Athletes. Was: Digest Number 49

[Guest guest]

Goofy question from someone who is planning a metal to metal resurfacing:

How long does one normally have to observe hip precautions post-op? You are

doing these at 9+ weeks. Is this normal? Does one have to have these in the

back of one's mind for good, or is there some point at which the danger is

definitely past (I realize some danger exists always, I just want to know

if one is always as on edge about a hip dislocation such as with a THR).

For the more athletic of you, at what point did you feel you could resume

sports, even at a low level? I am pretty athletic now and would prefer not

to lose too much of much strength/cardiovascular conditioning, since

building it up is a miserably slow process (rule of thumb: double the time

you take off to get it back). Are there any competitive swimmers here? Are

there any athletes who would care to comment on what they are doing for

sports activities? Finally, could I get some references to talk to anyone

who has had this done who is athletic? Supposedly there are many (dancers,

joggers etc.) I would dearly like to talk to any and all.

Finally, in the package I got from JRI in LA, it stated that Bo had

a resurfacing. I also heard on the grapevine that he has had several

problems with this and had to have at least a couple of additional

surgeries. Does anyone have the straight dope on this? I know he was

playing baseball professionally for a while after his first surgery.

Thanks!!

Jeff

>

>Hi Amy,

>

>I had the left femoral head resurfaced on July 11 of this year (AVN). Like

>you, the acetabular cartilage is fine. I've received differing

projections,

>or guesses, about the expected longevity of this procedure. Some range as

>high as 20+ years. The point of failure, if one occurs, is the wear of the

>acetabular cartilage. If that doesn't take excessive wear and impact, is

>there any reason why it wouldn't last indefinitely?

>

>The one major question I have is whether the acetabular prosthesis could

be

>installed at a later date, once it is approved by the FDA. I asked my

>surgeon and he said it would depend on getting a good mechanical mating of

>the two parts. Otherwise, it would be difficult (although hopefully not

>impossible) to remove the existing resurface and replace it with another.

It

>is cemented in place. However, if that part could be matched to the new

cup,

>you'd end up with the complete metal to metal arrangement.

>

>Sleeping.........I was on my back for most of the 6 weeks. I was then

>allowed to sleep on either side with a pillow between my legs. I was

allowed

>to sleep on the operated side as soon as I could stand to put that kind of

>pressure on the incision, which wasn't the case for several weeks. At 9+

>weeks, I still use the pillow, and I occassionally sleep on my stomach

too.

>You just have to be careful to observe the hip precautions while turning

>over.

>

>Showering........I didn't bother with showering until after the staples

were

>removed. I just stood in front of the sink and gave myself a thorough bath

>with a washcloth. Hair washing was done at the kitchen sink, with my

>operated leg kicked back, so that I didn't viloate the 90 degree rule.

>

>I haven't heard much about others who have had this surgery. We'll have to

>stay in touch and share the news of our progress. I'm taking some pretty

>intense physical therapy now. It feels good, even though it causes some

pain

>in those operated muscles. I used a cane after I came off the crutches.

Now

>I only use it when I'm walking for more than short distances.

>

>You'll feel much better after getting the staples removed. Just don't rush

>things, even though you feel like you could go right out and charge the

>world.

>

>Best Wishes,

>

>Don

>

>

>

>

>

[Guest guest]

In rush, but just to say, I am ex dancer, am 55 years old. One year two months since resufarcing in Birmingham by McMinn. It is great. Carry heavy loads (although I tend to try to stay on my other leg if it is very heavy - up a step with luggage etc)

I am able to teach, showing all exercises full out. Cannot lift my legs very high (but never could, just stiff of age with both legs!). McMinn said after one year check up, nothing not allowed, just to jump must be sure to have enough muscle bult back up, which I have. Swim breast stroke absolutely full strength now (frightened at first). Now really feel no fear. Also other pains in knee and ankle which I thought would never go, now disappeared after intensive exercises in the sea for three weeks this year.

HOpe this is helpful - couldn't recommend more highly. Must say was very careful at first, keeping striclty to instructions, and lots of non strenuous exercises, Pilates (body control), and o;r swimming lightly and barre work after two and a half months, very slow building up

Best wishes

Dancer7

[Guest guest]

Thanks! I am not a dancer, but do classical Japanese martial arts (hakkoryu

aikijujutsu, battojutsu) and lots of swimming. Most of the stretching etc.

I do (or would like to again :>) is identical to a dancer's stretching. (It

was very similar, until I started comparing notes with a ballet dancer

friend of mine and cheerfully swiped her exercises--they're just better.)

If you are able to dance, this is very encouraging indeed! Both for you,

since I know it must have been a big part of your life and for me, since I

have a really horrible case of DDH, which was undiagnosed until **waaay**

too late to treat. I'll take your advice to heart completely.

So you are able to jump? That's amazing, really when you consider the

surgery...

Thanks again!!!

Jeff

>In rush, but just to say, I am ex dancer, am 55 years old. One year two

months

>since resufarcing in Birmingham by McMinn. It is great. Carry heavy

loads

>(although I tend to try to stay on my other leg if it is very heavy - up a

step

>with luggage etc)

>I am able to teach, showing all exercises full out. Cannot lift my legs

very

>high (but never could, just stiff of age with both legs!). McMinn said

after

>one year check up, nothing not allowed, just to jump must be sure to have

>enough muscle bult back up, which I have. Swim breast stroke absolutely

full

>strength now (frightened at first). Now really feel no fear. Also other

pains

>in knee and ankle which I thought would never go, now disappeared after

>intensive exercises in the sea for three weeks this year.

>HOpe this is helpful - couldn't recommend more highly. Must say was very

>careful at first, keeping striclty to instructions, and lots of non

strenuous

>exercises, Pilates (body control), and o;r swimming lightly and barre work

>after two and a half months, very slow building up

>Best wishes

>Dancer7

>

>

[Guest guest]

Jeff,

Mine was ten months ago, but I think I can still remember the

timescales. Most of my restrictions were for six weeks, but because I

could not get to surgeon for sign-off consultation until 8 weeks, I

carried on until then (no running, 90%, not sleeping on operated

side).

After 8 wks, I started a little jogging (I still only do a little -

don't like it). Surgeon said I could do anything but contact sports

and bungee jumping, but build it up gradually.

Started a little tennis at four months and now play most weeks. Race

around like a madman and don't give it a thought. Even running back

for a lob and crashing into the fence. Friends all aghast, but it

feels so natural I have forgotten about it. Hmm, maybe tennis is a

contact sport?

Thinking of trying badminton again soon.

Never consider dislocation. When I had mine, out of over 2,000

Birmingham hips, there had not been a single dislocation! I will

check

at my one-year check whether they still have a 100% record.

Strange about Bo - MMT site at

http://www.midmedtec.co.uk/thr_today.htm says he had THR, citing him

as an example of THR not lasting for very active people. It says the

THR failed within a year after returning to baseball.

Regards,

Dave Vale

[Guest guest]

Jeff,

I asked Dr. Mont what restrictions I would have after the hip has completely

healed, and he said 'none.' However, the hip joint is contained within a

capsule that takes about 3 months to heal. That membrane seals the joint so

that it holds the synovial fluid that lubricates the joint. Once all the

muscles and ligaments are back to full strength, hips that have been

resurfaced don't have the same risks of dislocation as traditional THRs.

I'm building strength and endurance every day with the physical therapy I'm

taking. I can still feel the weakness of those muscles though. It takes

awhile to build them back after surgery and months of dealing with the joint

pain before that.

Don

[Guest guest]

I have the Birmingham hip replacement. This is metal on metal and the blow by

blow operation proceedure is on a website < http:/www.jri-oh.com/surface.htm>

This website also compares various different prosthetics and their relative

success. I have been surprised at the lack of UK contributors to this email, but

maybe I shoudn't be. I had to fight the NHS quite hard to prevent them hauling

me in for total replacement. I had to discover BHR for myself and also, of

course, pay for it because it is " not yet in the literature " . Anyone else in UK

with this fight on their hands?

Don Cassell wrote:

>

> Jeff,

>

> I asked Dr. Mont what restrictions I would have after the hip has completely

> healed, and he said 'none.' However, the hip joint is contained within a

> capsule that takes about 3 months to heal. That membrane seals the joint so

> that it holds the synovial fluid that lubricates the joint. Once all the

> muscles and ligaments are back to full strength, hips that have been

> resurfaced don't have the same risks of dislocation as traditional THRs.

> I'm building strength and endurance every day with the physical therapy I'm

> taking. I can still feel the weakness of those muscles though. It takes

> awhile to build them back after surgery and months of dealing with the joint

> pain before that.

>

> Don

>

>

[Guest guest]

,

I've had to fight the NHS quite hard to get anything done at all.

I was diagnosed with OA in my right hip 5 years ago, but must have had it

much longer. I visited an Orthopaedic Surgeon here in Edinburgh about 2

years ago, and he told me I was too young for THR (I'm 43), and to 'come

back when I felt like it' but didn't suggest any alternatives. It's only

because of my Chiropractor that I heard about hip re-surfacing, and

persuaded my GP to refer me.

I have been referred to Glasgow to see Mr/Dr Grigoris, who I have discovered

has published papers with Dr Amsutz (they are on the jri-oh website) - I'm

not sure whether that's the same as the Birmingham operation, but Lothian

Health Board won't refer me South of the Border.

My OA is now causing me real problems and serious pain (any recommendations?

I take Voltarol), and I believe there's about an 18 month NHS wait (at least

I think they will pay for it).

Regards

Dave Houghton

PS - I had a look at your website, and would definitely come in for lessons

if you were closer to Edinburgh! I grew up believing I couldn't sing and was

tone deaf, until I went on a Can't Sing, Won't Sing weekend about three

years ago - a most liberating experience.

Re: Athletes. Was: Digest Number 49

>

> I have the Birmingham hip replacement. This is metal on metal and the blow

by

> blow operation proceedure is on a website <

http:/www.jri-oh.com/surface.htm>

> This website also compares various different prosthetics and their

relative

> success. I have been surprised at the lack of UK contributors to this

email, but

> maybe I shoudn't be. I had to fight the NHS quite hard to prevent them

hauling

> me in for total replacement. I had to discover BHR for myself and also, of

> course, pay for it because it is " not yet in the literature " . Anyone else

in UK

> with this fight on their hands?

>

>

> Don Cassell wrote:

>

> >

> > Jeff,

> >

> > I asked Dr. Mont what restrictions I would have after the hip has

completely

> > healed, and he said 'none.' However, the hip joint is contained within a

> > capsule that takes about 3 months to heal. That membrane seals the joint

so

> > that it holds the synovial fluid that lubricates the joint. Once all the

> > muscles and ligaments are back to full strength, hips that have been

> > resurfaced don't have the same risks of dislocation as traditional THRs.

> > I'm building strength and endurance every day with the physical therapy

I'm

> > taking. I can still feel the weakness of those muscles though. It takes

> > awhile to build them back after surgery and months of dealing with the

joint

> > pain before that.

> >

> > Don

> >

> >

[Guest guest]

There are a few Birmingham resurfacees here. Have you also seen the

MMT website at http://www.midmedtec.co.uk/index.htm This is

specifically about the Birmingham procedure. It's also referred to in

the Links section of this site.

I was " done " by Mr McMinn last November - feeling tremendous, playing

a bit of tennis and thoroughly enjoying an active life again.

For UK patients trying to get it on the NHS, Mr McMinn's advice is to

make sure your GP refers you to a surgeon who does the procedure. You

can get a list from MMT.

Vale

> I have the Birmingham hip replacement. This is metal on metal and

the blow by

> blow operation proceedure is on a website <

http:/www.jri-oh.com/surface.htm>

> This website also compares various different prosthetics and their

relative

> success. I have been surprised at the lack of UK contributors to

this email, but

> maybe I shoudn't be. I had to fight the NHS quite hard to prevent

them hauling

> me in for total replacement. I had to discover BHR for myself and

also, of

> course, pay for it because it is " not yet in the literature " .

Anyone

else in UK

> with this fight on their hands?

>

>