Jacob Said:

Metal allergies with hip replacement?

We Answered:

I've had both hips replaced at age 59. My stem and cup are made of cobalt-chromium. The bearing is cobalt-chromium ball on poly cup liner.
Your father needs to bring this issue up for discussion with his surgeon so that he can go into surgery with confidence. It may be that the foot problem had nothing to do with the titanium implant in his foot but rather that the problem was due to infection.
Revision surgery for total hips is done for several reasons; among them: instability; infection; aseptic (non-infection) loosening. The hip replacements of older people may outlive them. This is good. I have had my fake hips for 7 years and they are great. How wonderful to be able to walk miles without pain!

Frank Said:

Knee replacment... now HIP replacement surgery?

We Answered:

Rheumatoid arthritis is not caused by the cold. If that were the case, everyone north of the mason dixon line would have it. The cause is poorly understood, but one's genetic make up may make them more prone to an auto-immune response after an infection by bacteria, virus, etc, but there is no known link to the cold.

With RA, multiple joint involvement is common. It's not unusual for those with advanced RA to require both hips, both knees and in some cases, both shoulders to be replaced.

The good news is, the outcomes (even with an infection) are largely excellent for both hip and knee replacements. Her body is attacking itself...she should be seeing a good rheumatologist and be on a course of something to control that response (often Methotrexate). I wouldn't say she's destined to have the hip done, but it's quite possible.

Good luck.

Harry Said:

How can I improve my mobility with significant arthritis in one hip?

We Answered:

I find it very frustrating when orthopedists say someone is "too young" for a hip replacement. Does that mean you should stop being active until you are "old enough" for a hip replacement?

To say the very least, at least he/she is trying conservative options first. First, regarding the frequency of PT of three times a week, I rarely find this to be needed unless the case is very acute or post-surgical. Most non-surgical, chronic pains can be addressed with a frequency of two times a week...especially because the goal is to show someone a home exercise program...we certainly aren't going to cure your arthritis, so it will require long term management. PT at 1-2 times a week is often very appropriate. This may certainly make it more affordable. However, I realize that you have tried PT before, and perhaps either you need a different approach of PT or that PT simply isn't the answer for you.

My next suggestion would be to discuss a water aerobics class...particularly if you have a facility that follows the guidelines of the national arthritis foundation. Programs sponsered by the NAF keep the pool heated to a certain degree which tends to be more comfortable for people with arthritis. You very well may get some relief from this type of program which focuses on low impact joint movements, cardiovascular health and joint flexiblity. However, even if you don't get pain relief, at least you can exercise in a medium that should make exercise more tolerable.

You may also wish to discuss cortisone injections as a way to mange your pain. A hip resurfacing procedure, a less invasive surgery than a hip replacement may also be of consideration. Even a hemi arthroplasty would be less invasive. These are all options to discuss with your surgeon.

Next, you could venture to alternative therapies...accupunture etc. ...however, the jury is still out on these types of approaches. To say the very least, it won't hurt you or worsen your condition.

Finally, if you've exhausted all your options and it HAS been confirmed that arthritis is the cause of your hip pain and your surgeon continues to refuse a hip replacement, I would simply seek another opinion. I see no reason to disable a young person because they are "too young" for the procedure. While it is true that you may eventually need a revision surgery in the future, you should know that hip replacement procedures are lasting longer and longer...I've seen several that have lasted greater than 10 years (and remember that the technology has improved since then) and I'm sure we'll start seeing them last 15-20 years. At that rate, better to have your revision done by age 71, rather than waiting until you are 65 to have the surgery and having to go through a revision at the age of 85 when surgery becomes a greater risk!

...I have seen MANY hip replacments performed in people under the age of 60...in fact, several have been in their 40s....it has GREATLY improved the quality of their life.

Best wishes to you.

Diane Said:

How to relieve hip pain?

We Answered:

I've had both hips replaced in separate surgeries. I took Aleve (double the OTC dose daily on advice of physician) up until 2 weeks before surgery (I was asked to stop all NSAIDS for 2 weeks before surgery because they thin the blood and can delay clotting)., After that all I took was Tylenol at the maximum dose. tylenol is not an NSAID. Tylenol didn't work all that well but it was better than nothing and was ok to take up until surgery. I also used a cane. Have you asked for something that you can take for pain? Unless your surgeon prescribes something else for the pain I guess you'll have to tough it out on NSAIDS and/or Tylenol. That's what I did.
BTW, my new hips work great and I have my life back now.

Sherry Said:

Questions about total hip replacement surgery?

We Answered:

1. Your hospital stay will depend on whether you have a traditional THA or a minimally invasive. With the traditional replacement, average stay is 4 days. With the minimally invasive surgery, an overnight stay is usual. These are general guidelines assuming there are no post operative complicaitons and that you are able to be discharged home. People who are not mobile enough to go home (ie, usually elderly patients who live alone and/or have a lot of stairs.) They typically require inpatient subacute rehabilitation at an extended care facility after the hospitalization until they are mobile enough to go home.
2. For PT while in the hospital: you might get up that day to the chair, or the next day, you will probably walk a little the first day. The next few days will teach you how to perform your basic mobility: getting in and out of bed without dislocating the hip, walking with a walker, stairs and/or any other environmental barriers you might encounter at home and very basic exercises. PT in the hospital is typically 1-2x a day. Occupational therapy 1 x a day is also performed so one can learn how to get on shoes, socks, etc with special equipment (because when you have a THA, you cannot bend over, cannot turn your leg in, or cross your legs for 3 months). After that, home health therapy is usually performed for 2-4 weeks at 3x/week. Depending on your level of activity, you may also go to outpatient rehabilitation after home health is completed. This is where you can do some more advanced rehabilitation than what can be done in the home. Most people don't really need to go to outpatient, but if you are a very active individual: regular golf, exercise, yoga, aerobics, etc, then outpatient will be appropriate. This is typically 4-6 weeks at 2-3x/week.
3. A brace would be highly unusual after a first time THA.
4. If you do require an extended care facility, you usually have PT 1-2 sessions, 1-2 hours a day and some occupational therapy.

Recovery is a lot quicker than a knee replacement and it's typically much less painful.

Good luck with your story

Esther Said:

Having a hip replacement in 2 days?

We Answered:

I've had both hips replaced in separate surgeries several months apart. I had never had surgery before either. The anticipation and fear before surgery are worse than the experience. I especially feared that I would be in extreme pain after but the reality was that whatever pain I had was well-treated in the hospital with a PCA pump for a day or so and then oral meds for a few more days. Hospital personnel seem very tuned into patients' pain levels. The worst pain was sporadic, usually related to moving "wrong", getting into bed, etc. I learned quickly which moves hurt the most. The very worst was when they turned me in the bed, rolled me from my back to my good side. I would just grit my teeth for a few seconds and it was over. Actually I found it a relief to be on my side for even a short time.

They had me up and walking on a walker within a few hours. I used a walker at home and 2 forearm crutches outside the house for several weeks, gradually moving to a single crutch, then a cane, then nothing.

After your formal PT is over, you will no doubt be delighted that you can take long walks again and walking is good exercise. I joined a gym and continued to do my PT routine way past the formal PT sessions + spent time on an elliptical trainer, bicycle, recumbent stepper, etc. As for getting in shape, don't forget about your upper body; you may also want to try free weights and tension bands. There's even an "arm machine" in some gyms which gives aerobic benefits just from arm movement alone - good for your early post-op days when your hip is still healing.

I don't what the reason is for the expectation of a permanent limp - that seems unusual but perhaps there is some aspect of your case that warrants that prognosis such as a leg length difference, which can be treated using a shoe lift or built-up shoe so that there is no reason to limp. The only way I know to "cover up" a limp is to use a walking aid such as a cane to smooth out your gait. Doing this is better than limping because your muscles will eventually "learn" to limp.

As for me, I have a small leg length difference and use a small lift in one shoe. It isn't enough of a difference that I limp without it but I am more comfortable walking with the lift (and have less chance of tripping because of the longer leg). Otherwise I now have no limp, no pain, take no pain meds, use no walking aids, and can walk miles.