Originally Posted by
surgeonstone
For all joint replacements it's a balance between how long they will last before a need for replacement and how much you can reasonably endure. For me, with a recent hip replacement, the guideline was my ability to work effectively and the ability to get sleep that was uninterrupted by pain. When either or both , as it was with me, became the case then surgery was the answer.
The vast majority of orthopedic surgeons routinely and reliably perform both Hip and Knee replacements. They are considered the " bread and butter cases" of orthopedic surgery, i.e. commonly performed. The ankle and shoulder require a person who has more experience with the procedure.
Personally, I would not want surgery from anyone who does not specialize in knees and hips, but YMMV. I selected a surgeon with those qualifications and who is also a cyclist, not someone who rides a bike, but a cyclist. The tipping point issue is one part of the equation: I have trouble sleeping --at times --because of knee pain, I have trouble walking any distance --at times --, and I have otherwise restricted the range of activities I do because of my knee(s). However, I can cycle for a reasonable amount of the year without pain, but then there are those times when every ride has more pain than not. I am 70, I have had two heart attacks, but I am in good health and ride 6000 or so miles a year and most of my rides involve climbing. I can average 18mpg over a reasonably flat 45 mile course, so I am no speed daemon, but I am happy with where I am cycling. I decided that given overall health can change in a heartbeat --- or not --- I am going ahead (at PCAD's urging!) with the TKR while my health allows it.
My past hesitation is the unknowns about cycling post-TKR. Now, there is plenty of literature that says riding a bike is good exercise post TKR, but riding a bike and cycling 200 miles a week and climbing 12-15k a week are different things. I have consulted four different surgeons and 2 suggested that I might not be able to ride at that level after surgery. The surgeon I selected gave me a strategy for how we would proceed after surgery to keep riding at my current level. As far as I can tell from a casual look at the medical literature, there just isn't a lot of data about the long-term effects of high activity among persons with TKR. There are a ton of anecdotes from individuals who have done remarkable things, but in the four years I have been contemplating this I have also heard enough horror stories of TKR gone wrong that I realize things there are no guarantees. I have not done a literature scan in 6-9 months, but the studies I have seen before do show some promise that those who have successful surgery without significant complications have a good chance of riding at whatever level we choose.
Good luck with the hip and let's hope there are no knee issues in your future!