Steve – information/opinion for new or potential members

Dear All,

I am no more (and no less!) qualified to offer advice than many others, including Hip brother Tom. But I know that I was desperate for hope when I found this site and therefore I offer a few things in response to questions posed by new visitors.

As a matter of responsibility, I suppose I must offer the typical disclaimer: Every case is different and my comments/advice may not apply to all situations. There – that’s out of the way.

After my own research, and lengthy conversations with my surgeon at Hospital for Special Surgery in NYC, I believe most of the conservative restrictions post surgery are nonsense and old-fashioned. This field, like most other human endeavors, has advanced dramatically over the years.

1. The notion that the implant will somehow shake loose with impact or repetitive activity is false, according to my doctor. When the bone knits to the pores in the implant, it makes a solid bond. My doctor implied that the new femur is as strong or stronger than my natural leg. His only precaution was to resist running for 12 weeks post-surgery to allow the bone to grow properly into the implant. If too much motion occurs too early at the interface, fibrous tissue can develop, which is not a good thing. Thereafter, it’s good to go.

2. The idea of the parts “wearing out” seems equally nonsensical. Many, perhaps most, of the folks on this site have a ceramic “ball” and a polyethylene socket liner. Both of these materials have evolved so as to have nearly indefinite life. One study I read of the newest highly-crossed polyethylene showed virtually no wear at all after many years of activity. My impression is that they really don’t know the longevity because it simply hasn’t been in use long enough. But at least my doctor was quite certain that it will outlive me. I’m 67, but still as active as several decades ago. It seems silly to restrict activities at all, considering that the life of these things may well be 30 years or more. If I’m wrong – if he’s wrong – I’d still rather do everything I want to do.

3. The final piece may not sit well with everyone, but . . . Although my doc may have some professional interest in what follows, he certainly made a powerful case for me. There are several computerized systems available for guiding hip replacement surgery. The process, over-simply stated is: A CT scan is taken. Using this image, the surgical team designs a digital model of the precise hip the patient will receive. This includes implant size, angles of implant, etc. The digital model is perfectly symmetrical, balanced and aligned. Then, during surgery, the computerized system essentially requires the surgeon to create what has been designed. There are, of course, many human checks and balances through the process. The result is an accuracy rate that is much higher than with traditional human measurement and surgeon experience. It may not be a relevant factor, but I believe my fast recovery and current completely normal function is partially because of this. Also, referring back to #2, one cause of premature wear would be any small error in alignment of the parts, which is less likely with a computerized procedure.

So, there’s my two cents. Or maybe it is more like a quarter. Sorry for going on so long. I would have liked to read this when I was investigating hip replacement. Perhaps only I like it!

Cheers and good luck,

Steve