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Hip Replacement
Old 12-22-2012, 12:19 AM   #1
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Hip Replacement

Hi,

i think I have mentioned before that I am getting osteo-arthritis in one hip. Doc calls it mild to moderate, from his physical exam and x-rays in certain positions. The Doc is an expert, he's a Doc to professional sports teams locally. He has not mentioned surgery, but I have also not talked to him about wanting to increase certain activities, since it is only lately that I have been really missing these things. A doctor I know socially says don't have surgery that you don't absolutely need. Just too many poor to awful results.

Starting early last fall it became painful to walk a long way, and I walk a lot since I have not replaced my car which was destroyed last fall. I was also in a wreck about 7 years ago which may be related.

I can row my C2 all I want, with no issues. I can dance Arg. tango, with giving some attention to avoiding certain moves. I have a woman friend who dances tango very well, even though she has hip osteo bad enough that she cannot walk across the parking lot to her car. She does not want to get a repair, even though she is a PT and works with orthopods.

I don't notice any issues doing house work, running the trash downstairs, etc, but for a walk over 1.5-2 miles, I want to have my collapsible cane in my backback. Maybe I won't need it, but walking with it avoids pain when I am getting some pain without it. It especially helps when I am carrying a load like groceries in my backpack.

I am hoping to get information from people who have had this surgery, and who are athletically active, to try to find out just what it should do for me, if it works out alright. At the present time my main goal would be to return to fast swing dancing, as I am missing my friends from that activity. It doesn't put quite as much load on the planted leg as singles tennis does, but it is similar in the cutting and direction changes as I am sure many of your older members will remember from junior high and high school. The the other thing I would like to do again is fish off jetties out on the Coast, so I would need to feel confident scrambling around on the rocks

I won't take the risk of being made worse unless I am very likely to get this kind of gain from a good result, because I am doing fine day to day, including my exercise program. I rarely even take an ibuprofen, so I don't need this for current pain relief from my present activities. Also, if anyone knows non-surgical ways to get back more function, please share.

I'll be happy to get any comments, including just opinions.

Ha
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Old 12-22-2012, 04:50 AM   #2
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Surgical Errors Occur More Than 4,000 Times A Year In The U.S.

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Events that should never occur in surgery ("never events") happen at least 4,000 times a year in the U.S. according to research from Johns Hopkins University.
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Marty Makary, M.D., M.P.H., an associate professor of surgery at the Johns Hopkins University School of Medicine, said:
"There are mistakes in health care that are not preventable. Infection rates will likely never get down to zero even if everyone does everything right, for example. But the events we've estimated are totally preventable. This study highlights that we are nowhere near where we should be and there's a lot of work to be done."
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Old 12-22-2012, 06:17 AM   #3
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Originally Posted by haha View Post
my main goal would be to return to fast swing dancing
...
the other thing I would like to do again is fish off jetties out on the Coast, so I would need to feel confident scrambling around on the rocks
Just an opinion -- you may be asking a bit too much.

A good friend had a hip replacement done a few years ago at the age of 70. He had been in good condition all his life (military), but his arthritis got to the point where he needed it.

These days, he walks 2 or 3 miles every day, mainly to keep his weight under control, and has no problem with that or with stairs, but he feels quite nervous about anything at the level you're talking about, and would avoid those kinds of situations.
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Old 12-22-2012, 06:44 AM   #4
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My dad is very active and had both hips replaced in his early 60s. Before surgery, the pain in his hips was terrible and had reduced his activity level considerably. Even walking a few miles was painful. Now he is back snow shoeing, mountain biking, hiking, and working around the farm. Still, he has to be very careful as some movements could cause his hip joint to pop out. So some activities remain off limits.
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Old 12-22-2012, 07:04 AM   #5
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Lots of friends and relatives have had successful hip surgery and are happy with it. I don't know any that had poor results although, as you say - they happen. One thing to consider is general age impact on activities. Your balance will get worse with time and things like scrambling around on jetties could be counter productive - e.g. you might needlessly break your good hip. I am also curious about whether many of your fast swing friends will keep swinging fast when they hit their 70s+ - just worth thinking about whether this is an really an activity you will pursue long term with the new hip. Walking will always be a good exercise so, if your doc says that will get progressively worse, that would add weight to the replacement surgery side of the equation. And, once you get to the point that it seems worthwhile for walking even a few years of fast swing (if the docs say that is possible) may tip the balance.
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Old 12-22-2012, 09:49 AM   #6
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I would probably say the vast majority benefit from this surgery. Perhaps the hesitancy for surgery from your doctor friend comes from the occasional cautionary tale like my fathers experience. My father after dealing with considerable pain in the hip and coming off two successful knee replacements had the surgery. Two years later we are still dealing with trips to the doctor. Something went wrong in there, and he has had to have a new surgeon and 2 additional follow up surgeries. He said if he had to do it all over again he wouldn't have done it. Before surgery he walked in pain, but without aid. Now he has to use a cane. The doctor provided hope that it could still get stronger and improve, but it hasn't shown yet. At age 76, I don't know if improvement is really possible.
I would certainly offer no one a recommendation, but as I approach 50, I have already begun to curtail some activities (no more competitive tennis or jogging). I will continue to curtail when needed to avoid surgery. I am sure,however, there will eventually be a "no mas" point where I would finally succumb to surgery, but I am nowhere there yet.
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Old 12-22-2012, 09:54 AM   #7
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Quote:
Originally Posted by haha View Post
Hi,

The Doc is an expert, he's a Doc to professional sports teams locally.
<snip>
I'll be happy to get any comments, including just opinions.

Ha
How many hip replacements does the team members of the professional sports team have? How many of them has this doc performed?

Just saying...

My experience is that if you have something that requires some sort of specialization, that you go to the best...Experience and Volume matter...BIG TIME. You want a hip-replacement surgeon that is a Meticulous Technician.

Just did a google for top hip-replacement hospitals and found a NYT article that supports my experience...

http://www.nytimes.com/2010/07/03/he...vfEaGFSfgS1x6g

and looked for surgery success factors and found the Journal of Bone and Joint Surgery agrees:

Association between hospital and surgeo... [J Bone Joint Surg Am. 2004] - PubMed - NCBI

Ha, I wish you the best...FIND the best.

BTW, mine started hurting earlier this year and I fear one is coming in my future.
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Old 12-22-2012, 09:58 AM   #8
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Just had a total replacement to my left hip on Dec. 4th at age 71. Came home from the hospital on the day after the operation. Had the minimally invasive procedure which resulted in a cut of about 9 inches, plus a few punctures where they added pins and braces to stabilize the bones during the operation. Was in and out of surgery in around 90 minutes and walking that afternoon.

Walked with a cane for the first week. Now after a little over two weeks most of the pain gone. Occasionally take aspirin or aleve as needed. Discarded prescribed pain pills after a week and half. Religiously do the exercises recommended by therapy. Have a little swelling and stiffness yet, however much better than before surgery. I was on 4-6 aleve a day just to maintain daily functions.

This is the second surgery. Had the right hip replaced about two years ago. That also went wonderfully. Out of hospital the second day etc. Having absolutely no problems with it. One big however, the right hip has been recalled by Stryker due to metal flaking and possible metal contamination in the blood stream. Now on a monitor regime of MRI and blood test every 6 months. So far no problems, but nearly 60% of the "installations" are requiring replacement.

Would I do it again? Positively! I hope to be back playing racquet-ball in a few months.

Tom
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Old 12-22-2012, 09:59 AM   #9
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These are very valuable comments. Thanks.

I can always find partners to dance. Men who have good rhythm and are pleasant and are not trying to cop a feel are not that easy to find, so younger women, even 20 year olds are happy to dance with you. After all, it's not a hookup.

It may be that I can do some things better now than I could after a replacement, even one which worked very well. For example, I can put 30# on my back and walk quite a distance, certainly 5 miles, with using my cane. And just 6 months ago I could do it without a cane. It hurt a little, but I am not real sensitive to pain anyway. And I can do squats without huge weights, though I have shifted to alternatives that would not place me under a barbell if I failed. Stairs no problem, as stairs usually have a railing, and some of the weight can be shifted off the impaired hip by using the rail, the same way that one would use a cane.

I think I would only want to do it if I can get these activities I mention back. At least the dancing. Jetty fishing is demanding, and I really do not want to fall or get washed into the North Pacific.

I have read that there is a about a 10% rate of one or another poor result. Perhaps temporary, like infection, perhaps some continuing pain. It is hard to get straight talk about it. I also found a piece by Nortin Hadler, MD, which states that hips tend to be the most successful joint replacements- better results than knees or shoulders. Dr. Hadler is an academic and rheumatologists, and no cheerleader for either medical or surgical therapies. I know that I watch old Simon Templar episodes on late evening TV, and one of the major sponsors is some lawyer trolling for hip replacement complaints. That, and various ways to chemically or mechanically help get it up.

Ha
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Old 12-22-2012, 10:05 AM   #10
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Originally Posted by tjwolf View Post
Just had a total replacement to my left hip on Dec. 4th at age 71. Came home from the hospital on the day after the operation. Had the minimally invasive procedure which resulted in a cut of about 9 inches, plus a few punctures where they added pins and braces to stabilize the bones during the operation. Was in and out of surgery in around 90 minutes and walking that afternoon.

Walked with a cane for the first week. Now after a little over two weeks most of the pain gone. Occasionally take aspirin or aleve as needed. Discarded prescribed pain pills after a week and half. Religiously do the exercises recommended by therapy. Have a little swelling and stiffness yet, however much better than before surgery. I was on 4-6 aleve a day just to maintain daily functions.

This is the second surgery. Had the right hip replaced about two years ago. That also went wonderfully. Out of hospital the second day etc. Having absolutely no problems with it. One big however, the right hip has been recalled by Stryker due to metal flaking and possible metal contamination in the blood stream. Now on a monitor regime of MRI and blood test every 6 months. So far no problems, but nearly 60% of the "installations" are requiring replacement.

Would I do it again? Positively! I hope to be back playing racquet-ball in a few months.

Tom
Wow. If you can play raquet ball, you are certainly doing very well. I am also your age.

Thanks

Ha
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Old 12-22-2012, 10:06 AM   #11
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Originally Posted by REattempt View Post
How many hip replacements does the team members of the professional sports team have? How many of them has this doc performed?

Just saying...

My experience is that if you have something that requires some sort of specialization, that you go to the best...Experience and Volume matter...BIG TIME. You want a hip-replacement surgeon that is a Meticulous Technician.

Just did a google for top hip-replacement hospitals and found a NYT article that supports my experience...

http://www.nytimes.com/2010/07/03/he...vfEaGFSfgS1x6g

and looked for surgery success factors and found the Journal of Bone and Joint Surgery agrees:

Association between hospital and surgeo... [J Bone Joint Surg Am. 2004] - PubMed - NCBI

Ha, I wish you the best...FIND the best.

BTW, mine started hurting earlier this year and I fear one is coming in my future.
I get what you are saying, He does not do these surgeries, but refers.

Ha
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Old 12-22-2012, 10:12 AM   #12
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If it's one thing I've learned over the years, it's to not give advice... especially on matters of health. The bad part is, learning, does not mean doing, so also know that this is an easy way to get into trouble.

That said, sharing personal experience is a sneaky way of being able to offer opinions.

Arthritis is a strange bedfellow... and not always an either-or thing, especially at a younger (read that under 65 age). One day the pain, another time, none. Early on, I worried about debilitating effects, and considered how to deal with the onset. That was 15 years ago. Now, not so much. The walking was the worst. Seeing people 10 years older than me, walking a few miles a day, worried me, since I would start hurting after a half mile (hips). On the other hand, biking was and still is no problem. No aches at all, even after two or three hours.

Always, the fear was there... "Is it going to get worse?" In my case, no. Oh yes... arthritis... hands, and hips, and enough to take naproxen... but it's been matter of adapting, and keeping a perspective. I no longer think about this, except as an old folks ailment.

Many friends are not so lucky... living in nearly constant pain that colors their outlook on life. One has had a knee replaced three times. Others ambulate only with a walker, or a chair. Others have been freed of pain, and have gone on to live a much better life.

I can't recall anyone who has had arthritis, who was substantially helped by an exercise regimen, though many have tired, and still do this. We never know if it is a deterrent to further decline, but as a cure? Not that I can recall.

This is just a ramble... I have no answers. Most of us are faced with decisions like this... not necessarily operations, but life altering changes. My own recent decision was what to do in the case of advancing non-diabetic peripheral neuropathy... found after a failed carpal tunnel operation. After hours of research, and a visit to the neurologist... even though he was ready to prescribe extended therapy, I made the decision to live with it... balancing the risk/reward question.

In short... I believe you are doing the best thing... going for the best answer, and making a decision after doing due diligence. I wish you well.
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Old 12-22-2012, 10:19 AM   #13
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I had a right total hip replacement done in 2003 when I was 52 yrs old. Because I was so young I waited until the osteoarthritis became so painful that I was unable to walk much at all and was using an electric wheelchair at work and home.

I researched extensively what type of implant I wanted, and the surgical approach I believed would be best, and the surgeon with the best outcomes I could find. Nine years later, I am very happy. I have had zero issues with the hip, and zero pain. The hip has always seemed rock solid. I am hopeful it will remain so for many years.

The TOTALLY HIP website helped me to prepare for the surgery and answer questions post-op. Welcome

My opinion is.....you will know when you're ready because the pain has created barriers you're unwilling to live with.
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Old 12-22-2012, 10:43 AM   #14
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...(snip)...
Starting early last fall it became painful to walk a long way, and I walk a lot since I have not replaced my car which was destroyed last fall.
...

I don't notice any issues doing house work, running the trash downstairs, etc, but for a walk over 1.5-2 miles, I want to have my collapsible cane in my backback. Maybe I won't need it, but walking with it avoids pain when I am getting some pain without it. It especially helps when I am carrying a load like groceries in my backpack.

I am hoping to get information from people who have had this surgery, and who are athletically active, to try to find out just what it should do for me, if it works out alright. ...
Have you checked your shoes out thoroughly? Are you getting the right support during walking?

I'm not sure it's such a good idea to walk with a large load like groceries or have a loaded down backpack. How many pounds are you carrying? Could this be eliminated in some way -- like take a taxi after shopping or have the stuff delivered? A bit more costly but then again you are not paying for car maintenance. Or maybe use one of those carts to haul the groceries -- doesn't look so "cool" perhaps but maybe there are some snazzy ones out there like the wheeled luggage many use nowadays.

Does walking on a softer surface (park setting maybe) give the same discomfort as a harder asphalt or concrete surface?

Has the sports doc approved of each of these exercise activities or does he see some risk in things like carrying large loads long distances? Sometimes the details matter.

I find that I have to ease up nowadays in cold weather and be careful to warm up more gradually.
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Old 12-22-2012, 10:47 AM   #15
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Fellow runner/friend of mine had a hip and opposite knee replacements earlier this year done on the same day. He is early 70's and has been running since the 60's, he has well over 100,000 miles in the books. The last few years his knee was really bothering him and compensating for the knee probably didn't help the hip. He finally decided to go to a specialist this year that he found on the internet , but it turns out this specialist in Philly, close to his daughters where they stayed for part of recuperation(he is from here in the mtns of WV) was ranked as one of the top ortho's in the country and was a runner also. That was a long sentence but anyway he is back running about 40-50 minutes a day, albeit a little slower and for the most part pain free. He did say that he under estimated the pain after the surgery but would do it over if he had to. This Doctor told him that the years of running weren't the cause of his knee and hip problems, which surprised me but makes me feel better about my running.
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Old 12-22-2012, 04:01 PM   #16
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DW had both hips totally replaced at the same time one year ago. My major piece of advice is to find a surgeon who uses the anterior approach. This does not involve cutting through any major muscles as the posterior (older) approach does. The result is that the recovery is much easier with minimal or no restrictions on movements during the recovery period. DW says she often forgets that she has artificial joints.

Her surgery was done at the Anderson Clinic at Mount Vernon (Virginia) hospital.
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Old 12-22-2012, 04:18 PM   #17
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Just to provide a post with an opposing point of view, I wouldn't do it if I were in your situation. You are mobile and can do most of the things that you want to do in life. And, surgery never has a guaranteed outcome. There is always a risk; you could end up worse off, or you could even have a reaction to the anesthesia and die! And, for what. Nope, not worth risking death, to me.

If I was 71 I'd rather be focusing on what I *can* do, not what I *can't* do.
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Old 12-22-2012, 04:41 PM   #18
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Ha, Hip surgery is indeed the most sucessful joint replacement but I would advise not having it until it is really necessary . Like W2R said there are risks to any surgery and unless you are in extreme pain I would also advise waiting .
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Old 12-22-2012, 05:21 PM   #19
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Ha,

My mother had hip replacement surgery about 5 years ago. She waited until the pain was unbearable. Mom's not one to complain so we knew it was pretty bad at that point.

Her surgery went well and she recovered quickly. I was still working then and arranged 6 weeks off using my sick and annual leave to care for her. She was good on her own in just about two weeks. I'm pretty sure you're much stronger, younger and more active than her so would think you'd have an even better chance for a quick recovery and good outcome.

Good thoughts coming your way from Virginia.
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Old 12-22-2012, 05:32 PM   #20
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Ha,

Another argument for waiting....some of the major issues with replacement hips is the issue of materials (the mating surfaces wearing out, the implant not becoming 'one with' your existing bones, etc.)

As new nano-materials and techniques are constantly being explored, by waiting you would be able to take advantage of the latest and greatest in material developments. Here's a recent article (and there are likely many others)
Toward a better material for hip replacement and other joint implants

It's my understanding that all replacement hips will need to be replaced in due time, so that's another reason for waiting a while longer....as that would mean fewer (or perhaps even no) replacements needed over the course of your life.

omni
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