1st hip resurfacing blog -54 year old man - Surgeon:Professor Cobb

[Treetop]

I have decided to post my experiences after finding this forum so useful in giving me confidence to proceed. Was particularly good to hear the experiences and note the normal ups and downs during recovery so I had some idea what to expect. So I hope my experience can also be useful for others

Background
I am 54 year old man who is quite active but not to a competitive level. I am simply a recreational sportsman and  I love the outdoors and was regularly running  5-10k a few times a week, going mountain biking, hiking and racing a sailing  dingy.  I first noted an ache around left side of left hip in early 2020. It wasn’t limiting anything but was definitely worse after heavy exercise. I went to the Dr then and was referred for X-Ray and was very surprised to be told to be told I had early onset of arthritis with significant narrowing of the joint. The ball of the femur was deformed apparently and so had rubbed away the cartilage in many places leaving bone to bone

To cut a long story short this condition progressed over the next 18 months to a point where the left hip became very immobile and stiff with limited lateral movement making getting on a bike very difficult unless canted right over and had to reduce running down to 5k per week and expect soreness afterwards. Ducking under a boom in the sailing boat became an occupational hazard as I just could not bend forward. I was fortunate not to be in great pain unlike many of the contributors here,merely experiencing discomfort, but it was starting to impact the quality of life and worrying me that it was getting progressively worse meaning I would not be able to do the things I loved in the future when I retire in a 2-3 years which was my goal.

My father had both hips replaced so I knew about THR but also knew that there were questions about the longevity’s  of this method for ‘Younger’ people. I was also aware that it would not keep me doing the activities I loved as the THR joint cannot sustain the physical  impact of  running etc, so I started to investigate other options and came upon resurfacing by chance when Google searching, as it seems most GPs not very aware of it and those that are have tended to only hear the stories of metallosis.  I ended up finding a surgeon myself whose profile included Resurfacing but even he had said he was not doing them any more due to the mettallosis perception. However to his credit he did refer me to Professor Cobb at King Edward VII Hospital in London and I have been so glad he did! Professor Cobb has been superb patiently explaining the procedure and addressing the metallosis  concerns as well as referring me to this site to see  the real evidence from a variety of experts and those that have had the procedure. I also was encouraged by the Andy Murray experience. After seeing Professor Cobb at end of Oct I was booked in for the operation on 6th Jan. It could have been earlier but I wanted to get through Christmas first.

Day 1 (the Operation day Jan 6th)
Arrived at hospital for 6.30 am admission and was quickly established in my room and had all the pre-Op stuff done
Wheeled to theatre at 8am and within mins was anaesthetised. Next thing I knew I woke up and it was done. I did not feel ill or groggy at all and no sign of any pain. I had to look at the dressing to be convinced that the the operation had taken place at all and even then I wasn’t totally sure because I was expecting redness and swelling and there was nothing but a long thing bit of dressing

I was wheeled back to the room and set up with painkiller drips etc. That afternoon was visited by the physio and she prescribed  exercises to do on the bed. The movement was slow and a bit sore due to the surgery but more like the feeling of the whole side of the thigh being deeply bruised rather than any what I would call real pain. A 2 out of 10 on the pain scale

I did note that I felt a little bit of slight ‘clicking’ when doing the raised leg exercises but both the Physio and Prof Cobb this was just where the tendons were moving over the new joint as they had become used to not moving. They confirmed this was normal and would go away over time as the muscles regain strength

Professor Cobb visited and confirmed he was very satisfied with the op and post op x-rays were good.

Was difficult to sleep with multiple tubes etc and having to sleep in a different position but other than that no real problems

Day 2 Jan 7th

Physio introduced more exercises today and I walked the corridor on crutches and went up and down stairs. Definitely started to work some areas that have been under-utilised for many months so was more sore than the day before. However the team just re-emphasised the need to listen to your body and continue to take the pain meds rather than try to be brave as the pain meds allow you to do the essential exercises. It’s a weird feeling trying to convince yourself to put some weight on the leg and try to use the crutches to support walking normally  when it is sore like that, but again the Physio was very good in explaining the reason for the soreness and providing confidence that I was not doing any damage to the new joint.

Saw the Professor again today and he is advising will be discharged tomorrow. I had prepared myself for 3-5 nights so to be going after 2 is amazing. However I’m glad I had mentally prepared for longer.

So, all good so far. My advice at the moment to anyone else thinking of this procedure would be better to get this done early while you are still active so still have some muscle strength, rather than wait until it has become so bad that you have stopped being active and muscles start to atrophy as surgeon and physio have been very clear that my ability to do the exercises now and be discharged early are the result of the muscles still being strong. I would also advise doing daily exercises to keep the joint mobile. I found some on YouTube and it definitely enabled me to stay active for longer. The medical team here were surprised I was still being active considering how worn the joint was and think it was definitely the result of doing this joint mobility routine every day for the past year.
The other thing I would say is prepare yourself for it being uncomfortable and tricky recovery and if it’s better than that it’s an upside!
From the forum I know there will be down days and the recovery won’t be plain sailing, but right now I am feeling very happy to have had it done

Day 3
Returned home. Expected soreness in area of operation but moving around house Ok on crutches. Doing the prescribed physios exercises Ok although movement laterally is very sore. Went for short walk (150m!) on 2 crutches. Slept a little better and even managed to spend a short time lying on my non-operated side. Taking paracetamol or ibuprofen during the day but nothing stronger. One dose of paracetamol needed during night

Day 4
Already feels like the soreness is less although still on paracetamol during day. Went for a slightly longer walk 400m. Tried using one crutch around the house. Seemed OK

Day 5
Physio going well and walked 600m. Noticed slight stinging in incision area and evidence of blood seepage onto the dressing but nothing major. By end of day noticed leg had swollen quite a lot, particularly above the knee. Had been told to expect this so not unduly concerned but will check out with King Edwards VII specialist Nurse tomorrow who had given his number to ring if had any concerns (another great example of the great care provided by King Edward VII)

Day 17
Restart. Had been making steady progress day by day up to day 14. No issues doing the set Physio exercises  and had got up to 2.5k per day on 2 crutches.  By day 14 external swelling was down and dressing removed showing scar was healing well. Stupidly I then decided to do 2.5k walk just with one crutch as had been moving round the house fine with one. Bad move. The walk felt fine but obviously was using slightly different muscles when only using one crutch. Within a couple of hours I had a real soreness across the top of my thigh at the front and my heart rate was up to 90-100 fairly consistently I guess as the body tried to heal itself. Next day was a bit sore but better and heart down to 75-85 which is better but still high for me. Was good that had my first out of hospital Physio appt and be basically said I had overdone it and would not have expected to be doing that sort of distance on one crutch until end of wk 4. advised rest for a couple of days. However he also prescribed how to evolve the existing physio exercises to make them just a little bit more stretching for a coup;e of weeks before our next appt. After 2 days rest am advised to use 1 crutch (trying to walk upright and  properly not ‘like an old man) to walk 1k per day for the next week and then building up to 2k again by end of wk4. Did the walk as advised today and first set of new exercises. All feels good so far, so hope back on track.
Lesson learned..don’t push to quickly!

End week 5
Had progressed from 2 crutches to 1 by mid-wk 3 and no crutches at all by beginning of week 5. Seeing Physio every fortnight and getting set progressively more strenuous exercises. Doing daily walk of at least 1.5k, more at weekends. Able to put sock on for first time last week! Walking up and down stairs properly now although with slight need for the banister. No pain from the joint at all, just muscle soreness as work the muscles in the physio exercises. Progress is great and  Physio proposed moving onto low level weights next week. Still taking it slow and cautious but really pleased with how the rehabilitation is going.