Marc's Hip Resurfacing with Dr. Raterman 2014

I have been cleared for all activity without restrictions. I am now playing singles tennis without holding back. I am out of shape (for 95 degree singles tennis), and still feel not as flexible or as strong, but have had no pain even after 2 hours of drills and playing. The hardest thing I find doing is bending and staying down, but I have been standing straight for over 10 years. I expect to continue improving as I keep pushing myself.

3/4/2014: I am a 57 year old physician who had a left hip BHR performed by Dr. Raterman on 2/19/2014. I have been posting my pre- and post-surgical thoughts  on youtube ( https://www.youtube.com/channel/UCYWv7uE53NUtshlWk20lq4Q/playlists ) for those that are interested.

I first became aware of chronic hip pain that impaired my function 12 years ago while playing a tennis match, when I developed a severe groin “pull”.  Over time, without improvement, x-rays revealed that I had developed arthritis in both hips, worse on the left. I was severely limited at first, unable to participate in sports, having difficulty walking short distances and unable to sleep without having a pillow raise my calves. I took up pilates and elliptical training, with gradual improvement in my overall physical fitness. I was able to sleep at night comfortably flat on my back (only needing a pillow when turning on my side), and played singles tennis for up to 2 hours at a time (although I could not run fast). More recently, my function quickly declined with my inability to sleep comfortably through the night or to even walk on the elliptical. I gave up trying to play tennis.

During this time period, I researched my treatment options with the risks and benefits, and felt that a Birmingham hip replacement was the correct approach. I spent quite some time researching surgeons with the help of surfacehippy.com, and decided on Dr. Raterman out of Tampa. Logistically, this was the easiest decision as I live near Orlando. I was prepared to fly to elsewhere to get an experienced surgeon as the greatest experience with hip resurfacing tends to be at larger tertiary care facilities.

I was extremely pleased with my decision. Dr. Raterman is a competent, caring physician with extensive (over 1800 cases) experience, having been one of the first in the U.S. to have performed this surgery in 2006. He always had time to answer all of my questions (I would advise everyone to come with written questions beforehand and a companion notetaker). Additionally, I was extremely pleased and pleasantly surprised at the care given at Florida Hospital Wesley Chapel, a small new 80 bed community hospital. I felt like I was in a boutique facility rather than a larger chain. The entire medical and support staff were friendly, caring and attentive.

Realizing that everyone’s experience is different, I do not feel mine is particularly unique. I awoke from surgery at 11 AM, at 3:30 PM I walked 5-10 feet with a walker before I became light-headed. Pain was minimal (2-3 out of 10) - less than what I was accustomed to pre-surgery. Many interruptions that night for meds and vital signs. The next day my foley catheter was removed and my IV was disconnected. I felt lightheaded trying to stand before breakfast, but felt stronger after eating. I walked 300 feet in the morning, and another 300 feet in the afternoon. This resulted in my left butt ”burning on fire” later (pain 6-7 out of 10), so I took my first oxycodone along with Soma and tramadol, took a nap, with easing of my pain (actually more of a dull discomfort) to a level of 2-3.

On day # 2, I walked 400 feet plus stairs, showered and felt great (on meds), even having no pain. I was discharged to home at lunchtime. Over the next 2 weeks, I walked often and did my PT exercises. I walked non-stop for 90 minutes (approximately 3-4 miles 7 days after surgery, then cut it back to 30 minute periods of walking to space it out better with my PT exercises. Initially, I could not abduct or adduct (slide leg out sideways) at all, but 10 days after surgery I do it to about 40 degrees (I could only go 15 degrees before surgery). Straight leg raising is still the toughest at 12 days, but I have gone from not being able to lift at all to starting to raise my leg without assistance. Overnight is my roughest time - I still get up every 2-3 hours to go to the bathroom or for pain meds. I am most uncomfortable as I am lying in one place for too long a time period. I get stiff and uncomfortable if I do not shift positions every 15-30 minutes. This is worse upon awakening, but improves as the day goes on.  I find the Iceman to still be extremely useful, and still use it often after exercising. My leg swelling has been relatively minimal. I am still wearing thigh high pressure stockings to prevent swelling and blood clots after 12 days.

Day 14 post-op: my 2 week visit with Dr. Raterman and associates went well. My waterproof bandage was removed and steri-strips were placed until they fall off, but the skin is healed with very little scarring. X-rays demonstrated my hardware was in really good position, there was good balance between both hips - I was extremely pleased with the way the images looked (as was Dr. Raterman). I was advanced to a cane from a walker, which I expect will only be for about another week. I will begin outpatient physical therapy next week, with advancement of my exercises. My muscles (quads, adductors) are weak, but are getting stronger every day.  I am allowed to drive since I am not taking narcotics (only Tylenol, NSAID or tramadol as needed), don’t use my left (operated) leg for driving and only need a cane. However,  I cannot sit for extended periods of time. I am taking full dose aspirin 325mg daily for another month. Next visit in 4 weeks.

Day 16: I have been out driving, and have started walking without a cane. Finally able to do 10 straight leg lifts (with great effort though). Tightness and pain is improving.

Day 21: I am undergoing outpatient physical therapy 3 times a week. I am still experiencing groin tightness from my hip flexors, worse if I am sitting more than 20-30 minutes at a time. I am occasionally using Tylenol for generalized muscle soreness from my rehab workouts. I am on the elliptical 40 minutes daily at the lowest level to increase my mobility. Usually I walk without a cane, but if I am tired and tight I will still use it. Due to groin tightness, I feel like I have a slight limp when walking, which is improved when my muscles are warmed up. Straight leg lifts are easier- I am doing 2 sets of 10 three times a day, with less but persistent groin tenderness. I have been doing shin slides along my non-surgical leg, getting to the bottom of my kneecap. While I can go out and drive, I am only comfortable for short periods of sitting for about 20-30 minutes. Overall progress is occurring, but it is less dramatic and slower than I would like. I have to remember that even before surgery I would be sore for 1-2 days after a heavy day of exercise. I am trying push myself with rehab exercises every day, so there are some days in which I just feel tired and run down (usually worse in the morning) and need to nap.

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