So is running REALLY ok with an HR?

[imgetinold]

I read the report, and what catches my attention is the time frame.  I don't know the date of the study, but the mean age of the implant is 10 years.  From what I've read (someone correct me if I'm wrong), they have only known about proper cup angle placement - and the correlation between that and revisions - for about 5 years.  Unless you factor that into that study, I'm not sure how we can know what is truly impact-based, and not high-cup-angle related.

[chuckm]

This video of Vicky Marlow interviewing Dr. McMinn might be a re post but it is very convincing about the durability of the BHR in athletic men. Are there any hippies out there where running, or any sporting for that matter, was the reason for their BHR to fail? I'm mostly interested in those whose implants were put in correctly, had a good recovery, and then had a failure.

http://vimeo.com/12462399

Chuckm

[Jon]

Great question from my perspective.  I hope that we don't get too many affirmative responses though...!

[Pat Walter]

I recently had an email about BHR and running.  I am going to weigh in on this subject of running and post my reply:


I can’t give you an answer since I am not medically trained or a doctor.  I don’t know specific studies which show why a runners BHR failed. 

It just comes down to this â€" you decide if you want to run or not.  Do you want to take the chance of a problem.  Most athletes decide to be as active as they can.  I do have a story or two where runners wished they had just enjoyed their new BHRs and not run since they required revisions to THRs. 

Mr. McMinn’s info is good, but I don’t know at what time frame he is looking at.  5, 10 years, etc.  It is difficult enough to just get general information about BHR retention rates, failure rates and reason beside going into just failure rates for runners and why they failed. I don’t know of any studies.

I do know almost all the top surgeons have said they would prefer their patients don’t do high impact sports.  I sat in hip resurfacing courses at least 4 different times and listened to them.  They did say that they know patients won’t listen to them, so they OK high impact sports.  The BHR is basically a mechanical device and after a time, can wear out.  No bearing lasts forever and the BHR is a bearing.  The body joints don’t last forever, so how hard to you want to push it.  Normally the rest of the body and it's joints are not far behind the hip in a person with an arthritic hip joint.  So do you want to push your whole body?

If you are younger, you say it won’t happen to me and push, push, push.  If you are older, you decide you can live your life in moderation.  That’s been my choice since I have been given a great pain free life back with my BHR.

You need to listen to your inner voice â€" it is usually right.  Obviously it is concerned and you should listen to it if you spend hours researching specific studies about running and hip device failure.  You are trying to prove high impact sports are fine to return to.  No one can give you a guarantee.  Make your choice and live with it.   

Pat

[curt]

      So now, its my time to weigh in.  It most certainly IS a personal decision on whether to run or not.  I would venture to say that most of the people visiting this site that ask the question were at least recreational runners prior to injury...that's why they ask right?  The same questions arise about every activity or sport, depending on one's former addiction, because we all want to return to the things that we loved prior to our injury.


     Looking back on my earliest inner debates about whether to get an HR or not, it really came down to what, if any, procedure would allow me to achieve the highest return to activity.  I also contemplated the life-span of the device and my age at the time of the procedure.  I was one of the many patients that were advised to get a THR, and lacking an alternative would have gladly gotten one in order to be nearly pain free.  The chance of being q

[curt]

(apoligize for fat finger submission!)...

     I finally had to decide that an HR is the best opportunity for me to fix my hip pain and regain a higher level of activity.  In short the surgery by Dr. Gross was intended to help put me back in charge of my life.  I do not now wish for the life of my device to become the one in charge, otherwise what was the point in the first place?

Curt

[stephen1254]

I'm running again. Not as far and not as often but I'm running.

One suggestion that I'll throw into the conversation - Hoka One One running shoes. They have been talked about many times in many threads but they are absolutely the real deal. I ran from the middle of September - my 6 month point - to the middle of December, then stopped when the snow on the ground got too deep. I just started again about 10 days ago with my first 3 runs on the street, as opposed to the trails. First run was 2 miles, then 2.5 miles, then 3 miles. Not even the slightest amount of stiffness or soreness. I will never run again in anything else.

The concern with running is with the impact and these shoes lessen the impact.

[stevel]

Todd,

Reviewing your prior posts, I see that you are also a patient of Dr. Su and a Dr. and received a left hip resurfacing less than a year before I did.   When I asked Dr. Su if it was OK to run, he replied, "You are an Engineer, you figure it out!"  He did say it was OK to ski and play racquetball.  Pat is also an Engineer and she gave you her response.  I see that you other hip is nearing a resurfacing so obviously it has been prudent not to run until you receive the second resurfacing.  Vicky Marlow once advised, if you really want to run (esp. in competition) then go to a Dr. who will unequivocally give his blessing that it it Ok to run, such as Dr. Bose in India.  Dr. Rogerson has stated that the heel strike of running imposes a tremendous load on your hip.  I suppose the larger the stride, or faster the pace, then the greatest load will be imposed when landing on single foot.  Good luck with your resolution!

[Dannywayoflife]

I personally think that some common sense need to be applied. I do lots of stuff(when not at dam work!:-() no real running but other high end activity. This was the reason I went for a HR per thr. Any device could probably last a lifetime if you just sit around and do nothing! What's the point in that? Now I do risk ascess everything I do and I've yet to start running again but I'm sure that I will start at some point. If your an avid runner I would advise as much cross training as possible to lessen the impact but I'd still do some running if guys what you love as that's why most of us got bhr's.

[chuckm]

I agree with Danny's point of view to use good judgement. Some hippies have posted that their sugeons told them staight out - no running ever. And in those cases, maybe there was somehing else going on besides having a resurfacing, like soft bone or small components, etc.

But, when a surgeon "advises" against running, I think that is different than being told not to run. And with that advice, it seems some hippies have decided to become idle after resurfacing without further conversation. And that is the personal choice part. I made sure my surgeon knew exactly what activity level I wanted to acheive after the surgery and I also made sure he was clear with me about how he felt with regard to my intended activity levels. No offense, but that way I wouldn't have to ask you hippies advice on what activities are acceptable for my new hip.

Chuckm

[Dannywayoflife]

That's the thing chuck I was told to crack on and do anything I wanted. Although preferably no bunjee jumping

[chuckm]

I have the same approval to return to whatever activity I want. But, I continue to research what to expect from my new hip. Everything I find indicates that if you are a select patient with a properly implanted resurfacing device, that your hip will be quite durable.

We all assume risks when we participate in impact sports when we use our native hips. I haven't seen any studies that compare the durability of native hips compared with resurfaced hips.

While I doubt anyone can truly answer my curiosity, I do wonder if it is any riskier for me to do impact sports now with BHR than before with my native hip? Am I more fragile now or not? Unlike my other hip, my new hip isn't likely to develop OA  ;)

Chuckm

[Dannywayoflife]

I would have thought that a bhr is more susceptible to injury than a natural but for what it is a mechanical device they are amazing!!

[Bierhead]

I'm about to have my 4 year post HR anniversary.  I started back to running as soon as I was allowed and have been running regularly ever since. I run about 30 miles a week.  I'm not fast (9-10 minute/pace).  I have not experienced any pain.  Its been a wonderful 4 years and the best decision I ever made. I continue to ski, bike ride and do just about whatever I can.  I am super careful about ice when running.  Good luck out there!

[Canadian-Ice]

Since we have so little data, I was woundering, Pat, exactly what details you can recall about those couple of BHR recipeints who reported regreting running prior to revision to BHR? What evidence did they have that running influenced the need for revision? Did any of them have surgeons considered top surgeons on this site?

Thanks, Stephen, for your comment on Hoka One One shoes, as also responded to my similar post earlier. I've bookmarked that and contacted a retailer. Can't wait to try them out in the spring.

[Pat Walter]

I just posted this study. Thought it interesting since there are so few studies about sports and hip resurfacing.

http://www.surfacehippy.info/excessive-sports-longivity-hip-resurfacing-study-2012.php 

Original Release  http://www.eurekalert.org/pub_releases/2012-02/aaoo-esa020812.php

Public release date: 8-Feb-2012
American Academy of Orthopaedic Surgeons

Excessive sporting activity may impair long-term success of hip resurfacing

Patients should limit activities to maintain hip prosthesis

SAN FRANCISCO â€" In hip resurfacing the femoral ball in the hip joint is not removed, but instead is trimmed and capped with a smooth metal covering. Young and active patients with arthritis often choose hip resurfacing over total hip replacement to minimize the risk of hip dislocation, and to preserve the bone for a revision surgery should the primary resurfacing fail. However, the long-term effects of sports on a resurfaced hip were unknown.

In new research presented today at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), investigators surveyed 445 patients between one and five years after hip resurfacing. The type of activity, frequency and duration of the sessions, and intensity of participation were documented. Over the next 10 years, each patient's hip status was monitored. The mean age of the patients was 48.7 years, and 74 percent were male. There was a correlation between higher activity scores and risk for surgical revision. Other independent risk factors for revision included small component size, low body mass index, and 1st generation surgical technique. Patients with an Impact Score (IS) lower than 50 had a revision risk rate 3.8 times lower than the patients with an IS of 50 or greater. Survivorship for patients with a lower IS score at eight years was 96.4 percent versus 88.8 percent.

Large amounts of high impact sporting activities â€" such as daily running or tennisâ€" can be detrimental to the long-term success of hip resurfacing arthroplasty. Surgeons should advise patients to limit their physical activity to levels that the device can sustain.

[obxpelican]

Well, I'll be 5 years post-op this August, I just started back to racquetball and basketball, now I am re-thinking all of this, I do not want to destroy my hip and go through the surgery again.

I am just wondering if cementless would be more durable than cemented when it comes to the pounding that I am putting on my hip.  Dr. Gross cleared me to do whatever I wished but I am wondering if he's changed his opinion?


Chuck

[Pat Walter]

I don't think any of the surgeons have changed their minds and written new articles or studies about running.  I would not worry about normal sports and moderate running.  Most patients are going to do it anyways.

I had this study and forgot to post it.  I just thought it would be interesting for this particular discussion.  There are not many studies about sports and resurfacing that I know of. 

As I stated before, I think moderation is a good thing, but that doesn't mean everyone needs to only walk and rock in their rocking chair :o

[obxpelican]

I zipped an email to Lee anyhow, just to see if Dr. Gross has had any change in his mind. 


Chuck

[chuckm]

I think what is frustrating us former impact athletes is that these impact studies (unlike most other studies) have no specifics regarding the causes for the revisions. I've only seen a few studies on impact sports and they just say the chances of needing reivision is higher.

Are impact athletes having failures due to the same reasons as the non-impact resurfacing population? Notched femoral necks, poor cup placement, femoral cap place in varus, etc.

Are impact sports ruining perfectly good surgeries or are impact sports just amplifying the poor surgeries?

Chuckm