Cold Therapy Devices

[Jason0411]

Please do as Mr McMinn says I did not and paid the consequences.
Still find it hard to believe I damaged his work as I did and am still going three years later.

[Dannywayoflife]

Pete did you discuss with your surgeon doing some jogging? I ask as its been conclusively proven that in the first 12 weeks your most likely to have a femoral fracture due to lower bone density levels.

Also I know several top surgeons have had early revisions which they have put down to too early a return to impact. This can make the bond between the device and the component weak and lead to early failure.

I don't mean to sound like a bag puss but I'd hate for you to have an early revision when it's easily avoided by showing some early restraint. Most of the liberal top surgeons say 6 months as a minimum to returning to any level of impact more than walking and other activities of daily living. Many like Mr McMinn say 12 months as its been proven that the femoral bone requires 12 months to return to it's full strength.
Danny

[Granton]

Hi oldtennisplayer,

I am another old tennis player who has had two BHRs from Mr McMinn.

I know the waiting is tough when you feel great, but do what the man says. He explained to me that it is not about the fixing of the prosthesis, but that after osteoarthritis, the bone itself is at risk from fracture.

You know that he knows what he is talking about and he has seen your bones!

Congratulations on having the surgery behind you and a much better life ahead.

[shoraztri]

Hi Dannywayoflife.

Your latest post on taking things "easy " till the 12 months is up is VERY , VERY TRUE. I am now 8 months Post op., and have snuck in a few serious runs and done 2 short Triathlons of 250-20km and 3km . I handled the Swims and Bike  well , but think I may have ?? pushed a little to hard in the run . Typical endorphins and adrenalin kicking back into the body !!. Felt no real side effects after the events , but at times can feel a "niggle " in the groin area. I guess coming back alittle to early , especially the Run side of things , can cause consequences down the track.
Summing up , it definately looks like the wait period of 12 months is alot better , than jumping the gun , at say 6+ months.
Am now going to wait out another 4 months before cranking back up into running . I guess that a wee jog in my Hoka Shoes , and on grass should be fine and dandy.
Thanks for ya input, its been a timely reminder. :D :)

[Dannywayoflife]

I do take on board all the information about giving the femoral bone time to remodel and the acetabular component to fix properly but I am light (under 10 stone) and do not believe there is significant impact in what I have done so far.
Next consultation in April, will be interesting to see what he says this time...


Bud we just want you to have a great longterm recovery......

[oldsoccerplayer]

oldtennisplayer,
not much to add on to what the others have said. Do what your Dr. says and don't overthink comparing that to others. Different surgeons have different protocols and it sounds like your plan has been customised for you and your sport (doubles / singles).
Can I pat myself on the shoulder for giving you an idea what to call yourself on the site?

[oldtennisplayer]

Yes, Oldsoccerplayer,  I have to confess I used a similar username....thanks for the idea, the username  though could go forward however into maybe oldgolfplayer, oldbasketballplayer etc etc.
Anyway I digress, thanks for all the replies guys and I will try to restrain myself prior to throwing myself back into doubles/singles tennis, its just that when you feel ok you are tempted to push yourself to far to fast. Should be seeing Mr McMinn for six week check soon so will be interesting to see his thoughts and to get the next set of exercises, as the current ones seem a bit tame.

[chuckm]

My feeling is that the surgeons are doing exactly what they need to do to ensure their patients have excellent outcomes.

Mr. McMinn's advice is good I think. It considers the time needed for the entire body to prepare for impact activities (on average). Six months to be sure the bones are fully strong enough then an additional six months to build strength and allow the soft tissues to get all sorted out.

The affect on femoral neck strength (density) varies from patient to patient. Hip resurfacing disrupts the circumflex arteries around the femoral neck and there is a period of density loss in the femoral head and neck early on as the body develops new pathways to supply blood to those area. The more severe and longer duration of OA before resurfacing means you will be less affected by this because blood flow to the head and neck will have changed from external arteries to intaosseous vessels. That is why they make you wait until you have developed OA. Resurfacing surgery is traumatic to the soft tissue and if the head and neck still get most of their blood flow from the soft tissue around the neck, it could be a bad result.

It is difficult for surgeons to tell for sure if blood flow is intraosseous or still through some of the external arteries that is why they are conservative.

Chuckm

[shoraztri]

Hi Dannywayoflife,
Thanks for the reply, and YES, sure want some longevity out of my Op. I am about 68-68:5kg, and 1:73cm , so are light framed and build. Being really fit preOp., gave me an advantage I feel , once the recovery stage started.
I sure do want that long term recovery to give me plenty of value down the track. Look forward to your April posts.
Cheers,
Kiwi Boy. :) 8)

[Beth]

***UPDATE***
Had my appointment today. Cautiously optimistic.
Multiple xrays show my hip device looked perfect. Phil spent a lot of time with my husband and I looking at the xrays in detail. Perfect angle. Device looks like it should.
So, it turns out I do have bursitis. Phil had me lay on my good side and pressed the usual spot for bursitis and OMG...OUCH!  It was so odd, because I never felt discomfort when poking around my incision area.  I also likely have psoas tendinitis...Great.  I got a cortisone injection for the trochanteric bursitis.  I also had a metal ion levels in addition to other blood tests to rule out infection. Phil wasn't all that concerned with my hip noises and other sensations. He says everyone feels and hear weird things at some point in their recovery.
So the plan is this: return to taking ibuprofen, ice, continue both crutches for a few days then switch to one crutch. He will call me Wednesday next week to discuss the symptoms and metal ion levels.
Keeping my fingers crossed for normal metal ions. <deep breath>
Beth

[Dannywayoflife]

That's very positive news Beth!! :)

[MattJersey]

Just read the thread Beth, it sounds like an awfully rough ride you've had. Very encouraging your last post, and my fingers are crossed for you. From what I have read and learned, the clunking is consistent with your psoas or piriformis (among other) muscles not working properly, perhaps weakened and in a negative spiral. Hopefully the injection and some controlled physio will see you right.

Best wishes for good blood results, and progress.

[petemeads]

Hi Kiwi Boy, there is a bit of crosstalk going on here I think - Danny had quoted a section of my post then commented on it but the quote did not highlight. He is concerned about my risk of doing damage to myself by pushing too hard too soon.

Danny,  thank you for your concerns, and I hope your recovery is going well now. I have done a lot of research on recovery, femoral head density, acetabular loosening and impact forces from walking, jogging and running. My surgeon has had one case of femoral head fracture at 6 weeks in 200 resurfacing and I have not done anything yet which would spoil his record. I did start walking outside from day 6 and worked up to 5 miles by day 23, and this would be the furthest I walked until 6 week day when I could drive again. I went to the country and walked 6.4 miles at 4 mph then found I could not walk unaided when I got home, going back to one crutch for the next 12 days.
I managed to be crutch-free by my checkup but I came clean to my surgeon, who was not surprised. As he said, I now know how far is too far and to be sensible. The x-rays were perfect, though.
I initially jogged with a trekking pole sharing the impact and did not run unsupported until week 9, a slow shuffle. If you look for technical papers on Pubmed you can find there is little difference between fast walking and slow jogging as regards impact so I don't expect to do any harm as long as walking is promoted as being the best recovery - even my Physio said so. And I only jog 5k once a week, and missed that last week because of the long day in the hills.
I am being pushy, I know, and we are all different so nobody else should follow my example, but I still have another BHR to be done and time is passing...
I shall check what my surgeon thinks when I see him next month and let you know.

[Tim Bratten]

That sounds like good news. Thanks for keeping us informed.

[Dannywayoflife]

Wish you the best of luck for your recover Pete :)

[chuckm]

I am being pushy, I know, and we are all different so nobody else should follow my example, but I still have another BHR to be done and time is passing...

Petemeads, sounds like you are fully aware of the risks so go for it.

But here is a short story to consider.
I didn't start any regular walking routine until the third month. The first three I took it very cautiously. I was able to gently get back to soccer in six months and I never looked back.
In contrast, a good friend of mine had his hip resurfaced just over a year ago. He was in fantastic shape going in to surgery and very light. He was perfect candidate. His surgery went so well that at his one month follow up he was given the go ahead for any activity except any jumping. Running was OK. (yes folks, some surgeons now feel comfortable identifying those who are not high fracture risks). So he got real busy like you with biking and jogging etc. But, ultimately, his full return to activity took much longer than mine because he kept pushing it. The psoas stayed irritated.

The point is that you can go for it but it probably won't speed up your healing. It might actually delay your full return to activity.

Chuckm

[Granton]

Should be seeing Mr McMinn for six week check soon so will be interesting to see his thoughts and to get the next set of exercises, as the current ones seem a bit tame.

I had a few sessions with a physiotherapist last time because I somehow hurt my back. Once the back was better, she concentrated on sharpening the exercises and making them work for me. Mr McMinn is not a big fan of physios, I think, but I did find that really useful.

[petemeads]

Thanks chuckm, I appreciate your story and have to add that the more I push the new hip to new heights the more the other one hurts. Running is not going to be a serious pursuit until after the next operation, whenever that might be. My other sport is rock climbing and I am already about 90% of what I expected to be at six months so am very happy to pretty much continue where I left off.

One question for anybody - is there a downside to the taking of Ibuprofen (for my natural hip) while the BHR is still healing? I know McMinn says that NSAIDs can spoil bone quality somewhat...

[Dannywayoflife]

I wouldn't worry too much regarding that as ibuprofen is one of the main drugs they perscribe for things like Hepotrophic ossification.

I've been on brufen or diclofenic noe for 4 weeks as pescribed by the doc.

[chuckm]

My surgeon said for me to go ahead and take one ibuprofen in the morning every day if I want to help combat the discomfort that is common with the psoas after resurfacing.

Chuckm