Young hip replacement – advise needed!

Benhughes29

Hi All,

It’s been a while since my last post (about 4 years) – here: https://www.hiprunner.com/?p=8422

I’m finally at the point where I’m scheduled within 1 month to take the plunge with a left THR, aged 35.

 —-

A brief background:

– previously a very active amateur footballer and casual runner. Aged 29 I was diagnosed with bilateral OA. Genetic/ over-use etc …

– I had a left hip arthroscopy 5.5Y ago and I did the same for my right hip last year.

– I have done Hyalauronic injections in both hips a couple of times over the years – last time about three months ago.

– I have pain most days which I try to manage with needling, massage and hard-rolling. At times I get very sharp, acute, shooting pain in the worse (imagine that’s the bone-on-bone?)

– Post op, the right is looking good on the X-ray (good spacing, no re-growth of impingements, no cists). Occasionally I get this annoying catching sensation and often muscular ache. I’m hoping that is scar tissue/ compensation for my (much worse) left hip as the Dr says the X-ray looks like I have a good few years left in the right hip.

– The latest X-rays on the left hip show visible progression over the years – irregular spacing, big spurs/ impingements, bone on bone at the corner, cists everywhere  – so I’m booked in for the left THR in 3 weeks….

—

I came to the decision over the past 12 months to finally get the left THR. I have struggled consistently to walk longer than 10 mins – often having to stop to stretch or rest the hip. I can exercise as usual on the bike/ cross-trainer/ swimming but haven’t run properly for three years. For me that’s not good enough: I have two young sons and I want to be an active dad, I want to be able to manage my weight and health with exercise, I dream of running or playing football casually again, I want to be pain free. I want to maximize my mobility now whilst I’m still young enough to do so.

BUT… I have struggled with the psychological aspects ( I think I still do, even now the surgery date is looming). ‘I’m too young aren’t I?’ / ‘ Will I ever run again’ / ‘will it wear out early and potentially need 2  revisions’? / ‘I can live with this – do I really need the surgery – it’s not life and death’….

 

The questions that are bugging me now in the lead up to the surgery:

– am I doing the right thing going for THR instead of BHR? I’ve obviously read the comparative analysis on the topic and spoken at length with my surgeon but I’m still a bit lost – for now I’m booked in for THR.

– a strange thing happened last week – I tried to run (nothing to lose now!). And my left –for the first time in years felt pretty OK afterwards. I had another 5 min run today – again no reaction. It’s so annoying that after years where I wouldn’t even try to run due to the pain when walking, that now for some strange reason I’m getting a reprieve from the pain ?! Perhaps it’s the painkillers/ injections kicking in? I’m going to carry on testing the left hip with light running – I’m hoping from some reassuring, familiar pain to remind myself I’m doing the right thing!

– again frustratingly my right (‘better’ hip) aches more than my left (‘THR candidate hip’) in recent weeks. As I said , the right hip surface is in good shape post-arthroscopy but I continue to get glute aching a year on from the surgery. I limp pretty badly – perhaps this is compensating pain for over-loading the right hip to protect the left? Anyone out there with recent similar experience – muscle tension weighing on the better hip (especially post scope)?

I need some re-assurances I guess:

– do I have anything to gain by holding out another 6-12 months?

– Will I be able to run / play light football (soccer) after a THR?

– When does the latest hardware look like it will run-out/ require revision?

 

I know inevitably I need a THR. No doubt. But I’ve been holding out as long as I felt I could to delay it over the past 5 years. I felt I took it as far as I could but now I’m worried I’m giving in too early.

Any advice/ thoughts guidance would be so much appreciated!?

Ben

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    • February 9, 2020 at 5:07 am #17691
      Benhughes29
      Participant

      Hi All, It’s been a while since my last post (about 4 years) – here: https://www.hiprunner.com/?p=8422 I’m finally at the point where I’m scheduled wi
      [See the full post at: Young hip replacement – advise needed!]

    • February 9, 2020 at 5:33 am #17693
      Felicity
      Participant

      Hi there. I’m an ultra distance runner. I put up with my right hip for 3 years before I had my THR in April 2012. Funnily enough like you it was the other hip ( the left one ) that needed done first. I was running again by the beginning of July that year slowly at first after the 12 week healing period. It was at least a good 18 months before I was fully comfortable although I can honestly say after the op of which I was initially terrified to have in case it stopped me from running, I wished I’d had it done long before. So when it came to the right hip needing done I didn’t hesitate and had the right THR in April 2014. From then on I’ve never looked back. I run most days in the region of 8-10 kms. I’ve done a few half marathons but haven’t attempted anything longer ….. yet.
      I would tell you to go for it, & get your quality of life back. The majority of us on this site still run. Although done surgeons will tell you not to, they don’t actually have any long term proof that it can harm the prosthesis. I hope this info can settle your mind. Good luck and let us know how you go.

    • February 9, 2020 at 6:33 am #17694
      AimeeC
      Participant

      Hi Ben! I too was a young THR patient (well, 42 — sorta ‘young!’) — Next week will be my 5 year anniversary for my new hip. Like you, I was definitely nervous about the surgery, put it off as long as I could — Have Dysplasia and the hip was doomed from the start, but I fought it hard as I could. Like Felicity said here as well — I wish I had done it sooner.

      The ability to get your life back is so worth it. If you know you are heading for THR anyway, just do it. Suffering on a bit longer won’t improve your quality of life and really in the big scheme of things a 6-12 month window in when you get the hip done is not going to have a big impact on overall usage expectancy for the implant.

      Since having my THR done I went back to running (took it very slow but completed a 1/2 marathon about 14 months after), walking hiking, aerobics, yoga, etc. The most important thing for me is the ability to walk and travel pain free. Recently traveled to Japan and several days in a row logging 10+ miles each day walking and sightseeing and went to sleep each night gleefully pain free.

      The biggest thing is be ready for the recovery — Feeling a bit broken for a while — Especially as a young, active person you will probably struggle with that. I actually wrote a piece for Prevention after my THR talking about this issue you may find helpful:

      https://www.prevention.com/health/a20459894/hip-replacement/

      Just remember to take it slow and let your body heal! Trying to push it too hard too fast will not benefit you. Go easy, give yourself a break and always keep the end game in mind — Pain free life!

      Good luck and keep us posted!
      Aimee.

    • February 9, 2020 at 8:03 am #17695
      Hip Brother Tom
      Keymaster

      Hi Ben.
      I am 8 years in and just finished a 19 mile run yesterday. Hip brother Dave just ran a 100 mile ultra in under 20 hours. Look at your quality of life over the last year. You are never too young to improve your quality of life. And you will be able to do all of your favorite activities again. Maybe not great right away but within about a year and a half you will be nearly back to normal. Don’t worry! Stay optimistic! Good active times will return!
      Hip Brother Tom

    • February 10, 2020 at 1:32 pm #17699
      skeenen1
      Participant

      Ben, I echo the other comments. Grab quality of life now, waiting 6 or even 12 months isn’t going to heavily influence the life span of the implant. After recovery you will be able to run and play football (soccer). I run almost every day. However only 3 days are outside. The rest is on my zero runner – check it out. The zero runner has been a life saver for me. I have completed 4 half marathons since my right hip replacement. Hip replacement was anterior approach, ceramic on poly materials. I am just a recreational runner, however my post THR running is better than my pre THR running. Good luck and fast recovery!

    • February 11, 2020 at 12:32 am #17700
      Petemeads
      Participant

      Hi Ben – re: BHR versus THR, I have one of each. Both hips were failing at the same time (I was nearly 65) and I could not tell which was worse. I did the research and decided I needed a BHR to allow me to carry on running, biking, climbing and mountaineering. I found a local surgeon who had a great reputation and could do the operation and got booked in. A friend then had a THR and I felt sorry for him because I expected he would not be able to climb again. Not true, he was back on the indoor wall at 8 weeks and has not looked back. My BHR went well, it turns out the left leg was the worse on X-ray, and I was jogging and climbing at 8 weeks and racing within 9months.
      Two years later the right hip gave up the struggle and I went back for another BHR but the head broke off my femur during the op due to poor bone quality..
      I got a ceramic/ceramic THR by Zimmer. Surgeon said I would not be able to break it, and ceramic will not wear out (metal/metal does have some wear and allergy concerns). Back jogging at 6 weeks, long days in the mountains etc within a few months, currently looking at a 24 hour challenge hike in the Lake District.
      This THR leg has a better range of movement and less feeling of being a replacement than the BHR, surprisingly, although I do still have concerns that the mechanics of a THR are not apparently as good as a BHR (big spike in femur and smaller bearing). Mr McMinn, the inventor of the BHR, recently admitted that metal bearings are dead, and ceramic resurfacings are being trialled in a few places, and ceramic on cross-linked polythene seems to work well as a THR bearing (cheaper than all-ceramic). I would suggest that at your age you find a bearing where the plastic part can be swapped out easily or go for all ceramic if available – both should give over 20 years active service. Good luck!

    • February 11, 2020 at 6:30 pm #17715
      sjw7625@yahoo.com
      Participant

      Greetings,

      I’m 43 and just had a left THR in October. It’s a ceramic/plastic and was done through the anterior approach. I had all the same thoughts and concerns that you did and even experienced notable improvements for two months leading to the surgery. I think that was because I really started focusing on overall fitness and nutrition to prepare for the surgery.

      I will tell you that I don’t regret getting it done at all. I Didnt have a lot of pain but the mobility I lost was really starting to wear on me. I ride dirt bikes and couldn’t even get on or off the bike without pain or even falling over. I’m still recovering but I’m back to being active again. Running is taking a while to get back up to speed but I think that’s due to muscles shrinking from the 3 years that I suffered. (At least that’s what the therapist says)

      I’m only 4 months post op and the improvements are amazing. I almost have full mobility and strength back, more energy and no arthritis pain. As far as the psychological part I struggled with that too. Will it wear out, will it break if I crash my bike? You name it and I thought of it. My doctor assured me that if I stay healthy and active I should be fine. Might last 20 years might last 50, everyone will be different. He said if I wear it out and they catch it early he can do a simple revision as the new hip is modular. Also said to live my life and do what I want. No real benefit to squeezing a year or two out of your original equipment at the expense of quality of life. Good luck and keep us posted.

    • February 11, 2020 at 6:48 pm #17716
      Dave Whiteside
      Participant

      Hi Ben, you have to be comfortable with whatever decision you make, but it’s yours to make. All we can tell you is our experience and most of us writing here are doing so because we’ve had good outcomes. There’s no guarantee but technology and materials have got a lot better and will continue to. I had my hip replaced 10 years ago and run over 2,000 miles a year, but yes I’ve had some injuries with the hip area, but not the actual replacement. If I do too much speed work, it will make my hip sore. I’ve learned to listen to my body and back off so I can run another day. I’ve just completed a 100 mile race and finished 9th out of 173 runners and my hip wasn’t a factor, nor has it been in many other ultras I’ve ran. I’ve never regretted my decision and often wish I had done it earlier, hopefully you’ll feel the same. Good luck. Dave.

    • March 6, 2020 at 1:43 pm #17900
      Karl.os
      Participant

      Hi Ben, Amazing Dave…….. Pete thanks.
      Recent THR’s removed Resurfacing due to Metal poisoning.
      Inserted Ceramic on Ceramic with spacers so I have the largest ball size. 40mm helps hunting due I don’t want dislocation out in the bush.
      There are some great Poly products out there as well.
      Be safe check out what your body may like of the debris is all I can say.
      Poly has some of this issue but ceramic seems better which is Zerconia.
      Check out Zimmer, Biomet.
      I am hoping I can run again 1 day in the next 6 months.
      Good luck with you decisions.
      Cheers K
      🙂

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