Houston_Biker

I have had significant problems with my right hip over the past three years. While I was generally able to ride my road bike competitively and perform basic life functions, my hip finally got to the point where I was unable to ride, I walked with a limp and lost most of my mobility in my right leg. I had a condition called osteoarthritis, whereby the articular cartilage, the smooth lining that covers the surfaces of the ball-and-socket joint of the hip, wears away, and the hip socket has bone-on-bone contact with the femoral head. In other words, I had no cartilage in my right hip socket and this caused a great deal of pain and lack of mobility. Unfortunately, I am only 43 and at an age that many say, "you are too young for a hip replacement..."

On Wednesday, December 10, I had a hip resurfacing procedure in Houston, TX. This procedure, similar to a "total hip replacement" is a relatively new procedure in the US and was made popular by Floyd Landis, as he had the same procedure following his 2006 Tour de France competition. In this procedure, my damaged hip ball (femoral head) is reshaped and capped with a metal prosthesis. In addition, the damaged hip socket (acetabulum) is fitted with a metal prosthesis — similar to what is used in a hip replacement. The implants are made of a cobalt-chromium alloy. In my particular procedure, the doctor went into the hip socket from the anterior (front) side of my leg and was able to access the femur and hip
socket without detaching many of the muscles typically disturbed in traditional hip replacements/resurfacings.

I got home from the hospital yesterday and will be at home recovering over the next couple of weeks. I am walking with the help of a walker - yes, the same walker typically fitted with custom tennis balls. I should improve my mobility every day and off the walker within one to two weeks.

I am expected to make a full recovery and should be on a stationary bike within three weeks to a month. Most of my rehab will take place once the incision is healed. Since I have been off the bike and mostly sedentary for the past couple of months (due to pain and lack of mobility), I am anxious to get back to normal and back on the road.

I have attached a picture of my hip resurfacing implant.



I'd be curious if anyone else has had a similar surgery or are contemplating a resurfacing or replacement in the near future? I do know that others on BF, most notably, Hipcycler, had a total hip replacement several years ago and is back to 100% -- and this is encouraging.

Steve

the_mac

Should have gotten the ceramic bearings, they're so much smoother and you save 16g per pair :-D

Honestly though, sounds like you've got the right attitude to push through this and come out swinging. Keep us posted.

Bontrager

Who did the surgery?

waterrockets 

H_B is my brother-in-law, and has ripped my legs off in more than one TT...

Dude, I think I'm going to buy some carbon fiber arrow shafts and JB-Weld you a proper walker.

One thing I've learned from my recent (comparatively minor) injuries is that there's no sense rushing the comeback. You'll know what you can do. We'll be ripping up the TX masters and/or Cat 3 soon enough

Houston_Biker

Dr. Stefan Kreuzer from Memorial Bone and Joint in Houston.

Bontrager

Never worked with him.

Good luck healing. Listen to your doctor and don't rush recovery. Discuss your cycling with the physical therapist. You shoulda had the surgery in the dead of summer. I remember winter is great riding in Houston.

terrymorse 

Does the hip resurfacing come with activity restrictions?

I fractured my hip into 4 pieces in 2002, and I'm probably looking at a replacement in a couple more years. I don't want the total, if I have a choice, since it comes with activity restrictions. There's a risk of dislocation if you "move wrong".

For what it's worth, I was back on the road in 6 weeks (without my doctor's permission).

Bontrager

There's always a risk of dislocation anytime you do surgery on a joint because the tissues that hold the components of the joint in place aren't as strong or tight as before. Sometimes this is because patient's think they know better than the surgeon after the surgery is done and stop listening to him when it comes time for the most important part of the surgery - recovery.

Resurfacing is not without its own problems and it doesn't mean you're not going to need a revisional surgery down the line.

Houston_Biker

Obviously, there is a lot of rehab to do before being released to weight bearing exercise. Following recovery, very high impact activities are discouraged (running, basketball, etc.) but not totally off limits. There will be very little restriction with lower impact sports such as cycling.

Resurfacing is recommended for patients who tend to be younger, and have femoral necks strong enough to support an implant. Since most of the femoral bone is preserved in resurfacing, patients can have a subsequent total hip replacement as a revision surgery later in life.

Depending on whether you are a candidate, I would start with resurfacing as an option. A orthopedic doctor specializing in hip replacements and resurfacing should be able to assess which is best for you given your specific anatomy and history.

Steve

terrymorse 

Strong enough femoral neck, there's the rub. I have one of these metal doodads running through the middle of my femoral neck:



Might make resurfacing impossible.

triplebutted

Good luck dude! Hope you get on the bike soon.

BTW, does this mean you are now a "hipster"? Will you have a fixie?

Houston_Biker

Yeah, I see what you mean. You obviously know your anatomy around your hip!

In a resurfacing procedure, the femoral head would be "cored down" with a round saw to decrease the surface area and allow for a new metal head. The question is whether this procedure is possible given the pins connecting the femur to the femoral neck. A good surgeon should be able to determine the best implant technique given your unique situation.

Do you have any restrictions or pain riding right now?

Nachoman

As others have said, don't get back on the bicycle too soon. But when you do come back, make sure to come back with a vengeance.

Houston_Biker

Thanks for the well wishes. The weather has been great in Houston and it is tough sitting around in recovery mode. As soon as I can, I'll be back on a spinning bike I purchased for our home. And yes, I will heed the advice given by the doctor.

Are you a orthopedic surgeon or in the medical field?

Houston_Biker

That was a long time ago and before you got a power meter!

Yeah, in a couple of months, I'll be back on the road to recovery and I am sure I will quickly get my fitness back. Doubt I will be dragging you around anytime soon...but it can be a long term goal

terrymorse 

No restrictions on movement, other than some loss of flexibility in the joint.

Lots of riding will make it sore, as will walking up stairs with a heavy load. Both things I do on a regular basis when running a tour.

HAMMER MAN

take it easy and heal the right way without pushing yourself,listen to the DR.

good luck

motorcade

I was a triathlete and marathoner in the early 90's until hip pain and the arrival of three children caused me to become less active, with most of my exercise then consisting of walking on the golf course 1-2 times per week. I had a right total hip replacement in November 2002 at age 42. My surgeon at the time did not recommend the re-surfacing. I can't complain. The surgery was a complete success with no complications and quick recovery. In July 2006 I started getting back on the bike for the first time in over ten years. I quickly became hooked again and now ride on average four days a week (more but its winter here), including road, MTB and fixed gear. I raced in a half-dozen CX races this year and had a blast. You should do great. I wish you best of luck.

Steve
Ellicott City, MD

Houston_Biker

Steve, that is very encouraging! I am 43 so it sounds like we had similar situations. I plan to let myself heal then get back on the road bike as soon as possible. Will probably start on a spinning bike, get my strength and aerobic fitness back up, then start tearing it up on the road.

Good luck to you!

Steve

Miller2

I had a total hip replacement at age 42. I too was concerned about the restrictions and possibility of dislocation. After alot of research I determined that the dislocation factor is almost nonexistent. My doctor hadnt seen a dislocation in 25 yrs of performing hip surgeries.

I have zero restrictions. I can even run if I choose to but that is discouraged.

The total replacement is the best decision I ever made. I wish I hadnt waited so long.

kraftwerk 

If you are looking into a hip resurfacing procedure check out this site:<< https://surfacehippy.info/>>
There is a lot of good information, video interviews etc on the procedure.
I am considering it.
I snapped the head off my femur in the 1990's in a motorcycle accident.
The doctors bolted in back together with three
stainless steel screws. The screws were removed about five years after.
Lately, though in the past four years I have been
experiencing a lot of pain. Takes longer to warm up on the bike.
I will post what I discover after my first Doctors visit in January.
Surface Hippy helped me locate the Dr. Only problem is my 400 $ a month health insurance is not recognized by this particular hospital. It is a relatively new procedure in the US.
Two kinds of pain: hip pain and wallet pain....

bostongarden

Hi Steve,

Thanks for posting this. Best of luck!! Please keep us posted as I will be reading with great interest. I have a worn out left hip and I have been watching the data on resurfacing for about 3 years -- if my memory is correct -- since the FDA approved it in the US. I'll never forget the day I took my first step for a run back in 2002 when I felt a tug and I thought it was a groin pull. Well, it was not a muscle pull :-) I eventually got to a point of total pain in everything I did, sitting, standing, driving, sleeping, you name it. Then I found this fellow who I can only describe as someone who knows how the body, muscles and bones work. I don't necessarily seek out "new age" stuff, but Arthur helped me relearn how to do a lot of movements.

Running is out of the picture and I still have a limp more times than not when walking, but, I've learned over the past 14 months that I can cycle without hip pain -- even started racing again in March. I'm happy, but, yeah, I suspect that I would be happier after a resurfacing. Are you aware of the SurfaceHippy Yahoo group? If not, you should check it out; you'll find people from all over the world with lots of information and support about hip troubles.

Best of luck with your recovery. If you make your way up to Austin for a ride, I'd like to spin the wheels with ya (and I'd like to meet WR as well -- I met Ravenmore today on the bagel ride).

Houston_Biker

Hey Bostongarden,

Sorry to hear about your hip pain. I had bad pain the last three years and managed to just "suck it up". Was able to ride my bike up until the pain got too bad three months ago. I raced 11 races last season and did pretty well (2nd at Pace Bend in Masters 4/5, Second at Fayetteville Stage Race).

I went in to the orthopedist in March to get X-rays and the doctor said I need a new hip -- it wasn't a matter of years, it was a matter of months. I got a second opinion and the 2nd doc confirmed it.

I decided on a Houston surgeon who performs "direct anterior" hip resurfacing from the front of the leg. Pretty amazing procedure.

I have gotten a lot of good info from www.surfacehippy.info. Check it out.

I come to Austin quite often and hope to be back on the bike by Mid-January...won't be in good shape but I'll make Waterrockets wait for me

I have ridden with Ravenmore a couple of time...good solid rider. I did Hugel with him last year and he was quite stout on the hills.

PM me with your email and phone and I will ring when I come up to Austin in January or February. I stay with several different family members ranging from Mopac and 45th to Mopac and Slaughter. Let me know if you want more info on the hip subject.

Steve

dgoff59

I am 49 and I had hip resurfacing surgery on December 3rd. I started having problems a few years ago and this summer I got to the point that it was having a significant impact on my activities. It did not hurt much when riding, but after riding the pain was noticeably worse.

The therapy is going well and I feel that I am ahead of schedule. My doctor told me to use a walker for four weeks. I can walk (limp) without the walker, but I am trying to follow orders. Prior to the surgery the doctor told me that the initial recovery with resurfacing was a little slower than with a total hip replacement (THR), but the long range benefits made resurfacing appear to be the best route for someone my age. One of the benefits is, if needed later, a revision is much easier with resurfacing than with a THR. The other important benefit is after 3 to 6 months there will be no restrictions on my activities.

I started riding a couple of years ago and have not been a very serious rider. I ride road and mountain bikes and, so far, my longest ride has been 42 miles (mountain bike on a gravel trail). I hope to start riding more this spring and plan to ride my first century this summer. The therapist told me that I should be able to start riding a stationary bike in a few weeks and I should be back on the bike by the time the weather warms up this spring.

For now the worst thing about the recovery is boredom. I hope to get outside to walk some soon, but the weather here in the North Carolina Mountains is not cooperating.

Good luck with your recovery!

Bontrager

Let me get something straight.. You researched a hip prosthesis and then went to an orthopedic surgeon and told him you want that procedure and he agreed to do it? Did he congratulate you because you figured out which hip prosthesis you needed without 4 years of medical school and 5 years of residency?
??