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Old 08-20-11, 04:52 PM   #1
Sculptor7
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What's Up with Hip Replacements?

Lately everybody I meet (gross exaggeration) has had a hip replacement. Also on this forum I see threads concerning same. Is it some kind of fad or what. Thing is all these people are younger than me. Could it be from running? The strain on the joints, etc.
Don't get it. But then I did not get back pain either until two years ago when I badly strained my own. Guess I should just consider myself lucky and hope that my good luck continues.
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Old 08-20-11, 04:59 PM   #2
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I would guess that most of the hip replacements would be secondary to arthritis. My wife's hip replacements were due to a birth defect on one of her hips.
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Old 08-20-11, 05:37 PM   #3
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Yes, it's a fad.
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Old 08-20-11, 06:58 PM   #4
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I"m torn between appreciating all these guinea pigs who are helping the surgeons perfect their art before I need any joint replacements and worrying that they are driving Medicare to the brink of major negative changes.
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Old 08-20-11, 07:00 PM   #5
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maybe they are just a FL wannabe
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Old 08-20-11, 07:23 PM   #6
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I had a hip replacement two years ago. I was 51. I am not on Medicare. I had insurance, and paid for the several thousand that the insurance did not pay. It was extremely painful and took, to date, two years to rehab. I still have a limp. I am extremely happy that the surgeon and the hip were both available to me, and that I am now pain free. The indication for total joint replacement is end-stage arthritis, or destruction of the joint. Surgeons can't just do operations because they feel like it. There are specific criteria that have to be met if the surgeon or the hospital expect to be paid for their work. I had congenitally mis-shapen hip joints, and over time, that caused the joint to be destroyed by arthritis. I have arthritis in the other hip, in my hands.
The reason there are more hip replacements now than there were decades ago is that there are better hips available, people are not satisfied to be wheelchair bound starting in their 40s or 50s, and people are not willing to be in constant pain or on narcotics for decades. Before the last couple of decades, total hips lasted about 10 years, and then had to be re-replaced, so few people wanted to go through the pain and rehab, knowing they were going to have to do it again in ten years. Also, I think before the baby-boomers started to age, people thought that it was perfectly reasonable to be on a cane or in a wheelchair or on 24x7 narcotics for the last 20-30 years of their life,and give up sports or what we might consider to be run of the mill recreational activities. No more. The newer hips last for 20+ years. I have a hip that has been in use in Europe for almost 30 years, and shows NO wear, so I am counting on it lasting me for another 40-50 years. One reason you see a lot of hip replacement patients on a bike forum is that artificial hips, in general are not durable enough for running or some other hard impact sports, so a lot of post-hip replacement folks have taken up or returned to bicycling. So, yeah; it's a fad. ;-)

Last edited by Wreader; 08-20-11 at 07:33 PM. Reason: noun/verb disagreement
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Old 08-21-11, 07:14 AM   #7
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I think before the baby-boomers started to age, people thought that it was perfectly reasonable to be on a cane or in a wheelchair or on 24x7 narcotics for the last 20-30 years of their life,and give up sports or what we might consider to be run of the mill recreational activities.
I think you capture an essential truth Wreader. Our expectations have changed. What our grandparents likely saw as simply something to be accepted we today cry out for something to be done.

Is that good? Bad? Probably a mix.

Certainly it is good for a human being to be able to enjoy an active life for all the years available to them.

Certainly it is not good when the cost to society exceed its ability to pay, and that thus actual payment is differed to future generations who will have their own expenses to deal with.

I recently had shoulder surgery. It, along with 3 months away from my work responsibilities, was paid for by workers comp. The accident happened on the job. What was that "accident?"

A co-worker had left a large window open over the weekend. He had jammed something in to hold it open. I, coming in early and being able to see my breath (this was this past November), went to lower the window which unbeknown to me had a broken sash weight. Down it came. I tried to stop it. Badly damaged my rotator cuff in the process.

I'm 64. Would that have happened to a younger worker? I doubt it. So the cost to the institution for having me, an older worker, doing something that, well, happens from time to time, was huge.

I'm glad I had the surgery. I'm glad the institution picked up the bill because I most certainly could not have. But still I question how society will be able to care for all us older people who aren't willing to just say "Yes, I'm getting old" and accept what past generation saw as a natural part of that process.

-don
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Old 08-21-11, 09:37 AM   #8
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I injured my right hip in the service when I was 21. It slowly deteriorated over the years probably from bone spurs that the wonderful retired contract doctor failed to diagnose back then. It got so bad that in my late 30's I had to give up biking because of the pain and lost range of motion. I wish the doctor would have let me have hip surgery when I was in my 40's but they wanted to wait until it was totally gone so last year I had it replaced at 52. I did find some things that helped ease the pain like laying off of dairy, drinking cherry juice and other natural anti inflammatory foods but that last xray showed no cartilage left and the socket was oblong and the ball end was worn flat on one side. I have health insurance but still ended up paying about 4K which was money well spent in my book...
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Old 08-21-11, 10:58 AM   #9
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I have OA rather badly. Left knee was bone-on-bone for multiple years prior to replacement 11-09. Right hip went from stage 2, to stage four inside 14 months due to my OA, so it was replaced 06-06-11. I am still in Pain MGNT. I still limp. I still get sore and have minor swelling after every ride. It hurts less now than it did prior to the surgery.

OA sux~!
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Old 08-21-11, 11:02 AM   #10
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I injured my right hip in the service when I was 21. I have health insurance but still ended up paying about 4K which was money well spent in my book...
If there is one group that should be assured all the care they need it is those injured in the service. When I hear stories of 2nd rate care to such an one as you it makes me blood boil.

Best wishes along with deep thanks.

-don
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Old 08-21-11, 11:29 AM   #11
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Jumping on the Hip Replacement Bandwagon!

Having just jumped on the bandwagon on Wednesday, 8/17, with a total hip replacement, i must say that jumping on the smartphone or iPad or even the Justin Bieber bandwagons would have been a heck of a lot easier and less painful.

But here's what i'm hoping this fad will do for me: at age 63 and with a history of osteoarthritis in other joints and a total knee replacement in the offing, i would like to continue to work, to travel with my husband more and to remain physically active well into my dotage and that includes thousands of miles a year on a bicycle. None of this has been possible for the past year; nor has a good night's sleep, nor being pain free for even a day. Bicycling used to provide relief and a break from the pain, but this summer it only exacerbated it. i can't wait to get back on the boring old trainer in the basement!

Four days post-op and i am already walking short distances without any assistance from the cane, and NSAIDs rather than narcotics are helping with pain management (encouraging!). i say this only to offer reassurance to those who may be thinking about THR; we live in an age of incredible medical technology and skilled surgeons, and to NOT avail ourselves of them seems a bit like donning a hair shirt.

There's a big difference between H-ingTFU and needless suffering.
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Old 08-21-11, 11:43 AM   #12
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Compared to TKRs, it seems that THRs create a wide range of rehab time. It took me 7 weeks to go from a walker to a cane (I was riding before then), and right now today, it's still 50/50 on whether I go up stairs one at a time or not.

That said, I've read of folks like yourself, and others that took like six months...
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Old 08-21-11, 12:30 PM   #13
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Yes, it's a fad.
"The indication for total joint replacement is end-stage arthritis, or destruction of the joint. Surgeons can't just do operations because they feel like it. There are specific criteria that have to be met if the surgeon or the hospital expect to be paid for their work. "

Fad huh? Yeah sure..........

What planet are you on?

I suppose my dual TKR was a fad choice????
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Old 08-21-11, 12:52 PM   #14
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Yes, it's a fad.


As one in line for a new hip (when it finally goes from occasional flareups to insufferable pain) I have only one thing to say:

Call us Hipsters. That'll confuse the fixie crowd.
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Old 08-21-11, 01:22 PM   #15
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Compared to TKRs, it seems that THRs create a wide range of rehab time. It took me 7 weeks to go from a walker to a cane (I was riding before then), and right now today, it's still 50/50 on whether I go up stairs one at a time or not.

That said, I've read of folks like yourself, and others that took like six months...
I feel very fortunate when I hear stories like that.. I only stayed in the hospital 2 nights, was back to work in under 2 weeks and not using crutches or cane after 3 weeks or so. I did work out like hell for a month and 1/2 before surgery even doing some running that hurt like hell but figured I couldn't hurt any more...
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Old 08-21-11, 05:36 PM   #16
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I think some of the variability in rehab has to do with how much joint destruction there was before surgery, how invasive the surgery was, what your pain tolerance is, and what your baseline level of strength or fitness was pre-op. If you had pretty good muscle and range of motion, but pain in the joint, just replacing the joint might be a relatively simple matter, and the rehab might be pretty quick. If you have lost a lot of motion, and/or lost a lot of muscle mass. If you need to have more or less bone taken to accomplish the replacement, etc... your rehab will be longer or shorter. It is pretty variable. Floyd Landis had a total hip and was back on the cycling circuit within, I think it was 4 or 6 months. To say that people should not have their joints replaced when they fail seems to be a bit short-sighted. If a joint replacement costs $X today, and the technology is improving every year, then you can expect that over time, the techniques will be better, the re-hab times will be shorter, and the cost will go down. This happened with coronary bypass graft (CABG) surgery. 30 years ago, a CABG was the state of the art treatment for end stage coronary artery disease (knows in the parlance as a massive myocardial infarction - or a heart attack). Over time, the techniques got better, the invasiveness of the procedure got less and less, and a huge number of people who a few years ago would have required a CABG, now have a cardiac catheritization and stents placed in the affected vessels. That is how medicine works. You (in this case let's say you are a cardiac surgeon) find a way to treat a problem. You invent a better suture or a better instrument or a quicker technique, etc., you take your savings or your retirement money and invest it in this new treatment. Then, as the years go by, smarter guys come along behind you and tweak your technique or your procedure or your instrument or whatever, and so on and so forth, and over time, with more and more improvements, patient survival gets better and better, and the risks of the procedure get lower and lower, and the cost goes down. It is much cheaper to go to the cath lab for two hours and have a stent put in and go home the next day, than it is to have open heart surgery, spend three days in the ICU and go home a week later.

Last edited by Wreader; 08-21-11 at 05:39 PM. Reason: typos
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Old 08-21-11, 07:03 PM   #17
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My wife's issue was from birth with a malformed socket on her right hip. She had several surgeries as a child and into her teens. She had a very slight, barely noticeable limp when I met her 43 years ago. Her left hip got OA from her not putting any weight on her right leg and in her late 30's, early 40's had a hip reconstruction done on the left hip which keep her in bed for almost three months. The following year they replaced her right hip. The hip reconstruction normally has a 20-25 year longevity but the OA came back faster than they expected and she had to have the left hip replaced as well. The right hip has over 20 years on it and her surgeon said that she may have to have it replaced within a few years. She uses a cane to keep pressure off of the left hip but still gets out and rides daily (providing it isn't raining).

So far, I have not had any issues with my hips. However, if I ever did, I would not hesitate to have them replaced seeing what my can do with two of them.
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Old 08-23-11, 01:54 PM   #18
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I'm 57 and had both of mine replaced; 1 in 2008 and 1 in 2009. I was out of work for 6 weeks both times, though much of that was the Dr. being protective of me I don't recall having a lot of pain in either one. On the 2nd one, the first night after surgery, a nurse came in and did PT on me in which she bent the leg pretty severely... that hurt, but I'm glad she did because getting up and walking the next day was easier. I was in the hospital for 3 days, and used vicodin as my pain meds at home, though I didn't use a lot. I walk without a limp now, thanks to some additional PT. One of my golf buddies tells me that if he didn't know it, he could never tell I had them done.

One thing I would advise for any looking to have this done, is to look at the doctors and procedures you have available to you. The older method is a posterior surgery. One characteristic of this type of surgery is the hip having a chance to dislocate bending forward (like to tie your shoe). Recovery is normally slower from this type of surgery as well.

Newer minimally invasive hip replacements are typically known as anterior replacements; dislocation with these is the leg back and foot rotating outwards. This is the type of surgery I had, and what I would recommend.

Ask other doctors/surgeons, etc. that you may know who in your area (or outside of it) they would use if they needed something like this done. Also ask respected PTs which doctor's patient's seem to have the best recoveries. Find out as much as possible about the doctors, what implants they use, and also go to the maker's website to read up on what they offer.
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Old 08-25-11, 05:14 PM   #19
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I have a theory that what we are seeing now is the impact on the first generation of heavy exercisers, those who started, for example, running in the 1970s and who might be in their late 50s now. That was also the first generation to do heavy weightlifting.

Because that was the first generation of heavy exercisers, I think we weren't aware of some of the consequences of heavy exercise, the need for periods of rest, the need to protect joints, proper shoes, and so on. Barring a specific injury, it takes a long time for arthritis to manifest symptoms. By then, it's too late; the process has already started.

I was a lifelong heavy exerciser---running 6 miles a day; biking 150 miles a week; racquetball; backpacking; kayaking; heavy weightlifting; skiing several times a week. I'm not sure our joints were built to take that much constant exercise, all that pounding. It's not surprising that I've had carpal tunnel syndrome (from biking without gloves in the 1970s) and now have arthritis in my shoulders, hips, and back. It is considered premature in my case as it began in my early 50s. Actually I was aware of the hip pain in my early 40s but my doctor refused to believe it could be arthritis and would not x-ray it. Had I known about it back then, I would have changed my exercise habits and maybe preserved my joints a bit later. Instead I actually increased my exercise after age 45.

So I'm guessing that the increase in joint replacements is related to the huge increase in hard exercise among a certain segment of the population. I think weight lifting in particular is a culprit because I suspect that muscles can eventually outpower joints to the point of failure. I think premature joint failure is going to increase dramatically in the future because people are doing ever more demanding activities. This has something to do with our whole testosterone-driven cultural intensity, these Type A folks skiing off mountain tops, leaping into canyons, running endurances races, and such.

(Except for the 50% of the population who do no exercise at all.)

Regarding the cost of joint replacements, don't forget that thousands of people have no medical coverage whatsoever. Many people with premature joint failure could finish out their lives crippled with pain. Twenty or 30 years is a long time to suffer with a failed hip for lack of medical care.
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