exercises that seem to have help in quicker recovery so far. Also walking a bunch along with spinning on the trainer about 4-5 times a week for 45mins to an hour. The first 6 weeks I took it easy (except for the exercises) , way easier compared to the first one and the leg was real week and atrophy really set in.

[blinky]

Oh yes.

It was comical how little I could raise my legs to the side. Front lifts, no problem. Side lifts? Fuggetaboutit! I think I went from doing 2 at a time to 30 each side with weights over a period of weeks. It will come.

I do still have trouble lying on my side, however, because the fat is gone. I need a pad under my hips.

[John C]

Yep, the initial attempts at side leg raises can be kind of comical. The mind says move, and the leg says nope. It helped me to do some variations at addressing those muscles. Standing side leg raises with or without resistance, sidestepping with a sports band around both legs, and clam shells, are all good exercises to build the strength up to side leg raises. You are right on schedule, and you will find that those side leg raises will improve dramatically over the next two months.
I definitely still liked using the pillow between the legs at six weeks, as I had for a few years prior to surgery. I forget when I stopped needing the pillow, but it was somewhere within the first few months. First time in many years that I was able to sleep without the pillow.

[Rn2md]

At 6.5 weeks at this point-
Noticing some small but noticeable improvements with modifying the side leg raise to standing position. May try again in lying position after my follow up appt this week.
Front raises aren’t an issue.

Also doing light elliptical, stationary cycling, and walking before or after gym workouts, and that’s probably starting to pay some early dividends as well.

Still have a mild limp, which varies in severity throughout the day. I think it tends to be worse as the day wears on, or after I’ve been sitting in one place for a while.

Pressing on.....
Have my follow up on Thursday

[Rn2md]

Today’s 7 week follow up visit went well. Xrays looked fine.
Strength overall continues to improve.
However, the one thing that is lagging is the abductor muscles function and flexibility, and persisting weakness with abduction.
So I’ve been doing a modified version of the side leg raises in the standing position since last week. I think the function is improving but very slowly. Dr. Gross saw the issue and gave me a reasonable strategy to continue the standing side raises for another week or so, then work up to the ankle weights in standing position, then finally doing them in the normal side lying after a few weeks.
Its this persistent abductor weakness is what’s causing the residual limp.
He also suggested that for people that are particularly muscular preoperatively, those larger muscles may be more traumatized and stretched during the surgery than if they were smaller or atrophied, which may lead to this kind of a scenario.  Unfortunately in this case, I fit into that category.
So I guess I may have shot myself in the foot with part of my vigorous preop training. With original intent to facilitate recovery, Part of what I did was intentionally strengthen those muscles with lots of ankle weights and reps on side raises. Squats and lunges too.

So given these observations, I guess one might carefully consider which and how much pre-op exercises directed at this particular muscle group that one should really do, to help avoid similar issues.

Im not happy to have a delay in something, but I’m glad I fully understand the exact problem now and have a good plan of dealing with it.

And my progress in other areas is on schedule.

Will keep posting on progress

[Rn2md]

8.5 weeks post op-

I’ve been focusing on the abductor weakness with the standing side leg raises with/without ankle weights, and getting stronger gradually. I also gathered the courage to try them again in the side lying position positioning a pillow between the legs without weight for the last couple days and that’s improving mildly too. Can now get up to about 8-9 uncomfortable reps, but haven’t lost patience. I know it will take a little time.

Still doing the gym workouts with mostly upper body exercises. But I did venture off the reservation today and tried some lower body stuff cautiously  with very light weights. Just leg extensions/curls, seated calf raise, and the rotary hip machine, which exercises the flutes without really loading the hip at all. And 30 min elliptical machine for cardio.
It was a far cry from a real workout. But it still feels like progress, since I’m slowly re-introducing more activities to then build on further.

Straight leg raises are pretty much where they were under normal circumstances, and could do as many ankle weights as I want with those.

I’m looking forward to seeing where I’ll be in another month or two. Hopefully back to full strength on the side laterals, which I think is the last real frontier on the early recovery. After that, it should be smooth sailing.

I can tell already the significant improvements on hip rotation exercises, as the hip feels like it glides smoothly through the movement, without any pain at all. Also if I stand or walk for long periods, no problem at all, which is another big improvement.

[Rn2md]

10 weeks post op-

Using the 10lb ankle weights on the lying side raises for the last couple of weeks and for the front raises for 4 weeks.
Walking is brisk and nearly back to baseline. Still intermittently a somewhat conscious effort, depending on the time of day.
Can use stair master while pacing myself without any problem.
Can sit for extended periods with only minimal aching and stiffness.
Overall, significantly improved

[Rn2md]

At 4 months, I’m doing light squats on the smith machine with less than 100 lb for 20 rep sets.
Started with assisted bodyweight at about 2 months.
I still feel mildly uncomfortable stiffness and soreness when I push it on abduction machines but it seems to be working itself out over time. I’m taking it slow and gradually increasing weights on both abductor and adductor machines, since I’m generally in the gym anyway. I’m at about 60% of the preoperative strength, when it comes to these groups. I could probably do more or go faster, but I don’t want to have a setback.
The limp was totally gone at about 7 weeks, but I was initially compensating by leaning over slightly toward the affected side.
Just a consequence of the temporary abductor weakness, which is now gone. I stand and walk as I always have now. Brisk walking is no problem at all.
My cardio is entirely 30min of either rigorous stairmaster workouts or stationary cycling. I take walks occasionally, but don’t have the time to get enough cardio in through regular walks alone, which would take at least an hour a day.  That wouldn’t leave much time left for the gym workouts. Thankfully I get in a fair amount of walking day to day.
Can’t wait until the 6 month mark, when I’ll feel legitimately licensed to start pushing things more.

[Rn2md]

Just short of the 6 month mark at this point.
I’ve returned to all activities except running and weighted squats. But that’s mainly out of respect for the standard post-op guidelines. I can do body weight lunges and squats well, particularly squats. And I can go all the way to the floor each time easily. The lunges leading with the operated side are a little weaker than the other. But I think that’s eventually going to even out. I may start doing more sets/reps on the operated side to correct for that. I stretch and still do all of the previously mentioned gym and cardio machine workouts about 3-6 times week, I do still get mild soreness intermittently on the operated hip after a day or days of heavier use, but nothing requiring medication to deal with. I believe that may be because it is still internally healing. I just listen to my body and back off anything involving the hip whenever it seems sore. I just focus on upper body exercises more, or else just take a day or two of complete rest, for example.  I’m looking forward to seeing what the ultimate end result will be.

[Pat Walter]

Sounds like you are doing great. Thanks for posting your experience in detail.  It is so useful to others thinking about hip resurfacing.
I wish you the best and look forward to your future improvements.
Pat