Hip Talk Forum About Hip Resurfacing

Well, I took the plunge for the outpatient resurfacing by Dr. Gross earlier today.
All was a great success and happy with how everything went.  Currently resting up on post op Day 1 at the hotel with pain controlled.
Just visited by the visiting nurse as well...just when I thought i couldn’t be any more impressed.

Five stars all the way around for Dr. Gross and team.

Here’s the story:

41 yo male with left hip OA mild to moderate symptoms and Fapreventing favorite activities such as weighlifting, running, and martial arts.
Symptoms of stiffness and during the job when I had to  stand for periods of time.

So I first sought local opinions from various Orthopaedic surgeons, who initially offered either steroid injections, stem cell injections, or total hip replacement. Tried steroid injections and PT first, with limited and temporary improvement. Then fortunately the Ortho who did my injections mentioned the option of hip resurfacing since I’m relatively young.
So I began looking into it and first went to the HSS website to find Dr. Bryan Kelly, who I saw had expertise with FAI.
But I later discovered after the office called me back, that arthroscopic solutions were typically no longer viable once OA has set in.
They offered to send my information to Dr. Su, who does resurfacing, and I agreed.
His PA called me a while later and said I was a great candidate.
However, various life circumstances prevented me from scheduling the surgery at that time.
Later, when I revisited the option, my insurance has changed and I was back to the drawing board.
I again looked around and this time found this website and various other surgeons such as Dr. Gross, who seemed to have both long experience and many great reviews from patients.
I saw he also took my insurance.
So I sent him my info.
3 weeks later I got a call from him and told me I was an excellent candidate. He spent
Surprisingly, I immediately received a surgical date, extensive preop instructions, and a hotel reservation for me made by Dr Gross staff. I was impressed with the level of service already.
So I began preparations for setting this up, arranging plenty of time off work in advance , I took 4 weeks.
During the time leading up to the surgery, I did extensive research on resurfacing, with particular emphasis on various information found in this website. On advice of some on the site, I got into the best shape possible with the OA for the surgery.
I put emphasis on weight bearing exercises like squats, even though they were painful, since bone density is so important for the surgery. I also emphasized Hip adductors and abductors and Psoas on my gym routine.
The initial consultation went well and Gross answered all questions and was quite personable and down to earth. A well organized office routine. Also met Lee Webb, who also inspired confidence with her knowledge and demeanor.
When the date finally came, I reported to the surgery center at 6:30 AM.
About 10 minutes later, I went back to get changed, bring my polar care unit and crutches for post op.
They started me off with a cocktail of OxyContin, Tylenol, and an antacid. Then they had me change into a gown and they placed the IV and drew blood.
Lee Webb cane and asked if there were any more questions, then the anesthesiologist explained her side of the procedure, including a spinal anesthetic and propofol. They gave me another cocktail of IV sedatives in prep, then I woke up and all was finished.
Once I was awake enough, I ambulated on crutches with the therapist and then attempted to void. I did get nauseated at that point, so they took me back to bed.
They scanned my bladder and it was full. But I did get to void successfully a bit later after the nurse reminded of the the potential need for a straight catheterization.
So the trip to the hotel was uneventful and kept on top of the pain meds. 
Had nausea again that first night after standing, but subsided eventually.
Did the bed exercises here and there and keeping up the schedule for post op meds.
Doing pretty well overall at the end of post op day 1, but will probably need to bump up the pain meds, as it increases toward post op days 2-3.

Wish me luck for a continued smooth recovery and rehab

Congratulations, and welcome to the other side. For myself, and many others, it was one of the best things we ever did for ourselves.
I would suggest that for the next 6 months to a year you be prepared for the unpredictable. There will be aches and pains that come and go, worries about doing too much or not doing enough, and maybe some worrisome moments about whether you did the right thing or whether you did something to screw up the new prosthesis. The good news is that Dr Gross's wonderful support staff of Lee Webb and nurse Nancy are there whenever you need them. If you email them anytime you have concerns, they are always there for you. My experience is that Nurse Nancy is able to get back to you the fastest, and is very knowledgable. In the rare event that it is beyond their comfort zone to answer, Dr Gross is there with his wonderful and patient phone calls. In the same way that you were impressed with the surgical experience, the aftercare is also five stars.
From what I have read, you will be the ideal rehab patient. Just take the time to allow healing, and be prepared for the surprise ups and downs along the way. If you treasure the tiny improvements that happen on a regular basis, it is a fine journey.

Thanks John.
Your comments, as always, are helpful and welcome. :)

I’ll be sure to keep posting periodically about the progress.

Yesterday on Post op day 2, I noticed being more awake and able to ambulate several hundred feet on crutches. The 9 hour drive home from SC to Florida went surprisingly well too. Keeping the routine with the pain meds was very important, which helped keep a positive mood and do ankle pumps and quad/glute sets with minimal to no pain on the drive. I also was using portable ice packs and placing them near the incisional area for the ride, 1 hour at a time. (The kind you activate by popping them, so no ice and water messes in the car) I think not having an interruption in the ice therapy helped progress too.
I had elected to stay at the hotel for 1 additional day just to get over the hump on pain control, lingering anesthesia side effects, and movement. Glad I did. I also wanted to get a few doses of the Eliquis on board before a long car ride, as DVT or PE would foil the whole plan.
Got home last night by about 7pm and had a nice juicy roast beef sub, which I think my body thanked me for. I’m sure I needed the protein, calories, and iron for healing.
Today, my ROM continues to improve and I’m ambulating independently on crutches around the house. Not for exercise yet, just for necessities. Pain is virtually zero and I think I’m going to titrate off the narcotics completely by tomorrow. Still taking it easy with the polar care on as much as possible and there is really only minimal swelling.
Next item on the agenda is getting the bowels to move, which should be facilitated by the colace, movantik, fluids, prune juice, and increased walking.
Will keep posting on progress, and things are definitely moving in the right direction.

As I am sure you know, getting off those narcotics is another big key to getting the bowels moving again. If you need something more than Tylenol for another day or so, I found that Tramadol was sufficient with fewer side affect for me. If you can get by on Tylenol without negatively affecting your sleep or exercises, all the better.

Post op day 4 and pain controlled with Tylenol and Mobic alone.  No narcotics today.
Had a scary slip with the operated leg last night when crutch walking to bathroom, due to the crutch being inadvertently placed onto a hand towel that fell on my tile floor. Didn’t fall, thank goodness, but it did require a reflex contraction of my operated glute and adductors to stay upright, which was somewhat painful. I don’t think it caused any real problem though, as there doesn’t seem to be any undue soreness or pain today. Have to be real careful for the first few months to avoid disrupting any muscle or soft tissue repairs that are not yet healed.
Continuing ice therapy, fluids, crutch walking, and prescribed leg exercises.
Range of motion continues to improve today.

Glad you are home and your trip went well. Many of us had strange, small problems like your bathroom slip.  It really scares you to think you could injure something in the new hip.


Take it easy.  Looking forward to your posts as you progress in the healing process.


Pat

End of Post op Day 7 and still making incremental improvements in mobility.
Bowels we’re moving on post op day 4. So that’s no longer a concern.
Started walking with 1 crutch last night and today, taking it slow but doing fine.

I notice that the glute on the operated side is still slow to activate or incompletely activating? It feels funny putting more than 50% of the normal load on the joint when walking. So I still use the crutch to offload it some.

I’m thinking it will just take a little more time for that to normalize.

Had my first outside walk with one crutch, several houses down the street and back, with my wife walking along side me holding the other crutch just in case.
I’m now able to get in and out of bed without using the aid for lifting your leg, just taking time.
Continuing the simple hip exercises as prescribed.
Still zero pain.

When should walking feel normal again?

Hi Rn2md,
I am a little ahead of you - this is week 8 post op (Bilat) with Dr. Gross.  I can tell you when I started feeling better walking. 

At week 3 I walked about 1/4 mile without crutches.   That was certainly tentative, slow and did not feel normal but felt good to be able to do it without crutches. At week 4 I was able to walk about a mile without crutches.  At 4 weeks,  I could also walk around the house and it felt pretty normal.   I live in the northeast so this was all inside as we had a snowy winter and I could not walk outside.  Between week 4-6 I would say walking started feeling more normal and I was able to walk a 1-2 mile at week 6 without crutches.  This past week I have been walking about 3-4 miles per day.   Walking has definitely felt pretty normal between for the past 2 weeks.  I am still somewhat stiff if I have been sitting for a while.  Once I get walking it feels normal.   

Thanks. That helps.
I’ll continue to listen to my body and walk as much as I can. It seems to be a slow and gradual process.

Lying/ sleeping on my non operated side causes a slight tightness/achiness even with pillows between my legs. I’m guessing that’s because my gluteus medius and minimis muscles are still recovering.

For now I’m primarily sleeping on my back, which I don’t prefer, but I’m starting to adapt

sounds familiar.  I slept on my back for at least 3 weeks.  sounds like you are doing great.  This is certainly a process.

Regarding the question on walking: Dr Gross just says that you should be able to walk a mile unaided at 6 weeks; before that everyone is different. For long walks, which I tried to do twice a day; 2 crutches for the first two weeks, one crutch with my wife carrying the other one for week 3, one crutch with short stretches of my wife carrying that for week 4, and walking without aids during weeks five and six, while carrying a cane just in case. At week six I would say that walking was still a conscious effort to try and make everything function ideally. I am a little strange that way, but I really enjoyed making walking a very conscious process, trying to internalize and be aware of every detail.
Walking "normally" is a relative statement. For me it took a couple of months to work through getting a natural stride, and trying to get rid of the limp I have had for years. After a record snow winter here in the mountains with spectacular skiing, I went for my first spring walk the other day, and am so delighted with the youthful springy walk that I have not felt in 20 years of having bad hips. You are still in the starting gate of a very long journey.

Post op day 11-
Still getting around easily with 1 crutch. Definitely could go to the cane. Drove yesterday for the first time since pre-op and also walked 1/2 block. Was slowly progressing with walking distances over a couple days.
Today, I’ve noticed slightly increased swelling of the lateral upper thigh, and a little at the upper medial thigh as well. Also some mild soreness of the vastus lateralis.
So I decided to rest up today and do only minimal walking today, keeping it elevated with plenty of ice.
I guess this is my body telling me to slow down. It didn’t really feel like an unreasonable amount of exertion at the time though.
But I’m listening to my body anyway.
Glad I took plenty of time off work, so I have time to wait these things out.
Still no significant pain. Taking Tylenol morning and evening, Mainly for prevention and for comfort in transfers and necessary ambulation

Don't be surprised if the swelling slowly works its way down your leg as you spend more time up and around, and gravity gets ahold of any fluids from the surgery site. The vastus lateralis (and the IT band), were definitely the sorest area on me for a month or so. Nothing serious or that got in the way of rehab, just noticeably tender. I massaged up and down the leg, and used a hand roller, and both of those felt good. Doing lots of quad extensions also felt good for that area.
Glad to hear that you are doing well.

Took a walk with one crutch about 2 blocks, which felt ok.
Finally went out shopping at Walgreens for a cane, which felt a little weird, since I had no idea how to really pick one. Lol. But I finally settled on one. Then I looked on you tube to see how to use it.
Walked around with a cane later in the day, which definitely feels like a step up. The hip feels mildly sore  and stiffer. I feel a slight weakness in the hip now and again, if the timing of the cane with the step of  operated leg is slightly off. Not painful though, just stiffens up suddenly. Odd sensation.
Definitely feels like the vastus lateralis on the operated leg is being put to work.
I do think things are still coming along well though.

Hi
You use the cane on the opposite side from your surgery.  It goes forward as your operated hip and leg go forward to take a step.  Don't use it on the same side as the surgery.  Many people do.  It is hard to believe, but there is much more support and assistance using it on the opposite side.

Here are some articles:
https://surfacehippy.info/how-to-use-walking-aids-and-equipment-after-surgery/ (https://surfacehippy.info/how-to-use-walking-aids-and-equipment-after-surgery/)
Good Luck.
Pat

Now 16 days post op.
Still using a cane to walk but seeing daily improvements in the ease and speed of walking.
Getting in and out of bed and shower is much easier too.
Still tricky to get a shoe onto the foot of the operated side, but that’s improving also.
Had another upper body gym workout, followed by the normal hip exercises for phase 1 and that all went well. Feels weird walking around the gym with a cane, but whatever.
I think I’ll be able to lose the cane in the next couple of days, the way things are going.

Most people are not in the gym at 16 days post op and and the result for a lot of people who push recovery faster than their body will tolerate is lost ground and additional pain and recovery time- them's the lucky ones- some injure themselves. 

I think that Jimbone's thoughts about not pushing the early recovery process too fast and hard is wise and makes a lot of sense. I also think that Rn2md's description of his gym session involving an upper body workout, combined with the Dr. Gross's Phase 1 exercises sounds like an ideal program for 16 days out. There are many healing benefits to getting the heart rate up, breaking a sweat, and pushing those parts of the body that were not involved in the surgery, and that balance can work for someone who understands their body and knows their way around a gym. Within a week, I was doing daily upper body workouts, and at the same time was very cautious to not allow those workouts to stress my healing hip. It sounds like Rn2md has found a good balance of getting a good workout for the upper body which will benefit his whole system, while protecting the early hip healing process by sticking to the Phase 1 exercises. It is always a tricky balance, and that description sounded like a good start.

Thank you for the comments.

The quads/vastus lateralis seem to be the Achilles heel of this part of recovery.

It is the first area to become sore and mildly swollen as walking and activity increase in general.

I have also been at a conference for the last couple of days involving sitting in a regular auditorium chair, but with a fairly decent amount of intermittent walking as well. Walking down declined walkways or stairs remains a little tricky, as the quads occasionally cramp and strain, particularly toward the latter part of the day. That seems to be lessening in frequency through

I would say the quads are probably the factor limiting a more rapid recovery of my preoperative stride.

At least walking with the cane is becoming easier on a daily basis. The first part of the day seems the prime time for walking, getting more difficult as the day wears on.

I think I misread your post and thought your workouts were causing you concerns due to pain.  By day 16 I was definitely doling upper body work, but at home as I was a long way from being allowed to swim/sauna or stretch in the jacuzzi.  I started doing dips between a pair of chairs, a bicycle inner tube for chest/arms/shoulders'legs. Truth be told- it was hardly enough.  It felt like those muscle groups were getting worked and they were to a degree but returning to the gym at 7 weeks after 6 week restrictions were lifted I learned how much strength had really been lost.  A single pair of pull ups demanded my full attention and were my limit, 40 pushups and hit the wall.  I recently reviewed my workout schedule since mid Nov. 2018 [my 7 week release] and   I've skipped 6 days.  I found the key, for me, was consistency and a great deal of patience and self care.  I push it, sometimes to the point of soreness the next day, but not to where there is nothing left for the next day, and the days I took off were because there wasn't enough there to get the maximum benefit from the effort and the day off let the body heal up.  The progress made is completely reassuring I am moving in the right direction.  I suppose sounding an alarm against overdoing it reflects my reading of other archived folks who ended amateur athletic pursuits by not accepting new and temporary restrictions.  Balance is key.  Sounds like you;re doing well, great to hear it.

As mentioned, the lateral quad was the longest issue for me as well. After six weeks, I did a lot of quad extension work, starting with an exercise band for resistance. After six months, it continued to be the sorest muscle when skiing, so I massaged and rolled it after skiing each day. I would not call it a big problem, but at 8 to 11 months, it is still the sorest muscle in terms of skiing endurance. At 11 months, I would say that it is about 90%, and still improving. Based on my earlier hip 10 years ago, I expect it to eventually get back to 100% by 18 to 24 months.

Thanks again for the insights. I’m aiming to strike a balance to favor overall constant forward progress, even if it’s slow, with minimal to no set backs. So far that has been my course.
I noticed that many others have had the prolonged soreness and swelling of the quads as well, which is reassuring.
It would still be interesting to know exactly why this still occurs in a specifically conditioned person. For example, I was intentionally strengthening the quads pre op with this post op problem in mind, and I would be doing multiple sets of leg extensions with 340 lb, in sets of 25-30 reps each. And of course, squats and lunges too. I also saw some others pre op routines which seemed pretty rigorous too, and they still seemed to have the same kind of quad soreness/swelling.
I wonder how much harder it would have been, had I not done that prep work....

I’m just happy to still be moving in the right direction.

For now, I’m just keeping up the phase1 exercises, icing it daily, walking with a lighter cane now, and machine based upper body gym workouts. Will keep everyone posted.

Thanks again  for the feedback and comments

And I have also been trying to massage it, which also seems to help. However  I don’t think I’m allowed to do any lower body work with bands yet.

Nope. I did not start the bands until after the six week clearence. It sounds like you are the ideal rehab patient. Keep up the good work.

19 days out and noting continued improvements in walking, self care activities, and some early recovery of general fitness. I have a slight 4mm leg length increase from the surgery, and I started using an insert on the opposite shoe to compensate, which seems to help balance when walking. Had a machine based gym workout focused on chest, shoulders, abs, and triceps, taking great care not to do any weight bearing on the hip.
I even experimented with a few sets of bodyweight calf raises, thinking it could further help advance the walking. That went fine too. Won’t take it to any extreme though. Don’t want to have a dilemma confusing calf muscle soreness with potential DVT.
Tomorrow I’ll focus more on back and biceps, then hit some abs again. The crunch machine seems pretty good at this stage, since it’s easy to get in and out of, and doesn’t cause any stress on the hip. Already using the whole stack of weights again on that. Feels good.
Next early goal is to lose the cane, which hopefully can be in the next day or two.
Meanwhile, I’ve definitely been able to use the cane for many workarounds concerning multiple various every day tasks in addition to walking. Everything from helping put shoes on, closing car doors, picking things up or moving them out of the way, even getting dressed, lol. I’m sure I’m not the first to notice these other uses for it though.

20 days out-
Took my first unassisted outdoor walk today while carrying the cane, about 1/2 mile. Walked to the gym to kill two birds with 1 stone.
Not a fan of the the awkward waddling gait that I have without the cane, but at least I can manage without any pain. I’m sure the gait will improve as I walk more.
Continuing the upper body workouts, which Im enjoying.
Incision still looking good and healing.
I also tried some modified reverse lunges on the non operated leg using a wall to stabilize myself.
That went fine too. I need to be able to lower my body for certain work related activities to resume next week.
So far so good

I would pass on one of the most common recommendations from PTs. They emphasize the importance of gait quality, and will recommend using whatever walking aids allow for the best gait. Doing without is okay for getting around inside, but PTs recommend that for any long outdoor walking, a person should continue to use aids whenever the gait starts to deteriorate. My experience confirms that walking quality improves fastest if quality is valued over getting rid of aids too soon. Up until about four weeks, I carried one crutch for longer walks, and would use it periodically for portions of the walk, whenever I felt my gait was anything less than ideal. Keep up the good work!

Ok. Thanks.
I’ll continue with the cane for longer walks and intermittently otherwise. In general, I’ve noticed people most often reported issues when advancing too far, too quickly. So I’ll plan to continue the reasonable stepwise progression.

31 days post op today-
Over the past week, I’ve noticed significant further improvements on the speed and ease of walking. My wife has difficulty keeping up with me when she comes along now.
I still have a limp without the cane. So Im electing to still use the cane until my gait normalizes completely. The limp is also improving almost daily though. I don’t think I’ll have it for too much longer. We’ll see.
I walk 1-2 times daily about 1-1.5 miles. That seems to be the sweet spot, since more than that seems to still cause a little swelling and soreness in the quads and not speed up healing.  I have to hold myself back somewhat. But it’s much more comfortable to walk now than it was preoperatively. No hip pain whatsoever. I still use the ice machine most evenings after settling in, mostly for prophylaxis and comfort. I also feel like it may still help promote healing on some level and may prevent swelling after long walks. It’s soothing anyhow, even in the event it isn’t helping otherwise. The incision looks great.

Still Regaining my upper body strength in the gym and expanding my repertoire to also selectively including some work with dumbells and barbells in addition to machines. Nothing that places any stress on the hip of course. But it’s a boon for morale to have such consistent progress.

Already thinking about the 6 week follow up visit with Dr. Gross. How time flies!

31 days.  It really goes quickly doesn't it and the return to health is like the coming of Spring except with even better weather.  Sounds like you are right on track- remember Dr. Gross doesn't expect an unaided mile from patients until 6 weeks.  2 more weeks you're likely to see another big jump in improvement.  One thing I found helpful starting right around 1 month was to begin walking on some steep hills- not far and not fast but each day made a little more elevation on the big hill out behind the house, although it's street walking- off road broken ground was still a long way off.  About week 5-6 I also started in stair climbing. There is a 20 step flight outside the building at the track I walked.  I found both of those- hills and stairs very beneficial to the glute repair.  Quads stayed sore and tight for a long time- but not as weak- I had a Pro Sports Thumper- hand held percussive massage deal and found it helped loosed a lot of tight tissue.  I am still working on getting the quads stretched out to a feeling of normal at 7/9 months.  Have seen a lot of progress but still see a large room of improvement as well as the capacity to get there.  Sure Dr.Gross will be pleased with your progress.

Thanks for the feedback Jimbone.

I have a hill near my house that is not too steep and have walked it a few times. Also do some stairclimbing in the house once or twice a day. Tried doing more stairs than that last week and it felt like I may be overdoing it, so now I just use the stairs only if I need to get to the second floor. Ill probably start a more recreational use again though, since now I'm probably further along.

Have an achy feeling in the buttock of the operated side if I sit too long. Then its achy again on standing, but goes away with ambulation.

Ive seen people describe similar things here. So thats probably normal.

I havent bothered to try tying shoes on the operated side yet, but probably will try in earnest in the next week or two. All my shoes are pre-tied, or else I use slip ons. The shoe horn and the device to put socks on are still very helpful.

The sitting/standing thing is very common I believe.  I certainly experienced it and watched it fade over the months but it hasn't disappeared entirely- maybe it will or not it's hardly crippling, more just an annoyance.  At 64 next month I sometime question how far I'll be able to recover a 40 year old's response time/strength while the ongoing negotiations with Father Time continue but I don't fret about too much and try to enjoy the challenges and developments.  Gotta be realistic. 

One symptom I read someone else mention- which made me feel relieved I wasn't the only one- is a certain level of discomfort when going from weight bearing on one leg back to both.  For example- standing to put your pants on you lift one leg and stand on one- when you are back on both feet/legs I would feel a distinct discomfort.  It felt very othopedic to me and concerned me.  Over time and with practice this condition has reduced itself probably 90% or more and is now mostly a rare occurrence.  I think it's because the tissues surrounding and supporting the joint are healing themselves, getting stronger and more stable so the joint is less stressed.  I should mention in the 2nd month [at the latest] my PT had me start standing on one leg- with hand support at first- and then without and building the time to 90 seconds.  I found that a very helpful exercise but needs to be introduced only when the body is ready.  It did leave me feeling vulnerable at first but very helpful soon thereafter.

Everyone struggles with the shoes and socks.  My standard was complicated by the instruction I received from a coach as a teenager sitting on a bench putting my shoes one when he said "You're never old as long as you can put your socks on standing up".  So that was how I measured that process.  It was every bit of 10-12 weeks before I was able to do the socks standing- with a shoulder against the wall- and while I finally was able to bend over to tie my shoes on the left leg by around 3 months, the right leg- which got two screws in the cup and gave me more grief healing- took a lot longer.  I was really only able to bend over to tie the right about a month ago at 6 months and then only after a full work out when I was stretched out and loose.  Now a month later it is becoming a more natural act but still a conscious process that takes effort.

I'll bet you'll start liking the hills and stairs more in another 2-3 weeks.  It will really get the glutes a good burn and you'll know the workout is getting them stronger- a perfect motivator.  In all it sounds like you're doing real well, clearly physically fit going in which as you know makes a big difference and you haven't even made your 6 week check up.  The whole process strengthens our patience as much as out joints.

I seem to be doing much better now with standing one-legged on the operated side, most noticeable when putting pants or shorts on. I dont need any balancing aids or a wall now. It never occurred to me to use that as a specific exercise for the hip. That's good to know.

I guess I don't fit the definition of youth yet, as defined by the socks standing up rule. I still need to sit and use the sock device. Hopefully, my cat-like 41 year old reflexes will be returning shortly though, and return to top form.  ;D

Im definitely looking forward to turning things up a notch with the hills, stairs, and exercise machines. But Ive read the many cautionary notes from those that went before, about the mishaps and disasters from overdoing things. So I guess Im like the race horse stuck in the paddock for now.

5.5 weeks post op-

Mostly Walking without a cane with mild residual limp at this point. The limp worsens beyond 1-2 two blocks if I’m not using a cane. But it isn’t that obvious for short walks, like within the house. The everyday walking around the house and office is pretty close to my post high intensity workout baseline that I had preoperatively. My walking speed is essentially at baseline.

Also, there is a soreness in the hip joint area that starts showing up on unassisted walks beyond a block. I feel it with each step I take, once it showed up. Not painful, but kind of a nuisance though. So I back off if I start to notice it. Usually rest or cut the walk short. I guess that will go away soon. Maybe it’s the uncemented implants telling me to Hilo’s back and wait longer for ingrowth.

There is a new issue that’s shown up though over the past week or so. It’s a twingy kind of ache radiating down the back of the thigh and also towards the back inner part. I notice it mostly when using my left hamstrings for something like moving myself forward in a rolling office chair or getting up from a low position without enough assistance. Today was probably the worst, since I got up out of my low slung sports coupe with some drinks in both hands and no free hands to help propel myself up and out of the drivers seat. When I stood up, I had a mildly painful twinge in the back of my thigh, just below the buttock. It was obvious that something was strained or at less stressed to its limit. When I got inside, I got into bed with the ice pad on and just completely rested it for a couple hours. Took a Tylenol just in case, which I had weaned off of about 2.5-3 weeks ago. I don’t feel it anymore. Guess it’s just one of those ways ones body reminds them not to outpace the healing process.

Otherwise Still use ice machine after workouts or walks in general, for what it’s worth.

The upper body workouts continue to intensify and I use a workout app to track progress.

The quads soreness issue hasn’t shown up in a couple of weeks. So that seems to be resolved for now. Once I start the next phase of exercises and up the intensity, I may see it again.

You're doing everything right and were clearly prepared for the procedure done by one of the top surgical teams available your chances are as good as it gets and my money is on it with odds.  I found it very helpful to track the progress forward as well.  Marking the small improvements and larger milestones made for greater reassurance and reinforced the efforts.  Even the setbacks, small as they were and the occasional twinge or unusual occurrence that could be alarming, when noted in the journal were kept in perspective as the dissolved in the wake.  You mention a soreness in the joint that shows up when walking.  On my second hip the surgeon needed to secure the cup with two screws.  Healing from that was quite different than the first.  I experienced a soreness in the screwed joint for several months, both walking and at rest, but intermittently and always reducing in intensity.  I read elsewhere in a thread that some folks experience difficulty when coming of weight bearing as in weight bearing of on one leg and then shifting to both- they will experience some level of discomfort.  This was very much true for myself and something I monitored carefully with the intention that if it hadn't cleared up by 6 month I would get a consultation and imaging.  As it gradually tapered of and was gone by month 4.5-5 or so I no longer worried.  It will still show up now once in awhile now at 7/9 months but rarely, less uncomfortable and quickly fades.  I will ask about it at my 1 year check up but currently chalk it up mostly to soft tissue damage and healing right there at the joint which is why it felt orthopedic to me but I no longer think it is/was.  I have been very careful about impact related damage.  Te first 5 jogging strides I attempted at month 4 told me immediately I was not ready, again at 5 months but at 7 I have been able to to short 50-100 yard jogging paced, 5 MPH stints without undo feelings of impact.  When it feels impactful, I stop.  I will take the time to build strength in the tissues before subjecting the device and bones to do the work.  My work was uncemented as well.  Your experience sounds similar to me and if things quiet down with rest/ice/tylenol I would guess you are just being a good patient and working your way through it.  The time that takes will be revealed to you cause there's no telling.  I've let my sense of vulnerability guide my recovery decisions and for me it seems to be working.  Are you able to do any hamstring stretching?  That was and is a challenge for me that is now gaining traction but straight legged/palms on the floor are nowhere yet in sight. 

Thanks for the perspective.

The hip soreness with increased walking sounds much like what many others have described as they build their walking distances. I didn’t feel that at all when using a cane, even with longer distances. I guess it’s just a matter of building things up again from scratch, only without the cane this time. The process of bony ingrowth supposedly starts at around 6 weeks, which is around now for me. So I may just have to either keep using the cane a while longer or settle for shorter distances for the time being.

I haven’t risked an earnest hamstring stretch yet, because I was pretty sure that wouldn’t be allowed yet. I have been gradually reaching more toward my left shoe, which I can now tie as of about 4 days ago. That’s without pushing it though. If I hadn’t known better, I might have tried to make a conscious effort to hit that milestone sooner. But I think it just would have just risked a painful setback if I did.

Running is definitely a ways off, but I’m confident I’ve set myself up as well as possible to get back to it. I look forward to trying it out with the new hip when it’s time.

Sounds like you are doing great. Right on schedule.
As far as walking longer distances; rather than cutting the walks short, I just always carried the cane with me until it was a non-issue. If a pain started, I would just use the cane for a block or two, and often the pain would go away and I could continue without using the cane for another stretch. You get pretty good at doing twirling tricks with the cane on those long walks.
As far as the hamstring issue, all I can say is that recovery is a little bit like playing the arcade game whack-a-mole. Things will keep popping up in all sorts of different places, which Dr Gross's recovery sheet says to expect for up to a year. Not only are we recovering from surgery, but all of our muscles around the area are relearning how to work after our years of limping and compensating. It feels so great to walk like I am twenty again, but it took awhile for my whole body to readjust to that kind of movement.
As for shoe tying, when you start the phase 2 exercises at 6 weeks, some of them directly address that, so it will come. Shoe tying is not something Dr Gross would suggest pushing for prior to six weeks. For me, shoe tying is now easier than it been in twenty years, so I am pretty stoked.

Rn2md-

Patience, practice and perseverance.  But patience first. I have to question the wisdom of 340# leg extensions effect on the knees- but you are younger and more of athletic.  Wisdom has been defined as learning from another's experience.  My favorite line from Stone's "Any Given Sunday" was,
"Every athlete wants another chance".  You've been given yours.  Use it wisely.  Best wishes.

So I started the Phase two exercises yesterday.
All went fine, except for the side leg raises.
I can’t seem to do those at all, just maybe a couple inches, and it feels uncomfortable, extremely weak, and tight.
It’s also uncomfortable to turn onto my side without a pillow between my legs, same feeling as above

Anyone else notice similar issues at just over 6 weeks?

 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.

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.

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.

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

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

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.

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

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.

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.

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