Labrum surgery recovery: The first five days were rough, although I was in better shape than I had expected to be. If you are needing to have this surgery, make sure you have help 24/7 for the first 5-7 days. I needed help with *everything*, especially getting up to go to the bathroom overnight. The following is my account of Week 1 recovery from labrum and FAI hip arthroscopy.
Evening after surgery: I was surprisingly alert coming home from surgery, especially given I had a GA, but then physical fatigue set in within an hour. I started Percocet about four hours after my surgery, and continued to take it every four hours. At the three and a half hour mark, the surgical pain would start to come back and I knew I was almost ready for another. The one downside of Percocet for me was that my mouth very dry, I needed water constantly. I had to get up to use the bathroom a lot with all the water consumption, and all the fluids given during surgery. I tried using crutches but was Very unstable on them. I decided that the walker (with the tennis balls on the bottom) was better initially for getting used to walking on only one leg.
We also figured out pretty quickly that the raised toilet seat with handles I ordered prior to surgery was an absolute necessity and my husband got that installed. The regular toilet seat was just too low. As far as going to the bathroom, I needed help for the first few times, and also discovered that wearing underwear was challenging – one more thing to pull up and down over my dressing – so I ditched that for a few days and made sure to wear loose (but appropriate 😉 pants. I also needed my compression hose right away. I had a few pairs in my closet from when I was pregnant, and they really helped to keep my lower leg swelling under control. Lower leg swelling and bruising is common because of the way that your leg is in traction for surgery – your leg is locked into a ski boot device and the leg is pulled to create more space in the joint for the camera and surgical instruments.
Overnight, I put a 32 oz water cup with a bendy straw on my nightstand with my Percocet and set an alarm on my phone every 4 hours to remind to take my next pill. Keeping on schedule with your pain medication is vital to a quicker recovery – if your body is busy fighting the surgical pain, it can’t use all of it’s resources to heal! The only alarming thing I noticed at night was my surgical gauze under my waterproof “saran wrap” dressing was soaked with bright red watery fluid. After re-reading my discharge paperwork, it made sense that it was the bloody irrigation from the surgery (normal). It was a bit more than expected, but didn’t increase in volume throughout the night.
Post-op day 1: The morning was rough, I had barely any sleep overnight – partly due to the Percocet effects and my alarm going off every four hours, and partly due to getting up at night to use restroom every two hours and my slow maneuvering with walker. I also had to sleep in one position all night, on my back wedged between two pillows to prevent rolling on my side, which was very awkward for me. My voice was also very hoarse the whole day due to intubation during the surgery. I started Mobic, a high-powered NSAID, to help decrease extra bone growth on the areas that were shaved down, and to decrease inflammation in the joint. I also started Colace to help with bowel movements – as I would learn as the days went on, Percocet makes you VERY constipated. Starting the Colace as soon as possible is in your best interest. The hip was very sore, as to be expected, but my Quad muscles kept twitching randomly over the patella and into lower half of the medial (inside), central and lateral (outside) muscle, and the skin just below the three incisions was still somewhat numb. I tried using crutches more during the day and used the walker for steadiness at night. I continued with preventative icing, icing the incision area 15 mins on, 45 mins off with the TheraPearl Back Wrap. I found that pack to be the best as I could ice the incisions and the side of the hip where I had muscle soreness all at the same time. I also found that the non-surgery leg and glute, and bilateral shoulders and triceps were very sore from supporting all of my weight on the walker and crutches!
The biggest surprise of the day was receiving the Op Report, per my request, from my surgeon’s MA. In Post-Op recovery the nurses had stated that surgery went as planned and there were no surprises found, but I discovered that was not entirely the case. The labrum tear was larger than anticipated, and I also had fraying in the posterior labrum. I had the pincer/CAM combo FAI as seen in the MRI, but the biggest surprise was Grade II chondromalacia in the femur head, which was not shown in the MRI. Chondromalacia is a degenerative change in the cartilage that protects the bone, and most likely is a result of having the labrum tear for almost two years and the bone on bone friction allowed between the flaps of the tear. If the labrum tear is not addressed, it can lead to accelerated degeneration in the joint (starting with chondromalacia) which will ultimately lead to needing a hip replacement. I’m very thankful I had the surgery when I did!
That night we went out to dinner (12/23 – me wanting to have some sort of low-stress Holiday dinner out to celebrate my surgery). I sat in my SUV instead of my sedan that I used to come home from the hospital, and definitely had more difficulty getting up into the higher seat than down into a lower one. I had to adjust the tilt of seat to make the surgery hip more comfortable during the ride.
Post-op Day 2: That night I slept all night! I woke up with my pre-set cell phone alarm every four hours for pain meds and also got up to use the bathroom every time, too, to make things more efficient for me and my husband which helped us get more sleep! I still used the walker at night, I felt more stable in the dark. Upon waking in the morning I had moderate pain and spasm in my erector (spinal) muscles in the lumbar spine, most likely due to sleeping in one position at night and my new gait (walking pattern). I applied a warm TheraPearl pack to my lower back to relax the muscles while sitting in my recliner, and that seemed to help quite a bit within 30 minutes. I continued to have intermittent Quad pain and twitching around the knee, but it was less frequent. The gauze and oozing around three incisions was dark red in color indicating old blood, and the numbness in the Quad was less as well. I found I was really utilizing all the single leg balances and single leg RDL exercises from PT prior to surgery – I needed them for strength and stability, and also to pick things up off of the floor. 🙂 There was no change in bowel movement at that point, so I continued with Colace as prescribed. I carried a Nalgene water bottle with looped handle while using the walker. I also took the padded Crutcheze handles from my crutches and moved them to the walker handles. The palms of my hands were getting very sore from all the force on my hands with walking.
I took my first shower since surgery and definitely needed assistance getting in and out. I situated the shower seat under the shower head and made sure my soap, shampoo, conditioner, razor and towel were within reach. My shower did not have a sprayer attachment so I borrowed one of my daughters bowl-shaped bath toys to help rinse. I was lowered into the shower with help from my husband and sat on the shower chair so my surgery leg was stretched out. The waterproof “saran wrap” dressing protected my incision from water very well. Drying my hair was interesting, I ended up doing a single leg balance agains the counter so I would use my brush and dryer at the same time! It was Christmas Eve and I was determined to dress up and look nice despite my circumstances.
Post op Days 3 and 4: Day 3, Merry Christmas! These two days were more of the same from Day 2, but movement started getting easier, partly because I had less swelling in the joint and tissue, and partly because I had some functional processes down to help efficiency and mobility. The twitching migrated to my calf and glutes on my surgery side and less in the Quad. I felt less of a need for pain meds at the four hour mark, but continued every four hours to keep the pain managed. Once again I took a shower on Day 4. Maneuvering in and out of the shower was a little easier, but I still needed my husband’s help. He also had to help me put on my compression hose, underwear and pants because I still could not bend down in forward flexion. Directions from the surgeon indicated strict guidelines to not rotate the hip in the joint and not put the hip info extreme flexion (forward hip hinge) more than 90 degrees to protect the labrum repair and anchored sutures. Icing the hip also continued every few hours.
Post op Day 5: My husband’s birthday. We planned to go out with some friends for his birthday at a favorite brewery. Being I was on Percocet, no beer for me, but I had a good time nonetheless. I even asked one of our friends to be our Designated Driver so my husband could have a few drinks being I couldn’t drive. I managed pretty well in the regular restaurant chairs for about 2 hours, then the last hour I rotated between propping my leg up on another chair and standing with my crutches. At the three hour mark, I had to go home and started icing down my hip and Quad.
Being my pain was lessening, I tried spacing out my pain meds to every six hours versus every four. That wasn’t really the best idea, especially being I sat in a restaurant chair for three hours…! I had more calf twitching and really tried to use my crutches more for efficiency. I made a conscious effort to lay down throughout the day to relax the front of my leg and take the strain off of the psoas muscle. Sitting in a chair and hanging the leg with just toe-pressure weight when moving around really tightens that muscle, and a tight psoas can put pressure on the labrum repair. I followed some of the information I found online and began resting my toe and foot on the ground instead of hanging it which really helped loosen my Quad and psoas. And hallelujah, I had my first bowel movement!!! I followed a friend’s advice and started eating dried apricots on Day 4, and they worked. 🙂
Post op day 6: That morning I took the surgical dressing off. I was scared, but the incisions looked good. The larger incision was a little red but my surgeon stated that redness can happen for a bit when you take the surgery dressing off. He instructed me to watch for the redness to spread over the course of a few hours, and to call if there was a significant change in redness color or location, or red spider-looking streaks starting down my Quad. I was also instructed to watch for fluid that oozed a green/yellow color, which may also be a sign of infection. As instructed, I replaced dressing with a few breathable, sterile band-aids over the incisions. Later in the morning I took shower *without assistance*! I replaced the breathable band aids with waterproof ones for the shower as instructed. After the shower I pat-dried the incision with a clean tissue and re-applied the breathable band-aids. I also went back to taking Percocet every five hours instead of the six I had tried which helped me feel more comfortable.
I also had my first post-surgery PT appointment that day! In his evaluation, my physical therapist Eric Christensen, DPT with Chandler Physical Therapy, checked my hip range of motion (ROM), incisions, and swelling of my leg. He guided me through some isometric contractions of the glute and leg muscles to improve muscle tone in surgery leg being those muscles were not being used. He applied Kinsesio-tape to my lateral and anterior thigh and he scraped the fascia in my posterior leg with a metal tool (the Graston technique) to help with muscle function and decrease swelling. I finished my session with stim and ice on my hip and he taught me how to walk on my crutches properly for efficiency of movement and correct posture. That was the biggest help once I got home. It took me a while to get coordinated with my new movement on my crutches, but I no longer felt the crutches digging into my armpits and actually used my arm muscles to push down on the crutches for movement. This also really helped to keep my posture upright and helped to keep my pelvis in alignment.
Stay Tuned for Week 2 Recovery notes! I hope you are enjoying this and learning about the process of labrum arthroscopy recovery!