Lifting restrictions

[muzza]

I am about ten weeks after my left hip resurfacing and all going well.   I have overseas visitors coming to stay with me at the end of November.  My home is a bit of a mess so I need to do a lot of work which involves lifting - shifting beds around, buying a lounge suite and getting it into the house etc. etc.  Although my hip feels good and capable of handling decent loads, I believe I should play safe and get my kids or delivery men to do all the lifting. I see my surgeon in two weeks time and will ask him then. Just wondering what lifting restrictions others' surgeons had imposed, and for how long.

Neil

[obxpelican]

I think Dr. Gross is 50# until 6 months, @ 6 weeks he lifts the dreaded 90 degree rule, that is if the x-rays and everything look good.


Chuck

[muzza]

Thanks Chuck.  I think I'll avoid lifting much at all.

Neil

[kb134]

Hi Neil,
I saw your post and thought to chime in ...
The most important thing - take care of your hip. I got a resurfacing back in early 2008, but am now suffering with a loose acetabular cup. And it hurts.
I am not saying that any movement or physical work will hurt you or your device. But man to man, I think that once we "feel good" it is easy to try being the "Hercules" that we, as men, can be, and easily over-do it. Shifting beds around and moving, lifting, pushing, pulling means dynamic movement and a lot of torquing on your new hip. I have read (I am no way a medical pro, so take all this with a few grains) that at 6 weeks, the acetabular cup is "sticky" ...
Physical work is good - weight bearing exercise if great! Just have some limits. Your hip joint already has its own - most people cannot break the 90 degree rule anyway and avoid the hip to chest with internal rotation movement - a recipe for a possible dislocation.
Enlist help. You need it, and it is good to ask for it. Yes, it may cost a little to pay for movers' services, but in the long term it is still an investment in your hip and that is your first priority so you can be hercules later
I hope there is something in what I have written.
Cheers.

[obxpelican]

What device did you get?
I noticed you said you had a loose cup.

Chuck

[kb134]

Hi!
I got similar advice. The loose acetabular cup is either due to the poor design, or surgeon error or both, in my opinion, (my "experienced" surgeon also notched my femur-neck, and then had the balls not to document it!)  ... not my post-op activity. I followed all restrictions carefully, and got into the pool as soon as my incision allowed to work on range of motion.
My point was not to do certain activity too early which could lead to an implant migration/failure. Apart from that, these devices are so robust ... even beautiful ....
Thanks for asking!

[obxpelican]

A notched neck?  You are lucky you did not fracture your femoral head!!!!!

Some surgeons will have you cut your activity in hopes that the cup seats itself, is that what you are doing or did you get revised?



Chuck

[kb134]

Hey,
Yes, for the notch, I first discovered it on my one year post-op X-rays while looking at them with my surgeon. I noticed the notch and asked, "What's that, is that a notch ..."
His response was one like a man tripping over his own feet, as he fumbled with the words, "well, its not mentioned in your operative report!"
To my own shame, I dropped the matter quickly because I was also there to talk about my future as I need to have my left hip resurfaced as well (I am 30 now, so it has been difficult to deal with all this shit!) Later that day, as my mind came back to the notch, and long after the surgeon consult. did it hit me (I think I was also reading about the subject of notching too) that the notch was my surgeon's error.
As for the device, the Acetabular Cup is the Durom Cup by Zimmer, which many of us know had some serious issues when patients, up to two years post op with good X-rays, were experiencing the same symptoms as a patient with a loose acetabular cup.
My surgery was in May 2008. Right up until the one year mark, I thought the pain that I was experiencing was the pain of healing ... (maybe I was in serious denial)
but shortly after, during family barbeque type games, I felt a sharp pain that did not subside. My first thought was - I have just fractured my femur neck ...
I saw my family doc right away who then sent me for X-rays. no fracture .... no femoral component movement (but there was that damn notch!)
I sent digital pics of my X-rays to Vicky Marlow, a patient advocate for resurfacing who then sent my x-rays to Dr De Smet, Dr Bose, and Dr Su. All three agreed that the Acetabular cup was the culprit, and that a full blown revision is needed (due also to my femur-neck thinning ...)
Long story ... and it is still going ...
Best.

[muzza]

Thanks for your advice kb134. I will be careful. It's easy to get overconfident. I hope your own problems get resolved for you.

regards,
Neil

[obxpelican]

I salute you for being so intuitive and proactive about your hip health.   Neck notching can be a serious thing.

If you must have a full blown revision to a THR it's not the end of the world, the rehab is a lot like what you've been through so you know what is going to happen.  Make sure it's a large MOM device you're getting.  Many people do really well with a THR.

I know it's easy for me to say all of that, I would be upset too, but you will be fine in the future

I do not think I would choose the same doc to do my revision, especially since he caused a lot of your issues.

Good luck, please keep us appraised about what is going on.


Chuck

Hey,
Yes, for the notch, I first discovered it on my one year post-op X-rays while looking at them with my surgeon. I noticed the notch and asked, "What's that, is that a notch ..."
His response was one like a man tripping over his own feet, as he fumbled with the words, "well, its not mentioned in your operative report!"
To my own shame, I dropped the matter quickly because I was also there to talk about my future as I need to have my left hip resurfaced as well (I am 30 now, so it has been difficult to deal with all this shit!) Later that day, as my mind came back to the notch, and long after the surgeon consult. did it hit me (I think I was also reading about the subject of notching too) that the notch was my surgeon's error.
As for the device, the Acetabular Cup is the Durom Cup by Zimmer, which many of us know had some serious issues when patients, up to two years post op with good X-rays, were experiencing the same symptoms as a patient with a loose acetabular cup.
My surgery was in May 2008. Right up until the one year mark, I thought the pain that I was experiencing was the pain of healing ... (maybe I was in serious denial)
but shortly after, during family barbeque type games, I felt a sharp pain that did not subside. My first thought was - I have just fractured my femur neck ...
I saw my family doc right away who then sent me for X-rays. no fracture .... no femoral component movement (but there was that damn notch!)
I sent digital pics of my X-rays to Vicky Marlow, a patient advocate for resurfacing who then sent my x-rays to Dr De Smet, Dr Bose, and Dr Su. All three agreed that the Acetabular cup was the culprit, and that a full blown revision is needed (due also to my femur-neck thinning ...)
Long story ... and it is still going ...
Best.

[kb134]

Hi Chuck!
Thanks man. It has been a hard road, but as you know, what we learn along the way is ... priceless if I might say.
The surgeon who implanted my hip is not going to be doing the revision. When all these issues were hot on the table, this surgeon got offended that I would seek other opinions elsewhere, and stated,
"It sounds like you've lost confidence in me!"
"Damn right!" I said. Due to the notching incident.
When I asked about certain tests that were recommended by the three other surgeons to test for and confirm what was causing me pain in my hip the response I got was,
"Now you are telling me how to do my job!"
I know, one would think that I would have had a different surgeon from the start but honestly,   outside sources, I had heard that he was a good surgeon and had confidence - talked the talk during our pre-op appointments.
I am guilty though for not asking many of the questions that I was to find on this site - thank you Pat for that list! - most of the information that I read came after the operation, I am sorry to say, because I wanted to understand what was done to me.
I let my arthritic pain, even with all the years of waiting for tests and specialist appointments, set my course, and as soon as I saw an opportunity for relief I took it.
I should have done better research on the Surgeon that operated on me. I also should have stuck to my guns when I asked for the Birmingham Hip, due to the success of it and the success in Floyd Landis' story. I am or was a competitive cyclist and had been out of competition for a very long time ... very discouraging ...
Floyd Landis, at about 10 months post-op (August 2007,) rode the Leadville 100, a 100 mile mountain bike race, which Lance Armstrong won this year. If I remember right, Landis crashed hard o around the 8th mile - somewhere near the beginning anyway - on his new BHR Hip. He got up, got back on the bike with his shorts torn and bloodied, and rode on to capture second place behind the former race champion Dave Wiens. Wiens was pushed hard by Landis, so much that he set a new course record.
I wanted a BHR like Landis! At the time, I was told, with a dead-pan face, "We feel that the Durom Hip is superior."
I was hesitant, but conceded.
I believe that there have been very successful surgeries out there with the Durom Hip. But, when it fails, it is unique in that it does not show the usual signs of a failure, unless the Acetabular Cup migrates to the point of an extreme angle and there is no question.
The ironic part - shortly after the Durom Hip was implanted in me, my surgeon and his colleagues stopped using the Durom Hip, due to the rise in revisions and Metal Ion issues, and went back to implanting the BHR.
In September, I did travel to Montreal to visit with another surgeon for another opinion. The consult was great, and we discussed everything from devices to a the credibility of the surgeon on the West Coast that would be performing the revision surgery.
So now, I do advocate asking the hard and straight-up questions, and getting to know your surgeon's history, before he cuts you open.
I let a surgeon, who would advocate a THR over a Resurfacing cut me open ...
Was it his fault in the failure of my hip ... perhaps. The implant itself also   plays a part ...
My left hip is still natural ... it will have to wait a while ...
Best.





 

[moe]

KB, I am very saddened to hear your story. I am a former competitive cyclist myself so it really hits home. I also knew the Landis history and would only go for the BHR. Good luck and hang in there, moe