Extreme skiing--ANY restrictions?

[P-Dub]

Am considering resurfacing, and thrilled to see so many happy, post-op skiers.  Several posts say they were released to ski "without restrictions."  Does this include, e.g., hucking a 15' cornice?  Skiing on a double black where a fall could mean 100 yards downhill?

Common sense suggests care, but my question really is, "Once fully-recovered from surgery, is the repaired hip every bit as strong as a normal, healthy hip?  Can I really do post-op anything I could do pre-op even if those activities are very aggressive?"  And, if the answer is "no"--what restrictions are imposed?

Thanks!

[Pat Walter]

Hi

You can do anything you want - but you might want to consider that you have required to have a metal hip replacement to start with.  So being a bit conservative might be a good idea.  If you are going to do extreme sports - you need to talk to your surgeon to see what he/she recommends.  Many don't want their patients doing extreme sports - but the patients do them anyways.

You healed hip is just as strong as your original hip if your bone stock is good.  Remember that something has gone wrong for you to need a hip replacement. You did not say what your problem was.  If you have any osteoarthritis - it will evenutally spread through your body and your joints are never as strong with arthritis.  You just get old and things are never as good as when you are younger.  Sorry, but that is the truth. 

When you are my age, 65 years old, you look at things quite differently than when you are younger.  Just be sure to talk to your surgeon and be honest.  You don't want to go thru major surgery and then need a revision to a THR.  Sometimes caution is best - but very boring.

Good Luck.

Pat

[DirkV]

Hi P-Dub, I really related to both your question and Pat's reply. Four or five years ago (age 44 or so), when my hip problems were diagnosed as osteoarthritis, my reaction was: what can I do to keep playing hockey at a competitive level? Unfortunately, resurfacing wasn't FDA approved at the time, and the answer from 3 docs was "nothing." After diagnosis, I could play with diminishing capabilities for a year, and then I waited another year until I had the surgeries.
Now 2 yrs after surgery, I'm just starting to play hockey again. My surgeon says no restrictions, and my first attempts have felt good and gone well. But after 5 yrs, it's not as important. When I couldn't play hockey, I filled in the time with other recreational activities. And one has to consider that goaltending is getting attention as inherently stressful on hips. But I rationalize that I had FAI, so I think that my shiny, smooth, new hips shouldn't cause recurrence of hip problems. But then again, I worry that I essentially wore out those couple body parts through active, somewhat extreme activities, and I wonder about the state of knees, shoulders, head (well that's what my wife wonders about :-) ), etc.
I'd say, have the surgery. Recover an active lifestyle. It sure beats the situation we'd have been in 50 years ago. Depending on your age and commitment to rehab, the prosthetic will likely not preclude a return to extreme skiing (of course, talk to your surgeon). But I think that it may take a couple years, at least, out of your career, and you may find that your perspective changes with the couple years and the fake hips. I was, and am, ecstatic that I could again ride a bike for hours or play basketball with my son, or go for long hikes. We're talking about hiking to bottom of Grand Canyon. Just 5 years ago, when I was diagnosed, all these things weren't in the realm of possibility (based on my advice at the time to have small-ball replacement).
I posted recently about hockey, and mentioned my surgeons response  (it's classic) when I asked about goaltending. He said that he couldn't see any technical, theoretical reason why I couldn't, but that he'd never heard of anybody doing that activity yet. So he said go ahead and give it a try, but let him know how it goes.

Good luck,
-Dirk

[stevel]

Hi P-Dub,

Yes you can.  From what I have read, you'll break something else before the new hip breaks.  A hip resurfacing device has as much risk for dislocation as a natural hip.  I ski the black diamonds and trees in the back country and moguls at the resort.  I skied at 6 months post-op last Spring and skied the entire 2009-10 season (39 days) with no problems.  I didn't ski a double black or jump off a 15 ft cliff or cornice, because I didn't do that much before hip surgery.  Once before hip surgery, I lost an edge on a double black, slid downhill about 100 feet and crashed into a tree with my left shoulder.  Nothing broke, but it took a year for the shoulder to heal.  I have had aches in my new left hip from running on a treadmill whereas I haven't had many aches after skiing all day for four days in a row.  I've read other posts, where people graduate into running, including running outdoors on hard surfaces.  Running isn't a priority for me and I get my cardio workout using the eliptical or recombinant bicycle at the health club.

[John C]

Hi P-Dub,
I certainly relate to your concerns and questions. At the age of 56, I had my left hip resurfaced in June of 2008. At six months, I returned to my 38 year career of teaching high level skiing, 8 hours a day, seven days a week. I am just wrapping up my second season on the resurfaced hip. I continue to have occasional minor aches and twinges, but it is vastly better than before surgery, both in terms of pain and range of motion. When I was younger, I was what you would call an extreme skier, doing extensive cliff jumping, film stunt work, and mogul and aerial competitions. My doctor okayed skiing at six months, with no restrictions after one year. He also said that I would be an interesting case study with my level of skiing activity. I returned to my annual helicopter skiing trip up to BC after one year, with no problems, including numerous pillow drops of 1'-10'. Whether the concern is real or not, here is the one issue that I still bear in mind; in a normal joint, the cartilage acts as a shock absorber, and now any impact is between two hard metal surfaces with no shock absorber. This means that all impact is transferred straight into the bone, and the metal bone interface. Personally, I would not jump off a 15' cornice, unless there was substantial soft powder to cushion the landing. In skiing hard bumps, I will always change lines to avoid taking a sharp impact. At this point, I find myself reluctant to even step off a two foot curb onto concrete, without landing mostly on my other leg, and I have heard other surface hippy skiers make similar statements relating to hiking and rock scrambling.
Bottom line: most resurfacing doctors will say no restrictions, but no one really knows the limits, including 15' cornices. As my doc said, I would be an interesting case study, as you will be. My experience, as with others, is that we find ourselves to be somewhat self restricting when it comes to landing impacts. Good luck.

[P-Dub]

Thank you all for the terrific comments--thoughtful, optimistic but realistic.  I'm 47 yr. old athletic male with osteoarthritis who's begining to realize that just because you can do something doesn't mean you should.  Stevel is apparently clairvoyant:  I'm writing from a condo at Squaw Valley and am here with my wife and 4 year old son but can't ski because I tore my ACL in Jan.  Last year, we moved to Park City for the winter (between jobs) and I tore the bicep off my arm skiing, requiring two surgeries and missing nearly the entire season.  Apparently, there's a reason Warren Miller never called 

I will ski hard again, but will dial it back--there are so many ways to challenge yourself--even on a blue run, and even the greatest powder day will pale in comparison to the joy I know I'll get when I ski with my son for the first time....Just good to know that the hip is unlikely to keep me from having fun out there, even if the definition of "fun" needs to change a bit as we age...

Again, thank you all so much for your insights...

[AKinOR]

P-Dub,

Just my two cents....you should be fine. Like you, my skiing background involves freeskiing, cliffs, big jumps, halfpipe, acl tears, etc. I had my second resurfacing this Christmas, but before that I had time to test out my first resurfacing and everything was fine. The hardest and most worrisome part was getting my ski boot on and buckled while trying not to rotate the hip inwards, etc. Once I was on my boards, it was like I was ten years younger, and I'm only 34 now. Especially skiing powder, you shouldn't have anything to worry about. Let me know if you have any questions.

Thanks.

Steve

[tedroberts]

P-Dub, I had bilateral resurfacing Jan. 2009.  This year I was able to ski race and ski double black diamonds with no problem.  I have had many crashes including hooking  gates and flipping myself forward (3times), crashing in the terrain park and jumping out of the derailed chairlift.  Bottom line was I hurt many parts of my body but never my hips.  I  was held back much more by missing the last year of skiing and my cartilage free knee than my resurfaced hips.   I can say that my legs are still recovering from the years of arthritis and the resurfacing surgery.

Ted Roberts, Bi-Lat BHR, Dr. Nelson, Edina, MN 1-7-09

[P-Dub]

Again, thank you everyone--this really helps.  I have now consulted with two highly experienced surgeons in the LA area (Matta, Schmalzreid) and both have confirmed what you all have said.  Good to know!