This picture makes me laugh so much!
It was taken prior to any of my surgeries. I was at my mom’s house getting my hair done and while waiting for the foils I laid down to play with our dog. (I promise she was there and this wasn’t some strange photo shot!) My boyfriend took the picture (without warning) and sent it to me as we often joke that I was like a golden retriever (as this was the easiest way to describe my situation to people).
What is hip dysplasia?
So if you’ve never had a golden retriever, or a friend who’s had one, the simplest way to put it is that hip dysplasia is when the hip joint is under developed. Or as Google puts it:
What is hip dysplasia in humans? – The hip is a “ball-and-socket” joint. In a normal hip, the ball at the upper end of the thighbone (femur) fits firmly into the socket, which is part of the large pelvis bone. In babies and children with developmental dysplasia (dislocation) of the hip (DDH), the hip joint has not formed normally.
And so I grew up with ‘not formed normally’ hip joints.
Hip dysplasia is usually only found in one hip and can be fixed when your an infant. They put you in a cast for a while to ensure that the hip joint grows and forms properly and then you move on in life. If it’s not fixed, it increases the chance of hip dislocation, along with early wear and tear, as the joint is not fully developed and able to secure the head of the femur to keep it safe and functional.
Symptoms for Adults – hip pain (in the deep front of my hip/groin) and a limp (which I use to call swagger).
Hip dysplasia is normally only found in one hip. Mine was in both.
This is likely why it was missed at birth because while they checked me (like every baby) both hips would have felt the same, not raising any flags.
I know a little more about this hip, as it’s the only one that has had an MRI.
There is nothing left in it and I can’t make it any worse (not that I wanted to try). The labrum (cartilage that helps the joint move smoothly) is gone or at least fully torn , there is bone on bone and a whole bunch of fun things going on in there that was causing me a lot of pain and mobility problems. FUN!
There is a chip off the top of the joint, just floating in there, chilling. Who knows for how long. The inside of the joint is likely the same or perhaps even worse then the right but I’ll never truly know as OHIP won’t see a reason to get an MRI since it’s being replaced anyways (which makes sense).
I use my hands to help explain what is going on in my hips to other people, as I find that visuals are usually the most effective (at least for me):
This is a normal hip:
This is a hip with dysplasia (there isn’t actually a build up of bone at the top, I just can’t cut off my fingers):
And this is my hip (as my hip bone has worked its way upwards a bit from it’s original positioning with the dysplasia):
What it means for surgery
A hip replacement surgery is usually 1-1.5 hours.
My surgery is about 3 hours a hip. Due to the severity of dysplasia in the joint, along with years of wear and tear, I require a bone graft. This is done for two reasons:
- There is enough bone to put a shiny new ball and socket into, and;
- There is enough bone to work with in the future for when they have to do it all over again! (Likely more then once… although I’m hoping medical technology gets to the point where they just give me a needle with micro-somethings in it and the joint will re-build itself within a couple of minutes.)
Bone Grafts – there are a few different ways this can be done:
- Your own bone – they take this from the head of the femur to re-build the joint, since they cut that part off anyways.
- Allograft (donour bone) – they use a piece of someone else’s bone from a donour bank.
- Trabecular Metal – it’s a material made out of tantalum, element. number 73 in the periodic table (for all the science buffs out there). Simply put, it allows your bone to grow in and around it to take it over as your own. It’s a great cool material actually.
I was able to use my own bone (the head of my femur) for my graft. However, they weren’t sure they could do this going into surgery so they also had an allograft available for use as well.
They had to make a larger incision then I anticipated. Instead of the incision being about 5-6 inches long, which they told me before surgery it would likely be , it’s was 7 1/4 inches long. But I’m fine with that, scars are cool. They had to do this because the muscles around my hip were stronger then anticipated (or that they normally deal with) and the joint was in worse shape then anticipated so they needed more room to work.
What it means for recovery
Since I have a bone graft along with a new hip joint my recovery takes a bit longer. I have to be on crutches for 6 weeks with 50% weight baring to allow the bone graft to heal (just like a broken bone).
I still start rehab like any one else but my precautions last about 6 weeks longer as I have to wait for the bone to heal. So while some (obviously depending on their situation) may be off precautions in 6 weeks, mine lasts for 12 (which means no driving for 3 months!).
What are precautions?
Precautions are all the things that you can’t do while your hip is healing. Mine included some of the following:
- Avoid hip flexion greater than 90 degrees (a right angle), no bending, sitting or pulling up on the leg
- No crossing of the legs
- No twisting of the leg
- No lateral movement (had to do a lot of movement of my butt to move from the bed or a sitting position)
- No laying on your side (either one for a while so it could cause the hip to roll to one side of another)
- No more then 50% weight barring (due to the bone graft)
…and all the related activities.