When to have HRA?

[LarryBud]

X-ray shows bone on bone.  The pain comes and goes.  Not real painful but I most always know something is not as it was in the past.

Had a phone call with Dr. Gross and he said we can do it now or do it later.  It just depends on how long you want to go on in your current situation.  I’d say I’m coping with the minor challenges but not anywhere near where I was prior to an acute onset in December of last year ( 2020 ).

How does one know when to go for it?

[jimbone]

Larry-

People that have done HR have done it at varying stages of decline.  OA will continue to deteriorate your hip.  How quickly is a crapshoot without predictable prognosis.  It took me about 12 years from onset of symptoms until I couldn't have avoided it, but at least the last 3-4 years were deeply and miserably impacted by chronic pain, reduced mobility and quality of life.  Insurance coverage was a restriction for me as well.  The ACA that removed pre-existing condition restrictions allowed me to move forward.   Best health decision I ever made.  I now, 3 years post bi-lateral have my life back with no restrictions on any activity I want to pursue.  Severity of symptoms can increase dramatically without warning and rapidly for some- my second hip did just that.  A friend facing scoliosis surgery told me when I was still on the fence, "When the pain gets bad enough, you'll get the surgery'.  She was right.  Depending on your age, activity level and quality of life your decision will depend on your restrictions.  It won't get better, will in all probability get much worse and you'll need surgery.  Dr. Gross is at the top of his profession along with a few others- he can likely inform you best.  Might be a good idea to discuss your options regarding bone quality if you decide to wait, but if you read through this website you'll see the overwhelming majority of patients are incredibly happy to have had the surgery and moved beyond the pain and limitations.  Best wishes.

[LarryBud]

Thanks Jimbone.

I should probably add that I'm 60 years of age and have always been very active.  I spend a lot of time hiking in the Rockies ( 4 weeks of it last year ) and had planned on continuing for the foreseeable future.  Aside from the hip I'm in good shape. 

I'm currently thinking I should just do it and move on ( recover while I'm younger ) but then there are days when its not bad at all and I think why would I want to have major surgery when I feel fine?  One of the biggest decisions I've faced.

[imgetinold]

I can't speak for anyone else on this site, but if you read enough stories, a common theme emerges:  I wish I had done it a year (two years, etc...) earlier.  Like you, my pain would come and go.  In general at the time, I would have 2 to 3 weeks of constant, droning pain that kept me from sleeping well and never left, followed by maybe a week of no pain.  The only reason I had no pain is because I would be sedentary for those 2-3 weeks of pain, so then it subsided.  So, of course, I would be active for a week, and then pay for it for another 2-3 weeks.  In fact, I ran 4 pain-free miles the day before my surgery!  Talk about second guessing your decision. 

You have to ask yourself if you'd like to have your old, active life back with no pain.  That's what you'll get.   Plus, Dr. Gross, Lee, and Nancy are just the best.  He did both of mine.  One 9 1/2 years ago and the second about 8 months ago.  I'm working out like a fiend already.  No pain (but still range of motion issues until I fully recover, which in my experience is about a full year).

I'm sure Dr. Gross discussed it with you, but after a certain age resurfacing is no longer an option.  I don't know what the age, but the older you get the lower the percentage of good outcomes.


Good luck. 

[MarvinB]

Hi Larry!

Andy and Jimbone are good.  Andy and Jimbone are wise.   And so is Dr. Gross! 

Another thing you’ll read on this forum is that everyone is different.  Some have had pain for years, some won’t tolerate it for too long before pulling the trigger.  A recurring opinion seems to be that most of us wish we had done it sooner because we missed out on a lot of fun.

You have to do what’s best for you.  It’s a lonely road to plow, but only you and your surgeon can decide.  At the tail-end of my six month rehab, it seemed interminable at the beginning and an uphill climb all the way, but looking back it seems like last week and I am soooo thankful for the team at Midlands Orthopaedics and Neurosurgery.  Dr. Gross’s crew are THE BEST!!

[jimbone]

Larry-

Gettinold makes a good point- age related surgical restriction.  I was 63 when I had both hips done, 8 weeks apart and at my first consultation with Dr. Pritchett I was told I was "on the cusp" for age related cut off.  I was in good health and physical condition other than the hips and it was thought I was a good candidate.  Had I been able to hold off a decision a couple more years that might not have been so.  Also as mentioned the chronic pain had driven me into  gradually increasing periods of sedentary habits- to avoid the pain- which, had I continued would have contributed to reducing my chances for both surgery and recovery.  While it is a major decision, in the hands of the top doctors, this surgery is mostly considered one of the major medical advances of the 20th Century, akin to the relief cataract surgery has positively provided millions of people.  Outcomes for HR are overwhelmingly positive, these days there are very, very few bad results and the prosthesis being used are spectacularly successful.  Being in good health prior to surgery, especially the kind of physical conditioning you get from hiking will add to the speed and ease of recovery. You'd be back on the trail, even the strenuous ones inside of a year in all probability.  Best of luck.

[autoazure]

When to have HRA! If the x rays provide evidence of bone on bone, time to have it done. If one allows the condition to progress too far it is possible it may actually reduce the pain as the nerves are destroyed leading to a false sense that there is an improvement. Read my story if you have time!

[Saddlepal3]

Another thing to consider. The healthier you are, the easier your recovery. I was convinced that the surgery was inevitable at sme point, so why wait (as long as the x-rays and the good Dr Gross feel that it's appropriate). With those latter points in place, as they are, I'd do it.

[PalmettoGolfer]

LarryBud,

I was in your position about 7/8 months ago.  I was worried that I was making a hasty decision.

I thought it was a muscle thing at first as I was working out and doing a fair bit of running at the time.  I was diagnosed bone on bone in April of this year.  I decided to go ahead and have it done.  Was sporting a brand new hip as of May 17th.  I'm just about 6 weeks in.  Dr. Gross did mine and the process was amazing!  I had almost no pain (like really no pain).  All the OA pain is gone, I have a very slight limp, more due to tightness than any pain.

Knowing what I know now, I would do it again.  Pain free golf is in my very near future   

I read somewhere on this site (or maybe somewhere else on the interwebs), you can live with your current pain, as little or a much as it is, but know that it WILL NEVER GET BETTER.  Or have the procedure and live with the pain, if you have any, knowing that every day it gets a little better.

[LarryBud]

Thank you all for the replies.

For the most part, you're confirming my decision to have it done.  I'm bone on bone and while I'm not totally incapacitated, it's there every day, reminding me that something must be done one day.

I've reached out to the clinic and asked to be put on the schedule.  No date planned yet.

I'm sure you'll hear more from me.  This is a great resource!

LB