Hip or knee replacement information

Not a question, but I work as a nursing assistant on the Orthopedic/Surgical Unit of a large hospital. Many of our patients have just undergone hip and/or knee replacement surgery. I have been able to scrub in on numerous procedures and just want to put it out there that if any of you are about to undergo this surgery or are thinking about it, I am NOT a doctor, but I can answer a great many questions about the procedure and the recovery. I also have psoriatic arthritis in every joint in my body, so I do understand the pain and disability we all live with. I used Enbrel for a few years but stopped last August for personal reasons. I will soon need to undergo knee repacement myself, but right now can't afford to take the time off.
Anyway, I'm no expert, but if you have some questions I may be able to answer for you, please find me on the Anxiety Forum..........my username is Greenlydia.
Peace
Greenlydia  

[spastic]

Hello there.  It is so good to have you on board.  I just wanted to welcome you and say we are lucky to have you here.

Your Friend,

Spastic aka Ada

[greenlydia]

Hi and thanks for the warm welcome! Like I said, I'm no doctor, but I do know a great deal about hip and knee replacement, so I can answer SOME questions.
And I've lived with arthritis for nearly 45 years, so I'm sort of an old pro at that.
Since I'm a CL on the Anxiety Forum, I feel I could also maybe help with some of the pre-surgery fears and anxiety that are pretty common before this, or any surgery, so if you get someone who is really freaking out, please send them over or have them PM me from here.
You have a great group of people here giving out some wonderful advice!
Keep up the good work
Greenlydia

[smittygirl]

Thanks so much for that information.  I am the CL here on the Arthritis Forum, you and I have actually chatted before when I posted under the header Biologics.  I also happen to manage an Orthopaedic Surgeons office for a large hospital, small world!   I would love to PM you about our previous post as I am currently taking Enbrel.   Let me know if you would mind my PM you.   Thanks again for your offer of help, we can absolutely send people your way since the two diseases are very much at times connected.  Look forward to hearing from you.   Take care.


Sue
smittygirl

[greenlydia]

I would love to chat anytime! And it IS a small world, isn't it?
I'll look forward to hearing from you sometime.........I bet we have some good stories to tell each other!
Peace
Greenlydia/Linda

[jojokdz]

Hello!  I am wondering if I will need a hip replacement.  My hip is always sore and achey (achy).  It is sore to touch it.  I am a overweight but working on it.   I am getting something new here too which may be related but maybe not.  I am getting a prickly/pinching sensation that runs from that hip area down to my groin.  In your experience working with patients have you ever heard of this type of symptom before?

Thanks so much!!!  Joann D.  

[nellieann]

Hi,
Thanks for offering your expertise!  My question is how long it takes to completely recover from a hip replacement.  My surgery was done last November, but I am still experiencing a lot of pain from my knee to my hip.  I need a cane to walk.  I addition, my new hip leg is now 1 inch longer than my other, so I walk with a limp.  My doctor seems to think it will all work itself out, but I am sceptical.  Is it normal to experience this much pain 8 months after surgery?
Thanks,
nellieann

[greenlydia]

Jojo..........unfortuantely, I don't have a crystal ball and so can't tell you if you are going to need hip replacement surgery. I have heard of all of your symptoms and plenty more besides those. Again, I am unable to diagnose you, first, because I am not a doctor, but secondly, because your symptoms could be related to many things. Your weight could be placing pressure on nerves in the areas you speak of. Many overweight folks have problems with their hips and knees simply due to the extra demands placed on them. I urge you to see a doctor. I would first see a rheumatologist to rule out arthritis as the culprit, or possibly bursitis or sciatica. He should take X-rays which will show any arthritis in the joints. You and he/she will then be able to work out a plan of treatment for the pain you are living with. Put the thought of hip replacement out of your mind for now. You would have been in much greater pain for much longer if you were nearing the need for a new hip.
See a doc.......put your mind at ease and help that achey (achy) hip!
Keep me posted, OK
Peace
Greenlydia

Hi Nellie,
Everybody is different in the length of time it takes to fully recover from hip surgery. It can depend on so many things, I wouldn't know where to begin, but if your surgery was done 8 months ago, in my humble opinion, you should be out chasing tennis balls or climbing mountains by now! I've seen 80 year old women back to bingo within two months. But there is also a little thing called "motivation" that helps your recovery. If you have been afraid to really use that new hip and have taken up a sedentary life style, that will most assuredly slow your recovery time a great deal. That you are still feeling a great deal of pain, require the aid of a cane to walk with a limp on a leg that is now one inch longer than it was before the surgery sends up about a dozen red flags to me! Have you been back to your doc since he told you he "seems to think" this will all work itself out? Sorry, but I think that is a REAL horse pukey answer! (And trust me when I say I used much softer language than I wanted to!) In short, I think he's full of BS and I would highly recommend that you get yourself a second opinion. I would love to hear his reasons for your continued pain and the limp! You may very well have a lawsuit on your hands! How old are you? Are you active? (Or WERE you before the surgery as much as possible?) Have you fallen recently? Did you follow up on all the physical therapy for your replacement?
My best advice...........go get that second opinion and don't waste any more of your life gimping around in pain! What you are dealing with is NOT right. I will add a small "caveat" here...........not knowing all the details of your surgery or the condition of your hip at the time of the surgery, there is a small possibility that SOME pain will always be present in that joint, but I'm afraid I can see no reason your leg should now be an inch longer! In some rare cases I have seen a person who had to have so much extra bone removed, their leg became shorter, but even that was NOT by an INCH!
Please let me know what the second ortho had to say! I am REALLY curious about this one!
Good luck and I hope you find some relief soon.
Peace
Greenlydia        

[sdbrit]

Hi, thanks for offering help.  I had hip arthroscopy 18 months ago for a torn labrum to correct a problem that was causing me great pain when i tried to get from sitting to standing - my hip would 'catch' and have to be painfully wiggled into place.  The MRI showed a cyst in the acetabulum and the surgeon advised doing a bone graft at the same time telling me he had someone very good to do that.  I have also been told I have OA and may eventually need hip replacement.  Before the 'catching' problem i could walk fine.  Since the surgery the original problem is fixed but I cannot walk much without pain and cannot stand for too long - both result in a lot of pain in my legs, front of thighs.  I thought I was getting the original problem in the other hip and tried acupuncture which helped a lot. I also tried Pilates which helped a lot initially - significant difference after one session but not so much since, then I had to quit that because it's too expensive.  Recently I was doing some yoga stretches at home and felt something 'shift' in my hip that hadn't had the surgery and great pain since then that is exacerbated by stretching especially external rotation.  I looked it up on the web and seems similar to bursitis so have been icing and taking motrin but keep getting the pain again if I do any type of exercise.  

I understand that you are not a Dr. but it seems that it's tricky to get anything other than a prescription for meds that I'm afraid to take since the Vioxx issues or surgery as an option.  I was just wondering if these issues are consistant with hip OA as two Dr's have told me, or soft tissue issues as various holistic healers have told me.  I have spent loads on various treatments since i want to avaid surgery as the outcome of the last wasn't good.  Forgot to say the ortho surgeon did the bone graft himself and i think he either had never done it before or not much.  Since then I also have had really tight IT bands in both legs and they (IT) bands are full of lumps - that are really painful.  I would hate to have surgery again and still have all these issues - but if something can totally fix me so that I can be active again I'd love it.

Sorry it's a lot of info and I don't know if you can help but thanks anyway.

PS: Also during past year I've had benign cysts on my thyroid and a/c joint became slightly separated and painful but getting better.  It's all very depressing and that doesn't help.  I'm going to be 50 next month and want to look forward to the next ten years not dread them.

[dstew42000]

My husband has been denied by two surgeons to do his hip replacement because of his weight.  He is on a walker and can get no exercise.  He has lost 26 lbs since his first visit, but they still will not do it until he loses another 70.  He is in extreme pain, on lots of meds, and is growing more and more depressed...he has even talked about taking all of his meds at once...you know where he was going with that idea.  I am all over the internet, but haven't been able to find a name of a surgeon that will work on the overweight.  Do you have any suggestions?  Does anyone have any suggestions?  ***@**** or post here.  thanks

[carolanivey]

Hi, I've had two hip replacements so I can speak from experience. I was not overweight when I had them done, and my surgeon told me weight gain would be disastrous and greatly shorten the life of the implant. To be specific, the socket liner they use to cushion and supply a smooth bearing surface for the ball part is not indestructible - it's basically plastic. The more weight on this part, the quicker the liner will wear thin and require replacing. This is why they won't do knee or hip replacements on the obese - it'll wear out in a year and the patient will be back to square one. This is major, major surgery and you don't want to repeat it if you don't have to.

There is a new class of implants out though, for which I don't qualify because i've had too much bone removed. I don't know if this would be an option for him or not. I believe the weight would still be an issue.

I would suggest looking into something like Optifast to get enough weight off to qualify for surgery. Afterward, he will be able to exercise more (just nothing high impact) and keep the weight off. There is a good site on the web that offers free weight loss tools - it's the livestrong site, look under myplate.

He should be able to do some kind of exercise, such as water exercise or a recumbent stationary bike, which has you sitting in a seat more like a chair than perching on a bike seat. Gentle work with resistance bands can strengthen the muscles and tendons surrounding the hip. It may not seem like much, but every little bit helps. The stronger he is going into surgery, the better the outcome. Good luck!

[Knot4Cindy]

Hi and thanks for the offer of advice!  How do you know if you have arthritis?
I have never been diagnosed.  I had a knee injury about 6 years ago and had a torn meniscus and had it repaired.  At that time the surgeon said I had no cartilage but to not have surgery until I could not put it off.  After several bad falls I went to another surgeon and he said I had to have both knees replaced.

I did and when I went back for a follow up because one was hurting more then the other and very very crunchy sounding.    he said that was normal that both knees do not heal at the same rate.  Well that was 8 months post surgery.


I am now 14 months post surgery and I can barely walk up stairs, am in pain when ever I move and it bounces and pops when standing or sitting if I try to move it and I went back to see him.  He now says there appears to be cement floating around in the left knee and wants to go in as soon as possible.  Can leaving it there be dangerous?  can it travel?  Or is this a result of arthritis?  last night my wrist hurt so badly I could not sleep....does arthritis travel?  is that what is happening to my joints?  will it keep going?  If that is true why should I bother with this next on???  What happens and where does it stop?

[carolanivey]

Have you seen a rheumatologist? A rheumie is qualified to treat you for OA (the wear-and-tear type, which I think is what you're dealing with) and autoimmune disorders like RA.

OA pain can seem to travel from joint to joint because, as the old song goes, each joint is connected to the next. Knee pain changes the way your walk, sit, stand, even lie down, and the imbalance eventually causes pain in the adjacent joints - ankles, hips, back, etc.

It sounds to me like you need a comprehensive evaluation with a rheumie and a serious sit-down with your knee surgeon. Don't leave the office until all your questions are answered to your satisfaction and your fears put to rest. Knees can take a long, long time to heal, IMO knees are much harder to recover from than hips. It's imperative that you keep up with the post-op therapy no matter how much it hurts. Have you done this?

arthritis.org and mayclinic.com are both good resources for arthritis information.

[bikeman948]

I had my knees replaced two years ago and i have been in constant pain
ever since , the pain is worse than my bad knees were and my surgeon says they are good and there is nothing he can do about it. does anyone know how to help this i am considering ending my life if there is nothing that can be done. the pain is un bearable. help.