Possibility of hip replacement anytime soon ?

[Briefencounter]

I have had RA and OA for 30 years which has resulted in one left Total Knee Replacement , one right Total Elbow Replacement , a plate and 9 screws in my left ankle and badly deformed hands , with ulnar drift ( both ) .I am on MTX and Sulfasalazine as well as meloxicam etc . etc .

I am seeing my rheumatologist next week because of a very painful left hip , which began around 1st March . Started in the groin and is moving up round the hip , whilst still in the groin . I have seen a doctor who diagnosed OA and gave me exercises to do and said he would see me in 6 weeks . As things have deteriorated , I rang the RA helpline and my f2f with my rheumatologist has been brought forward to next week .

I bought a small Zimmer frame type walker to help with walking but I was leaning on it so heavily that my hands , wrists ( that are not flexible ) and my shoulders are all hurting , as are both knees . The back of my left had appeared bruised , I guess from pressure . So I bought an upright rollator with arm rests , which has been a great help and a portable , electric wheelchair so that I can get out . My bed is downstairs , in the dining room now , as I can’t manage the stairs .

My reason for writing this is to ask if anyone has been in a similar situation during the past couple of years and had any offer of a hip replacement ( or any other joint replacement ) in the near future . I’ve read all the media stories of elective surgery having to wait for a couple of years . When I had my knee replacement , years ago , my rheumatologist wrote to my surgeon requesting that it was done sooner rather than later as by using crutches , as I was then , I was ruining all my other joints . So the NHS paid for me to go privately because I was over the designated waiting time . ( I know , hard to believe what happened in years gone by . ) At the time of the TKR the surgeon took an x-ray of my left hip and told me that it wouldn’t be long before it needed replacing .

I’m wondering if I will even be offered an X-ray of the hip . Or whether this will be another appointment months down the line ?

PS - I am doing the exercises that I was given , religiously , and they are helping .

[rabbits65]

You say you bought a small Zimmer frame and that where you leant on it heavily had done damage to your joints. This is ashame because usually you can adjust these frames to suit your height . There should be little notches on the frame to make it higher for you .

[Briefencounter in reply to rabbits65]

Thanks , yes Rabbit , we were able to do that for a couple of notches , then it was too tall . It's a bit difficult to explain but neither of my wrists flex at all ( thanks RA ) so my arms go straight down into the hands without any bends , so my whole weight was going through shoulders , wrists and hands .

The tall rollator is great because I can lean my arms on the horizontal rests ( I've glued some foam on as my arms started to hurt ) to take my weight . And grab the uprights at the end . Not sure if you've seen them , they have wheels on the front and sort of ski rockers on the back .

[rabbits65 in reply to Briefencounter]

I am so pleased you’ve found the Rollator and it’s helping you . I worked as a home carer for 26 years and saw quite a few different aids . Now I’m 69 yrs myself and very soon might need these aids one day . I have awful feet. And poor balance but have to keep going as I’ve two poodles to walk . Good luck to you .. 😊

[Briefencounter in reply to rabbits65]

Thanks ,Rabbit, keep well .

[rabbits65 in reply to Briefencounter]

And you too , thank you xxx

[Bella59]

Sorry to hear you are suffering with hip.I'm afraid hip and knee surgery will have a massive backlog.I suppose it depends on what area you live in some will move quicker than others.I have had to use up my savings to go private as I cannot stand pain for another possible two years.I had two knees replaced ten years ago within six months of each other by nhs.Way back then I only waited about twelve weeks for first op.Unfortunately a lot has happened in that time.Covid has added greatly to problems within nhs.Surely your gp could send you for a hip x Ray to see if this is cause of your pain.If it is bad you could then be referred to Orthopaedics.My sister has been waiting nearly three years for hip replacement.I am getting second hip replaced next week privately had to raid my pension pot to get operation.Best Wishes.

[Briefencounter in reply to Bella59]

Thanks for your reply , Bella . I'm sorry that you're having to pay for your hip operation. I can see that's the way I'll be having to go too . But then if you can't do anything else because of pain there are not many avenues left .

When I saw a doctor about this , at the beginning of March , I did ask if I could have an x-ray and a referral to the surgeon who did my knee 13 years ago and who had told me that my hip would need doing soon . But unfortunately, that's not the way it goes now . So my first step was to be given a sheet of exercises to do and the promise of another meeting in 6 weeks time .

I'm hoping that I will be offered an x-ray next week at my rheumatologist consultation .

I'm sorry your sister has had to wait so long for her hip replacement, as well .

[Hidden]

Morning. Obviously I can’t give a definitive answer, but my neighbour had a hip replacement last January. I was surprised it wasn’t cancelled, but not even a delay (city). However, a friend of mine had to wait months and months for a biopsy and was (understandably) in bits (town). It does seem to depend on where you are, and what you are having done. I can’t see that having an x-ray would be an issue though. I had my breast screening last year and that was all very straight forward (city).

[Briefencounter in reply to Hidden]

Thank you , CripLady . Yes , "where you are" does seem to plat a large part in how quickly you get seen . I have felt so sorry for those patients with suspected cancer , who cannot really afford to wait . I'm hoping something productive will come out of my meeting this week , if only an x-ray to see what's happening with my hip .

[Hidden in reply to Briefencounter]

Best of luck.

[Runrig01]

Unfortunately the length of waiting lists for joint replacement have soared. I worked as an orthopaedic ward sister till 4yr ago. We regularly used the private sector, who would take the fit and well patients from our list. This meant we had the complex cases which needed longer stays, so never really helped.I do feel it would be best if your gp did the X-ray, which would make next weeks rheumatology appointment more productive. You may find rheumy offers you a steroid injection of the hip. I’m told by my colleagues that the wait in our hospital is over a year now, but suspect that will increase, as we live on the south east coast with a higher than average elderly population who retire here.

You’ve done absolutely the right thing, buying a roll actor with the gutter support, although in a perfect world you shouldn’t have to. You may find if they inject, it buys you enough time till the surgery. My last knee injection eased my symptoms for a year. Good luck and hope they can help in some way.

[Briefencounter in reply to Runrig01]

Thanks Maureen for your usual constructive reply . I was wondering about a steroid injection , but I've had them in the past in various joints and there has been no improvement. I was once hauled in , as an inpatient , for what was called "pulse therapy" , which if I remember correctly was steroid infusions . The idea was to "tamp down" my inflammatory RA to give the drugs a chance to work . This worked fantastically for a couple of days - then the pain/stiffness returned . So I guess they don't work for me , although they might do , now I'm much older . I know they work like magic for some people .

I understand they don't like giving you too many injections , although as this was years ago I might be OK for a few more .

I'm hoping I might get an x-ray at the appointment. When I go for a checkup on my TER I always get one and the surgeon discusses it with me . The same used to happen with my TKR .

[Runrig01 in reply to Briefencounter]

Yes steroid injections probably have a good outcome in 50-60% of cases, with 7-8% getting worse. You should only have a maximum of 3 injections into a joint per year, otherwise you risk weakening and potentially tearing a tendon. I’ve been very lucky I had 2 in shoulder, and 2 in knees, both areas settled for over a year. I’m currently waiting to have C6-7 injected as it has slipped, and calcified in the slipped position and starting to press on my cord. Not sure how successful that one will be due to the level of calcification that’s occurred. I just feel if your GP orders the X-ray the result will be there for your rheumy. Otherwise you risk him ordering the X-ray and saying they will review when they see you in 3 month. Good luck, and your doing the right thing persevering with the exercises, as they make recovery so much easier. Take care 🤗

[Briefencounter in reply to Runrig01]

Thanks for your quick reply , Maureen . The pressure on your spinal cord must be excruciating . In some ways pain in a limb can be disassociated but the spinal cord is such a central part of the body that it must be impossible to ignore . Hope you get your injection soon .

When I saw a doctor at the beginning of March I did ask for an x-ray plus a referral to the surgeon who did my TKR and mentioned my hip in his notes .

Unfortunately, he wasn't my doctor but a young registrar trining at the practice . At the end of our talk he implied that there were more formal steps to go through before x-rays and referrals , which is when he gave me the exercises and said he would see me in 6 weeks time .

He asked me if he could record my telephone conversation and subsequently film our f2f consultation , both for training purposes , as he is being mentored by one of the practice doctors (a partner) .

I readily agreed as I'm all for training new doctors and I feel that our HC is a good one . Some time after this I received a visit from an OT bearing a loo riser , shower stool and walking frame . ( The latter which I replaced with the rollator with arm rests as the normal one was causing significant strain on all my arm/hand/shoulder joints ).

So I assumed that the consultation/phone call had been seen by a practice doctor resulting in all these aids .

After ringing my rheumatologist help line and getting such a quick appointment , I didn't feel like ringing the practice again and asking for anything else . I know they are inundated with patients and many of the doctors are off sick with covid . It's rampant here in the SW .

[Runrig01 in reply to Briefencounter]

In fairness all X-rays have to be prebooked so it’s unlikely they would manage prior to your rheumy appointment. Good that you’ve been provided all the equipment you need. Certainly sounds like your in good hands 👍🤗

[Briefencounter in reply to Runrig01]

I fear you'll be proved correct .

[Runrig01 in reply to Briefencounter]

I waited nearly 3 weeks for an urgent chest X-ray appointment last year.

[Briefencounter in reply to Runrig01]

That's dreadful . I'm so sorry . I'm not expecting or hoping for anything different . We're living in a very difficult time during covid . There will be many more people needing an urgent x-ray than I do .

[dippyd09]

Hello, really sorry to hear you are having this problem. I can only tell you about my experience. I, like you, have had several replacements, left elbow, left shoulder, right knee, bi lateral jaw, and a couple of others bits. I need a right elbow and a left ankle replacement now. I’ve been seen by the consultants and they agree these replacements are badly needed but sadly, the hospitals where I live are under a huge amount of strain due to the covid situation so basically it’s a waiting situation. I’m not expecting it any time soon as the NHS here are incredibly short staffed too. I really hope the situation where you are is much better. The good news is, I have had several X-rays and the surgeons at pre incredibly understanding. I truly hope you get seen soon and get your operation too. I live in hope. Take care.

[Briefencounter in reply to dippyd09]

My goodness , dippy , you're almost totally bionic . I'm so sorry you've had so many problems in the past . I thought I was bad enough . I hope all your replacements , like mine , have been successful and worth the pain and disruption that ops like these cause . I did contract an infection during the TER operation and that involved quite a long hospital stay with antibiotic infusions , picc line , debridement etc but thankfully the elbow "joint" stayed and I'm on lifetime antibiotics .

Until then I was quite sanguine about the operations , as the outcomes were always successful ( I still consider my TER a success as movement is so good ) . However , although I'm hoping for a hip replacement as soon as possible, I'm not quite so gung-ho about the procedure .

I'm so glad your consultants are so sympathetic and I hope you get your treatment sooner than later .

[dippyd09 in reply to Briefencounter]

Yes, me too but understand the enormity of what’s happening in the hospitals just now. I’m so sorry to hear about your problem and hope sincerely that it was a one off. Mine have all so far been extremely successful, reducing pain enormously and giving me back some kind of quality of life. Just have to hope that operations start sooner rather than later up here. I do hope you get your op soon. I’m thinking it must depend on your area and how covid is affecting both the staff and waiting times. Fingers crossed x

[Hidden]

Sorry to hear you’re having problems. I’ve been struggling with my hips for ages, literally years, first one, then joined in by the other last March. By September I was permanently limping and my mobility massively reduced. Rheum were convinced it had to be inflammatory even though it didn’t improve with steroids (my RD is uncontrolled and has been since diagnosis two years ago), but sent me for an MRI to check. Even though I had an MRI two years ago, and they also failed to tell me that plain x-ray 2 and a half years ago, done as part of trying to get the RD diagnosed, showed changes consistent with OA, several medics had somehow managed to miss femoralacetabular impingement (FAI), that I’ve likely had since birth. As that was left undiagnosed and untreated, both hips are now indeed riddled with OA to the point that I have no cartilage left in places. Even more annoyingly, though, is that FAI can be successfully treated with minimally invasive surgery, up to the point that OA sets in. I’m 38 now, and first started complaining about my hips in my teens, having had tests as a baby because they thought I had hip problems at my 8 week check (dysplasia). Hindsight is a wonderful thing.

They referred me to orthopaedics when the MRI results came through in December, and after much chasing, I have a (phone 🙄) consult this week. Not entirely sure it’s going to achieve anything more than being told they need to see me in person, though - the referral letter from rheum didn’t mention my mobility is so bad because of my hips I’ve now been awarded PIP, they only mentioned the pain. I’ve already been told that the most likely outcome is bilateral replacement, but that the wait locally is long. No one will quantify how long at this stage, but I’m hoping ortho will be able to give me some idea when I speak to them on Wednesday. I’ve been a full time carer and single dad to my disabled teen for the last 7 years, and benefits dependent as a result, so not in a position to even consider going private. Although, if the NHS wait is really, really long, who knows, I might be able to save up quicker than they can get to me… 🤔😂

Obviously it varies from place to place, but generally speaking, I haven’t had issues with getting imaging done at all during the pandemic in our neck of the woods (Surrey), and the waits haven’t been bad. My GP organised hip x-rays that were done the same week in November, and the wait for the MRI was three weeks. I waited about the same length for the last one, which was pre-pandemic. Not hip related, but for my arthritis generally, ultrasound appointment waits have been between 2 and 4 weeks. I think you should be able to reasonably expect to be able to get an x-ray, and fairly quickly, although an MRI may well be what’s needed - my x-ray didn’t look that bad (report actually said unchanged from the one 2.5 years ago, I just didn’t know there’d been anything on the original report), but the MRI told a completely different story.

[Bella59 in reply to Hidden]

So sorry to hear how badly you are suffering with hips.It must be a nightmare for you as you are also caring for your disabled teen.I hope your call will bring some good news I pray they will take into consideration your situation at home.Best Wishes.

[Briefencounter in reply to Hidden]

I'm so sorry to read about your situation, Charlie . If anyone deserves help it's you - especially with your dependent child . I do hope this is all taken into consideration, as well as your specific pain and mobility issues .

[Angjoplin]

I'm sorry to sat I've been on the waiting list for a knee replacement for 15 months now. I'm being told June..

[Briefencounter in reply to Angjoplin]

Thanks for your reply , Angjoplin . From all the kind replies I've received, I feel that I'm in for a similar wait .

[oldtimer2]

Please pressurise your GP or Rheumatologist for a referral to an orthopaedic surgeon. You may indeed have to pay privately, I'm afraid in the present state of the NHS but the sooner you get this sorted out, the better for your other joints. If you can - pay!If you can have a hip replacment before your fitness deteriorates too much, you will have a much better result.

[Briefencounter in reply to oldtimer2]

Thanks , old-timer, I fear you are correct in your assumption that all my other joints will soon join the party if something isn't done .

In fact , in the good old days ( 2002 ) my rheumatologist contacted my surgeon , urging him to do my TKR sooner rather than later . I was using crutches at the time and he felt that this was destroying many of my other joints . The result was that I was paid for by the NHS to go to the local private clinic , where the surgeon who would have done the op in the local NHS hospital carried out the knee op . At the time he xrayed my hip and said it would need to be done in the not too distant future .

Roll on to the present day and I'm hoping to get a referral to this surgeon . However, if I want anything done soon I know I'll have to pay for it .

[1ChLoE]

Hi Sorry to of all your problems with RA . I wonder if you could ask your GP for an X-ray before your see your rheumatologist. At least then the rheumatologist can see the X-ray at your appointment. I have also been sent for X-rays whilst I was seeing the rheumatologist and then taken the X-rays back to the rheumatologist and continued the appointment. Maybe that is a possibility too. Good luck

[Briefencounter in reply to 1ChLoE]

Thanks 1ChLoE , for your reply . I see the rheumatologist on Wednesday so there's not really enough time to get my GP to organise anything . However , like you , in the past my rheumatologist has decided he'd like an x-ray and I've been sent off to the department and returned to the consultation with it . This has often happened when Ive had a followups with a surgeon .

Of course that was then , this is now . I'm not holding my breath . Gone are the days of unrushed rheumatology consultations .

[1ChLoE]

Fingers crossed you will get your X-ray quickly.