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Author Topic: Time between first symptoms and surgery  (Read 4173 times)

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Minniemuis

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Time between first symptoms and surgery
« on: March 02, 2021, 07:32:04 AM »
I have been reading on this forum for many hours now, but I have not found an answer to this question: how long was it between your first symptoms and the hip surgery?

From what I have been reading, it seems most of you have had a gradual onset of symptoms, and as time went by, there was an increase in pain and ROM limitation, until one day you decided you could take no more. I always thought that in the beginning stages, the pain would come and go, with alternating better and worse periods. Also, do the pain intensity and the limited ROM go hand in hand?

The reason I am asking is because in my husbands case he was symptom free until last year one day his groin started aching, and that ache never went away. Aside from the groin pain he does not have any of the symptoms most of you report : no pain at night, no morning stifness, no pain walking, no limp at all, tying his shoes does not cause any problems. Anyone else with a similar OA progression?

Since the pain is always present (when awake) we are definitely considering the resurfacing but we want to be sure that the OA is the cause of the pain. It would help if we knew there are others who experienced the same thing.

Any insights ?

PistolPete

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Re: Time between first symptoms and surgery
« Reply #1 on: March 02, 2021, 09:16:43 AM »
Has he had X-Rays done?  That is needed in order to diagnose.  I've had both my hips resurfaced with the most recent just 3 weeks ago.  My first one started with a major decrease in flexibility and then I noticed my right leg was nearly 2" longer than my left.  My impingement caused that and then the pain settled in.  From start to surgery was prob. 8 months. 

This time around it was much slower.  It started with some impingement and gradually became harder and harder to tie my shoes and bend over etc.  Made working out a real challenge.  I didn't have the pain as much except when I moved the wrong way.  This took over a year and I realistically prob. could have waited until the fall to get it done.   I figured with Covid and things being shut down I might as well do it and get it behind me.  I'm glad that I did.

Saddlepal3

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Re: Time between first symptoms and surgery
« Reply #2 on: March 02, 2021, 01:18:37 PM »
Minniemuis,
My first symptom was groin pain while skiing in January. I assumed it was a pulled muscle and was shocked that x-rays revealed "mild" OA. Symptoms flared when I went running but, otherwise, were not too bad until October when it hurt to walk. My surgery was late November. If your husband has not had x-rays, he should do so. Also, he might want to visit a physical therapist to make sure there are no back issues that are mimicking hip OA. I have heard that this can happen (although it didn't with me). As others have advised, if your husband is interested in resurfacing, he should only go to surgeons who have a lot of experience in that procedure. Also, be aware, that there is a 'window" in which resurfacing can be done. If there is too much damage, it might not be possible. Good luck!

dannythebeerman

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Re: Time between first symptoms and surgery
« Reply #3 on: March 02, 2021, 04:36:24 PM »
I didn't find this sight until I had had enough, nearly 10 years.  I was told too young for total hip replacement, they weren't lasting, you would know when the time was right.  I tried everything, wasted a lot of time and money, wish I had known of this site but glad I found it.

When I had enough I started looking and found this website about Hip Resurfacing.  Pete make a good recommendation to compare femoral head to acetabular cup spacing in xray, if it's tight he'll have problems.  I just read in another thread that your husband has some congenital problems from birth.  Because I waited I needed a bone graft to my acetabular cup, lots of prayer and an extra 6 months of restricted activity, not doing heavy lifting.

And if you have trouble finding a doctor in your area because they only do Totals or get told "no" for a Resurfacing, press forward with one of the doctors mentioned here on this website.  I was told "no" and sent mine to Dr Gross for a free consult and guidance for lining up insurance.  He has performance data about his outcomes that gave me confidence to use him. 
« Last Edit: March 02, 2021, 05:07:19 PM by dannythebeerman »
~Danny Hahn

July 2020 Biomet Magnum Trispike, Dr Gross. Needed 5cm3 bone graft behind acetabular cup.  That's a whole lot of packed in bone dust I pray heals.

Minniemuis

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Re: Time between first symptoms and surgery
« Reply #4 on: March 03, 2021, 04:29:36 AM »
My husband had X-rays and MRI's taken. They showed OA in both hips, although only one is symptomatic. Even so that after our last visit at Dr De Smets Clinic, we were sent home with X-rays, were they showed us that there was some touching of the bone at the outside rim of the hip. It wasn't until we studied these at home that we saw that the side with the bone on bone touching is actually the non painful side. This is al very confusing.

It seems that because there is evidence of OA in the hips, nobody is willing to look beyond that. Can someone assure me that al those symptoms are 100% because of the OA?

We have been through a similar situation with his shoulders... rotator cuff tear and labral tear, surgery was 'the only option'. Now a year and a half later, he is fine without the surgery. That is why we are hesitant.

I don't know if this is denial or intuition speaking, but I feel we need to be sure before proceeding with the resurfacing.

PistolPete

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Re: Time between first symptoms and surgery
« Reply #5 on: March 03, 2021, 05:18:53 PM »
Any reputable surgeon will tell you if it is time or not.  I know they are trying to "sell" their surgery so they get paid but any good surgeon has more patients than they can handle.  If his surgeon says it's time I would likely listen.  Or, send the X-Rays to some of the other surgeons and see what they say.  It's a balance to have a quality of life.



My husband had X-rays and MRI's taken. They showed OA in both hips, although only one is symptomatic. Even so that after our last visit at Dr De Smets Clinic, we were sent home with X-rays, were they showed us that there was some touching of the bone at the outside rim of the hip. It wasn't until we studied these at home that we saw that the side with the bone on bone touching is actually the non painful side. This is al very confusing.

It seems that because there is evidence of OA in the hips, nobody is willing to look beyond that. Can someone assure me that al those symptoms are 100% because of the OA?

We have been through a similar situation with his shoulders... rotator cuff tear and labral tear, surgery was 'the only option'. Now a year and a half later, he is fine without the surgery. That is why we are hesitant.

I don't know if this is denial or intuition speaking, but I feel we need to be sure before proceeding with the resurfacing.

blinky

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Re: Time between first symptoms and surgery
« Reply #6 on: March 03, 2021, 08:45:36 PM »
Four years. At first I could run through it. I thought, everyone thought, it was a muscle pull. But it got worse and worse until it hurt all the time and I could barely walk. I'd be in the airport walking to my gate and the cart would stop and insist I get on and ride. I looked that bad.

Don't wait that long.

OA won't get better. Sure, your H should check every alternative treatment. He may well have some good days, even weeks, left.

catfriend

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Re: Time between first symptoms and surgery
« Reply #7 on: March 05, 2021, 02:03:54 AM »
I'm not really sure. I was told I had hip dysplasia in December 2012, and that in about ten years I would develop arthritis in my right hip and need it replaced. I had the right hip resurfaced in January 2016 and the left hip resurfaced Monday. So I have some issues with that initial diagnosis! Later this same doctor told me I had bursitis, and suggested injections and physical therapy. I blamed myself for a lot of the pain I felt in this time frame. I did PT and hip specific exercises all the time. In July of 2015 I went to a different doctor for another opinion. He was shocked I didn't know I had full blown arthritis. By that time I was bone on bone. I consulted with Dr. Pritchett on Christmas Eve 2015. He just looked at that July x-ray and told me I needed surgery. I had my right hip resurfaced January 19, 2016. I was in a tremendous amount of pain, but I don't know exactly when I developed arthritis.

My left hip was in pain for a considerable amount of time. I would have had surgery a couple of years ago if I had had health insurance. But I didn't. This is the first year I've had insurance since 2017. The US is a country in which insurance is not always available or affordable. This year I managed. Once again I was bone on bone. I had my left hip resurfaced Monday.

In both cases I had been in pain for a substantial amount of time. Had I been correctly diagnosed the first time and insurance sooner I would have had both surgeries long before I did. If your husband is in pain and has access to medical care there is no advantage to waiting.

Arthur Plastie

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Re: Time between first symptoms and surgery
« Reply #8 on: March 06, 2021, 10:04:36 AM »
I had a birth defect I didn’t know about until the groin pain started 5 years ago.  I knew I wore braces on my legs at night because, as my mother said and baby pics showed, my legs looked like parentheses!  Probably would’ve made a good cowboy!    :D  I thought the braces fixed everything.   I didn’t know what “femeroacetabular impingement” was, but the first surgeon I saw gave me that diagnosis along with deteriorated cushioning cartilage in the socket, labral tear, and tried to push me towards total hip replacement.  There was nothing wrong with my femur, other than a little too much bone causing the impingement.  Why cut it off and live with restrictions?!?

Minnie, if your husband wants to get back to high level performance with no restrictions, it would be in his best interest to talk to a surgeon that does resurfacing.  Two months after and I’m already better than pre-op and getting stronger every day.  Looking forward to golf in 4 months (walking the course! Of course!) and snow skiing in Colorado next winter!
« Last Edit: May 02, 2021, 05:30:44 PM by Arthur Plastie »
MarvinB
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Saddlepal3

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Re: Time between first symptoms and surgery
« Reply #9 on: March 06, 2021, 03:45:48 PM »
I understand why you and your husband may be skeptical; however it isn't useful to ask this group to assure you that your husband's pain is due to OA. Instead, contact several doctors mentioned on this site: Gross, Pritchett, Brooks, etc. You already have met with deSmet who is one of the most experienced resurfacing surgeons. Send x-ray images and ask for second opinions. They will gladly share their expertise. Don't delay.

imgetinold

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Re: Time between first symptoms and surgery
« Reply #10 on: March 08, 2021, 12:49:28 PM »
Hi Minniemuis.


My very first symptoms started about 4 years before my surgery.  I clearly remember walking home from the bus stop with my 1st grader at the time and having this sharp, deep groin pain.  It came an went, and I went to an orthopedist who said I was nearing bone-on-bone.  Here's the weird thing:  I started taking glucosamine/chondroitin, and my hip pain literally went away for about 4 years.  At that point we had moved to Georgia and started playing a LOT of tennis (on top of running and weights and biking).  This ended up being enough to do it, though I suffered through about a year of constant pain before pulling the trigger at age 44.  I wish I had just done it right away.  You immediately get you life back.


If he just has the pain when he's awake, give the glucosamine/chondroitin a try.  It's cheap, and if it works for him, he might be able to push it off for several years like I did.



« Last Edit: March 11, 2021, 11:59:23 AM by imgetinold »
Andy
- Right Biomet uncemented HR with Dr. Gross on 1/11/2012
- Left Biomet uncemented HR with Dr. Gross on 10/28/2020

BOILER UP!

stevel

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Re: Time between first symptoms and surgery
« Reply #11 on: March 09, 2021, 11:35:23 AM »
One year for the right hip.  Osteoarthritis progressed from mild to moderate to severe with bone contact.  Xrays showed cartilage thinning.  Two orthopedic surgeons said it was time for surgery.
Steve
LBHR 60mm/54mm Dr Su 9/29/08 age 55
RBHR 60mm/54mm Dr Su 11/1/19 age 66
Age 70

spartacus

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Re: Time between first symptoms and surgery
« Reply #12 on: March 20, 2021, 07:06:15 PM »
Mine was due to avascular necrosis which set in quite suddenly over the course of a few days, culminating in a gigantic limp. I have since read some medical literature suggesting that there is a school of thought regarding AVN where it's a one-time event which then eventually progresses into OA, which would line up with my symptoms, where things improved modestly for the first couple of months but then went irreversibly downhill.

Anyway, it was about 4 months until I had a confirmation of AVN due to waiting for various referrals/MRIs/clinic appointments. After that point it was about another 3 months until I could get an appointment with Dr. Su, then another 4 months until we agreed it was time for surgery after a cortisone injection did not yield improvement.

So that's 11 months from first symptoms to beginning to plan the surgery. All throughout that time the pain got worse and my range of motion continually decreased. It was another 5 months until the surgery due to the pandemic; by the week of the surgery I could barely walk 1000 feet without having to rest from the pain.
« Last Edit: March 20, 2021, 07:08:26 PM by spartacus »

stevel

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Re: Time between first symptoms and surgery
« Reply #13 on: March 21, 2021, 12:29:26 PM »
I had been getting x-rays and metal ion blood tests every two years mainly to monitor my LBHR installed on 9/29/08 but also a pelvic x-ray is taken that examines my right hip and lower back.
The radiologist's report for 09/13/17 states:

"...Mild hip joint and lower lumbar spine degenerative changes reidentified.  Pelvic phleboliths are identified."

I had no issues with the LBHR or the right hip.
In June, 2018 I had pain in my right hip and was limping after playing racquetball.  I laid off racquetball for the Summer but the right hip pain was reaggravated after moose hunting in September, 2018.  So during my annual physical, I had an x-ray of my right hip on 9/27/18.  The radiologist's report states:

"Right hip: 2 views Joint space narrowing, especially notable at the roof of the acetabulum laterally.  Articular surfaces are smooth.  Trabecular pattern and the femoral head are normal.  Impression:  Early degenerative changes."

I had difficulty sleeping for a couple of months due to pain in the right hip, but the symptoms alleviated.  By next Summer, 2019 the pain and limping returned so I visited my local othorpaedic surgeon in July, 2019 then had a biannual x-ray taken 1 1/2 months early on 8/07/19.  The radiologist's report states:

"...On the right there are findings of severe osteoarthritis with joint space narrowing and subchondral sclerosis, progressive in comparison to the previous examination (9/13/17) with further narrowing of the superior joint space with apparent bone on bone contact at the upper margin of the acetabulum.  No fractures are evident.  Examination of the soft tissues is unremarkable.  Impression:  1.  Left hip arthroplasty  without evidence of hardware failure or loosening.  2.  Severe osteoarthritis of the right hip joint, progressive in comparison to previous study."

So after consulting with Dr Su and his PA, I scheduled surgery for my right hip to be done on 11/01/19.

The arthritis progressed from mild to severe in about two years and I began to notice symptoms especially starting about 1 1/2 years before surgery.

« Last Edit: March 23, 2021, 11:31:06 AM by stevel »
Steve
LBHR 60mm/54mm Dr Su 9/29/08 age 55
RBHR 60mm/54mm Dr Su 11/1/19 age 66
Age 70

TotalWus

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Re: Time between first symptoms and surgery
« Reply #14 on: March 23, 2021, 03:05:22 AM »
5.5 years, in my case. There are too many variables to predict, because (1) everybody's different in terms of anatomy and exactly where your cartilage is wearing in relation to exactly which nerves are involved; and (2) people usually modify their activities first and/or take medications and/or start PT to address strength deficiencies, all of which temporarily delays progression.

Pain tolerance is also a factor; but that encompasses many variables, as well. Every surgeon who saw my X-rays since my 2015 diagnosis said he didn't know how I was still skating on my hip and assumed that I have a high pain tolerance, which I most definitely do not, because my very first X-rays showed bone-on-bone contact. I just didn't feel any pain until after getting showered and dressed, and even then, just something that I could minimize by altering my stride and, more recently, limping. Had I starting experiencing more pain sooner, I'd have had surgery that much sooner. So, you can't directly correlate X-rays or formal diagnoses with symptoms, either.

In my case, I stopped raising my leg over the boards and always got on/off the ice through the doors, and I started taking Celebrex, and then, I gradually reduced my ice time from 6-7 hours/week to barely 1 hour/week and my leg workouts from 2x to 1x/week, and reduced my elliptical training more and more before cutting it out, completely. My symptoms got better, but gradually returned during that 5.5-year period until it bcecame clear last year that I'd pretty much gotten every possible bit of use out of my hip and that I really had no choice. If I'd have waited any longer, it would have started disrupting my sleep and I'd have been walking with a cane. I'm now 10 days out from my anterior THR and doing my second post-surgery upper body workout right now, but only walking for my legs until I see my surgeon next Monday for my first follow up. Hoping to get the go-ahead to hit the elliptical and light leg workouts next week. You won't be returning to activities as quickly after a BHR; but that, and my concern over the metal-on-metal issue (and being a wus) was one of the main reasons I went with anterior THR, instead.

« Last Edit: March 23, 2021, 03:57:19 AM by TotalWus »

stevel

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Re: Time between first symptoms and surgery
« Reply #15 on: March 23, 2021, 12:06:10 PM »
20 years for my left hip.
First symptoms began in January, 1988 from a motor vehicle accident.
Most bilateral hip resurfacing patients don't wait as long for the second hip (opposite) surgery, unless they need to have both done at the same time.
My story (Steve Lee) is located under patient stories for Dr Su on this website.
Steve
LBHR 60mm/54mm Dr Su 9/29/08 age 55
RBHR 60mm/54mm Dr Su 11/1/19 age 66
Age 70

imgetinold

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Re: Time between first symptoms and surgery
« Reply #16 on: March 24, 2021, 11:28:46 AM »
Funny, I was re-reading this thread, and realized that I only answered about my left hip.

My right hip was completely different.  I went from doing boot-camp style workouts to complete hip pain the prevented pretty much any exercise.  I was basically sedentary for four months, at which point it began to improve.  But, I had already scheduled my 2nd hip at this point because I wasn't going to go through years of this crap again.   Of course, COVID put hospital availability back 5 months, but finally got it done 10/28/2020.

So, even in the same person that time frame can be wildly different.
Andy
- Right Biomet uncemented HR with Dr. Gross on 1/11/2012
- Left Biomet uncemented HR with Dr. Gross on 10/28/2020

BOILER UP!

stevel

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Re: Time between first symptoms and surgery
« Reply #17 on: March 26, 2021, 11:44:35 AM »
I also have moderate to severe arthritis of my right shoulder, diagnosed 8 years ago with an xray followed by an mri.  It has stabilized as I continue with sporting activities without much pain afterwards, although I can feel and hear the clunking of the arthritic shoulder.
Steve
LBHR 60mm/54mm Dr Su 9/29/08 age 55
RBHR 60mm/54mm Dr Su 11/1/19 age 66
Age 70

PalmettoGolfer

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Re: Time between first symptoms and surgery
« Reply #18 on: May 02, 2021, 01:24:01 PM »
I'm glad you asked this question.

I'm 6 months from the onset of symptoms and was so worried that I was jumping in to surgery too quickly.  Was doing kick boxing training 3/4 times a week.  Zero problems.  They closed and I went to a popular hiit style workout.  Let just call them Red Hypothesis fitness.  Went for one month with a LOT of uphill running and BAM, I'm done.  I've been to sports medicine ortho doctor and he said I still had 'tread on the tire' and wasn't sure why I was in such pain.  I got a second opinion from Dr. Gross, he looked at the xrays for about 2 minutes and told me I was bone on bone.

I've been reading the forums for a week or so and saw people were experiencing pain for years.  You folks are stronger than I am, there's no way I could do this for years.

I've done PT for about 2 months 9-10 sessions and it doesn't seem to have helped at all. So, here I am scheduling for early July.......nervous but really glad I found this forum to help my analytical mind process all this.

imgetinold

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Re: Time between first symptoms and surgery
« Reply #19 on: May 03, 2021, 08:35:56 AM »
Hey, PalmettoGolfer.  Glad you found Dr. Gross.......he is the best.  You cannot go wrong there.  Good luck!
Andy
- Right Biomet uncemented HR with Dr. Gross on 1/11/2012
- Left Biomet uncemented HR with Dr. Gross on 10/28/2020

BOILER UP!

 

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