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February 14, 2008
I've changed my mind about the dislocation cause...you may
not remember that I was less than 3 months from my left knee
replacement (when my dislocation occurred). That was my
worse knee and the OS straightened it much more than the
right side which would require more stretch to the inside
quad. Since I've started back exercising, it's been real
clear that the quads that run from hip to medial side of
knee are "stuck". I've been trying to stretch it out now for
months and just may have to live with it this way or get it
"released".
So, what I think happened is that those
muscles/tendons/ligaments involved in the quadriceps and
their kin wouldn't give sufficiently for that bent, rotated
movement I was doing and the weakest link was the set of
muscles et.al. that hold the hip back from rotating inward.
These are also the hardest to get back to full strength I
would imagine since treadmill, elliptical trainer, recumbent
bike et.al. don't help them. So, Dr. Barrack, my BHR
surgeon, didn't "screw up" my left hip although he didn't
center the pin of the femur head part of my right hip and
that will increase my chances of a break there. That will be
my final word on that dislocation I think. But others should
be warned and PT's should take special note when knee
replacement follows BHR if the hip hasn't had a chance to
recover.
November 17, 2007
My hip dislocation is now about 14 weeks or so old and I’m
back to tread milling ½ mile but building up pretty quick.
The dislocated side seems to work differently from the right
side…if I don’t remember to point my foot out when I get up
from a chair, as I put weight on that leg it will try to
collapse inward (that surgical motion) and I can feel the
tendons/ligaments/muscles rub over some bone. BUT I can
catch it in time to correct it. It may be the knee
replacement and not the hip replacement that’s causing it.
I’m just going to be careful and keep building up my
strength and endurance…what else is there? I can rule out
the extreme stretching that I was doing and everything but
something about the knee or hip replacement (BHR). Maybe
both combined with a torqued pelvis. I’m really able to do
some exercising now and will keep you posted. X-rays show
the hip prostheses in alignment except for a slight
misposition of the stem in the right femur.
October 05, 2007
Yesterday was my 8th and last week in a brace that limited
the movement of my dislocated hip leg...I'll have more on
that. But I'm now starting back on my home treadmill,
elliptical trainer, recumbent bike. That's after 8 weeks of
bed exercises for strengthening the quads et.al. I feel fine
but also feel the weakness after so long in a brace (and I
cheated a lot since that thing was so heavy). I've had two
orthopedists tell me that the acetabulum cup was misaligned
on the dislocated side (three if you include Dr.
Bose)...that may be the case.
August 19, 2007
At 10 days post-dislocation, my belief is that the cause was
a convergence of things, none of which were due to poor
surgical technique. Both of my BHR hips were still
involuntarily rotating toward the centerline so I hadn't
recovered full strength hip-wise although it was getting
better and better. My 12 week old replaced knee was still
having an involuntary very small collapse that caught itself
and wasn't anywhere near recovered. I had been
over-stretching my hip muscles thinking that was a good
thing but placing palms on floor with straight legs was too
much for me at this point...had some
popping of tendons across the joint (tendons?) when I did
that. Last but not least, my position at the time of the
dislocation was very much like the one used to pop the joint
in a posterior BHR. Other recovering surface hippies need
to know that dislocations can happen and it doesn't have to
be a mis-step by any of the BHR technical people that causes
it. So Cuidado!
With respect to Dr. Barrack, every OS in my region(Texas/Louisiana/OK)
seems to know of him, if not personally. I don't know for
sure but think he's very active in academia as well as his
OS practice at a university hospital. I thnk he was dept
head at Tulane Med. The number of BHR's is certainly a
measure of the all important experience of an OS and
potential success but it was only one of my criteria. IMO,
people are wired differently and some are naturals and some
require lots of repetitions and some never get it no matter
how many repetitions. It would be really great to find an
OS that's actually had his hips BHR'd so can relate
personally to some of the feelings and phenomena of
recovering from this surgery.
I just wanted to follow-up on this as well as thanking Pat
Walter for taking it seriously... thanks Pat.
August 14, 2007
It didn't occur to me (duh) that this would alarm
surfacehippies. Let me give more background. Following the
bilat hip replacement, after 7 months, I had a right knee
replacement and then 6 weeks after that I had a left knee
replacement. The latest left knee replacement was 11-12
weeks ago. This left knee didn't have the ROM of the right
one and for other reasons, I was exercising on a recumbent
bike forcing my left knee to bend. That worked and I had
gained the ROM I wanted with that knee and had stopped
upping the time of exercise but increasing the force
required to build muscle. When I finished a session I
stretched by putting my knee to my chest (as much as I
could) and stretching it.
Another thing is after these knee surgeries there was a
weakness of a small knee collapse which always caught
itself. This was more pronounced with the left knee than
the right where there was more correction (7 degrees).
What I think happened was there may have been one of those
knee collapses at the same time I had my knees bent to put
boots under the low coffee table.
At least I hope that's what happened. The positioning on my
left hip prosthesis (BHR) was perfect. On both hips, I've
had the "twanging" of tendon, ligament or muscle...something
when the hip has been bent sufficiently. Additionally, I'm
one of those people who have a very high pain threshold and
prone to overdo.
So this is probably a unique situation. If I had it to do
again I'd do the exact same thing with the same OS...I'm
happy with it. I'm not happy with post-surgical, long term,
instructions on healing.
Linda Dickens, bilateral BHR, Dr. Barrack, 9/06
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