Total Hip Replacement/Hip Resurfacing

Anyone out there in USMS/Board world had a total hip replacment or hip resurfacing? If so, here are my questions:

1. How long until you were back in the water training?
2. How long until you were back in the water racing (pool and/or open water)?
3. How long until you could do flip turns and push hard off the wall?
4. How long until you were biking?
5. How long until you felt "normal?"
6. What is your experience re range of motion post surgery?

thanks

[A.K.]

I have a friend that just had this procedure performed at http://grossortho.com/ he had hip resurfacing or replacement http://www.grossortho.com/hipre.html .

He said you have to wait at least 1 month for the incision to heal before entering the water.

He has been swimming since his operation a few months ago and is taking it easy on turns and kicking- he mentioned he will wait a few more months before reallly pushing it and kicking hard- he does not regret the procedure....BTW he says he is kicking all the 20 year old's ass in workout.

He mentioned there was a Dr in LA or UCLA to be precise that also performs the same procedure.

Hope this helps.

I'd love to talk with your friend. I'm scheduled for the resurfacing procedure on Jan. 30.

thanks

[Glenn]

Carl,

My wife had a hip replacement when she was 67 and we went skiing 17 weeks later!!!

GLENN

[jean sterling]

A guy at the Y where I swim had a hip replacement and later played basketball on it with the "lunch bunch" - he was in his 60s.

[A.K.]

Originally posted by botterud
I'd love to talk with your friend. I'm scheduled for the resurfacing procedure on Jan. 30.

thanks

I sent his contact info through this PM and email options - let me know if you received it.

A.K.

[Tom Ellison]

I have had two total right hip replacements. My first lasted 10 years until the cup became loose.

My operations were different then most. My hip, pelvis and sacrum were crushed under a 28-ton dump truck in 1977. The damage to my pelvis and hip area was horrific to say the least. Both operations required bone graph build-ups to adequately anchor the cup to my hip, which made my recovery time somewhat outside the norm. Having said that, I was back in the pool (both times) right at six weeks. I did not do flip turns for another month to ensure my hip was healed.

After my operations it took three weeks to feel human again and four weeks to become pain free. On a side note, I strongly suggest you set aside your own blood for this operation to ensure healthy, disease free blood. Our blood supply is very safe in America with the onset of modern testing, but it is not bullet proof. I required 4 to 5 pints during both operations due to the increased damage brought about by my accident. My understanding is 2 pints is generally the norm.

I caution you to be very careful during the healing process. Both Wake Forest University Medical Center in Winston-Salem NC and Jewish Hospital in Louisville, KY are excellent joint replacement hospitals. Both hospitals have done extensive research in patient follow up after joint replacements. Both found the number one cause for replacement damage was caused by early strenuous activities with infection being second. Keep your incision clean and maintain a very regimented germ free environment after your operation. Be extra careful of dental work and ALWAYS get your dentist to call in a prescription for antibiotics prior to dental cleaning. PAY CLOSE ATTENTION TO THAT!

In short, let that joint replacement heal properly before you torque it to the max in the pool. I found breaststroke kicking to be very painful and dangerous during the healing process so be extra careful there.

Good luck and enjoy your new hip replacement after it heals. Both times, I went from serious pain to zero pain after healing.

Kindest regards,

Tom Ellison

A.K.: Got it and sent him an email. Thanks.

Glenn: Thanks for the input. Hope to see you sometime soon . . . Though I doubt I'll be in the water for the Caltech Pentathalon this year.

Jean: Thank you.

Tom: Thanks for the feedback. I understand the blood loss issues. I'm getting the hip resurfacing which preserves a lot of my bone and results in a much reduced blood loss. Your comments are well appreciated and I am really looking forward to that "pain free" part.

[Tom Ellison]

Carl:
TRUST ME.... it will be night and day different....or....the difference in Grant Hackett’s mile time.....and...my mile time.....

I waited way to long and suffered needlessly both times before going in and having it replaced. My second operation was a Godsend for the pain was way over the edge...and I mean way over the edge. Hey, they don’t call us Jar Heads for nothing.

[Gdavis]

Hi all
I returned home from a hip resurfacing May 28, so very early days. I'll be pleased to compare notes with other swimmers at various stages of their recovery and rehabilitation.
Best to all.
Guy

[JamieJ]

Hi-
I am agonizing over this hip resurfacing question. I can currently swim very well without pain, but have pain pretty much all of the rest of the time. I would like to be able to walk and bike without pain, but don't want to lose my ability to swim like i am now. Will I still be able to do flip turns and go off of the blocks? Will I be able to complete my workouts daily (3500-4000 yards), and how soon will I be back to the swimming form that I am in now. I need answers from swimmers who understand my dilemma. Please help if you have any insight!

[Sabretooth Tiger]

I had mine done on Jan. 30. I was walking w/o crutches or any other aid in two weeks and was cleared to re-enter the water as soon as the incision healed, at about the 2.5 week mark.

I did return, but have not been regular for any number of reasons, none of which has anything to do with my hip.

As for my hip, the arthritis pain is completely gone, and has been since the surgery. My range of motion is improved. I can get on and off my bike and ride it w/o pain. Before the surgery, I could not lift my right leg over the bike to mount it.

I can walk miles w/o pain . . . could not get down the block before surgery.

Am working out real hard w/ a trainer to work my lower body, improve strength long ago lost, improve flexibility and balance. I have been cleared by my doc as of the 6 month point to do anything I want w/o restriction . . . this means skiing/snowboarding this winter.

I've done some body surfing and will start surfing again as well. Could have done it months ago, but haven't been in the water.

My main impediment is getting my practice back into gear after gearing down in advance of the surgery.

If you want to contact me off-line, I'm happy to provide more information. My doctor (Schmalzried at the Joint Replacment Institute in Los Angeles) is the best, bar none.

I'm happy as hell w/ my results and life is vastly improved.

cheers

sabretooth

[Gdavis]

Hi STiger, glad to hear things are going so well - my experience has been very similar to yours. I'm now 2 months post op resurf and things continue to go well. No arthritis pain - on a good track to full recovery. I started swimming gently at about week 3 and am now back to (nearly) normal training. I have been flip turning since my week 6 check up. I have already regained my pre-op range of motion (which was compromised by arthritis) and I'm slowly improving from there. I'm not yet doing dives off the blocks but I hope eventually to be at least as good off the blocks than I was before. But I'm going to build up strength in the gym before I get back on the blocks. I'm doing gentle breaststoke vertical kicking to build up strength before going back to BR proper, which will also wait until after my 3 month check up.
I had been in increasing pain for years before but was encouraged by my ortho to wait as long as possible before going ahead with surgery. For me there were 2 key triggers to choosing to go ahead - I could no longer get into grab start position - which was symbolic of increasing disability - and I went on vacation and couldn't enjoy a walk on the beach. So I needed to regain quality of life.
I have found the biggest challenge post-op has been to regain hip strength. Eg at 3 weeks I couldn't yet do a leg lift on the operated side. I'm still relatively weak but doing plenty of leg lifts as part of PT. I'm getting my cardio fitness back slowly swimming. cycling and in the gym - did a good 4k session yesterday. My kicking is still weak but I'm confident that things are on track (for example, in the free kick set yesterday I was repeating 100s free kick at 10-15s slower than when fit pre-op, but 10s per 100 better than 2 weeks ago).
JamieJ, there seem to be plenty of success stories out there, and being fit seems to be correlated with post-op success and speed of recovery, based on all the experiences I've read on various hip discussion groups. Good luck with your decision. I shared your concerns pre-op. I think most people would recommend "Get yourself a good surgeon and don't wait". It seems to me that there's no reason you can't be as good as before within 6 months. The resurf option seems to be very successful for the sporty types.

[JamieJ]

Thanks for the info. I just went and saw a guy who does hip resurfacing. He wasn't very enthusiastic about my case. Apparently the rheumatoid arthritis is a bit of a problem, as is the possible metal ion release for a young woman. He didn't recommend a total hip replacement at this point either, because I am 31 years old, and he wanted me to wait as long as possible. I don't know what as long as possible means, but I guess as long as I can swim happily, I will wait. He also said that there was no guarantee that the biking would be better after the surgery. It seems like everything I read online is so positive about the surgery, that I was surprised at his reluctance. Anyway--thanks again for sharing your experiences! I guess I will be waiting for a bit longer.

[hornHead]

I am now 3 weeks post op with a total hip replacement. Up until the middle of May I was training 4 times per week for a total of 16K metres supplemented with weights and additional cardio.
At 54 I'm pretty young to be having a THR but the discomfort was overwhelming me as I couldn't sleep without potent medication.

The draw back to having a THR or resurfacing at an early age is that a revision will have to be done in 12 - 15 years. My challenge is to make it last as long as possible given my activity level. This will require me to modify my weight bearing activities from here on. No running, skipping, ice skating or anything that may put undue forces on the new joint. It will also require me to be diligent on rehabing and maintaining the hip flexors, quads, glutes, back & abs.

The affected side has been bearing weight since the surgery and over the last few days I have taken steps without the cane. I can go up and down a flight of stairs step over step with ease only using the bannister for support. Physio starts in earnest next week and pool work the following week.

I can't understate that the greatest risk in ANY surgery is the possibility of infection. If you get a bug in there and an infection sets in then ALL the components MAY have to come out and you start from scratch.

From a swimming standpoint it is going to interesting to see how long it will take to get back in form. Prior to the surgery I was swimming the 50 & 100 LC free in 27.5 and 1:02.03.

[Gdavis]

Good luck with rehab HH. Let us know how you get on. I found the hydrotherapy a great way to start the rehab. May there be a LC 27.4 ahead.

[hornHead]

Gd....your right on about seeking out a good O/S. I think I've got the best. We both swam for the same age group club. I was on my way out and he was on his way in. He was a Canadian National Team member in the late 80's - early 90's, 1991 World University Games 100 back champion and at the age of 39 he recently went a 1:00.88 LC 100 back, just missing the Canadian Pan Pac Trials QT.

Up until May we trained with the same age group club. He has a great interest in how I'm progressing. His attitude and attention to detail are second to none. That alone may be worth a few tenths.

[Gdavis]

Very clever move hH! A competitive swimmer O/S sounds ideal. I expect you'll be the "poster child" for diligent and successful rehab. As a matter of interest I was wondering why you went THR rather than resurf?

[hornHead]

Gd - Excuse me for being tardy in response to your question but I wanted to touch base with my O/S on the resurfacing issue. We did discuss it intially but I couldn't recall the reasons for not doing it.

His view of resurfacing from a surgical standpoint is that a larger incision is used and more soft tissue is disturbed to facilitate reaming of the femoral head and the acetablum. The femoral head component is cemented in place and cemented components have a greater incidence of becoming loose.

In large boned patients, such as myself, the size of the femoral implant can, but not always, be larger than the orginal femoral head and that a corresponding acetabular implant would necessitate more bone to be removed for the pelvis to accomodate it.

Resurfacing has been performed for a relatively short time compared to THR. There dosen't seem to be sufficient clinical evaluation data on resurfacing such as revision rates, longevity and the release of metal ions from metal on metal wear. There is also some speculation that with a resurfacing the weakest point of the joint is at the femoral neck and may be prone to fracture.

The most important consideration for anyone thinking of THR, resurfacing or any medical procedure for that matter, is the skill of the practitioner.

I am 5 weeks post op today. I have returned to work on light duties for 4 hours per day and am back to driving a standard shift. I have been in the pool every day starting last Friday.

Last nights W/O consisted of:

15 X 50 metres pull on 60 seconds ( average 42 sec. with very careful open turns )

5 X 50 flutter kick 10 sec rest ( no board )

200 scull with pull bouy

4 X 25 fly on 40 sec.

4 X 25 back on 40 sec.

4 X 25 free on 30 sec.

I also tried about 15 seconds of water polo "egg beater" without discomfort. Post W/O therapy consisted of a beer, ice pack and quad stretch with heat.

[Gdavis]

Thanks for the feedback HH. Interesting. Sounds as though your rehab is going very well - especially the post workout beers. Good luck with it. Best. GD