HIP

THANKS to so many with your valued information. Today replacement is common but only when last resort. Will go over the progression of arthritis, failure, and genetic/injury reasons. Sports specific loading and recommend pre and post-rehab. Not a doctor just a researcher. Some have a genetic or an injury that cause the outcome over time. Your success is all you. Prehab, Nutrition, Post Rehab. Figure 6 weeks to have appointments labs and prehab before surgery. Add 3 months of rest and 2 months of PT the process through Post-rehab is an easy one year process.

Standard of Care Test Diagnostics

Injuries Many times heal themselves with time and rest. Rest NSAIDs, Steroids, and Physical Therapy to strengthen, correct the form and increase range of motion can help and has to be tried before invasive surgery.

Naproxen OTC, Meloxicam script, Prednisone oral, Cort shot

Diagnostics TESTs XRay

Blood – RA Factor for rheumatoid arthritis

physical test – The Trendelenburg

https://www.ncbi.nlm.nih.gov/books/NBK555987/

Other tests are covered here in this link https://bjsm.bmj.com/content/49/6/357

XRAY / MRI

X-Ray MRI – many have images that show issues but no pain or dysfunction associated, no reason to have surgery. When the impingement causes the labrum to tare synovial fluid leaks and a cyst can develop. One cyst pressed on my sciatic nerve. Not good.

Self Test by questions can be found at this link https://www.orthotoolkit.com/ a HOOS score can be helpful to show progress or lack of progress.

REHAB Pre/Post

Most rehab will be prescribed by the surgeon. The more strength, practice and ROM range of motion increase the faster the recovery. recover is 6 to 12 weeks.

I do recommend a Visit with PT Resource for Cane height adjustment. Pre and post-rehab work and any questions on the recommend handbook supplied by the surgeon. Added recommended routines. Stretch bands are effective.

Set New Goals in my case more strength to left, and I will add a wall strap system for an interesting variation.

I use this stretch band workout – https://youtu.be/wmjlTjQ7gLE

Will add https://www.youtube.com/watch?v=PAXLCzUgsRY&t=9s some routines for this device.

WEEK 4 – 6 Rehab plan

Stairs (limit to 1 – 4 Sets of 12 steps up/down) daily

Walking total per day at 1/4 mile 1300 feet can extend weeks 5 and 6 to 1/2 mile every other day.

5 basic exercises for Hip

Seated arm upper body weights. 5 lb each limit Arm curls 10 lb. Shoulder lat and ant lift, arm curl, Triceps curl, upright row. 1 set of 10.

6 Weeks – Xray all good, no restrictions other than running or yoga. I can use bands and weights and progress from light to heavy over 4 weeks. I can extend walking to 1 mile.

Examples

Prehab and post rehab are similar . Prehab is judged by ROM %, time and distance. Use pain medication to control pain. There are minimal things to do and then add on.

Walking, Stairs, Stretch bands, and upper body weight lifting along with nutritional support. Iron and Vitamin D3

Example Excel Track pre post hab download

https://orthoinfo.aaos.org/en/recovery/total-hip-replacement-exercise-guide/ This is a generic guide.

A Nice Guide – Each Orthro group will have their our guide. This example is well done.

Advanced PT Strength

This is a home built strap system. A commercial product is available. You have to understand the workload LBS and pull out strength. Use at own risk

This uses 3/8 2 1/2 inch x 2 Lag Bolts to STUD. The weak link can handle 1,200 lbs. The D-Ring 11,000 lbs Break and 3,666 lbs working. Each Strap 1 inch over 3000 lbs break. Will add a cross beam at the top to anchor to 3 studs for added support.

My added work for the hip
Example
Part of advanced for HIP, Legs Glutes

Now at 6 Weeks and a good xray I can use the above but build up slow and steady over a 4 week period. Strength at 65% now based on Knee lift up standing. Slow means light at first , 5 reps 1 set, next day a break, build up to 10 reps and 2 sets in 4 weeks.

Add the MONSTER walk bands the last week.

Operation – How the work is done

5 Min Version

This link is a one hour in detail. https://youtu.be/5NqJa_J2dfw

SPORTS Risk

Summary of risk with source science documents

WEEK 6 POST– The idea is a 6 month period for the bone matrix to grow into the socket and stem. Time cannot be rushed. The strength of muscles and tendons is important to absorb shock. The risk for the top 3 issues is 1/2 of 1 percent.

The worst-case risk would be a broken femur that causes a fast bleed out and die. (check out https://www.stopthebleed.org/)

second would be femur brake and or pelvis was broken, fixable. Could cause amputation.

Third Dislocation fixable

Fourth Wear of liner over the spec fixable

Mitigation- Padded lower armor, lower speeds 40 not 60 mph. Muscle and posture/balance. Rest to avoid heat build-up in joint. Less rotation in technique angles by ankle and knee versus hips. Hips come into play in racing. NO moguls. Wating 6 months for bone/implant healing.

My Care Team

Health is a TEAM effort but you are the most important to plan and drive the process. It takes 4 weeks to cover the pre-surgery timeline. The team is about 30 people total including staff admins who have to schedule and keep things on track with documentation

PCP – Dr Syma Rizvi Sara and staff

Cardiologist – Dr Hafeez Syed

Orthopedic – Team of Dr Marc Hungerford – LISA the joint coordinator was my email go to. My PA Julia who answered my questions and listened to what scared me.

Physical Therapy – Max Birikov https://www.physicamedica.net/

Pharmacy –

CRANE SURGERY CENTER @ MERCY Thanks to Charles Crane

Mr. Charles Crane left a family foundation. His generosity is the reason we all can benefit from having access to a state of the art surgery center. His bio is worth reading http://www.thecranefoundation.org/pdfs/bio.pdf

The Charles Crane Family Foundation has donated millions of dollars, mostly to THE ASSOCIATED: Jewish Community Federation
of Baltimore, Mercy Medical Center, Jewish educational institutions, and programs to prevent youth violence.

AFTER SURGERY

ISSUES I HAD

Hiccups for 4 days reaction to spinal block- Medication Baclofen 1 dose took care of the issue.

Constipation as expected -Senokot-s each evening for 3 days then Merilax (PEG) should work then with 1 hour. Get a 4 type Probiotic for good gut bacteria, and 1 yogurt a day. Antibiotics are loaded via IV day of Surgery.

Swelling – management by raising leg above heart. Icing before and after PT and. Compression stockings.

ICE is your friend – Used Gel packs but pro type they last 2 hours. Ossur Cold Rush – used over 150 lbs of ice in 5 weeks.

Ossur Vid link for my replace supply lines. A COld Ice box with in and out pumped cold water lines.

Video Proof

Walking with a cane and making the GOALS EACH DAY. Do not overdo Stay slow and steady the first 2 weeks

MY PT by the BOOK

http://skidome.org/ZardozRen/wp-content/uploads/2020/06/mercy_postoprehab.pdf

PT’s first 6 weeks is limited to the few basic exercises, Walking goals, and stairs. No need to rush. many cellular activities are going on ant the reason for surface temp to be warmer because cells are working hard.

3 Weeks – HOOS score – MAY 6.9% (0% worst) Aug 17 70.6%

4 weeks HOOS Score 94.4% Progress daily

Added seated 5 lb upper body and arm workout 1 set of 10.

6 Week – HOOS 98/100 NO running or Yoga – over 4 weeks build strength via weights, stretch bands, and suspension.

XRAY of IMPLANT

Sept 10, 2020 6 Weeks all good