Any semi-elite runners or triathletes with BHR?

[Johnny V]

I am a former competitive runner (3:43 1500m, 4:02 mile). I am 33 now and barely able to run anymore because of my hip. I've had 2 arthroscopies on it (2015 and 2019) and now considering the BHR. I still try to run but even slow and short runs come at a high cost so I tend not to. I have done everything from game ready icing, BMAC stem cell procedure, hip trac for hip distraction, countless physio sessions, band work ad nauseam, yoga, cortisone injections, hyaluronic acid injections etc.  All to no avail.

I ran a 14:36 5K in October 2020, 1yr and a half after the second arthroscopy. Hip blew up off the back of that and we did some scans then that showed accelerating degeneration since the last scan.  Message from high profile sports doc was that my hip would not stand up to the rigours of elite running.

I almost did the BHR in November 2021 but pulled out fairly 11th hour as I wasn't comfortable, especially as my first 2015 operation made things a lot worse. I still have a concern around the lack of precedent of anyone running at an elite or semi-elite level post BHR.

I also struggle to bike without hip pain (examination under anaesthesia showed 90 degrees hip flexion until impingement and subluxation) so swimming and cross trainer (on a good day) are my only cross training outlets.

Any input would be highly welcome, from any athlete, regardless of level, but bonus if anyone is out there running at faster paces!

At this point, I am looking for improved quality of life. I'd love to be able to go for a 20 minute slow steady run pain free and without the inevitable delayed pain reaction as things stand. 

Thanks very much in advance.

[Minniemuis]

Hello Johnny,

I have not been to this forum in a while, so I am not sure if you will read this reply, but I figured it may help others, so I will post it anyway.

My husband was an elite runner, you could say. 10K PB at 30:31 and 2:24 marathon PB. When he was 50, he still won a regional 10M road race beating lots of younger runners. However, 2 months later he started having some groin issues which at the time we thought was a groin pull. Long story short, he ended up having an MRI which showed advanced osteoarthritis of the hip. We were both shocked since he never had any symptoms before. Things went downhill pretty fast but we went through the whole phase of denial, looking for other solutions, and even a very expensive RegeneX stem cell therapy.

Ultimately, on march 29 of this year he had his left hip resurfaced (adept MoM) by Dr Koen De Smet. Dr De Smet was very honest about not being able to give any guarantuees for being able to return to running.

Next week it will be 6 months and I can tell you that he is back to running. (Dr De Smet allows running from 3 months) The road is still long, but to give you an idea, he limits running to 3 times a week, alternating with indoor cycling. He already runs under 40min 10K distance, at 4.5 months he did his first fast 1K in 3:30 (only 1 though). A sub 18min 5K seems attainable in the next few weeks. Running competitively is no longer on his wishlist, however, he still wants to be able to run fast and push himself as a runner.

His advice would be to start with balance training as soon as possible, and spend lots of time on core and stability work. (at least an hour a day). First month of running was only uphill running since this seemed to be easier, possibly because this needs less ROM. Also, there is less pounding....

Full disclosure: the first 3 months of rehab were not easy, soreness ALL the time. Most people may want to go slower than this.

We heard the stories of runners not being able to run after a resurfacing, but when the device is well placed by an experienced surgeon, you have a very high chance of returning to running. It happened a few times that after a certain time or distance the muscles around the hip would lock up where it was impossible to continue running. ( it felt like a wooden stick in his leg/hip) However, we have always felt that this is just your body's way of telling you that enough is enough, that the hip muscles are simply not ready for more. We found that the time/distance this occurred was not absolute, meaning that he could run uphill for 30 minutes without any pain, but his first flat surface run, the muscles locked up after 6 minutes. You need to experiment and try different things.

As 6 months is still very early in the process, we have to wait and see where this goes but I think my husbands story may be encouraging to other runners contemplating having a resurfacing done. I can tell you that my husband was really scared going in, had I not been there with him at the hospital, he would have checked out before the surgery  ;D

[petemeads]

Hi Johnny V,

I'm glad Minniemuis has replied to you, and very glad to hear how well her husband is doing.  I was reluctant to respond initially because there is no way I was ever going to be a semi-elite athlete but I now would like to add my experiences if you need convincing about the BHR!
I started running in my thirties because I was getting old, my friends were doing marathons, and it fitted into my lifestyle - previously I was a rock-climber, in the days when being fit was not as important as now. Best marathon 2:54, best half 1:23, maybe a 5:19 mile PB - nothing special but ok for late 30s perhaps.
Spent many years sitting at work in front of a computer screen, when I restarted running at lunchtimes, aged 58, I was terribly out of condition but within a couple of years was matching my previous performances if you took the Masters age-grade percentage as the indicator. But my lower back was stiff and I was getting occasional sharp pains from my right hip. My doctor referred me to his physio, and he said my hips were shot and I should stop running and get a bike, when I could no longer get upstairs they would do hip replacements. Got the bike but carried on running, mainly the weekly 5k parkruns, but walking after running got harder and harder.
Eventually saw a surgeon recommended by my wife's best friend, her partner had been given a BHR although he was by no means a runner. Surgeon said left hip needed doing immediately, right could wait 2 years, and he would give me the BHR I was asking for. I was nearly 64 when the op was done, and jogging carefully at about 9 weeks. By my 12 month check I had done a training half-marathon in 2 hours and was running 5k in about 25 minutes. The other hip ended up with a ceramic THR because my bone was not good enough and broke during the BHR op, nevertheless I was jogging again at 8 weeks.
These hips are now 8 and 5.5 yrs old, having concentrated on running fitness during the Covid years I am now doing interval training to get some speed and my 5k time is down to 23:50, 74.9% age-grade and the best I have run for years. Absolutely no hip problems, apart from tracking down the results of my latest blood test for chrome/cobalt ions..
Yes, committing to surgery is scary, there are risks, but resurfacing/replacement can get you your life back. Oh, and Michael Rix has represented his country in Masters events and he has a THR - 17 min 5k as a V50 athlete!

Cheers,

Pete

[Johnny V]

Minniemuis and Pete - thank you very much for these responses.  I did not get a notification so am only just seeing them now. My main concern is around metallosis but my risk tolerance is higher knowing that running, and indeed running fast, is possible post op.     

Minniemuis - good thing you were there for your husband! I would love an update on how it's going now, I suppose closer to 9 months post op? It's great that he's pushing boundaries and I just hope it continues to progress. 

Pete - thanks for that too. Impressive times at your age, that's encouraging. If you see this, when you mention the blood test, how often do you do that? Is it annual? And did you end up getting pretty comfortable around the metallosis risk pre-op or just decide it was a risk you would live with? Thanks for mentioning Michael. I actually found him on Instagram a while back and we managed to speak on the phone.  He was pretty negative on the resurfacing as opposed to THR. 

Thanks again.
Johnny     

[petemeads]

Hi Johnny,

The blood test for metal ions is the  MHRA answer to the occasional metal-on-metal problem case, it is supposed to be every 3 years but this one was at 4 years due to the pandemic. I got the numerical results from my first test, they were fine, but the best I got from this one was 'satisfactory' from the surgeon who keeps the spreadsheet. Was hoping for more detail as training has ramped up over the last couple of years. Not greatly worried about metallosis now, it would have shown up sooner if I was allergic and well-fitted BHRs do not edge-load and wear out.

Don't know why Mr Rix has a downer on resurfacing, perhaps his surgeon had greater confidence in the THR than most of them do.

Just hit a 23:39 PB for 5k as a bilateral, and run 2 half-marathons sub - 1:53:00, picking up V70 prizes at both. BHR and THR working well!

Cheers,

Pete

[Johnny V]

Thanks Pete. Great to see the likes of Andy Murray and yourself scaling new heights with metal hips.

[Minniemuis]

Hello all,

Only 5 minutes ago I watched an amazing point by Andy Murray during the Australian open. To all doubters as to whether resurfacing is a good idea I advise them to go watch this.
I will try tp post a link... https://www.eurosport.nl/tennis/australian-open/2023/ausopen-murray-redt-werkelijk-iedere-bal-van-kokkinakis-en-maakt-wereldpunt_vid1814696/video.shtml

Before my husband went into surgery I also reached out to Michael Rix and indeed, he advised against resurfacing. Never understood why. He sent me the details of his prosthesis but I could not find any surgeon in Belgium who used this.

As for my husband... in a few weeks it will be his one year anniversary. He is doing well and is still improving. However, there is the occasional off day where the hip does not seem to want to cooperate. For an athlete this is always disturbing but as long as it is temporary, I guess he will have to learn to accept that. Acceptance does not come easy for athletes though ...

Runningwise he has been doing 30 min at 19 kph on the treadmill, 7 x 1000m at 20kph. As for outside running the farthest he has run so far is 18K. That went well but he is not confident about going further for now. Also, his knees are bothering him a bit too, so short and fast seems better.

@johnny V - did you go ahead with a resurfacing?

[Johnny V]

Hi Minniemuis

No, I am still dithering. I am pretty convinced at this stage that if the operation goes well, running at a decent level is a possibility. My main concern now is around the potentially catastrophic 1 in 300 type risks that would leave me worse off than I am now.  I am only 33 and the level of degeneration is not that bad (relative to what hip surgeons might commonly see in older people). So there is a question of, am I desperate enough to accept the risks of the op.  It's not clear cut in my case, e.g. a lot of people would say don't do the op if the pain doesn't stop you from sleeping at night. Or they'd say if running makes it worse, stop running.  What is the threshold / bar for an op like this?

Thank you for this update.  That is very encouraging and 19 / 20 kph is indeed quick. Please keep me posted on all this as I'm very keen to hear any updates.

As long as there continues to be a viable surgical intervention that could allow me to do more of the things I love (including running) with less pain then it's not going off my radar!

Best
Johnny

[stevel]

Hi Johnny,

I stopped playing racquetball at age 43, I stopped jogging at age 49, then eventually I needed a cane to walk a city block before having LBHR at age 55.
11 years later I was limping after mowing the lawn and an x-ray showed bone on bone arthritis for my right hip and two orthorpedic surgeons recommended hip resurfacing so I had my RBHR.
I didn't delay until I was disabled from doing activities of daily living or having or a restful sleep.

[Johnny V]

Thanks Stevel. Do you think with hindsight you'd have done them sooner?

[stevel]

Hi Johnny,  yes I would have done the left hip sooner.  Definitely a year earlier when it was first diagnosed as severe osteoarthritis.  For the right hip, no I wouldn’t have done it earlier, but I had it done a few months after it was diagnosed as severe osteoarthritis.

[Arrojo]

Hi there. I’m not sure I call myself an elite runner or even a semi elite runner, but I’ve computed at national masters track and field championships in the 100m, 200m and long jump with my BHR. I won a gold metal on an M 55-59 4x100 m relay team at the national championships several years ago on my artificial hip.

As a distance runner I guess you’d call me a mid packer.

Regardless, I find that my times in both sprinting and distance running are basically about the same as they were before my surgery, accounting for the age grade, of course, as I am no spring chicken.