New Hip.

[goldenboy]

Well, I'm definitely bored so I might as well give the play by play. I got the surgery in Basalt on the 31st and luckily they finally opened Kebler pass that day so I was home in CB by 6pm. It wasn't that bad that day and I was moving around pretty well. The next couple of days were pretty rough with the anaesthesia wearing off and the swelling getting worse.

I left the choice of implant up to the surgeon, he said he would do all ceramic as long as the cup size was a 52 or bigger and that's what I got. I think I'll be happy with that, I think I would need a new poly liner in 20 years at my activity level but maybe not.

It's been a much bigger struggle to get off the crutches than any of the surgeons I talked to said it would be. They uniformly said 2 or 3 days and I'd be off crutches. I'm at day 10 and very much using crutches which is really bumming me out. The surgeon said sometimes stronger "younger" guys like myself sometimes struggle more, because there is a lot more muscle to move out of the way for the implant, thus more trauma to the muscles. Part of me thinks it's all mental and I am not trusting the leg and I should. It isn't too painful right now, 3 Tylenol a day is where I'm at now. I never did take the heavy painkillers, just Tylenol. I maybe should have the first couple of nights, but I also wanted to poop and that was literally the first time in my life I've been constipated (from the narcotics of the surgery)

First PT tomorrow. That's been a bit of a shitshow. The biggest PT provider just stopped taking Blue Cross, so the other one up here in CB had 0 appointments available in June with all the BC/BS people like me trying to go there. So I'm stuck going to choice #3 in Gunnison, which is a bit of a bummer.

/sweetblog

[MagnificentUnicorn]

Yeah, that's the biggest concern. It sounds pretty rare. I don't think anyone is using metal anymore, the balls are almost always ceramic

Lots of metal heads still implanted, it’s age and activity dependent.

Ceramic head and poly liner is the standard for young active people. The newer highly cross linked UHMWPE liners, especially the Zimmer ones with Vitamin E, are very durable. I don’t know anyone using ceramic/ceramic.

I’m assuming you had a direct anterior approach and not antero-lateral?


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[goldenboy]

Lots of metal heads still implanted, it’s age and activity dependent.

Ceramic head and poly liner is the standard for young active people. The newer highly cross linked UHMWPE liners, especially the Zimmer ones with Vitamin E, are very durable. I don’t know anyone using ceramic/ceramic.

I’m assuming you had a direct anterior approach and not antero-lateral?


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Yes, direct anterior. I suppose you're right and metal is still being used, but none of the surgeons (I saw 5 total) mentioned it as something they would consider. I was trying to find the best surgeon for sure, so it seemed well worth it to get multiple consults.

Agreed that ceramic/poly is the most popular in the states. CoC has long been much more popular in Europe and Australia. CoC is more expensive and requires a more skilled surgeon. At least that's what my research showed. "Ceramic is the hardest implant material used in the body, and has the lowest wear rate of all, to almost immeasurable amounts (1000 times less than Metal-on-polyethylene, about 0.0001 millimeters each year). Consequently, there is usually no inflammation or bone loss, nor systemic distribution of wear products in the body." The newest poly liners are .01/yr

I would have been fine with poly, but it would have almost certainly required revision at some point later in my life.

Maybe it was a mistake, I don't know. I do know highly active people that went CoC and are happy with it.

[MagnificentUnicorn]

I don’t think you made a mistake at all, I was just clarifying some of the information posted. Like the idea that it takes a more skilled surgeon to use ceramic/ceramic. The skill is in the placement of the femoral stem and the acetabular shell. There’s no additional skill needed to place the head of any kind on the stem trunnion or the liner of any kind in the shell. I’m not saying that your surgeon wasn’t skilled. I’m saying this from the perspective of 35+ years of assisting in total joint surgery and having been a vendor rep for joint implants.

I think you should have great longevity from your new joint.


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[Spooky]

Thanks Telee! There are a tone of relatively young and super active people like me with trashed hips and replacements. I don't even remember liking to sit "cross legged" in elementary school, so this seems somewhat inevitable.

rod, glad to hear yours have gone so well, it seems like almost everyone who gets a THR is pretty happy with the results. Hips are wild in that often the pain shows up in knees and the lower back while everything compensates, or so everyone says.

Yep. Ever since getting mine done I've had so many acquaintances and friends of friends reach out about their hip issues. Had no idea how many young people were dealing with hip issues until I had them.

For years I just thought I had tight hip flexors from skiing so much and a bad lower back from overcompensation after breaking my thorassic spine. Turned out my hip joints were just fucked.

Yeah, that's the biggest concern. It sounds pretty rare. I don't think anyone is using metal anymore, the balls are almost always ceramic

Metal on metal still exists but only for resurfacing/Birmingham hip replacement as far as I know. I got one of these in Dec 2022 at the age of 39. As long as everything's implanted at the right angles then the risks of any issues are very low.

[Thaleia]

Yo Ice, apologies if it's been covered already here, what were the first symptoms that alerted you to your hip?

[goldenboy]

Yo Ice, apologies if it's been covered already here, what were the first symptoms that alerted you to your hip?

I can't speak for ice, but for me it was a steady loss of ROM, pain on the lower outside of my knee, pain in the groin, and lower back pain. Hip problems show up all over the place, and sometimes it's misdiagnosed. One of the local ski shop owners is still pissed that he got surgery on his back that didn't help anything, but then found out it was really a bad hip and the replacement got rid of his back pain..

There are a few other threads like "groinage pain" with other mags talking about their hip issues..

[gorgonzola]

mine was knee pain, leg length differential from the bad hip was causing hyperextension of my knee... never had any groin or back pain.

knew something was fucked playing beer league hockey and had difficulty getting my right leg over the boards. Also noticed on a bike ride watching my shadow with the sun directly behind me the knee wouldn't stay in a circular plane, looked like a taco'd rim

[plugboots]

I can't speak for ice, but for me it was a steady loss of ROM, pain on the lower outside of my knee, pain in the groin, and lower back pain. Hip problems show up all over the place, and sometimes it's misdiagnosed. One of the local ski shop owners is still pissed that he got surgery on his back that didn't help anything, but then found out it was really a bad hip and the replacement got rid of his back pain..

There are a few other threads like "groinage pain" with other mags talking about their hip issues..

So… any update? My injection didn’t really help, so I guess I’m onto resurfacing or total replacement.

[goldenboy]

So… any update? My injection didn’t really help, so I guess I’m onto resurfacing or total replacement.

Bummer. I'd talk to at least a couple of doctors and find one that you think will do the best job. I was a bit scared of resurfacing being metal on metal, even though plenty of people have great luck with it.

I'm at 6 weeks now and just had my follow up and everything looks good. I'm cleared to ride a bike on roads with the understanding I absolutely cannot fall. I'll be excited to ride MTB in another few weeks.

Overall my recovery feels slower than expected, as I mentioned in a post upthread. Even now, I have a slight limp unless I really concentrate on my gait, so I use a cane. But as my PT said, she sees plenty of people walking around that she can tell dropped their crutch/cane too early and still have a limp because they never worked on it enough. My lateral and medial ROM is better than before the surgery, but tying my shoelaces is harder than before. PT is confident that will come back. Recovery feels like a full time job right now. If I wasn't motivated to return to a high level of athleticism maybe I wouldn't care, but since I do, I spend a huge chunk of time every day stretching, doing PT, riding my trainer, and walking. It's groundhog day in a big way.

I'm still in the recovery phase, so I think there are plenty of people on here who are well past their surgery that can say more about how they feel long term.

[mcski]

Sometime cortisone shots miss the mark. Might try it one more time as well

[sb]

Good luck in the healing department!

[plugboots]

Sometime cortisone shots miss the mark. Might try it one more time as well

Huh. Crazy. My knee ones have all worked identically, which is to say, very well.

[Peruvian]

I'm one month out from my THR surgery. Oddly my pre-op stretching is really helping the pain but the ROM is still very limited which has caused my groin muscles to tighten (I can't throw a leg over my bike saddle). I'm starting to get cold feet on the surgery given the pain reduction. Any experienced post op folks want to talk me off the ledge?

[Shredhead]

I had THR 13 years ago.
Skied 130 days this winter and approaching my 70th day in the bike park this summer.
My recovery was pretty easy. I walked, swam and did water aerobics in a community pool.

Good luck!
You got this.

[rod9301]

I'm one month out from my THR surgery. Oddly my pre-op stretching is really helping the pain but the ROM is still very limited which has caused my groin muscles to tighten (I can't throw a leg over my bike saddle). I'm starting to get cold feet on the surgery given the pain reduction. Any experienced post op folks want to talk me off the ledge?

You will not regret doing it. Easy recovery and big improvement.

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[Dantheman]

I'm one month out from my THR surgery. Oddly my pre-op stretching is really helping the pain but the ROM is still very limited which has caused my groin muscles to tighten (I can't throw a leg over my bike saddle). I'm starting to get cold feet on the surgery given the pain reduction. Any experienced post op folks want to talk me off the ledge?

Presumably if your insurance has approved a THR you have stage 4 osteoarthritis. No amount of stretching is going to fix that. Even with less pain your limited ROM is likely to lead to problems upstream/downstream and/or on the other side of your body.

[goldenboy]

I'm one month out from my THR surgery. Oddly my pre-op stretching is really helping the pain but the ROM is still very limited which has caused my groin muscles to tighten (I can't throw a leg over my bike saddle). I'm starting to get cold feet on the surgery given the pain reduction. Any experienced post op folks want to talk me off the ledge?

How bad is it currently? It sounds like you're still biking, would you ski this winter? At the end of the day, you're going to get the surgery, it's a question of when.

I was feeling pretty good (skiing every day, even the day before surgery) before my surgery 5/31 and had second thoughts, but everyone said the recovery was pretty easy, and their only regret was waiting. I'm in the minority- I wish I hadn't gotten the surgery and if my other hip ever needs it, I'll wait until I basically can't walk. The doctor said I'd ditch the crutches in a couple of days- that ended up being a month, plus another 2-3 weeks with a cane. For the past 6 weeks I've been dealing with psoas tendonitis and sports hernia related to the surgery (not really a hernia at all), which means I'm not doing any of the things I thought I'd be doing now- i.e. riding my bike and getting strong before the winter. I just sit around all day hoping it will get better and it never does, despite the best efforts of PT. My ROM is barely any better than it was before the surgery. Pain is worse on a daily basis.

Anyway, most people do great with the surgery, I'm only letting you know how it's been for me because I wish someone had told me to hold off. It's a major surgery that isn't as easy as people (and the surgeon) make it out to be.

[Shredhead]

Sorry to hear that Goldenboy.

I could still ski and bike. But when I got in a car after either, if I drove more than 15 minutes, I couldn't get out.

I was trying to make it thru the ski season, but I ended up having my procedure 2/13/11.

[plugboots]

Goldenboy you’re bumming me out. But I’ve been waiting as long as I can as well. Now I definitely need a hip. It’s basically just constant pain.
Is there anything (other than not getting the surgery), you would do different? I mean it sounds like you did all the research, and got the correct replacement, and a good surgeon, etc..

[Peruvian]

How bad is it currently? It sounds like you're still biking, would you ski this winter? At the end of the day, you're going to get the surgery, it's a question of when.

I was feeling pretty good (skiing every day, even the day before surgery) before my surgery 5/31 and had second thoughts, but everyone said the recovery was pretty easy, and their only regret was waiting. I'm in the minority- I wish I hadn't gotten the surgery and if my other hip ever needs it, I'll wait until I basically can't walk. The doctor said I'd ditch the crutches in a couple of days- that ended up being a month, plus another 2-3 weeks with a cane. For the past 6 weeks I've been dealing with psoas tendonitis and sports hernia related to the surgery (not really a hernia at all), which means I'm not doing any of the things I thought I'd be doing now- i.e. riding my bike and getting strong before the winter. I just sit around all day hoping it will get better and it never does, despite the best efforts of PT. My ROM is barely any better than it was before the surgery. Pain is worse on a daily basis.

Anyway, most people do great with the surgery, I'm only letting you know how it's been for me because I wish someone had told me to hold off. It's a major surgery that isn't as easy as people (and the surgeon) make it out to be.

I'm really sorry to hear about your experience. It sure sounds like you are in the minority (which I realize doesn't make your circumstance any different).

My hip pain has been bad enough that it changed my walking gate. As I mentioned, the pain and bone on bone has limited my ROM and atrophied my muscles. Even my PCP knew I needed surgery when he saw the x-rays and the office test confirmed that I can't do a straight leg raise when laying down when any pressure is applied.

I know I need the surgery, it just that my hip feels better right now than it has in 2 years and that has me a little frustrated.

Fingers crossed my post-op will be just fine and I'll be skiing by Feb (I bought a pass as a result).

[PB]

Something to keep in mind: even if the surgery goes well, your recovery will be longer and harder the longer you postpone it based on general age stats. Assuming most of us considering THP are 50+, better sooner than later on average recovery wise. If you know you'll need it eventually why delay?

[rod9301]

Something to keep in mind: even if the surgery goes well, your recovery will be longer and harder the longer you postpone it based on general age stats. Assuming most of us considering THP are 50+, better sooner than later on average recovery wise. If you know you'll need it eventually why delay?

Very true

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[goldenboy]

Goldenboy you’re bumming me out. But I’ve been waiting as long as I can as well. Now I definitely need a hip. It’s basically just constant pain.
Is there anything (other than not getting the surgery), you would do different? I mean it sounds like you did all the research, and got the correct replacement, and a good surgeon, etc..

Sorry! Not my intention for you or Peruvian. I'm sure both of you will have great results, as most people do, and as I hopefully will too, eventually. I think I could have held on for a while longer, and that's where my regret stems from. But then again, it could have fallen apart any day. Recovery has been so wildly different than my expectations, from the surgeon to what everyone says, just look at Rod9301 "You will not regret doing it. Easy recovery and big improvement." That's what everyone says, so it sucks 10X worse when it doesn't go that way.

I don't think I would have done anything drastically different. I still think he's a good surgeon, the X-rays look great, he calls me every week or two for an update, etc. Maybe in retrospect I would have walked 10-20% more the first week or two, but it's hard to say what the perfect ratio of movement and rest should have been. One of those ice machines might have been nice in the beginning. I'm not really sure why I got the tendonitis issues that I did.

[North]

^^^Try a different PT? Completely different injury & surgery, but I plateaued with PT at CB Physio. Finally paid out of pocket and traveled to the frange to visit a PT that had fixed me up in the past. She had the tendonitis related to my injury (foot) improving drastically in <2wks. Still not perfect but still improving. It was the best $150 I've spent on this thing.