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I am a 47 year old male who works as a Medical School Professor and am very
active. I had a THR on Sept 15, 2008 and have recovered nicely. I learned a lot
of from reading the surface Hippy Web site and picked my surgeon, Michael Mont
of Baltimore based on this information. I have psoriatic arthritis (PA), which
is a form of inflammatory arthritis that is similar to rheumatoid arthritis. The
PA has hit my hip joints and caused the rapid decay of my right hip; my left hip
is on it’s way out also.
At the time when my right hip was bone on bone, I had been racing my bicycle
for years and seriously considered a resurfacing by Dr. Mont. I traveled to
visit him in Baltimore and did a lot of research on metal on metal hip
replacement devices. I felt that the resurfacing would have been good for me if
I only had an issue with a single joint or both hips. Yet, I have issues with
lots of joints, and I was concerned that the metal ions associated with metal on
metal devices might add an additional stress to my malfunctioning immune system.
Thus, I decided to go with a THR and use a 36 mm ceramic head and heavily
cross-linked PE cup.
Dr. Mont likes the wear characteristics of Ceramic and I got a large ball
head, so I have outstanding range of motion. It has now been 15 months and all
is good with my surgical hip. My experience with my recovery does not mimic some
of the miracle stories you read about on-line, but has been very positive. At
the moment my hip feels great, but I still think about it on a daily basis and
still need to do lots of stretching to keep it loose.
This is how things went. I had the surgery and woke up the next day and my
leg felt like a ton of bricks that I could not move. I did not have a huge
amount of pain, but I was not real comfortable. The pain medication works and I
recommend taking it as directed. I have to say having to have my hip replaced at
46 was sobering and I did not view having the surgery as a good thing, so I was
a little depressed by the experience and remain this way. Once home, I had a
couple of major mental concerns. First, I was worried about getting an infection
and had a few paranoid moments. If you get in this situation call your surgeons
office and they can help ease your fears.
The second concern, was related to the length of my surgical leg. A day after
the operation there was a huge difference in the length of my surgical leg and
non-surgical leg. Part of this was caused by changes in muscle tension and was
not a real difference in leg length. Yet, another part was real and my surgical
leg is now about ¼ inch longer than my non-surgical leg. This is not a big deal,
but I wear a small lift to equalize things. However, I was not mentally ready to
deal with the issue of leg length discrepancy and this caused me angst. I was
not sure if the surgeon had made a mistake or it this was normal, so this
bothered me a lot. At the end of the day it seems like my surgical leg is within
the normal range of length and all is good. If you can try to minimize the worry
about the small stuff this will make the recovery easier. Thus, try to know as
much as you can before going into the surgery.
In terms of getting back to walking and functioning things went smoothly. I
went through the normal progressions and was back at work in about 8 weeks. I
flew to a meeting to give a talk at 11 weeks. However, at 15 months my hip is
still healing. Dr. Mont used a lateral approach, so many of my hip flexors were
cut. It has taken a long time for me to be able to pedal a smooth full circle on
my bike. Yet, I keep getting stronger by the month and I feel really good at the
moment. Thus, I would look at 8-12 weeks as the time required to get back into
the flow, but plan for another year or two the get all the soft tissue issues
with your surgical hip to go away.
At 15 months out, I need to do regular exercises for my hip. I need to do
this mainly because my hip muscles tighten up if I don’t exercise them and my
hip hurts. As soon as I do about 10 mins of hip exercises the pain is gone. The
more I work the hip, the better it feels. After I had my hip replaced I have had
a few minor problems with my lower back. This seems to relate to me tweaking it
during PT for my hip, so you need to be careful.
The thing that I am working on now is getting the hamstring on my surgical hip
loose as it is always tight. I am told that this is due to the hamstring being
over worked due to weakness in my hip muscles. Thus, there is a bunch of work
that I have had to do to recover from the THR and this remains an on going life
long process. You need to be willing to work to help yourself if you want to
have a stable joint long-term.
Overall, I am very pleased with how things have progressed and I would have
this done again. Dr. Mont and other surgeons are now using the anterior approach
and this appears to enhance recovery, because fewer muscles are cut during the
THR. My left hip is on the way out, and when it is time, I am going to go see
Dr. Mont and have another THR via the anterior approach.
If you are considering a THR versus a resurfacing you should know that I have
great range of motion in my surgical hip. Some folks are concerned about the use
of ceramic heads because they can shatter, but I used ceramic because it has a
better wear rate, which will reduce the occurrence of osteolysis and failure of
the surgical hip. Yet, lots of folks like metal on plastic because it is well
tested. Yet, the surgeon you chose seems to be more important than issues
related to the different devices. Get the best most high volume surgeon that you
can find. I traveled 300 miles to have Dr. Mont be my surgeon and I work at a
major medical center.
The ceramic on plastic THR allows me to do what ever I want. I don’t do high
intensity sports any more, but this is mainly due to other issues I have related
to PA. Yet, I have been on long hikes in the Rockies. I can ride my bike to work
again and I also play basketball on occasion. I don’t have great lateral
mobility, but I am pain free and am having some fun. Good luck with you hip
issues and I hope that you can come up with a pain free solution.
Best,
DC
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