Saturday, March 10, 2007

Options are Good for Hips

There's several ways to deal with malfunctioning hips.

Once you've determined surgery is an appropriate course of action.

Know there's more than one option.

Hip resurfacing is one.

Actually the procedure involves resurfacing of the socket.

The implant is smaller.

Recovery time can be shorter. There's greater potential for resuming an active life style. Less chance of in accurate length post operation

The video offers some insight into the procedure. If your are contemplating hip surgery, in Edmonton, ask the surgeon what procedure he's going to use. Look at your x rays to see how much damage there is and what the options to total hip replacement might be.

Link Hip Replacement Surgery

High Tech in the O.R

Satellites in the OR, well not quite, but close . OK modified GPS, instead of satellites. cameras hooked to computers to enable surgeons to get it right. Right means precise. Precision is mission critical, in hip replacement surgery.

Cameras triangulate implant positioning.

The computer maps the area and helps the surgeon determine the correct size for the implant. There's lots of Geometry in in hip replacement surgery.

Precise measurement=Less wear

Patient Benefits

The patient is unlikely to end up with one leg longer than another. Less muscle tissue is damaged shortening recovery time . There's the possibility of more robust activity post operation because the the melding of the implements with bone. As my surgeon said post op, bone is gold.

Unfortunately, hip replacement patients in Edmonton's Capital Health region won't see anything like this. At least I didn't. I also ended up with an a longer operative leg and an insert in my shoe to make me level. Procedures performed here, in comparison, are light years behind what's going on in the US and Europe. For anyone considering hip replacement , watch the video below. It's 60 minutes, however at the end you'll have a true understanding of the procedure. Know, there's nothing dainty about it.

Three Key Questions to ask you surgeon prior to surgery.

What method are you using?
What materials are the implements made of?
How do you know the measurements are precise?

Click the pic to see the video

Thursday, February 08, 2007

Still Hurts At Week 8

The pain has been most severe at night. I'm unable to sleep more than two hours at a time. The pain shoots from the lower glute, at the bottom of my butt, down the IT band , into the quad muscle and then into the groin. I tried a short term fix, a cortisone shot, didn't work. There was no change in the pain level.

I've had two physiotherapy sessions a week for the last three weeks. There is progress in terms of function and strength. Despite, the pain, I am doing more repetitions of the exercises than when I started, three weeks ago.

Two alternative therapies Active Release and Message are working. The active release is part of the physio regime. performed by my physio Sarah Pearce. Weekly message, is from Leslie Olsen at Healthy Balance, in Sherwood Park. Seven treatments in combination, in the last two weeks, with limited impact is on the pain cycle.

I waited too long to seek alternative therapy. Post Operative pain should diminish over the first four weeks of rehab. Expect to be told pain is normal It isn't. If you aren't sleeping due to post operative pain, in your butt, look into message and active release. Tell your Doctor. You know more about your pain, than he or she ever will.

Active Release Practitioners in Alberta

Monday, January 22, 2007

Sore Groin Sore Glut

If your butt, groin and thigh muscles hurt like mine, it's likely the adductor muscles need attention.

There's five of them. They extend from the pelvis to the thigh bone and the pelvis to the knee.

The adductors main function is to pull the legs together.

I find the lateral extension difficult to do, however I'm doing it better now than I did six weeks ago.

There are two lateral extensions in the Hip and Knee Clinic booklet. If you are just starting the program I recommend you do those as much as you can prior to surgery.

Wednesday, January 17, 2007

Six Week Check Up

My six-week check-up didn’t start well. My surgeon took expectation to this letter to the editor of the Edmonton Journal.

“ Let's not get carried away with the Hip and Knee Program. The current protocol is myopically focused on systemic, non patient outcomes. Twenty weeks from pre-operation to surgery does not account for 12 weeks of ( post op) patient convalescence. I am four weeks into convalescence. I haven't seen a physiotherapist since I left hospital December 15th. The protocol of the new hip and knee centre should recognize patient outcomes don't end when the hospital door closes behind you.”
I had several issues going into the consultation. It took some time to resolve them.

Five things I learned at my six week consultation.

  • Rehab is a home based patient directed process for 6-8 weeks. (It takes that time for the healing process to take hold)
  • Physiotherapy will not be prescribed during this period.
  • My operative leg is longer, than it used to be, longer than my non operative leg. (This is considered a normal outcome of total hip replacement. It can be mediated with a shoe insert. I over used my non operative leg, in the initial rehab period. My right knee swelled. My right hamstring over stretched. I had more pain than I expected.

  • My operative leg abductor muscles are very weak
  • Physiotherapy starts, January 24th.

I need it

My surgeon and I intend to have lunch to compare notes.

I 'll let you know how we do.

Editorial disclousre, the first draft of this post was written January 17th 2007.It was completed February, 1. The healing process is longer and more painful than anticipated, preempting regular postings. My intention is to create a chronology of this process, by event date, not posting date. Hopefully, it will help future hip replacement patients.

Tuesday, January 09, 2007


Twenty weeks to get a new hip, or knee, is the goal of the new Orthopedic Centre planned for Royal Alexandria Hospital, in Edmonton. The Edmonton Journal has editorially embraced the protocol.

(Note: the link may not be live, as Journal does not 'permalink' its’ stories)

Prematurely, I say! I got my new hip in 12 weeks. That is impressive. I am quite pleased; I got in and out that quickly.

There is a problem. The current program is, myopically, focused, on the front end of the process. Twenty weeks from pre-operation to surgery is fine. Then what? The surgeon is done. The patient is not.

Capital Health, may want to talk to some patients. Patient feedback could prove enlightening. Six hundred orthopedic surgeries, a month, are performed, at the Misericordia and the Royal Alexandria hospitals. That is a massive database of patient experience begging to be tapped!

Hip Flex 24 hours after sugergy

Here is a summary of my post operation experience. Support from the Hip and Knee Clinic is sparse. My two-week post operation appointment was a perfunctory, fifteen-minute, visit to remove stitches. I expected a physiotherapy assessment of my progress, then.

I entered the program active, healthy and determined to shorten the rehab cycle, as much as possible. My pre operation preparation has morphed into a self administered, home based, convalescence, bereft of professional guidance. Program sponsored physiotherapy has been denied. I will launch my own post operation exercise plan, shortly. Watch for it.

Rail Walking 24 Hours after Surgery

Contrary to my current experience, all orthopedic patients need a professionally designed, personally managed, four week, postoperative rehab program. It should include; a progressive exercise plan, physiotherapy, and a dietary advice, recipes even!

Eating the right food, in appropriate portions, provides the energy to heal. I found it hard to eat, for two weeks. It took that long for the operational drugs to depart my system.

There's an important soical interaction component to convalescence. It is acceptable to be shut in, for two weeks. After that, there's a keen desire to 'get out' and socialize. Social interaction is a panacea a key element in the healing process.

The proposed new Hip and Knee Centre could be just the place to facilitate post operation interaction. It could become a 'patient experience ' laboratory. Information gathered could be catalogued and "paid forward". Use patient wisdom to benefit patients. That will only happen when "convalescence" is recognized as a key component of the process. Currently it isn't!

What is your experience? Let's talk.

Thursday, January 04, 2007


This is day 22 of recovery. It is proceeding well. Here's a clip from physiotherapy, 24 hours after surgery. Thanks to therapist Sherry Rioux for helping me through the exercises.