As I write this, I am sitting on a hospital bed in a rehabilitation facility listening to the non-stop beeping of other patients’ call lights as they wait for assistance from the nursing staff.
I never dreamed that I would be here… at least not this soon! Maybe when I was in my 80’s. As it turns out, I will celebrate turning 60 sitting in here.
In September last year I had double hip replacement (both at the same time) by Anterior Approach. It sounded so perfect, no muscles, tendons, or ligaments severed, exceptionally fast recovery, virtually no restrictions afterwards, and (least important), a very small scar on the front of my thigh. This sounded perfect compared to the traditional posterior approach surgery, with the huge scar down the backside, long recovery due to re-attached muscles and ligaments having to heal, and quite a few restrictions for the rest of my life. And, because almost every person I knew of in my mother’s family had had hip replacements, and I was having bone-on-bone pain waking me at night, and I was told the success of the surgery depended on the quality of the muscles BEFORE surgery, it made sense to go ahead and do it now.
Unfortunately, my surgeon spent all the time talking about the patient who was mowing his lawn a week post-op, and the woman who returned to work two weeks post-op, but he failed to talk about any of the possible complications. And I didn’t do any research beforehand. Our local newspaper had featured this surgeon and this new technique on the front page of the newspaper twice as the new miracle surgery for hip replacements, but they didn’t mention any of the possible complications either.
On September 13th I had the surgery. THEN I experienced some of the most common complications of this approach. The thigh pain began on December 8th, accompanied by knee pain. Over the next six months I was on every Orthopaedic Surgery website I was able to access, reading every case study I could find! I learned the correct terminology so well that when the staff physician did my intake here, he asked me if I was a doctor or a nurse! (I said “neither, just a patient who has done a lot of research”). The knee pain could have been from “compensating” for the thigh pain, or just pain radiating from the real problem. The thigh pain was attributed to the Lateral Femoral Cutaneous Nerve that lies in the surgery ‘field’. A cortisone injection in the knee settled that pain down, a nerve block for the nerve settled that pain down, but the deep pain in the thigh persisted and got worse. Fortunately I was able to continue working. (By taking more pain medications than I should), but when I wasn’t at work, it felt like I was practically disabled. The pain became so intense if I stood, walked, or even just sat in the car for more than 20 minutes. So I sat in the recliner or laid on the sofa most of the time, and had to pick and choose what was the most important to do, that was worth the pain that was sure to follow.
Finally, on June 4th at a visit with the surgeon, I said “the cortisone injection brought the knee pain to a tolerable level, the nerve block brought the nerve pain down to a tolerable level, but it (and I circled my thigh with my thumbs and fingers) feels like the pain is in the very center of the bone.” He looked at me a moment, sat up a little straighter, and turned around and zoomed in a bit more on the X-ray they had just taken. He simply said “the bone is building. Bone builds when it is stressed. There are two reasons for stress — a loose stem, or infection”. And then he just looked at me. I finally asked “what now?” He said I needed a revision surgery. That’s it! No discussion about what was involved, possible outcomes, complications, nothing.
I wasn’t quite to the “end of my rope” with this guy, so we scheduled the surgery. THEN I started having second thoughts. And I asked some questions. I learned that I was the first loose stem he had an from an Anterior Approach surgery, and that he had only done ONE revision by Anterior Approach. In other words, I would be the first stem revision by Anterior Approach. And I decided I wasn’t going to be his Guinea Pig! So I asked for a second opinion.