Is running the only reason to choose resurfacing over THR?

[rag33]

Hi everyone, I have resurfacing scheduled with Dr. De Smet in November, but I'm still on the fence. 
I'm 43 and have been a runner since I was 13. I have osteoarthris in my right hip due to a car accident when I was 12. I live in France where a THR would be practically free, but they don't do small sized resurfacing (although resurfacing is available for larger people). So I'm looking over the border and also the cost... resurfacing would be 14k but a THR in France would cost me a few hundred in the end.
So my main reason to do resurfacing would be to run again. I understand it's not a 100% guarantee, but I haven't run for 9 months and I'm going nuts. I read the other posts and got some answers to my questions, but I'm still wondering about a couple things like :
1)did you have to work with someone to change your running gait? I can see from the wear on my shoes how much my stride has changed since my hip problems started a few years ago.
2) at what point did you start running again for real? is racing a bad idea? should it be avoided?
3) are there cases where the resurfacing is damaged because of running?   
I used to run marathons, etc but right now if I could go out and run an easy 5k, I'd be in heaven. I can't even walk that anymore   :'(
Thanks a lot hippies.

[einreb]

I think the short answer to your question is no.  At 43, I'd argue that the bone preservation side alone is a huge benefit in the (hopefully unlikely) need for a revision at some point in the future.

My Doctor (Gross) said no running until six months.  The night of my six months I went out and played 2 hours of basketball.  My hip was the only thing that didn't hurt the next day ;)

1) I worked with a PT off and on for the first year.  For me, my psoas was very tight and stretching helped a lot to really even out both sides w/regards to stride.
2) I started at six months, but haven't done much more than 5-6 miles at a time.  I do a lot more cycling than running.  The simple joy of running hip pain free is quite fantastic.
3) I'm not aware of running specific damage.  That being said, stuff happens. I think the femoral neck is weakest at 3 months and thus the argument of not running until 6 months.  I do think that some impact sports are good for bone density, overall health and the benefits outweigh the risks.

-Bernie

[blinky]

Absolutely agree that running is not the only reason to go with a resurfacing for the reasons given by Bernie.

1) I didn't work with anyone on running per se. I am another Dr Gross patient, so I had to wait those six months to run. In the meantime, I walked like crazy, swam, did the simple exercises he prescribes. I felt like I had recovered quite a bit on my own. My walking gait was normal. But I did see a PT for those little quirks and weaknesses that remained. I think I ran for a few weeks before I saw her, so I had an idea of what to ask her about.

2) I followed a C25k (couch to 5k) type plan with lots of walking starting at six months. Was it real running? Not at first! I was blissed out to be out there doing something kind of like running, but I don't think I was really running until I hit the point when I was running 20 minutes at a time. And that was slow.

I don't think racing is a bad idea, but be patient and realistic. There are some on here !paprika!who are running pretty darn fast. I have used races as goals for distance and for pace.

3) I don't know of any running specific damage either. If you run too soon, you could crack your femoral neck, as Bernie mentions. Aseptic loosening? Maybe, but I haven't seen any studies on that and running.

Best of luck to you. I used to run four or five marathons year, so I hear what you are saying. I loved (and still love) running. It was more for my mental health than competing. I just liked to get out there and go. Today I run 3-4 x a week, between 3 and 10 miles at a time, depending on where I am in the training cycle. I am still not fast, but am hoping to be a "normal paced" runner this year. (I think of myself as avid but slow right now. I'd like to be avid but average. Maybe someday I'll get back to avid and fast for her age.)

[petemeads]

Hi. I went the BHR route nearly 4 years ago because the operation makes more sense from a mechanical perspective (despite the slight chance of metallosis) and I wanted to be able to run, bike, rock-climb and mountaineer again, preferably without pain.
It worked - and I was jogging gently at 8 weeks and racing at 9 months with no real problems.
Fast-forward to May 2017 for the other hip and the femoral head broke off during the operation so I ended up with a ceramic/ceramic THR and a leg a few mm longer than it used to be. This time I ran at 6 weeks, badly, and was up to speed again by 7 months - but things are still not completely settled down yet and I am limping a bit at the moment due to thigh pain, possibly ITB. Yes, I did overdo things this summer, mixing long days in the hills (25 miles on the Yorkshire 3 peaks), 70 mile bike rides and a small amount of outdoor climbing.
I have no qualms about my BHR, metal levels are tiny and it will see me out - I am 67 - and I think the THR will last as a joint but I worry about the spike in my femur. I am confident because I am old that I am now set up for an active retirement. I would be more hesitant at your age about THR as resurfacing gives you an extra 20-odd years of activity by even the worst estimates for wear & tear, and there is the possibility of component repair even then.
Spend the money, get the BHR, wait the 6 months then go for it!

Pete

[Saddlepal3]

Hi there, The sentence in your post that caught my attention was “they don’t do small size resurfacing” in France. I believe Dr. De Smet still is performing metal-on-metal resurfacing with small size devices; however, I don’t think many others doctors are because of the increased risk of metallosis. I had a MOM 44mm resurfacing installed in 2006 and I just had a revision (09/18/18) to a cross poly acetabulum cup due to early stage metallosis. If you require small components, you might ask whether De Smet can use something other than metal on metal.

[rag33]

Thanks for the input everyone. I am scheduled for resurfacing with Dr. De Smet now and did a thorough investigation about running, but also about THR. A THR is not the best thing for a 43 year old when other options exist. Dr. De Smet is in Belgium, just 45 minutes from where I live in France, so I'll be going there. Hip resurfacing in France is possible from 48mm but I'm too small.

[Slinkycarrot]

I had a double resurfacing done with dr de Smet and I’m a smallish woman (58kgs, 5”6). Can’t remember my size 42 or 44.
Just had metal test done two years out and they were at 1.4 and 0.8 so very low.
I picked him as the surgeon for this reason as he has good results with women.