[night owl]

Ok girls/guys,

When is it time for a total hip replacement?

a) When it gets harder to make it move?

b) When it takes longer to get it to move?

c) When the pain level is about #8?

d) When I can't straighten up from a sitting position?

e) When the spackle knives come out to scrape me out of the chair or my car?

f) all of the above?

g) None of the above?

h) some of the above?

Well, my left hip is a pain in my hip!!! and it seems to be getting worse every day. I know that in 5-10 years I'll need a new one, but why wait that long? I'd rather have it done earlier so I can heal faster and I would rather have it done now rather than waiting until I'm say 50 and up. I take Motrin 600mg bid and that seems to be ok for now, but how much Motrin is too much? I mean I don't want to bleed to death before I get my new hip...not that I'm having any GI symptoms which I'm not. So how old was your youngest pt. with a THR?

[kewlnurse]

It's a quality of life issue, pain and lack of mobility are the 2 main reasons to get it done. Get off the motrin and try celebrex or that other new one who's name has escaped me right now. I had a 26 yo male get both hips done d/t avascular necrosis. had a female in her late 20's d/t mva destroying her hip.40's and 50's are becoming more frequent. The proble with doing them in youngsters such as yourself is that you will need to get it redone in 10-15 years. Go see a ortho surgeon and see what he has to say (sorry 99% are men) you might be able to get by with a scoping to clean up the labrum, if not, and you do need a replacement seek out a md that will do a non cemented joint as your bone will grow into it and will increase the length of time you can go with out it being redone. they don't wear out per se, but the cement loosens up. The disadvantage to a non cememnted is your recovery time, you'll be tt or nwb for about 6-8 weeks , although right befor i left ortho we had a surgeon who was doing fwb pod 1 with non cemented.

[P_RN]

Even with the new stuff out there, 50 is still kind of young on an average. I have had patients as young as 11 ( rheumatoid arthritis) though who got THAs. Our oldest was 101.

There are some new metal on metal hips out there. I see you are in Pa. If you want to come to SC I will point you to one of the BEST in the whole country ! The press-fit (no glue) are the way for the younger patient to go. The cement will actually eventually rub the bone away from the prosthesis and cause loosening.

Seriously though, has any one *told you* that you have AVN or OA? Has anyone recommended a hip replacement?
Have you had any films or MRIs? Bursitis, disks, tenedenitis, abnormal gait can ALL mimic a trashed hip. Believe it our not hip pain is sometimes really back and sometimes enteral. I have 2 herniated disks and they really give my hips he**.

The Cox2 inhibiting drugs Celebrex and Vioxx and that other one I can't recall are easier on the tummy. They don't have the "pseudo protection" from DVT though, so some docs are having their patients add 1 baby ASA a day. BUT ask the DOC though. Some Cox2 patients have even developed DVT and PE while on these drugs.

Myself, Motrin 800 TID works wonderfully.....I think 3200/day is still the max dose. My tummy is fine and so in my drug budget....90 of them comes to $6. Vioxx is 15x that!

The precautions are pretty much the same for the non cemented hips as kewlnurse mentioned, although we had one surgeon who wouldn't let ANY patient give up the walker and the abduction pillow for 3 MONTHS.

Read up in the AAOS web site and the Wheeless Ortho site. I think THAs and TKAs are fascinating. But I can see how some others wouldn't. I used to say let the doc operate and then LEAVE us nurses alone! Could do a post op without ANY written orders, but......never got the opportunity

I have no financial interest in either of these sites but they have some neat pictures and pretty easy descriptions.

PS if you want the name of the surgeon here send me a message


http://www.vh.org/Patients/IHB/Ortho...ipReplace.html

http://www.vh.org/Patients/IHB/Ortho...ipReplace.html

[night owl]

Thank you so much for all of the very helpful information!

I also heard on the news this morning that they have this proceedure called viscous supplementation where they inject some kind of fluid into the joint. Worked wonders for some people. Anyways, I'll just go to this ortho doc who worked wonders with my elbow when I shattered it falling down three cement steps and onto the side walk in '96. Thanks again Kewl and P_RN.

Michele


101 for a THR? Holy cow! I wonder how he/she made out? That's incredible!

[lucieRN.]

I don't know where that 3200 mg amount is coming from (sorry, can't remember the name of the person who posted that). I read an article about 6 mos ago in nursing school that stated ibuprofen may be more harmful to the liver than previously thought. The total daily dose (not to exceed) was 2400 mg. Hope its not true! Because apparently i find myself taking hanfulls of the stuff the morning after a hard shift.

LucieRN

[P_RN]

I've been taking it since it hit the market almost. I am one of the FEW the PROUD the folks that it doesn't bother.
*****

Ibuprofen
Recommended Dosage: Analgesic effect 200 mg to 400 mg t.i.d. to q.i.d.; anti-inflammatory effect 400 mg to 800 mg t.i.d. to q.i.d.
Maximum Daily Dose: 3,200 mg
Common Adverse Effects: Agranulocytosis and aplastic anemia

http://www.springnet.com/ce/j107bs05.htm

*****

DOSAGE AND ADMINISTRATION

Tablets

Do not exceed 3200 mg total daily dose. If gastrointestinal complaints occur, administer ibuprofen tablets with meals or milk.

http://www.rxlist.com/cgi/generic/ibup_ids.htm