Total Hip Replacement – Which Procedure Should You Go With?

After our federal minister of health outlawed stem cell injections as a treatment for arthritis here in Canada, I was forced to go in for a total hip replacement this year in order to deal with the new level of pain I was experiencing.

SIDENOTE: The only reason I am sharing my story (and any other medical history) like this is in hope of sparing you or someone else the painful delay in making your decision to get a hip replacement, should you need one.

Having learned about Markham’s amazing hospital that now offers PRP injections (the ONLY one I will recommend for that procedure, going forward!), I got my case presented to one of their doctors and am very grateful for his reviewing my recent x-rays.

This surgeon determined that the PRP injections would NOT fix the level of pain that I was experiencing due to the severe damage to my left hip, as shown in the screen print below, of my recent x-ray.

image of my hips x-ray

The Markham Stouffville Hospital set me up with medically trained staff member David Simpson to consult with sometime back in May of this year. David scheduled all of our meetings using Zoom, and we met on several different occasions to answer any and all of my questions.

During the second of third Zoom chat with David, I anxiously explained about all of the patients whom I had learned of that experience a fall and had to go back for MORE surgery. David calmed me down, explaining that MOST of those “falls” were most likely from hip dislocations.

Apparently, hip dislocation after surgery is NOT all that uncommon and that most “falls” that patients were experiencing were actually caused by this… YIKES!

BUT… I was not to worry…

David informed me that there is a new procedure where a cut is made in the skin ONLY, from the front of the hip, and that the muscles are stretched to get at the hip rather than the muscles along the side of the hip being cut. And, that this procedure has a shorter healing time, with less pain being experienced.

For that I am MOST thankful to the Markham hospital, as David is responsible for having “planted the seed” for my giving serious consideration to having my hip replaced this year (even though I was no yet aware of his influence).

Plus, he suggested that I go back and talk to some of those patients to see if they are even continuing with the exercise program that they were put on.

At this point in time, I was very adamant in NOT allowing anyone EVER replace my hip due to so many horror stories of hips being damaged during a fall they experienced after surgery. PLUS, the new limited duties that several patients had after surgery, due to their new restrictions.

My lifestyle depends on my remaining independent and in my own home. Being limited as many patients are now that I spoke with, having a hip replacement was just not an option for me… or so I thought.

My level of pain just would NOT go away, and during a conversation with my dear friend Pamela (who was the one that suggested I meet with the professionals at the Markham hospital), she listened patiently to my ranting about NOT having any hip replacement.

Once I was done ranting, Pamela calmly suggested that I give serious consideration to having the hip replaced and only THEN if complications were as others experienced, THEN I could make a final decision.

Which, I have to admit was common sense. But that too seemed to have escaped me at that point in this venture, when being faced with NO decision except to go under “the knife” in order to be able to escape the level of pain I was now experiencing.

It wasn’t very long after that when I got to listen to Christie Brinkley’s experience when she was being interviewed by Dr. Oz that I FINALLY started to realize that just maybe the new procedure that David Simpson first talked to me about MIGHT work after all.

After a few days of thinking about Christie’s story, and her being the exact same age as me… I telephoned Sunnybrook Hospital on Wellesley Street East, in Toronto, to arrange to be met by the recommended surgeon that I saw about my hip back in early 2017.

With one failed visit to Sunnybrook for a consultation on the 16th of June, due to an accident on highway 401 (that happened at 3 AM earlier that day) not yet being cleaned up, it was impossible to get to the Don Valley Parkway, in order to arrive at the hospital for my 10 AM appointment.

A second consultation was setup for the 7th of July, and I was able to get there in decent time, this time.

It was only during that consultation that I learned that the surgeon I saw back in 2017 only does the OLD PROCEDURE, and that Canada isn’t even teaching the new procedure.

To top that off, I learned that doctors have to go to the States to learn the new procedure.

Anterior Total Hip Replacement Surgery video animated

Needless to say, this left me a bit baffled and totally uncomfortable to say the lease. I had NOT had the opportunity to do ANY researching on which surgeon in Ontario might be THE BEST surgeon to perform this new procedure, as I definitely would NOT go for the OLD one.

Thankfully, the technician had a surgeon in mind whom she trusts to do this new procedure. She claimed that he has performed the anterior procedure successfully on several patients. Not sure why I trusted her judgement, but I am SO glad that I did.

Dr. Chaudhry (pronounced chow-dr-e) was the surgeon this professional recommended, and she quickly arranged to have him come to her floor to meet with me.

It was during this meeting with Dr. Chaudhry that I discovered patients need to be determined as being a good candidate for this new procedure… or not. Thankfully, after close examination, he determined that I was definitely a good candidate for this procedure.

From there, it was only a matter of scheduling the surgery. Given the COVID-19 crisis, I actually figured it would be quite a long time before I would be able to be operated on. However, it was quite the opposite.

Dr. Chaudhry informed me to come up to his office once I was finished with the initial consultation, and speak with his receptionist to schedule my surgery. Which I did… and I was shocked to learn that there was an opening on 16th of July.

However, I asked if I could have some thinking time to plan this out, at which Dr. Chaudhry’s receptionist kindly asked me how about the 6th of August, at which I agreed to.

From there, things moved along at high speed… or so it felt, anyway.

I had so much to do BEFORE the 6th of August.

  • Back yard dismantled and furniture all packed away for winter
  • Back garden weeding
  • Hanging baskets moved to an easier location for watering
  • Front garden weeding that took 2 days (and extra help… Thank YOU Patti!)
  • Bushes trimmed for what might have been the last before winter
  • Grass cut on the 4th
  • Laundry all caught up
  • Vacuuming and washing of floors done
  • Walkers ordered and setup – one for the main floor, and one for downstairs
  • Raised toilet seats (1 bought, 1 borrowed) installed the day before surgery
  • Bedding had to be changed the day before surgery
  • Three showers with the special chlorhexidine soap that Sunnybrook Hospital provided for me to use for the three days BEFORE the surgery
  • COVID-19 swab test completed within days of the surgery and test results HAD to be online by the morning of the surgery (OR NO SURGERY!) (Had already been fully vaccinated by then, too)
  • Baby sitter arranged for Chloe
  • Taxi scheduled
  • etc.

Within days of the 6th of August, I received a telephone call from Sunnybrook, informing me that my surgery was now moved up to the 5th. WOW!

Thankfully, I was able to complete all that I wanted to do BEFORE the surgery.

Though, I have to admit that the morning of the surgery I was soooo exhausted from all of the work having to be crammed into a short period of time that I did NOT become anxious while waiting my turn for my operation… and, mine was delayed by over 30 minutes.

The staff at this Sunnybrook Hospital were MORE than kind, starting with nurse Deborah, and then Sandy and her assistant.

I opted in to be completely knocked out for the surgery and am sooooo thankful that I did.

Also, I let the anesthetist know of my fear of walking up in recovery with the pain remembered from DURING the surgery, and they let me recover slowly so that there was NO pain experienced. Pheeeeew!

In a previous surgery, I awoke in recovery feeling EVERY tearing feeling from that procedure. Once I was fully awake from and analyzing THAT experience, I realized that my brain must have retained all of the nasty pain DURING the surgery and then let me remember it in recovery.

Let me just say… it was NOT nice feeling to be experiencing.

When checking with a nurse during my pre-op with Sunnybrook, she explained that this is exactly what happened (my brain remembering the pain of surgery), which is why they offer the “other method” of spinal anesthesia.

NO THANK YOU!

LOL, when I said that… she said that I should let the anesthetist know of my fear at the time of the surgery, as there would be something they could do to prevent my remembering the pain in recovery that my body experienced during surgery.

I am VERY thankful that the Sunnybrook Hospital anesthetist was a lot more compassionate in understanding my fear, once I let them know, and they made SURE I did NOT experience ANY remembered pain in recovery.

At the time of surgery, I asked Dr. Chaudhry to please take a picture of the ball part of my leg bone that he cuts off in order to install the one part of the hip joint replacement. And though surprised by my request, he did take those pictures for me.

On the morning of the 6th of August, Dr. Chaudhry visited me to see how I was recovering. First thing I asked him was if he took those pictures for me, and he said that he did. His main issue with my health that he seemed VERY concerned about was just how SOFT my bones are.

  • first close up view of fovea capitis after removal
    The first close up view of my fovea capitis after it was removed. The ball portion of my left leg that fit into my left hip socket.

Wow, and here I thought that the tray of supplements I consumed daily would be helping to keep me health. Somehow, I’ve overlooked something that’s for sure.

The images shown above are different angles of the same portion of my leg bone that was removed and it clearly shows how badly that bone was peeling off in layers. The shiny white area is the ONLY “normal” area left. Apparently, my hip socket required a LOT of reworking also.

Dr. Chaudhry also informed me that he used dissolving stitches so that I wouldn’t have to worry about getting those out. YEEEEEAH!

This surgeon is super considerate given my “weak stomach” when it comes to all things like this.

Once I was at home recovering and feeling a bit better, I did some research online after hearing one of those well-known types of pharmaceutical commercials and discovered that antibiotics may have played a MAJOR part in destroying my bones like this.

Am doing follow up visits with my GP to see if anything can be done to stave off any further damage.

Now… getting back to my experience with my total hip replacement…

I was kept over two nights after my surgery, due to the excessive pain I experienced for over 30 minutes, twice during the 6th of August. This was due to a nursing shortage and my pain meds being delivered to late both times.

NOTE: I do NOT hold the nurses responsible either. Given COVID-19, I was surprised that there were any nurses available during my hospitalization. They had to have been getting burned out by this time, I was sure of it.

On the morning of the 7th of August, therapist Roxanne, came to my room to check me and to make sure that I could walk with my cane, as well as go up and down the stair case easily enough for me to be able to get to my home, and then inside from the taxi.

I arrived home within an hour of noon on the 7th, to find two friends eagerly awaiting my arrival, along with my Chloe.

On the 13th of August, I was told to remove the bandage from my incision. See images below.

Image taken on 11 Aug 2021Image taken on 15 Aug 2021Image taken on 29 Aug 2021Image taken on 1 Sept 2021

On the 15th of September, I attended my follow-up visit at the Sunnybrook Hospital.

x-ray of my left hip with hip replacementAfter having my hip x-rayed again… this time WITH the hip replacement, I returned to the waiting room to see the surgeon.

Again, the main concern for Dr. Chaudhry is still how soft my bones are. Though, he did give me the okay to go swimming, soak in my tub, or whatever, as my incision has healed up so much now as to be safe to return to those types of activities, if I so wished to.

They scheduled December 9th for my next follow-up with the surgeon’s therapist. We are to meet on Zoom, at which point I am hoping to remember to ask if and when I can resume hanging upside down on my inversion table.

After seeing the surgeon, I was directed to attend therapy, where Roxanne reviewed the new exercise routine that I am to follow for the next year.

By the 15th of September, I had packed my two walkers away, as well as removing, sanitizing and packing both of the raised toilet seats in their perspective boxes. Though, I was still highly dependent on the cane that my neighbour loaned to me back in 2017.

At the time of starting to write this (October 9), I’ve not needed the cane when walking around the house.

WOW! Does that ever feel good… FREEDOM!

Though, I am not confident enough to go without the cane when leaving the house for things like shopping and/or visiting close friends… you know… my “bubble friends” only.

One step at a time, and I truly feel my lack of dependency on the cane when walking around my home to be a major step forward in my healing.

The following article contains all of the GOOD stuff that I was informed of when it came to the Anterior procedure: http://www.biomet.com/web_accents/biomet_products/hiptreatment.cfm which was the reason I conceded to the surgery.

It wasn’t until getting ready to share my experience with you here that I actually did any research on comparing the anterior procedure (the new) with the posterior procedure (the old).

For the sake of being total transparent about this with you, I offer you the following chart.

Description of Procedure Posterior Anterior
Cuts through muscles x  
Long time healing x  
Needs therapy after surgery x  
Chance of hip dislocating x x
Faster recovery   x
Avoids cutting major muscles   x
Less post-operative pain   x
Fewer post-surgical precautions   x
Obese or muscular people may not be good candidates for this procedure   x
Technically demanding on surgeon   x
Potential for nerve damage x x
Stability feeling after surgery   x
Chance of infection of incision x x

Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256966/

https://www.arthritis-health.com/surgery/hip-surgery/advantages-and-disadvantages-anterior-hip-replacement#vh_footnotes

https://www.bannerhealth.com/healthcareblog/better-me/is-anterior-total-hip-replacement-better-than-posterior

When I discovered that patients from BOTH procedures are experiencing issues with hip dislocation with the hip that they had the replacement done on, I have to be honest with you; had I known that fact BEFORE calling Sunnybrook Hospital back in June, I would NOT have called them, ever… I’m sure of it.

But…

Having said THAT I am GLAD I did NOT know that some patients that under went the anterior procedure are suffering from hip dislocation too. Because so far, my surgery has gone well. My recovery time has been short, just like what Christie Brinkley experienced.

PLUS: The study listed under Sources above, clearly stated: “No matter how the transected structures are restored, the posterior tissues may be weaker than before surgery. Barrett et al. mentioned that preservation of muscle attachments to bone and avoidance of muscle division offer the potential for improved dynamic hip stability.”

My use of the opioid drug prescribed for my use was minimized due to less pain suffered with my preferred procedure. And thankfully, Sunnybrook suggested patients return all unused portions of their opioid prescribed meds on the day of our follow-up visit with the surgeon.

Pheeeew, this was a relief for me due to the criminal element of prescribed meds like this one. I surely do NOT want them in my home and I would not want to chance returning them to the pharmacy.

Besides that worry, I was a bit paranoid of becoming addicted to that drug; But I did NOT. The nursing staff insisted that when in pain I need to take the drug in order to do my exercises. Without the drug, I would not want to do the exercises. And, without doing the exercises my recover would not be successful.

In order to minimize the length of my story here… in a future post I will discuss my use of prescribed CBD oil that I started using one week before the surgery and then resumed taking 3 weeks after my surgery.

Do hope that my experience shared with you here might help ease your fears with this surgery.

The main “secrets” to successful hip replacement surgery that I can share with you is to:

  • pick the best surgeon you can find in your area (mine are located 20 minutes west of Oshawa, in Toronto) for your chosen procedure, even if you have to travel a distance to get there. It will sooooo be worth it to you.
  • follow the instructions given to you by the staff members, without deviation.
  • remain positive regarding your choice made.

Should you prefer or be forced to go with a Posterior Hip Replacement, then please be aware of the following video explaining the limitations you will be faced with: Don’t Make This Mistake After Hip Replacement Surgery.

Have provide a link only to that YouTube video, as I have a weak stomach and could only watch enough of their warnings to know that what they are telling their viewers ARE vital mistakes that you do NOT want to make.

Should you have any questions regarding my experience with my total hip replacement, please leave them in a comment below and I will respond in a timely manner.

UPDATE: 26 Oct 2021 – Am now able to leave home without a cane for the first time in over 2 years now. Yeaaaah!

And, to top this off, I’ve been relieved of 3/4 of the pain I experienced BEFORE the surgery was done. No more referred pain… pheeeew! Am back to using Voltaren to control my back pain.

 

Credit for Header: image by biomet.com

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Trish

Given my passion for genealogy, is it any wonder that I eventually wanted to publish my work? Learning to use a personal computer was a natural step once I was introduced it in the 1990s. Then the internet offered a second means to "publish" and now, here I am with a personal blog.

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