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Old 08-17-08, 06:30 AM   #1
surgeonstone
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When To Consider A Hip Replacement

This is for all you orthopods and hip replacement cyclists out there. I am 55, 180 lbs, 6 feet. I ride 25 to 35 miles 4 times a week. I have arthritis of the right hip , about 40-50 % joint is bone on bone. It has progressed to point where I can not walk more than a mile and that even cycling, which used to be pain free, hurts to the extent I have difficulty getting out of the clips. I walk up stairs with moderate to severe pain. My question is should I just keep curtailing activities, fewer and slower rides, or get a replacement now. How long after surgery before being back to work, and back to cycling. Any input welcome.
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Old 08-17-08, 08:21 AM   #2
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The question you asked is best answered by your Orthopedic surgeon… having said that.

I had my left hip replaced about two years ago at the age of 45: I should have had it replaced about five years before that, but it wasn’t in the cards financially, and I was far too stubborn to have it done. As a consequence of the time delay, my hip was in far worse condition; and in fact it had completely fused, and required much more work, a bone graph, and so forth…

If your pain is getting to the point that it is effecting your day to day life, I would truly be looking hard at getting it replaced, if your doctor feels that is the only option you have left. I have never regretted getting the surgery, because the level of day to day pain is so much less now, but a hip replacement surgery is a major surgery , and should never be looked upon lightly. It will be part of your life, the rest of your life…

I had the Depuy metal on metal hip put in, with the large femoral head, because of my age, and activity level, my doctor, and I felt that would be the best choice for me. But, do some research on your own, and get an idea of what is available to you, and you will be able to make a more educated decision, with your doctor as to which replacement hip is right for you. Depuy, and Zimmer have a bunch of good information on their Web sites… there are other companies that make replacement hips as well, but Depuy, and Zimmer are the only two I could remember off the top of my head.

As far as recovery time, it varies so much from person to person, but the average is somewhere around six to eight weeks… But, I’m sure your doctor will go into far more detail about all of that with you.

Well, best of luck to you… I hope this helped you some.
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Old 08-17-08, 07:19 PM   #3
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Worth periodically posting success/problems with hips and other joints. I'm looking at how my hip works and realizing that eventually it will wear out or give real problems. Continuing to tickle this type of things gives great insight into how the medical industry deals with the matter. Which is of great interest. Normally they're equipping people to successfully get to their cars, rather than climb mountains on a bicycle!
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Old 08-17-08, 07:45 PM   #4
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The question you asked is best answered by your Orthopedic surgeon… having said that.

I had my left hip replaced about two years ago at the age of 45: I should have had it replaced about five years before that, but it wasn’t in the cards financially, and I was far too stubborn to have it done. As a consequence of the time delay, my hip was in far worse condition; and in fact it had completely fused, and required much more work, a bone graph, and so forth…

If your pain is getting to the point that it is effecting your day to day life, I would truly be looking hard at getting it replaced, if your doctor feels that is the only option you have left. I have never regretted getting the surgery, because the level of day to day pain is so much less now, but a hip replacement surgery is a major surgery , and should never be looked upon lightly. It will be part of your life, the rest of your life…

I had the Depuy metal on metal hip put in, with the large femoral head, because of my age, and activity level, my doctor, and I felt that would be the best choice for me. But, do some research on your own, and get an idea of what is available to you, and you will be able to make a more educated decision, with your doctor as to which replacement hip is right for you. Depuy, and Zimmer have a bunch of good information on their Web sites… there are other companies that make replacement hips as well, but Depuy, and Zimmer are the only two I could remember off the top of my head.

As far as recovery time, it varies so much from person to person, but the average is somewhere around six to eight weeks… But, I’m sure your doctor will go into far more detail about all of that with you.

Well, best of luck to you… I hope this helped you some.
Having had both knees replaced I can tell you this is solid counsel. Very solid.

One extremely important point that will have a lot to do with how well you recover...........
DO YOUR RE-HAB THERAPY NO MATTER HOW MUCH IT HURTS!! Failure to complete the
THERAPY can leave you somwhat crippled due to tightened muscles. Sweat ,cuss, groan
but do your THERAPY!!!

One other point.....
Joint replacement implants are a manmade devices and as such have a limited life span.
This limited life span is getting better but it's still manmade so it won't last the rest
of your life like what God makes. Discuss this point with your doctor until you're in
complete agreement with the limitation.
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Old 08-17-08, 09:33 PM   #5
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I was told at the age of 38 a knee replacement was in my near future. I'm 45 now and can feel the signs of that prophecy coming true. When first told, I was too young to have it done due to limits in the technology. You could only get two replacements at the time, ad I was probably going to outlive the replacements.

Since then, technology has provided a method of having three replacements, which makes it a more viable alternative when the time comes. I'm still extremely concerned about it impact on my quality of life, however. I know the pain will be less, but activity levels concern me.

I have to second the research recommendations. There are several manufacturers of replacement joints, so shop around and learn. We usually wouldn't just walk into an LBS and tell them, "I need a bike", and walk out with whatever they handed us. This is a much larger decision, and should be treated as such.

Make sure your Doc knows your life style, and do some research.
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Old 08-17-08, 11:03 PM   #6
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...great insight into how the medical industry deals with the matter. Which is of great interest. Normally they're equipping people to successfully get to their cars, rather than climb mountains on a bicycle!
I've found this as well, which is sobering. A doctor wants only that the patient be minimally disabled.

I'm hoping that some insightful orthobiologic companies will see that many people who are end stage arthritic want to be able to do more than the activities of daily living and many are willing to pay for greater functionality than that. Money talks and maybe an affluent and aging baby boomer generation who doesn't want to slow down will stimulate the medical industry to do more than offer 1960's technology.
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Old 08-18-08, 08:19 AM   #7
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I've found this as well, which is sobering. A doctor wants only that the patient be minimally disabled.

I'm hoping that some insightful orthobiologic companies will see that many people who are end stage arthritic want to be able to do more than the activities of daily living and many are willing to pay for greater functionality than that. Money talks and maybe an affluent and aging baby boomer generation who doesn't want to slow down will stimulate the medical industry to do more than offer 1960's technology.
After I healed up, and everything looked like it was going according to plan, my Doctor told me, that the main thing I should do is: Don’t take up running, unless I’m in a burning building, or something is trying to kill me… Don’t take up Downhill Skiing, unless I’m trying to outrun an avalanche… Don’t fall out of my tree stand, when my wife and I are out Archery Deer hunting… Oh, and loose weight, preferably upper body weight; he didn’t care if my legs got as big as tree trunks, but keep my upper body small as I can. So far, the weight thing, is the only suggestion I haven’t been able to keep…

My Doctor is the one that actually suggested bicycling as a form of rehabilitation after my hip replacement., above and beyond walking… That worked out well for me, because I loved bicycling when I was younger, before my hip went bad… Swimming would be a really good thing as well he said, but I don’t have access to a pool enough of the time. My Doctor said, as far as activities go: if it really hurts, try not to do it… If it doesn’t hurt: try not to overdo it until it does hurt… And, I always added : If it feels good, don’t do it in public.

I guess I was lucky (if you could call it that) my hip got so bad, that the replacement has given me far better range of motion, and recovered far more of my mobility than I had before. I can see where, if someone young, and in good health, suddenly had an accident, and had to have a replacement hip put in, how that would be devastating to them… But, most people by the time their hip, or knees, get so arthritic that they can’t stand it anymore, they are glad to regain the more pain free life, that a replacement hip, or knee can give them. Of course on the other end of the spectrum, are the very old, that can never fully recover from the muscle damage, and weakness due to inactivity, and sadly never regain full mobility…

Having said all that… I’m glad that I got my hip replaced when I did, but I’m not particularly looking forward to having the other one replaced. I’m hoping and praying that medical science can figure out this cloning thing, or gene therapy, and grow me a new hip or at least some new cartilage… But, I fear I will be needing another new hip, or be too old for it by the time they do…

But, I’ve said way too much… I wonder why the O.P. has never posted back in? Hope we didn’t scare him off…
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Old 08-18-08, 09:21 AM   #8
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"Hope we didn’t scare him off… "

No, I hope we sacred him enough to get informed. Really informed.
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Old 08-18-08, 09:39 AM   #9
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Thanks for you insight and comments ,all. I will proceed with surgery, If recommended , hopefully the minimally invasive technique will be applicable.
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Old 08-20-08, 08:45 AM   #10
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I've had a knee replacement. Not a hip replacement (yet, anyway), but we're in the ballpark.

Best thing I ever did. Before the surgery, I could walk only with the aid of a cane, and my range was limited to about five or six blocks.

The surgery went beautifully. I spent a couple of days in the hospital afterwards. On the morning after the surgery, the doctor came to my room with a physical therapist, and they got me on my feet then and there. The next day, I was sneaking downstairs for a smoke (I know, I know -- I've quit since then). I was back at work exactly one week after the surgery (had the operation on a Thursday, was back at work the next Thursday). Stopped taking painkillers a week after that. I was on the bike shortly thereafter. Commuting to work almost every day a short time after that, and doing longer and longer rides on weekends as time went on. Rode a century within six months.

Go for it.
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Old 01-21-09, 03:42 AM   #11
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I am bumping an old thread as hip replacement is in my near future now. Met with the Doc today.
There are two choise, hip arthroscopy to try to rectify the random inpingement needle pains I get,
or go the whole way. As I have fantastic insurance at present, I will go all the way no, rather than
push it even further out for a few years. And if it goes well, i will do the other one too, as I knwo it
is not far behind either... *sigh*
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Old 01-21-09, 08:07 AM   #12
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This is for all you orthopods and hip replacement cyclists out there. I am 55, 180 lbs, 6 feet. I ride 25 to 35 miles 4 times a week. I have arthritis of the right hip , about 40-50 % joint is bone on bone. It has progressed to point where I can not walk more than a mile and that even cycling, which used to be pain free, hurts to the extent I have difficulty getting out of the clips. I walk up stairs with moderate to severe pain. My question is should I just keep curtailing activities, fewer and slower rides, or get a replacement now. How long after surgery before being back to work, and back to cycling. Any input welcome.

Replace now! Read about Landis' surgery, he was back riding in no time.

My mother-in-law had double knee replacement surgery a couple of years ago. She should've had it sooner but her heart condition had to be stabilized enough to handle the surgery/anesthesia.

They did not get her up and walking soon enough after the surgery and it cost her maybe a year of spending time in a nursing home, and going everywhere in a wheelchair. Now, she's walking around the house, rarely uses the walker, no pain in her knees. (I could hear the bone on bone before.) She's 82.

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Old 01-21-09, 12:07 PM   #13
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Having had both knees replaced I can tell you this is solid counsel. Very solid.

One extremely important point that will have a lot to do with how well you recover...........
DO YOUR RE-HAB THERAPY NO MATTER HOW MUCH IT HURTS!! Failure to complete the
THERAPY can leave you somwhat crippled due to tightened muscles. Sweat ,cuss, groan
but do your THERAPY!!!
Yup. And load up on the narcotics to make it tolerable -- that's what they're prescribed for.
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Old 01-21-09, 12:08 PM   #14
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I am bumping an old thread as hip replacement is in my near future now. Met with the Doc today.
There are two choise, hip arthroscopy to try to rectify the random inpingement needle pains I get,
or go the whole way. As I have fantastic insurance at present, I will go all the way no, rather than
push it even further out for a few years. And if it goes well, i will do the other one too, as I knwo it
is not far behind either... *sigh*
Hello FatA**/aka Mr.Markets, nice to see you outside of P&R, but sorry to hear you are having hip problems. I was surprised to see this old thread pop up, as a matter of fact I had forgotten about even posting to it.

I reread my post from back in August and everything I posted is just about all I know about hip replacements. Not much new with mine thank God, but I go in for my yearly checkup in March, so I hope everything is still as it should be. I’ll have my new left hip for three years at that time; I hope it lasts another 25 or so…

The only thing I would ad, is if your hip is not in really bad shape, they have something called hip resurfacing available now. It still consists of a new Femoral Head, and Acetabular Cup, but uses a shorter smaller Femoral Stem, which allows more original bone to be saved. I don’t know what the longevity prognoses, or stability issues are with this type of implant though, so you would have to talk that over with your Surgeon.

Well best of luck to you…

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Old 01-21-09, 11:30 PM   #15
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In my case I femur already had pins put in it some time ago when i was 15, so the resurfacing
is out. it is all or none for me....

And thanks for the wishes!
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