One Week After Surgery Direct Anterior Resurfacing Dr. Kreuzer

[sgoulet]

Greetings from Houston, Texas!    I am now one week post-surgery.  On December 10, I had a Cormet Hip Resurfacing prosthesis using the direct anterior approach performed by Dr. Stefan Kreuzer.  The anterior direct approach (also known as “Smith Peteresen”) is relatively rare in the U.S. as many surgeons have not yet been trained with this approach.  The reported benefits of the direct anterior approach are the avoidance of detaching the major muscle groups from bone to access the femur as the muscles are spread versus being cut or detached.  My incision is located on the front of my thigh, beginning at groin height and going down about 5 inches.

Here is some information about myself:

• I am 43 years old, very athletic and am a competitive cyclist and triathlete.
• Over the past three years, my right hip became progressively worse, losing range of motion, the loss of ability to do basic life functions (tying shoes, lifting leg, etc.) due to osteoarthritis. Within the past 2 months, I got to where I couldn't even ride my road bike or ride a stationary bike due to onset of pain that would start after about ½ into the exercise.  While my pain level and loss of function appears to be less than many others on SurfaceHippy, given my relatively young age, it was to point where I had to get something done.
• I researched different surgical techniques and settled on the hip surfacing procedure considering my age and the minimal impact of the procedure on my femur.  Once I decided on the hip resurfacing procedure, I had to pick a doctor and the surgical approach (posterior, anterior, cemented, uncemented, etc.)  While I am definitely not an expert of these variables, I chose Dr. Kreuzer and the direct anterior approach.

One week out of surgery, here is my progress:

• Incision is healing well.  Still very tender and itchy, but healing well.  The doctor used surgical glue on the top layer of skin with dissolvable stitches below the skin.
  
• I am able to walk with a cane and even able to walk slowly without a cane and a slight limp.  My muscles are obviously tight and I am not able to lift my right leg while in a seated position or laying down.  I still have to lift my leg on or off the bed or when raising it.  I am amazed at how I can walk and put weight on my new right leg with little pain.
• I have some nerve damage to my leg around the incision extending to the outside of my leg.  In other words, I can't feel this area of my leg in an area extending the height of my hand to the outside of my right leg.  Hopefully this will improve with time because it is uncomfortable not being able to feel your leg!
• My spirits are good.  While I do not like to sit around the house bored, I am pleased with my level of recovery after just one week and am looking forward to progressive recovery.  The first two days home from the hospital, Saturday and Sunday, I was rather depressed and feeling sorry for myself.  I think that reading stories about other hippies really helped to put my situation in perspective.

It's great to share stories with others in a similar situation to mine and this is a very supportive and informative website.

Happy holidays to all and I will keep you up to date with my progress.

Steve Goulet
Houston, TX

[sgoulet]

Oh yeah, I forgot to mention that i got some great support over the telephone from our very own "Big Bill" in Houston Texas.  Bill had a similar surgery approximately 5 months ago and is doing very well. 

Bill, it was nice talking to you yesterday and appreciate your taking the time to call me to share your similar experience.  I look forward to meeting you soon.

Steve

[hawaiieric]

Aloha Steve,

Words of encouragement your way, I too am 43 years old, very athletic and am a competitive person of life.  I always play hard and don't like second place, but I respect those who have more talent then me and are simply more graceful things.   I had my surgery Nov 3rd, and now at 6 weeks, I feel like I am flying high in my healing and the Doc told me at my 6 week post op, "your probably feeling really great, healing every day, muscles getting stronger, feeling like you can do things again...just remember, its these first 6 weeks and now the next 6 weeks that will make you stronger as in your bone needs to heal-it can even be 6 months to even 1 year for you to do those things that I know your anxious to do again"  My doctor telling me that he knows me, he would be doing and feeling the same way, being very active and always doing the most, then he mentioned some activities that I might want to check out to sub for the thrillers I do, funny, I have been doing some of those things as my PT.  In any case, you will find that your going to healing every day, doing things every days farther then the day before, its exciting and now I look back at the challenges and now they are just small speed bumps and there are new things to look forward too...

Daily you might be finding something new, maybe it might be weekly, and if you have questions or want to check on your progress, this forum is awesome!  I used this method as a good guide and it has gotten me farther via all the encouragement.  Don't overdue it, your body will know its limits.  Ask questions in here, and happy healing.

Eric

[Pat Walter]

Hi Steve

Congratulations on your new hip resurfacing.  Glad you posted information about the new anterior approach.  I have the videoabout the anterior approach from Dr. Kreuzer posted here

http://www.surfacehippy.info/shvideos/videossurgery.php   It is a graphic video, not actual surgery, that explaines the anterior approach.

I hope your recovery continues to go well.  I look forward to reading more about your recovery.

Good Luck.

Pat

[mindjoy]

I admire all you people who recover so quickly and, say, after a week post-op you can walk and lift your leg, go back to work, etc. However, I would be afraid of destroying the implant's integrity and stability by putting full weight on it after only a week!

I got my Birmingham done by dr. Brooks in Cleveland, OH and he ordered use of crutches for full 6 weeks with only up to 75% of the weight on the leg, which seems like a reasonable period of time. I don't need to rush to put full weight on my repaired leg to risk failure and nightmares down the road. Just my opinion...

[sgoulet]

I admire all you people who recover so quickly and, say, after a week post-op you can walk and lift your leg, go back to work, etc. However, I would be afraid of destroying the implant's integrity and stability by putting full weight on it after only a week!

This is a good point.  Although the doctor did say I could walk with full weight bearing on the new hip using pain as a guide, I must be mindful that my body is breaking itself in and I should give it time to heal without too much undue strain and stress.  I don't have much muscle pain and besides some tightness and weakness, it doesn't seem to be difficuly to walk on the new hip.

Has anyone else been given doctor's clearance to put full weight bearing on the repaired hip after a couple weeks?  I don't mean running, jumping, etc. just walking around the house, short walks around the block, etc.

Thanks for your replies.

Steve

[sroberts]

Different docs use different protocols and each patient has unique "work" done to them. So follow your doctor's protocol and rest assured you are doing the right thing.


spencer
rbhr 6/26/08

[obxpelican]

Spencer,


What I've found is sometimes you end up with doctors with completely different protocols.  Some doctors won't let you drive even after 4 weeks, some 2 weeks with Dr. Gross it was 3 days post-op no pain meds.

Siome docs don't allow weight bearing for a month or longer even with good bone density and a good resutling operations.... Pat once told me that US doctors are very conservative.

Although Spencers advice is spot on, listen to your doctor.  The majority of people end up walking straight lines it's just a matter of when, who cares as long as it happens.

Guys, don't judge yourself by anyone but yourself, I personally do not believe in spouting off about the miracle recoveries you hear about, to me the fact that a doctor can open you up, stick some metal in you and your walking within weeks or months is enough of a miracle to me.

Chuck

[wayne-0]

Hey Steve,
My doc gave me the green light for full weight bearing the day after surgery. I used a walker for 8 days then crutches for 5 then a cane for 16 days then no cane but I carry it just in case I get tired on long walks.

                                                 Wayne

[sgoulet]

My doc gave me the green light for full weight bearing the day after surgery. I used a walker for 8 days then crutches for 5 then a cane for 16 days then no cane but I carry it just in case I get tired on long walks.

Thanks Wayne.  I am ten days out of surgery and am able to walk without a cane without a lot of pain. I am focusing on form when I walk.  Pain is worst when I first get up off the couch or out of bed at night (ouch!).  I am not walking pain free, but I can walk and put weight on the joint.

My biggest problem is just the dead feeling in my leg from the incision(on the front of my thight out to the side of my thigh.  It is more annoying than anything, but the lack of feeling does concern me.

Steve

[obxpelican]

Steve,

I would not be too alarmed right now, you are 10 days post-op, you're body is in the midst of a lot of healing.    If you are walking without a cane 10 days post-op you are doing pretty dang good.  Many times I have read where people had numbness around their incision, apparantly the surgery and dislocation cause some nerve damage sometimes and more often than not you do get back the feeling in full. 

Around my incision area took about 3-4 weeks before it was not numb.

It sounds with your walking that you've hit that magical time 9-11 days when things start to work better.  From here on in you should start to feel a lot better as each day goes by.


Chuck

[Barbara]

I am 12 days post op today and can take a few steps around the bathroom without crutches. I could if I wanted to do more however I can feel the extra strain it puts on my bones and muscles. I personally think walking unaided at this time is not a good thing. It takes at least 6 weeks for the bones to have healed enough and months for the muscles to heal.

This is my 2nd surgery, I am 10 weeks post op with my right side. I was walking unaided at 5-6 weeks and at 7 weeks had a lot of pain and was unable to lift my leg from the bed or up on to the footstool once more. My PT said I had overworked my Hip flexor muscles and said people tend to try to move along too quickly when they start to feel better. He said that everything should be done in moderation and to remember that I had a major surgery and it takes months to heal. I think that was very good advice.

I also have some numbness around my incision site. I think this is normal after any surgery. I had it the last time and as Chuck said it took 3-4 weeks for all the feeling to come back. I think the numbness is probably a good thing. The body has a remarkable way of self protection. If those peripheral nerves were working as they should I'm sure the pain would be unbearable.

Good luck with your recovery
Barbara

[obxpelican]

Barbara,

I am glad to hear that you're doing well, man, by Spring you are going to be going gang busters on 2 new hips.

Here's how I did my intro to walking, I like you took a few steps after 2 weeks w/o crutches, weird feeling, but man it felt good to know I could do it.  I gradually went to one crutch, then I would walk outside unaided on the flats, never on uneven stuff.  Then one day I forgot where I put my crutches and never looked back.

I won't call this a problem, but I still am stiff and sore the first couple steps out of my chair or the car, then if I take 8-10 steps I feel better, after a block or so I am moving well no pain, nothing.  It's weird as if my body has to warm up or something.   Someone told me that after 8-9 months he did not have that startup stiffness, I hope mine comes sooner.


Chuck

[John C]

Hi Chuck,
Yep, Lee Webb called that "start-up pain", and said to that it would go away between six months and a year, likely around nine months. At six months, I can feel that mine is starting to improve, but is still there.

John

[obxpelican]

John,

I was telling my wife last night that it's easier for me to walk and stand for a while than it is to sit, get up and try to walk those first 5 or 6 steps.  After that it's like someone is pushing me along--- I know that sounds crazy but it feels like suddenly I am light on my feet and I move more quickly, it's hard to describe.... and no, I was not drinking 


Chuck

[sgoulet]

Now 11 days after surgery...  Although I am able to walk without a cane or crutch, I am definitely feeling the effects of the last couple of days of walking around without the support of a cane or crutch.  Feels like I have taken a couple steps backwards as my joint and muscles are very sore!

Time to slow down, use the crutch and take it easy!

Steve

[hawaiieric]

Steve,

When I walked into my first PT at around the 10th day stage, I tried to walk in without the use of the crutch, my PT mentioned to use it for it is better to walk perfect form then to limp and hurt and pick up bad habits.  Now at just shy of 7 week, I do have a walk with no limp, it comes...stick to the pt excersizes, do as much as your body tells you, and no worries...

Eric