Linda’s Dislocation Story – bilateral BHR Dr. Barrack 9/06
February 14, 2008 I’ve changed my mind about the dislocation cause…you may not remember that I was less than 3 months from my left knee replacement (when my dislocation occurred). That was my worse knee and the OS straightened it much more than the right side which would require more stretch to the inside quad. Since I’ve started back exercising, it’s been real clear that the quads that run from hip to medial side of knee are “stuck”. I’ve been trying to stretch it out now for months and just may have to live with it this way or get it “released”. So, what I think happened is that those muscles/tendons/ligaments involved in the quadriceps and their kin wouldn’t give sufficiently for that bent, rotated movement I was doing and the weakest link was the set of muscles et.al. that hold the hip back from rotating inward. These are also the hardest to get back to full strength I would imagine since treadmill, elliptical trainer, recumbent bike et.al. don’t help them. So, Dr. Barrack, my BHR surgeon, didn’t “screw up” my left hip although he didn’t center the pin of the femur head part of my right hip and that will increase my chances of a break there. That will be my final word on that dislocation I think. But others should be warned and PT’s should take special note when knee replacement follows BHR if the hip hasn’t had a chance to recover. November 17, 2007 My hip dislocation is now about 14 weeks or so old and I’m back to tread milling ½ mile but building up pretty quick. The dislocated side seems to work differently from the right side…if I don’t remember to point my foot out when I get up from a chair, as I put weight on that leg it will try to collapse inward (that surgical motion) and I can feel the tendons/ligaments/muscles rub over some bone. BUT I can catch it in time to correct it. It may be the knee replacement and not the hip replacement that’s causing it. I’m just going to be careful and keep building up my strength and endurance…what else is there? I can rule out the extreme stretching that I was doing and everything but something about the knee or hip replacement (BHR). Maybe both combined with a torqued pelvis. I’m really able to do some exercising now and will keep you posted. X-rays show the hip prostheses in alignment except for a slight misposition of the stem in the right femur. October 05, 2007 Yesterday was my 8th and last week in a brace that limited the movement of my dislocated hip leg…I’ll have more on that. But I’m now starting back on my home treadmill, elliptical trainer, recumbent bike. That’s after 8 weeks of bed exercises for strengthening the quads et.al. I feel fine but also feel the weakness after so long in a brace (and I cheated a lot since that thing was so heavy). I’ve had two orthopedists tell me that the acetabulum cup was misaligned on the dislocated side (three if you include Dr. Bose)…that may be the case. August 19, 2007 At 10 days post-dislocation, my belief is that the cause was a convergence of things, none of which were due to poor surgical technique. Both of my BHR hips were still involuntarily rotating toward the centerline so I hadn’t recovered full strength hip-wise although it was getting better and better. My 12 week old replaced knee was still having an involuntary very small collapse that caught itself and wasn’t anywhere near recovered. I had been over-stretching my hip muscles thinking that was a good thing but placing palms on floor with straight legs was too much for me at this point…had some popping of tendons across the joint (tendons?) when I did that. Last but not least, my position at the time of the dislocation was very much like the one used to pop the joint in a posterior BHR. Other recovering surface hippies need to know that dislocations can happen and it doesn’t have to be a mis-step by any of the BHR technical people that causes it. So Cuidado! With respect to Dr. Barrack, every OS in my region(Texas/Louisiana/OK) seems to know of him, if not personally. I don’t know for sure but think he’s very active in academia as well as his OS practice at a university hospital. I thnk he was dept head at Tulane Med. The number of BHR’s is certainly a measure of the all important experience of an OS and potential success but it was only one of my criteria. IMO, people are wired differently and some are naturals and some require lots of repetitions and some never get it no matter how many repetitions. It would be really great to find an OS that’s actually had his hips BHR’d so can relate personally to some of the feelings and phenomena of recovering from this surgery. I just wanted to follow-up on this as well as thanking Pat Walter for taking it seriously… thanks Pat.August 14, 2007 It didn’t occur to me (duh) that this would alarm surfacehippies. Let me give more background. Following the bilat hip replacement, after 7 months, I had a right knee replacement and then 6 weeks after that I had a left knee replacement. The latest left knee replacement was 11-12 weeks ago. This left knee didn’t have the ROM of the right one and for other reasons, I was exercising on a recumbent bike forcing my left knee to bend. That worked and I had gained the ROM I wanted with that knee and had stopped upping the time of exercise but increasing the force required to build muscle. When I finished a session I stretched by putting my knee to my chest (as much as I could) and stretching it. Another thing is after these knee surgeries there was a weakness of a small knee collapse which always caught itself. This was more pronounced with the left knee than the right where there was more correction (7 degrees). What I think happened was there may have been one of those knee collapses at the same time I had my knees bent to put boots under the low coffee table. At least I hope that’s what happened. The positioning on my left hip prosthesis (BHR) was perfect. On both hips, I’ve had the “twanging” of tendon, ligament or muscle…something when the hip has been bent sufficiently. Additionally, I’m one of those people who have a very high pain threshold and prone to overdo. So this is probably a unique situation. If I had it to do again I’d do the exact same thing with the same OS…I’m happy with it. I’m not happy with post-surgical, long term, instructions on healing. Linda Dickens, bilateral BHR, Dr. Barrack, 9/06 |