non-weight bearing vs weight bearing

[tricky]

I am one week out of surgery and have been instructed to be 100% non weight bearing for 2 weeks, then 50% weight bearing for another 2 weeks.  This surprised me somewhat since I thought the trend these days was to be weight bearing as soon as possible. I have been complying to the best of my ability, but I am wondering what the reason is to be non-bearing and what ill effects might occur if I fail to be compliant.  Also, how do you establish how much 50% weight bearing is?  Obviously this is the protocol my DR believes in but I was wondering why others believe in weight bearing so much earlier.

[resurface]

Tricky

Hi.  I am 3 weeks out.  My instructions are "No restrictions. Full Range of motion (except do NOT cross legs). Weight Bearing as tolerated." 

As always, listen to your surgeon. 

My guess that is that muscle atrophy is significant enough post-surgery and another few weeks will just add to that.  I can tell you I was walking down the hallway after surgery with crutches - so limited weight.  Cane at 2 weeks with more weight.  I am still trying to regain all my former muscle strength so that I can walk properly.

Not sure this adds to much but seems that there is not a great deal of concensus.

I wish you well...

[obxpelican]

Sometimes weight bearing is determined by how good your dexascan turned out, if your bone is not good stock some doctors will put restrictions on.

I would say the majority of doctors now want you to put weight on as soon as your body will allow.  Some green horn doctors will however be more conservative, nothing wrong with it, just make sure you keep that leg moving around, do foot pumps to keep them nasty blood clots away.


Chuck

I am one week out of surgery and have been instructed to be 100% non weight bearing for 2 weeks, then 50% weight bearing for another 2 weeks.  This surprised me somewhat since I thought the trend these days was to be weight bearing as soon as possible. I have been complying to the best of my ability, but I am wondering what the reason is to be non-bearing and what ill effects might occur if I fail to be compliant.  Also, how do you establish how much 50% weight bearing is?  Obviously this is the protocol my DR believes in but I was wondering why others believe in weight bearing so much earlier.

[DirkV]

Hi Tricky,
I am bilateral, 5 weeks apart. The 1st one was weight bearing as tolerated. The surgeon said I have very good bone density that made it a bit more of a challenge to get the cup fit just just right in terms of reaming out the bone (I recall a comment about really having to put the shoulder into the reamer tool), and he had a concern that the 2nd one was not as snug as he'd like, so I was 25% weight bearing for 4 wks after #2. Healing and bone growth are wonderful things. While the restriction was -- well, restrictive for a month, after a couple months, I think they were both at the same place. That is to say, that you are still healing at near the same rate even though you have the weight restriction.
I'm now at over 2 years with my new hips and loving a life of pain-free (at least from hips) activity.
To determine 25% , 50% etc., just step on a scale until it registers that percentage of your weight. That will give you a feel for it.
Good luck,
-Dirk

[doris]

I had a RBHR on 04/12/10 by Dr. Peter Brooks of the Cleveland Clinic.  I am on 75% weight  bearing until my 6 week visit (which is actually 7 weeks) - to be evaluiated at that time. From the information they provided to me, I understand that the most common cause of early failure of resurfacing is femoral neck fractures.  It appears that this is one of the precautions to help prevent this.  Dr. Brooks has excellent outcomes and has done close to 700 resurfacings (not sure of his exact number). While 75% weight bearing is a challenge and sometimes annoying - I am being 100% compliant as I am counting on this process being totally successful - and, I don't want to become one of his statistics, either! 

[shipnc]

Thanks to all for the input.  As always, this site is a great source of info and support.  I guess since I had this done at a relatively late age (66), the Dr. is being conservative to avoid the femur fracture situation.  So, I'll live with the inconvenience and look forward to mobility in the future.

[atbower]

Doris---I had my surgery with Dr. Brooks 4/28--maybe I will see you in the waiting room for f/u!  I hear you on the being a good do-bee with the weight restrictions (........and no driving, arrrgggh) As the mother of three teenage boys- hoping house will not be condemmed before I get off the crutches!  Trying very hard to be zen knowing it is in my best interest but it is hard.  Ready to throw crutches into fire pit.  I have started walking around the neighborhood on my crutches but it really is a pain.  Upside all my elderly neighbors Very Interested in my surgery story!  I fit right in.

[doris]

atbower --- I am with you in wanting to throw the crutches in the fire pit. I am 6 1/2 weeks post op and just this week the crutches have become more annoying.  I can't really walk with crutches in the neighborhood as our sidewalks are too uneven - I'm terrified of tripping.  So - I do many many laps around my house -- and -- when I can get someone to drive me (I also hate not being able to drive!) to Costco or Sam's Club - the walking there is great - with even floors!    Good luck with your recovery!  Aren't you amazed at how painless it all is???

[ptaylor]

hi
i had op on 1st april and im based in the uk where i think they are keen to make hospital beds available as soon as poss. so 4pm surgery for rbhr and 10am next morning the physio wants you out of bed! 2 stick,not crutches, walking up/downstairs allows you to leave hospital. i saw the surgeon after 6 weeks and upto then i had been concerned about going beyond the 90 degree in case this was wrong. he asked me to get much more flexible with the operated leg! he also said no impact sports for 6 months from the op which i will stick to. i played 9 holes of golf last night with no effects and if someone had said on 31st march i could do this before the end of may i would have snatched their hand off.
subject to the wound healing i would really recommend using a pool. the water bears much of your weight and thus gives confidence with stretches.
regards
phil

[johnoke]

yeah I'm weight bearing as tolerated, no restrictions. My dr (Matthew Phillips in Buffalo, NY) recently changed from restrictions to no restrictions. I'm now 5 weeks post op, and feeling great. If I feel pain, I go for a walk (with 1 crutch) and I always feel better, so my personal belief is that weight bearing is awesome.

However, as has been said, go by your own dr's restrictions. I know other doctors in the practice in Buffalo are all different, so you have to assume they have their reasons!