Posterior THR recovery experiences

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?

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.

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!

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.

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.

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

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

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.

Hi Darren, wondered how your operation went and hoping your recovery is going well. Janice.

Hi @HaveToRun,

How’s the recovery going a month on? What did your Consultant say when you saw him on 11th Jan?

I’m working with a physiotherapist who understands me and my drivers to get back to what I was doing before my op (some pretty intense HIIT workout programs and running – though just short bursts) and is working with me to get me back there – although I’m a way off still.

8 weeks post-op so lots of walking, static bike, elliptical & swimming plus upper body machine work at the gym. Hoping to get back to using free weights for resistance soon.

John