New Hip.

[goldenboy]

^^^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.

Totally agree, a great PT is so useful to have. Glad you're recovering.

That's a whole different shitshow. CB no longer takes BC/BS, so they were out from the beginning and I've never had anyone there that I thought was great. After my surgery, GVH PT was booked out for 5 weeks straight, so my only choice was to go all the way to Gunnison at Heights. The PT there was OK, but she was a travelling PT that maybe didn't really "get" working on a fairly fit mountain athlete. Eventually I got in with someone I know and like at GVH by about week 6. I only got 3 appointments with her before she popped out a kiddo. Then someone else filled in, who I actually thought might have been really good, followed by PT #4, who I've only gone to for 3 weeks so far. I feel like it's worth giving her a shot, and we're kind of going in a different direction now regardless after the doctor gave me the psoas tendonitis and sports hernia diagnosis. Plus, she had the same race coaches as I did at Winter Park, even though she's 20 years younger than me, so that's cool. Surely that counts for something, like the universe is trying to do me a solid, no?

Going to PT #5 at this point would just be confusing..

[bodywhomper]

Wishing you all luck with your surgeries and rehab. I’ve struggled with PT’s before. Jerks or people not used to working with athletes. It’s frustrating because I want to trust my PTs and my doctors referring those PTs to me.

Peruvian, if you’re really questioning the surgery or the timing, maybe get a second opinion.

[Mazderati]

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?

Revision. It's harder the second time around.

[priapism]

Looks like I'll be joining this club. I thought I dodged the osteonecrosis bullet when I had almost a year without pain after ending seeing it on an MRI (incidental) but the pain started this April and this month after an x-ray and ortho visit I found I have stage 2 necrosis in my left hip–too far along for core decompression so THR will be it. I came in expecting to need a labral repair.

Not pleased especially since the MRI showed damage a year ago but at least the recovery time is quick. I'm scheduled for follow-up MRI and gonna get 2 more opinions but hopefully I'll get it done in time for spring skiing next year

Anyone know the pros/cons of the different surgical approaches? Given my age (30s) I'd probably go for a CoP implant–and hunt for a surgeon who tends to operate on younger patients

[North]

Going to PT #5 at this point would just be confusing..

Man that is a circuitous PT journey for sure. I can understand why you wouldn't want start over again. Hope #4 does the trick. My first PT was a dud (I bailed after 2 appts), 2nd was CB physio, and 3rd was my go to.

If anybody needs an outstanding PT and can make it to Boulder, Nicole Haas will get you right.

[half-fast]

Have had both of mine done. Right in 2013, left in 2020. Waited too long for the first. I think getting off crutches/walker etc after a couple days is unrealistic. I used a walker for a couple days then a cane for a couple weeks. Big change from first to second is they didn’t want me to walk any distance for 6 weeks the second time. I had 10 pt sessions, did the exercises in the booklet they gave me plus stuff the pt gave me, rode a bike trainer for 1/2 hour all 3x a day instead of walking. I’m happy with the results. I don’t run or jump (much) anymore

[Full Trucker]

Totally agree, a great PT is so useful to have. Glad you're recovering.

That's a whole different shitshow. CB no longer takes BC/BS, so they were out from the beginning and I've never had anyone there that I thought was great. After my surgery, GVH PT was booked out for 5 weeks straight, so my only choice was to go all the way to Gunnison at Heights. The PT there was OK, but she was a travelling PT that maybe didn't really "get" working on a fairly fit mountain athlete. Eventually I got in with someone I know and like at GVH by about week 6. I only got 3 appointments with her before she popped out a kiddo. Then someone else filled in, who I actually thought might have been really good, followed by PT #4, who I've only gone to for 3 weeks so far. I feel like it's worth giving her a shot, and we're kind of going in a different direction now regardless after the doctor gave me the psoas tendonitis and sports hernia diagnosis. Plus, she had the same race coaches as I did at Winter Park, even though she's 20 years younger than me, so that's cool. Surely that counts for something, like the universe is trying to do me a solid, no?

Going to PT #5 at this point would just be confusing..

Totally get it, but if you do decide to try a fifth I know a highly capable and recommended PT in Salida that I've been working with on hip issues. I had a massive injury to my left hip that will definitely necessitate getting a THR at some point, but her help has improved my pain and ROM dramatically in the interim.

[goldenboy]

^^^ Thanks!

I actually have a great PT here that helped me a lot prior to the surgery. But she didn't work at all this summer while her office was being remodeled and on top of that she doesn't take any insurance. I'll probably go back to her if I have to, once I run out of my "free" PT visits (since the surgery maxxed out the out of pocket).

[PB]

Revision. It's harder the second time around.

Fair point. What's the life span on current THP replacement hardware these days? Seems like it's been getting better, maybe 20+ years? So if you're 50+, and get 20 years, you'll be in your mid-70s. Unless you're a genetic phreak, you've dialed things back a lot by then. I think most of us would gladly trade 20 years of quality living/skiing prior to things going to your pre-programmed decline. I would have, except I'm already in my mid 70s. If someone had guaranteed I could ski like I was in my 40's until I was 75 when I was 55, but the price was my soul, I would have been sorely tempted, as the writing was already on the wall.

[plugboots]

You kinda answered your own question. You don’t know ahead of time, and it ain’t 100%, and it takes rehab. My buddy is the fastest I know, as he skied 3 months after surgery.

[gorgonzola]

9 years out, THR at 52. The end of that last season was powered by bourbon/beer-buprofin. Finished the season and had the surgery the following week, end of April. Religious PT and and walk, walk, walk. Back on the bike by fathers day, ski'd black Friday. Wore hip pads and was pretty tentative the first few seasons. Still average 40-50 "days" (mornings) a season finish each one in May trying to bash bumps at K.
When I asked Doc Rothman how long it would last he said it would oultive me... we'll see

[priapism]

Are any of you bionic skiers comfortable with dropping cornices or jump turns?

[rod9301]

Yes, no issues.

Sent from my moto g 5G using Tapatalk

[priapism]

Yes, no issues.

Sent from my moto g 5G using Tapatalk

Reassuring. I'm not ready to end my career of mediocre hucking after THR

[mcski]

User name checks out


Oh, hucking. Never mind

[Spooky]

Revision. It's harder the second time around.

That’s exactly why hip resurfacing is the answer. Preserves bone so a later revision to a THR is much easier, but gives you incredible quality of life back in the mean time. There’s a reason why elite athletes with severe hip problems get resurfacing.

[priapism]

That’s exactly why hip resurfacing is the answer. Preserves bone so a later revision to a THR is much easier, but gives you incredible quality of life back in the mean time. There’s a reason why elite athletes with severe hip problems get resurfacing.

That's a benefit to the birmingham procedure but a downside is that the implant can cause metal toxicity as it wears, at least according to when I last glanced at the research...anyone know if they've developed newer resurfacing techniques that do better for wear?

[Spooky]

That's a benefit to the birmingham procedure but a downside is that the implant can cause metal toxicity as it wears, at least according to when I last glanced at the research...anyone know if they've developed newer resurfacing techniques that do better for wear?

Quite a few larger scale trials are underway with ceramic components rather than metal, but on the metal side there have been huge advancements in surgical technique, which have reduced the metal on metal concerns dramatically.

Research showed the main cause of metal issues related to the angle placement of the acetabular cup - when there was too high an angle it caused edge wear which could sometimes lead to issues with excessive metal ions. That research allowed surgeons to determine a safe zone for angle placement. However, that safe zone was harder to achieve with smaller complements, so the major manufacturers withdrew smaller component sizes, leaving only those with femoral heads above a certain size as qualifying for resurfacing (which largely excludes female candidates who were more susceptible to metal issues). These changes have resulted in hugely improved success rates - comparable with or better than the best THR results, whilst having fewer restrictions on activity, lower dislocation rates and most importantly, preserving bone for future revisions.

It is a more technically challenging surgery than THR so it’s more important to find a surgeon who specializes in them, and they’re much harder to find depending where you are. But the results are incredible if you can find one, especially if facing a hip replacement when young and active.

The website surfacehippy has a huge amount of useful info on the subject (which I read obessively whilst trying to figure out my best options).

[priapism]

Quite a few larger scale trials are underway with ceramic components rather than metal, but on the metal side there have been huge advancements in surgical technique, which have reduced the metal on metal concerns dramatically.

Research showed the main cause of metal issues related to the angle placement of the acetabular cup - when there was too high an angle it caused edge wear which could sometimes lead to issues with excessive metal ions. That research allowed surgeons to determine a safe zone for angle placement. However, that safe zone was harder to achieve with smaller complements, so the major manufacturers withdrew smaller component sizes, leaving only those with femoral heads above a certain size as qualifying for resurfacing (which largely excludes female candidates who were more susceptible to metal issues). These changes have resulted in hugely improved success rates - comparable with or better than the best THR results, whilst having fewer restrictions on activity, lower dislocation rates and most importantly, preserving bone for future revisions.

It is a more technically challenging surgery than THR so it’s more important to find a surgeon who specializes in them, and they’re much harder to find depending where you are. But the results are incredible if you can find one, especially if facing a hip replacement when young and active.

The website surfacehippy has a huge amount of useful info on the subject (which I read obessively whilst trying to figure out my best options).

Fucken-A that's what I hoped to learn. Frustrating how statistics either are too nuanced, or never get the nuance right. I'm gonna be on the look out for this as my femoral head necrosis appears tiny and the majority of the joint is still intact. It sounds almost too good to be true, but no way you'd be a big biomed shill. Not looking forward to searching far and wide for orthos who will do it though.

Did you have both hips done or just one? How is your activity now?

[Spooky]

Fucken-A that's what I hoped to learn. Frustrating how statistics either are too nuanced, or never get the nuance right. I'm gonna be on the look out for this as my femoral head necrosis appears tiny and the majority of the joint is still intact. It sounds almost too good to be true, but no way you'd be a big biomed shill. Not looking forward to searching far and wide for orthos who will do it though.

Did you have both hips done or just one? How is your activity now?

Lol, yep, not a shill - just a long term ski bum who got a bad diagnosis at a fairly young age. That left me terrified of not being able to ski hard any more, hence the obsessive research on my options.

I’ve just had my right one done so far. I’ve been so happy with it I would get my left one done tomorrow if I could, but my surgeon says my left has to get worse before he can justify putting me back on his surgical list, which is frustrating but I also kind of understand (my diagnosis was cam type hip impingement on both, but advanced OA on right and only moderate OA on left). I just want my left to be done asap so it can be as good as my right is now.

I was pretty lucky as my doc at Banff Sports Med who initially diagnosed me put me on to the idea of resurfacing straight away, and that allowed me to research local surgeons and then specifically request for my referral to the Calgary hip and knee clinic to go to one of the only surgeons who specialized in resurfacing. It meant I had to wait a little longer, but it was well worth it.

As for my activity now, I am feeling better and skiing and biking harder than I have in years. It’s been absolutely life changing. I guess I beccame so used to bad hips over the years that I didn’t realise how well a good hip could function. Even within 8-10 weeks of surgery my ROM on my operated side was better than I can ever remember it being. I was road biking within three months, mountain biking at just over four months, and then by the start of the next ski season I was ready to go and skiing strong from the off (op was at the end of Dec 2022 at the age of 39). I have adjusted my a skiing a fair bit - avoiding big cliffs and flat landings. That’s not because the new hip doesn’t feel strong enough for it though - more a case of trying to be smarter and preserve it for as long as possible, as well as being sick of the injury/surgery/rehab cycle (I had suffered two separate Achilles ruptures in ski and mtb crashes whilst waiting for my hip surgery). I have been hammering top to bottom laps all day long multiple times a week though, as well as still hitting some park laps etc, and it feels incredible.

Where are you located? That Surface Hippy website has a list of resurfacing surgeons by region, and often lists roughly how many they’ve done as it is a surgery where seeing a high volume specialist pays dividends. There are also some very helpful FB resurfacing pages which can help with getting advice on surgeons by region. Just be wary of surgeons who only do THR warning you against BHR, based on the historic issues with some of the implants. Confidence amongst resurfacing specialists who are up to the date with the research is far higher.

[plugboots]

Well, just got back from my appointment to check out my hip and it looks like I am getting a hip resurfacing at the next possible time they can schedule me.

[goldenboy]

Good luck Plugboots, it will go great.

I might be turning the corner finally. I've been mountain biking again which sure helps mentally. What I'm not doing is walking for the sake of walking, as that seems to be the motion that aggravates my soft tissue issues.

[Peruvian]

Monday is the day for new hardware. My hip feels better than it has in years so the pre-hab must be working. I’m still second guessing the whole thing but know I’ll be happy on the other end.

[yeahman]

Good luck Plugboots, it will go great.

I might be turning the corner finally. I've been mountain biking again which sure helps mentally. What I'm not doing is walking for the sake of walking, as that seems to be the motion that aggravates my soft tissue issues.

I went to a doctor once and told him "My leg hurts when I do this." He said so don't do that.

Monday is the day for new hardware. My hip feels better than it has in years so the pre-hab must be working. I’m still second guessing the whole thing but know I’ll be happy on the other end.

Good luck man.

[Peruvian]

48 hours out from surgery and it’s going well. Minimal swelling and only took the oxy the first night. I’m eating ibuprofen, naproxen and aspirin regularly but can walk easily using crutches for balance.
/fingerscrossed