Posterior THR recovery experiences

Hello all,

I’m scheduled for my op in 3 weeks.
I’m in the UK and it  will be a posterior approach. I would be keen to hear from others who have had surgery this way as opposed to a lot who have had anterior surgery. As with many, my consultant does not support a return to running which I have not come to terms with. Thanks in advance.

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    • #19892
      HaveToRun
      Participant

      Hello all, I’m scheduled for my op in 3 weeks. I’m in the UK and it  will be a posterior approach. I would be keen to hear from others who have had su
      [See the full post at: Posterior THR recovery experiences]

    • #19893
      OB
      Participant

      Good luck on your upcoming surgery. I had the posterior approach and slowly getting back running. This month I am shooting for 50 miles per week with a goal of 60/wk for Dec, Jan and Feb before racing a half marathon the end of February.

      I am wondering exactly why you are being advised to not run following surgery?

    • #19894
      Coddfish
      Participant

      Hi @havetorun

      I had total hip replacement 8 weeks ago in the UK with a posterior approach. My surgeon was supportive of running (he’s a runner himself). He just told me it shouldn’t be the first thing I tried to do and that I should mix running with other activities so not all my load came from running. I have met with more negativity from other professionals, I think if they don’t run themselves, they don’t understand why other activities aren’t good enough.

      I don’t know that posterior versus anterior makes a major difference to whether you can run. A good surgeon is going to be separating your glutes, not cutting them. Posterior makes for an easier, quicker operation, with less risk of nerve damage. Mine was 50 minutes, no bruising, no swelling. The surgeon will be using an approach they think is right for you.

      The main question I would want to understand is whether the implants can be uncemented. I suspect your running chances will be better if you can be uncemented. It will depend on whether your bones are suitable for an uncemented implant (ie they are strong enough). With an uncemented implant, you have slightly longer initial recovery time but the bones and implant will naturally bond, no risk of cement cracking or causing other problems. I haven’t seen whether you are male or female or your age. I am a mid 60s female and my surgeon warned me that most women of my age have softened bones and need a cemented implant. Of course, I am a runner, so when he got me opened up, he found rock solid bones and I got my uncemented implant. Knowing I wanted to be active, he fitted a Smith + Nephew Polar system with an oxinium head, they seem very suitable for active people. I have heard that some NHS trusts try to push a certain percentage of cemented implants because they are cheaper, so beware of this if you are having an NHS operation.

      8 weeks on I am very well recovered. I haven’t started running yet (and probably won’t for 6 months). I am power walking with Nordic poles. I am swimming, static cycling, using weights, basically working to get my strength and fitness back up. I still have a slight weakness in my groin from the surgery, but that will resolve.

      I had my operation privately and had invested time in identifying a surgeon who had a particular specialism in active people. He’s done a great job. Good luck with your operation.

    • #19896
      WedgeC
      Participant

      Hey there and best wishes on your surgery! You have made the decision – now WORK To make it the RIGHT decision 👍
      I selected a trusted local orthopedic who is very active and has worked on numerous athletes. I put my trust in him. He ONLY performs posterior approaches; when I asked him, he said there is “less risk of complications with posterior and that he absolutely will not do anterior approaches”.
      That said, and regarding your return to running, it is vital for you to “KNOW THYSELF”!!! Other than the first month where it was imperative to simply listen to doctors and physical therapists to simply take it very, very easy, everything I felt and had tuition with, both good and bad, has been accurate. I don’t want you to take my advice as “gospel truth“, but I was perfectly capable of easy running 60 days post operation, Could run 6 miles at 75 days post operation and 10 miles 90 days after operation. Again, easy, relaxed, pain-free running… Not 50 miles a week including speed work. I did 15 rugged miles on the Appalachian Trail in under four hours six months post operation and ran a 21 mile trail Under four hours race eight months post operation. Also note here that I had no hip joint pain, but plenty of the “good“ muscle soreness. So there is plenty of hope and I have many goals to knock down!

    • #19897
      HaveToRun
      Participant

      Reply To: Posterior THR recovery experiences

      Hi Janice
      Thanks for your reply – it is very encouraging.
      I’m 51, male, and was also late in life to running having started age 47. I was quickly hooked and went on like you from C25K. I ran a marathon in 2020 – alone as I’d entered The Manchester Marathon which was of course cancelled. The rest of 2020 was great for me running wise – I was running weekly half marathons and even managed to run the Cheshire Half with a new PB.
      I had arthritis when I started running (unknowingly) and I continued once it was diagnosed but it’s now bone on bone – I can barely walk some days.
      I have also opted to self pay but I’ve simply stayed with the consultant I originally saw on the NHS. He doesn’t support a return to running, mainly from wanting the prosthesis to last as long as possible. He’s very much a stats man and quotes proven numbers ie. which approach allows the best chance of success, which materials have proven how long they have lasted etc. He said metal on metal was once thought best now it’s proven otherwise. He says anterior minimal approach is all the rage, but the surgeon has a very limited view. I’ve been told the stem will be cemented or uncemented depending on what he sees on the day. Said it didn’t make much difference ?? The head will be ceramic and a cross polythene cup. He said he would expect it to last at least 15 years. None were fitted 30 years ago so this is not proven yet!
      I researched on the National Joint Registry. My guy does about 125 hips and 25 revisions a year. About half as many knees as well. He’s currently an expert witness in a litigation case against a surgeon who carried out an anterior approach replacement. I’m not sure how else other than recommendations how to find anyone more suited. I’m not sure if this forum permits sharing of such information but I would be interested to speak to your consultant.
      Darren

    • #19899
      WedgeC
      Participant

      Hello Darrin and it sounds like you are doing very thorough due diligence which is about as much as you can do. I believe Medicine is both art and science… coronavirus and how we mis-handled that is a great example… How much do medical experts really understand???
      That said, I would not set your mindset that your joint replacement will be perfect… I would set your mindset for the hopes that your joint replacement improves your current situation. If you have been dealing with pain, stiffness and limited range of motion for some time, the hip replacement will get you through that. I am almost a year removed from mine which included the operation, six months of physical therapy, combined with nine months of chiropractic… Perhaps it is the American medical system but the orthopedist is part medicine part Carpenter, physical therapy gives you some tools in mobility and strength surrounding the joint, and chiropractic is the spine and in the case of the hips, how it ties to the pelvis. YOU will be your medical authority and how this all ties together and what your future holds.

    • #19901
      Coddfish
      Participant

      Hi Darren
      It sounds like your consultant has a good success rate and knows what he is doing so I would think you are fine to go ahead with him. You can make your own decision on the running once you reach the other side. As you say, today’s implants weren’t in use 30 years ago. Running is a risk decision and it’s yours to take. I think you will know whether and when it feels ok to run. Mine doesn’t yet feel ready to run, but it certainly feels like I will get there.
      Not sure whether the obsession with anterior surgery is an American thing? Everyone I know in the uk who had been through it has had posterior surgery. I would always go with what the surgeon wanted to do (anything else is nonsensical given the surgeon is the expert) but I certainly had no interest in seeking out surgeons who specialised in anterior incisions. Not sure how well they work on women anyway, given our different interior ‘bits’.
      All the best for surgery, do post how it went.

    • #19902
      JohnG237
      Participant

      Hi @HaveToRun,

      Pretty similar story here – having my surgery privately (booked in for Thursday week). I have never been a huge runner but have completed up to Marathon distance. Not sure I want to go that far again, but looking at getting back to 5k & 10k if I can – not looking for PBs (well, only new-hip PBs), just to be able to jog round again.

      My surgeon, like yours is not overly keen on high impact like running, but seems happy if the volume is not too high – so bodes well maybe? I’ve been told my replacement will be uncemented, largely due to the exercise regime I have that will (hopefully) have kept bone density & strength high. I think that probably extends the recovery time, but this is the long game, not a quick fix. I think walking, biking & swimming will be enough of a challenge in the first few weeks/months anyway.

      All the best with the surgery and recovery/rehab – would be good to share experiences here.

      John

    • #19903
      Petemeads
      Participant

      Hi Darren, I have held off commenting up to now because my ops were both lateral incisions (Hardinge technique?) So neither anterior or posterior. You end up with a big scar down your thigh but that seems to be the only downside.

      I have a metal resurfacing and a ceramic/ceramic THR but I believe ceramic/poly will be just as good. My surgeon confidently stated I would not be able to break my ceramic device (which is uncemented, and I have not got good bones) so I was jogging before my 6 week checkup. My devices are 7 and 4.5 years old, last spring I ran Gold county standards at all distances from 1 mile to 30k, longest walk so far has been 42 miles. I’m 70 and expect the hips to outlast the rest of me. Good Luck!

      Pete

    • #19904
      HaveToRun
      Participant

      Hi Janice
      Thanks again for your reply.
      My deterioration has been so rapid – ran 26min (slow for me) Parkrun August 14th, few more pointless local runs, then run walk – even more pointless, then walking, then walking shorter, now only occasionally able to walk at all. Could dress ok last week now can’t put socks on. So from being in denial in June it’s been a rapid change to accept. Sleeping is even difficult now. I agreed to a THR in 01/09 with a six month wait. Two weeks later went back and opted for self pay – wait time 6 weeks ish.
      My consultant is by the sounds of it very good. His job obviously is to relieve me of pain and allow me to live a normal life. I’m sure he will achieve that. I’m not surprised most consultants discourage running because, as you say it’s a risk. They’ve not done there work for you to jeopardise it.
      I’ll post in the forum on the other side.
      Thanks again for your supportive replies.

    • #19905
      HaveToRun
      Participant

      Hi John
      Great to hear from you.
      I wish you well for your procedure next week – I’m counting down and can’t wait. Currently sleep difficult. In fact mainly in constant pain because I didn’t stop running early enough being in denial – regret it now. Consultant told me to get a replacement in January. Instead I got a cortisone injection and ran another 500 odd miles. If I’d have know the pain that it would cause at the end I would never have done it. 21 days to go.

      • #19907
        JohnG237
        Participant

        I hear you on the sleep front … that’s the hardest bit for me. I am in constant discomfort, even sitting I’m aware of the hip, and some movements are sharp reminders of the problem!

        So I’m going early for my THR – I could probably eek a few more months out of the original, but I don’t want to end up in a position where I’m *really* struggling. I had a cortisone injection in July – and it was fine for about 8 weeks, but then dropped off the edge of a cliff (after I’d completed a Wolf Run – 10k of mud, water & obstacles).

        After that my consultant said it was either manage with pain relief or have the replacement. I’m not a fan of pumping my body full of drugs (especially ones you could get dependent upon), so opted for surgery as the solution.

        That’s when I really started investigating post-THR exercise & running, and this site gives me great optimism that I’ll at least be able to get back to something that approximates to running – right now I’d be happy with a 5k jog/shuffle.

    • #19906
      HaveToRun
      Participant

      Hi Pete
      Thanks for you comment. It’s very encouraging.
      The range of recovery experiences is so wide it’s impossible to know what to expect.
      I need the THR and I’ll simply have to make the most of what I end up with.
      Will post recovery experience on the forum.
      Thanks again

    • #19910

      Good luck on your upcoming op, I’ve had both hips replaced in the past 2 and 1/2 years, both posterior ops. I would say by using a cross trainer before your op is the best way for a quicker recovery, strengthening glutes and ligaments gives a head start for post op. 18 months after my last op I can do 7 minute mile and 7.30 miles over 5k. My weekly mileage is only around 8 per week as I’m still taking it relatively easy for the next 6 months. As others have posted, listen to your new hip and rest when it tells you, but just walking immediately post op is the best exercise you can do, good luck.

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