Any tips for upcoming THR?

[Angel_doll]

My hip replacement is scheduled for five weeks time. PMR history is diagnosis end of 2020, and infrequent rheumy appointments. I was seeking advice for increasing pain from April 2022, so remained on 7mg pred for about a year, finally completing a slow taper to 6.5mg about a week ago. My GP had eventually referred me to a different hospital for a rheumy consult, and they arranged the hip X-ray which revealed severe osteoarthritis in one hip. I was then referred to an orthopaedic surgeon, who is going to perform the THR.

I wonder if I should remain on 6.5 mg pred until after the surgery (I had been planning to start another taper to 6). I was going to ask my current rheumy, but my appointment for today has been postponed.

I’m also interested in any hints or tips that those of you who have been through this procedure can offer. I’m really keen to do as much as I can both to prepare myself for the surgery, and make the recovery period as smooth as possible.

[123-go]

I have no experience of a hip operation but as far as tapering goes it may be wise to stay where you are for the time being. What is your gut telling you? Do you have a date for the operation?

[PMRpro Ambassador]

DorsetLady wrote a post about dealing with joint replacements which will be in the FAQs I imagine.

Here's the link

healthunlocked.com/pmrgcauk....

I wouldn't taper any further at present - you need to be under good control for rehab and they will give you a boost during surgery and monitor you afterwards in case you have a bit of a flare with the stress.

Was it beyond your GP to send you for an x-ray?

[DorsetLady PMRGCAuk volunteer]

PMRpro has kindly linked my post - mine were all done after GCA was in remission so no Pred to worry about, but would agree don't try and change your dose before the operation, and don't be in too much of a rush afterwards either. Make sure you are over op before you even think about it..

and good luck, you will be amazed how good you feel..

[oscarandchloe]

Hi Angel doll, just to re-assure you, I had two THR ops last year, one last May and the the other last November. I had been on 5mg Pred. for about a year before this and stayed right there all through last year and into this year, waiting until I felt really healed until starting to slowly taper. You must tell everyone in the hospital that you are on steroids, and especially your anaesthetist. You will need a hydrocortisone boost during the op as your system cannot cope with that stress, so really impress whoever deals with you that this is urgent. I was well cared for and checked afterwards by the anaesthetist to make sure I had no adrenal insufficiency symptoms. As for preparing for the op. I kept as fit as possible doing simple yoga for strengthening the hips and walking as much as I could (which was little due to pain). I also went to hydrotherapy once a week for months before and continued afterwards and found this a great way to stay fit, but you may not have a pool available locally. This really paid off as I was up and walking the day after the ops and without sticks 6 weeks after each op. I religiously did the the exercises given to me by the physio. A year on and I'm completely without pain, have walked 3 miles, done loads of gardening and never looked back. The only drawback are persistently weak hip muscles that I have years of parallel PMR and failing hip joints to thank. It's a miracle op but you have to work at getting your body able to use it. Good luck!

[Posey1]

I can thoroughly recommend DorsetLady's post re hip replacement surgery. I had my surgery last June whilst on 5mg pred. I had the spinal injection rather than anaesthetic and was so satisfied with the whole procedure. I followed aftercare instructions to the letter and couldn't be happier with the results.....as I understand most people are. I tapered the pred as normal after.My very best wishes for a successful outcome for you too 😊💐

[pegpowell]

I had left hip replacement July 2022 after putting it off for over a year. I was at 3 mgs pred late 2021 but increased to 4 mgs because of a slight flare in good hip. A few months after hip op, I reduced again to 3 mgs. This year, I have finally reduced very slowly to 1/2 mgs where I intend to stay for a while. The only physical therapy I had was walking. The first three months are the hardest, in that you cannot bend beyond 90 degrees. My replacement included part of my thigh as I had put it off so long. I am so glad I had it done.

[jls93]

I agree with oscarandchloe.. personally I have had 8 orthopedic procedures over the years with PMR going on( 2 hip 4 shoulder, 1 spine and 1 wrist). Prepare for success: "spirit -mind and body" Inform MD as described. Prepare house : Bed , Bathroom, Kitchen and living room . More than likely you are able to preview the Post op exercise protocol on line. They are readily available he in the States. Hope this helps