I have had RA since 2013 and have been well-controlled for the last 7 years with Arava (Leflunomide) and Sulfasalazine. I am having a THR in a month's time and I am concerned about stopping these drugs for 2 weeks either side of the op. in case I have a flare while recovering. I am also extremely anxious about the op. itself - I am 73 years of age and have osteoporosis as well.
I would welcome advice from anyone who has had a THR, what to expect and any tips on stopping drugs, preparation for the op. and recovery. Will I ever do my garden again?
Thanks to everyone,
Pat 64.
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Pat64
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Hi Pat. I had a THR 3 years ago when I was 69. I didn't have a general anaesthetic but I had a spinal anaesthetic and sedation which worked very well for me. My recovery was good with help from physio, some crutches and a very patient husband who helped with compression stockings. It was wonderful to be free of hip pain. I bought and used a long handled grabber, a long shoe horn and a raised toilet seat and frame. I was back in the gym using the treadmill and bike about 3 months after surgery. (My only complication was a DVT about 10 weeks after surgery). I also have osteoporosis in my spine. I was diagnosed with RA in March of this year so I can't help with your question on medication. If I can be of any more help re the operation and recovery feel free to ask. In the meantime there is some basic information on the NHS website nhs.uk/conditions/hip-repla...
Can’t help you with the medication question but my husband had a THR about five years ago when he was 71. He had his with a spinal epidural and sedation - definitely recommend having that if you are given the opportunity.
Before he had the operation I got a builder in to put a second banister on the stairs - my husband really grumbled about it but it has proved to be really useful for both of us so it was worth the effort. I also bought a second set of crutches from Amazon so that he didn’t need to carry them up and downstairs with him. The occupational therapists sold him a gadget for putting on his socks but I tended to do that for him. They also arranged for someone to come in and see that bed and chair heights were right for him and they also brought a raised toilet seat. He also had a long handled grabber and a long handled shoe horn which I mostly used and still use. We changed the shower room decorative towel rails for good strong hand rails that we still use as towel rails. We have a downstairs shower room so I brought a single bed down to put in the room next to it.
He had a physiotherapist who came to the house for a few weeks and then we paid for a spot of private physio which was worth every penny.
He said the same as Anniescottie - when he woke up the pain from the hip had gone - there was pain from the wound but that was nothing like the hip pain he had had. He put it off and put it off for years then it got so bad he had no option and he says now he was silly and if his other hip needs doing then he’ll have it done right away.
As for gardening - since he retired I have pretty much lost *my* garden. He does all the gardening. I bought him one of those fold out stools that you can either kneel on and use the sides as handles or sit on and that has been really good. I use it myself to kneel on and the handles are amazing for helping me up.
Like Anniescottie said - if you want to know anything else just ask.
PS - I was the very patient wife who helped with the compression stockings - a friend who wears them told me the secret is to rub cream on the legs before you try to put on the stockings and they just slide on - although a couple of people have said recently that they didn’t get them after their new hips so it depends on what your hospital does.
Thank you very much for replying to my post re hip replacement. All the information was very positive and I am beginning to feel more confident about the op. Glad to hear your husband enjoys his garden.
Hi. I’ve two new hips and would say yes. That being said I can’t garden on account of my wrists etc but hoping to change RA drugs soon. I was lucky in that I didn’t flare but was grateful to get back on them each time. Like others had spinal both times and used gutter crutches as can’t put weight through wrists. 1 time, 2019 had compression stockings; second time 2022 didn’t. Think practice on this may have changed but they assess us each on our risks. Good luck.
Hi I had a THR 6 years ago and have had no issues since. Pain was minimal afterwards and my mobility has been greatly improved. I found the operation straightforward, so do not worry I am sure you will be fine. I was told it takes 6 months for Leflunomide to get out of your system.
Thank you for replying to my post re THR. Reassuring to hear you had a good experience with your own surgery and outcome. I'm hoping the leflunomide still in my system will help avoid any flares.
I have RA and OA and am on Sulfasasalzine and hydrochloriquine and am 5 weeks post-op from having THR.
My surgeon told me to continue on my RA meds without a break. The only meds I had to stop 6 weeks beforehand was my HRT.
I was in hospital from Wed morning until Fri afternoon. The first 2 weeks for me were the hardest. My husband had to help me do most things, but you are encouraged to be mobile as often as possible. Walking around the house, up and down the garden path worked for me. I'm now walking outside between 1-2 miles per day.
I had a spinal epidural and moderate sedation. I did wake up midst the operation, but felt nothing at all. I was given the option of moderate or heavy sedation. My operated leg was numb for just over 2524Ahrs, but my surgeon put in a blocker after operation which is a form of anaesthetic to eleviate any pain. I also had 3 lots of antibiotics.
Although I had dissolving stitches and steristrips, I was not allowed to shower for 2 weeks post-post-op. Washing down only. I adapted my bathroom with a raised toilet seat, a bath board and installed a handrail before having the op. I also bought a long shoehorn and a grabber. You will need them and they are a godsend. I also bought a booster cushion for when sitting which helps when getting up.
I feel I was doing great until Friday past when I started getting pain and swelling in both knees and my good leg swelling up. I have been advised to elevate for 1hr 6 times per day and I see my surgeon next week for my post op.
It is hard going and alot depends on how you are prior to your op in terms of mobility, pain, health as to how fast you recover. I'm 57 and had not been mobile since December last year so I'm guessing it may take a tad longer for me.
You'll have physio after discharge, where you will have excersises to do. To be fair, they are relatively easy, but the physio in hospital will give you excersises to do until you have physio when home.
I will say, I have not had any RA flare ups thankfully and that horrid pain I had in my hip and groin for so long is no longer there. Recovery, resting and listening to your body is really important. Don't push too much until you are feeling you can, but moving around is key to not stiffening up and muscle strengthening.
Like you, I am an avid gardener and miss being out there doing my thing, but I am assured I will be able to do it again once completely healed. Not that the weather has been great here.
I wish you all the luck and a speedy recovery. Stay positive and you'll be great.
Thank you for your very encouraging reply to my post on hip surgery. Your info. and advice have been most helpful. I do hope the swelling in your legs improves with time and the rest of your recovery will go well.
Hi Pat, I had a THR last year at age 72. As all the others who've replied, with a spinal block and sedation. I recovered well, and was very good about doing the required physio. And was back to gardening later in the summer (I had the op in May) and those sit on gardening stools are great.
I was driving again after just 6 weeks.
I'm on 20mg methotrexate for RA and wasn't required to stop it. Protocols seem to change frequently. I assume you've been given specific instructions re pausing your Arava and sulfasalazine?
I wasn't required to use compression stocking, but was prescribed blood thinners for a month.
My most useful gadget which hasn't been mentioned yet is a 'leg lifter', for getting your operated leg in to and out of bed. You get them from places like Compleat Care shop, or prob Amazon. You are then in control of moving your leg and the manoeuvre is pain free. If you get someone to lift it for you, it hurts! (This is a temporary situation)
Nowadays I am rarely aware of the new hip (except that it's pain free). Though my other side has joined the OA party and I'm going for a new knee on Thurs!
All the best with your op and recovery. I would summarise mine as much less scary than I'd have thought.
Thank you for all your positive advice on hip surgery. Good to know you have recovered well and are enjoying gardening again. I wish you all the very best for your knee surgery on Thursday.
I have bilateral THR and bilateral TKR and can confirm that it is very likely you’ll be doing your garden again and pain free!! I was also wary stopping the drugs but it’s essential and you will be closely monitored. I can honestly say that my 4 joint replacements (over 18 months) changed my life. These were performed in 2013 at Addenbrookes and turned my life around. Go in there with a positive attitude and determination to be active afterwards, and of course do all the exercises in the early days post op, and you should also have a positive outcome.
Gosh, it’s like you’ve been rebuilt - you’re almost bionic! It’s wonderful what they can do isn’t it. My husband was done in Addenbrooke’s too. It is so important to do the physio exercises isn’t it.
His visiting physio said that he had to lie completely flat on the bed for an hour every day - which seemed a strange thing to have to do but I used to lie on the bed beside him and the togetherness was very nice - she also said that under no circumstances was he to sleep on his reclining chair at night.
Thank you for your very encouraging advice re hip replacement. The waiting time is the worst and worrying about the op and things going wrong is scary, so I shall work on a positive attitude, as you suggest.
I had both hips replaced in 5 months. The first couple of weeks are the hardest. I didn't have stockings due to having skin that rips easy, due to steroids for polymyalgia. Like the others I had a long shoehorn & grabber, and if you have a soft belt from a dressing gown etc tie a loop in one end for your foot its then easy to lift your leg in to bed. As for physio exercises there are instructions in the book they give you. I think it will depend on your paticular hospital. The only time I saw a physio was to see if I could get out of bed and walk a few paces,and again to discharge me where I was given a pair of crutches and sent on my way. Oh and do keep moving to stop feet and ankles swelling. Good luck I'm sure you will be fine.
Two hip replacements in 5 months is very brave! Recovery at home seems to be difficult without anyone medical on hand. Thank you for all your advice and I hope you continue to do well.
Best of luck Pat. I had a shoulder replacement five years ago. I stopped meds a week before and after op they gave me intravenous steroids so I would not have flare- all good! 💐Hope all goes well and you are back in your garden soon my lovely ☺️
Hi. Echoing all the comments from others on here re useful equipment post THR - anything that makes life easier for those few weeks post-op are very necessary. I’ve had both hips replaced seven years apart due to osteoarthritis (I also have long-standing RA and osteoporosis) and haven’t regretted either operation at all! I had spinal anaesthesia and sedation so none of that horrible hangover from a general anaesthetic and you’re up almost as soon as you’re awake - those pesky physios make you get out of bed straight away.
The pain is relieved as soon as the diseased hip joint is removed and there’s minimal pain from the surgery. I did have a stiff leg on both occasions and the ‘leg lifter’ is a boon if you are also bothered by that. The first couple of weeks are the worst for fatigue and needing help from someone to prepare meals and just be around as it’s hard work on crutches and being very slow! After that most of us make excellent progress and I was driving again by six weeks.
I had to stop my JAK (was on Baricitinib at the time) for two weeks prior to and two weeks following the surgery as my surgeon is ultra-cautious. I had no problem with that as I’ve been on steroids for years on end and had a booster during the op so never noticed the lack of other drug. I never had any physio after either op and had both at the Oswestry Orthopaedic Hospital. They just said walk so I did
In answer to whether you’ll ever do your garden again. Yes. I’m 70, I have a huge garden, which seems to need constant attention, and as soon as I was off crutches (at about four weeks) and onto a stick I was out there deadheading. You have to be really careful for the first three months not to overstretch the new joint - you’ll be told all about that in hospital - but as long as you’re careful to start with you’ll be fine. That awful grinding, sickening pain and immobility is gone, you can move freely and you just go from strength to strength. About six months on from both my ops I was as able as I’d been before the joint started to erode and now, two years on from my last THR I’d never know I’d ever had anything wrong with my hips.
Everything else may be falling off, spreading out and hurting but my hips are fine! Don’t be overly worried (bound to be a bit anxious) as these are done day in, day out by the millions each year and are one of the most effective procedures in surgery. I was an orthopaedic Sister for years and believe me, now is a good time to have a THR as opposed to 40 years ago.
Thank you for your most positive and informative comments on hip replacement surgery. Reading about your experience is very reassuring and I have made a note of some tips and advice. Good to hear you are doing so well.
My experience from two knee replacements might be useful for you. I'm about the same age. I prepared with muscle strengthening with a physio. That was actually very useful - basically doing the exercises they'd recommended. Anything to strengthen the muscles in your legs. On meds I'd follow the advice of. your doctors. I had to attend pre-op sessions in which they took me through the procedures and andswered any questions. I made sure I did the usual and brought a list! I hope it goes well.
I had a hip replacement when I was 66. One important thing to know is the kind of hip replacement it is. Will they make the incision at the side or in the front?I had the front incision hip replacement and the healing is much quicker with less restrictionists post surgery. If they cut at the side or further to around your back, they are cutting into large muscle mass and that means an extended healing time and a need to be careful about bending beyond 90 degrees. Whatever you do buy one of those “picker upper” contraptions. They are invaluable as you will always have a need for it.
Don’t try and be a hero- get as much help as you can. I healed quickly and after 4 months was back line dancing. I really don’t think about having a “fake” hip anymore. I have no pain on that side of my body. I wish I could cure my other issues as easily- OA, RA, fibromyalgia and spine issues!
As long as you follow the protocol post surgery, you should have a good experience. Good luck!
Thank you for your sound advice on hip surgery. I don't think there is a choice in the kind of hip replacement you can have but good to know all the pros and cons.
As I arrange things for my new knee tomorrow, here's a couple of other things I found useful after my new hip last year... I put a handy storage box with the day and night clothes I'd be wearing at home in the aftermath, so as not to have to ratch them out of drawers, wardrobe,under-bed storage, etc.
I also found a good supply of Tena pads was useful as you don't get to the loo very fast initially (especially if you, being the same age as me, may need a trip or two to the loo during the night...I just needed them for the night)
Hi I'm interested in reading all this. My ortho says I need thr but my issue is, I'm not in a huge amount of pain- just my groin, and can't tie shoe laces or cut nails on left foot. and I've put off because I'm putting myself through pain when not in much pain yet. I also worry that stopping biologics will make my eye flare up, which will require steroids to bring under control, and you know the long slow process coming off them. Ortho says I might still not be able to tie up my shoelaces afterwards, so you think - what's the point?
D’you know what, and sorry to mention it, you might not be in much pain now but you will be. If the orthopod says you need a THR then you need a THR and before you get to the screaming agony stage where you can’t bend at all, you can’t walk very far without having to sit down and your mobility is shot, have a THR and sooner rather than later.
Read the threads about how liberating it is to have one and how much better off you are afterwards. Get advice on your eye and steroids before you deny yourself a pain free life - and you will be able to tie your shoelaces and do all the things you can do now but without the pain once your recovery is complete. I’ve had both hips replaced and have not regretted it for a minute!
I had my first hip replacement aged 70 and second I was 73. I had an epidural with sedation. In hospital 3 nights then home. I wasn't on biological injections then and I can't remember now if I stopped the Sulphzasaline or not. I kept up the 15 week recovery programme and continued it at leisure. Not one size fits all re recovery but try to think of what you can do with a new hip what you can't do now.
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