Question
QUESTION: hi, i'm 45 years old and just had hip replacement 2.5 weeks ago. i would be doing fine, but when i move certain ways, i actually feel and hear my hip move like it's coming out of the socket. a few days ago it actually came out of the socket but hung up on the edge. the dr. was able to put it right back in. is it normal for the movement and clunking seeing that its only been 2.5 weeks? my dr. tells me that after 6 weeks everything will be fine. is he correct?

ANSWER: Hi Dan

It's been my experience that if you suffer any type of subluxation or dislocation within the first three months of surgery, you are more likely to suffer it again.  My advice would be to pay strict attention to your limitations of what you can and can't do. Don't go over 90 degrees and don't cross your legs or go over the mid-line or twist your upper body in a different direction than your lower body. (a swivel chair for instance does that).

Make sure you do your PT exercises.  The stronger your muscles are the less likely you are to dislocate.  If you keep having problems it may be that you need a larger cup.  In one of my revision surgeries the cup was too small and I kept dislocating (within weeks of surgery) and after a few years, I had to have the cup replaced and then I was fine.

There are several milestones in THR surgery and six weeks is the first, the second is the three month mark.  I would say that after you make the three month mark and you have no problems then you should be OK for the most part.  But remember that anyone can dislocate at any time if they do not pay attention to the limitations.

If you continue to have problems, I would suggest you find another surgeon to get a second opinion.  



---------- FOLLOW-UP ----------

QUESTION: hi sharon, just thought i would update you. it seems to be getting better, it still pops, is that normal? i'm walking better. i was wondering if you could tell me what range of motion i will have when this is completely healed.

ANSWER: Hi Dan
It's so nice to hear from you again and Im so glad you are doing better.  

Popping is pretty common, I still have it on and off and I tend to ignore it, but I do have an appointment with my doctor on the 20th and I want to ask him about it.  It's almost the same type of feeling and sound as when you crack you knuckles, right?

Why don't you ask your doctor, at least it will ease your mind.  My philosophy is to get information where you can and then ask your doctor.  My replacements are coming up on 10 years each so I will ask him about it.

Your range of motion depends on many things, the type of replacement you have, your precautions, etc.  If you stick to the precautions, and don't go over 90 degrees, or move your knee inwards, or go over the midline, you should have a fairly normal range of motion.  It might hurt a bit to squat, (when you rise from the squat), but you should be able to do most things.

I hope that answers your question, and please let me know what the doctor says about the popping.

Sharon


---------- FOLLOW-UP ----------

QUESTION: i was wondering if i will be able to bend past 90 degrees, i,ve heard that after 3 months that i will have almost a full range of motion. is that true? also, sometimes my popping is very hard and loud, almost feels like the ball is moving out of the cup. is this normal? i'm just about 4 weeks past surgery.

Answer
Dan
You should NEVER flex your hip over a 90 degree angle, you should NEVER bend where your chest touches your lap.  (If you are sitting in a chair, never bend straight over your lap.)  You should never twist into a position where your upper body is twisted to the side and your legs are straight.  You should never rotate your knee inwards towards the other knee, you should never take one leg and cross it over the midline of your body.

Because THR patients are no longer in pain they sometimes forget some of these precautions and are fine.  But if you do have a problem, most likely it will come from not paying attention to the precautions.

The popping you feel or hear, should not be loud.  It should not feel as if the ball is moving. You sound as if you are very concerned about this, and to me it sounds as if it is affecting your recovery.  Call your doctor and tell him your concerns and your fears.  Have him take a look at your hip.  Ask him to check your range of motion, (he can do that after four weeks), ask him what physical therapy you should be doing.  I would definitely tell him about the feeling you have of the ball slipping out of the socket.

Sharon