Need advice...

[triathlete98]

I have had three hip Arthroscopes, debrietment, and chondoplasty (sp), and the latest I had was a cartiledge transplant.  I am a 39 year old triathlete and want to compete again.  I don't have much arthritus according to my surgeon, so he doesn't feel I would be a candadite for BHR. I have pain that so many total hip transplant patients talk about, but none of the causes, ie arthritus.  I am going to see a specialist in the chicago area who did Bo Jackson's hip and hopefully I can get some help. I still have nerve pain throughout the day and can only run 5 miles before it becomes unbarable.  thanks, kevin?

[Pat Walter]

Hi

I am not a doctor, but if you had cartilage transplant - then you must be bone on bone, I assume.  Any person that would be a candidate for a THR should also consider a hip resurfacing.  Please understand, that most surgeons that don't do resurfacing or only do a few, will normally try to suggest a THR.  You can get a free consultation from several of the top surgeons to find out just what shape your hip is in and to see if you are a hip resurfacing candidate.  Dr. Bose of India, Dr. Gross of SC and Dr. Rogerson of WI are several who will give you a free consultation if you email them and send a copy of your x-rays in a digital format as a .jpg    Dr. Rubinstein is in Chicago and Dr. Rogerson is in WI.  Those are two that would give you good input as to what your options really are.  Hip resurfacing will allow your body to function as it did before your hip resurfacing.  It allows you to keep a natural gait because you have kept all your bone structure in place.  If you get  a THR, they saw off a large portion of your femur bone and your body never reacts in the same way as if the bone remains there.  Both the bone regrowth is changed when the long stem is placed into the femur. 

So if you want to compete again, I would only consider the very best hip resurfacing surgeons. Dr. Bose of India does a lot of athletes. So do many of the top, most experienced US hip resurfacing surgeons.  You can look at my list to get the doctors information  http://www.surfacehippy.info/listofdoctors.php


Please do your homework, do a lot of reading and listen to the video interviews from the surgeons like Dr. Brooks.  They will explain why a resurfacing is a better choice for young, active patients.    http://www.surfacehippy.info/shvideos/videosdoctor.php

Check out this page with many athletes that returned to their sports  http://www.surfacehippy.info/athletes.php   Many fireman, police and servicemen have had hip resurfacing because they can return to service with a hip resurfacing.  Normally, they can't with a THR.

Good Luck.

Pat

[hernanu]

Hey Kevin,

Welcome. You've had a lot of work done, all to the same hip? Maybe one thing you can do, to take a step forward is to get your XRays and send them to one of the HR specialists that Pat has listed on this site. They will look at the XRays and give you an experienced second opinion on what you have and how far it is. They do this for free, with no expectation of doing the procedure.

It sounds like you're taking a good path by going to a second doctor (many of us went to several). You don't have to accept pain, you're doing the right thing by standing up for yourself.

You can find several triathletes that have gone back to competition here.

[einreb]

I have had three hip Arthroscopes, debrietment, and chondoplasty (sp), and the latest I had was a cartiledge transplant.  I am a 39 year old triathlete and want to compete again.  I don't have much arthritus according to my surgeon, so he doesn't feel I would be a candadite for BHR. I have pain that so many total hip transplant patients talk about, but none of the causes, ie arthritus.  I am going to see a specialist in the chicago area who did Bo Jackson's hip and hopefully I can get some help. I still have nerve pain throughout the day and can only run 5 miles before it becomes unbarable.  thanks, kevin?

Kevin,

I'm in Chicago and am 8 months out from a resurfacing... now very active back on the bike and running again.

Who are you meeting with?  Dr. Robert Daley was Bo's original THR surgeon.  It didn't last long.

Bernie

[triathlete98]

wow thanks for the replies...I guess I should include some more info.  My first hip proceedure was in 2003 on my right hip with Dr. Terry.  My next proceedure which was also a Arthroscope was more extensive, was done by Dr. Nho of Midwest Orthopedics.  He shaved down the neck of the femur which was hitting the top of the acetabulem.  He also shaved some more torn cartiledge.  Dr. Terry did a microfracture which made some less than quality cartiledge. I did Ironman Louisville last August.  About five months after I started getting intense pain down the front of my quad and into my knee.  Dr. Nho stated there was "nothing of notice" about my xray or my MRI other than what the last surgeries did.  He said he could do a cartiledge transplant to hopefully add cushion to the joint, but it wasn't conclusive as weather it will work.  I tried sending my xray's up to Dr. rodgerson in Madison but he said again there wasn't any substantial hip disease that he could see.  So now i am stuck in nowheresville.  I have all the symptoms of hip degeneration but none of the signs.  So since i am not a candadite for a THR i was wondering at what point would a BHR be justified.  thanks all, kevin.

[Pat Walter]

Hi Kevin

Thought I would share some more info with you.  The top surgeons like Dr. Rogerson will never do a surgery if they don't think the joint is degererated enough, that includes a THR or resurfacing. A resurfacing is for the same hip deterioration or disease as a THR except they don't have to saw off a part of your femur to place the femur cap.   Sometimes pain is not the only indication of problems.  Some people have very bad hips and little pain, while other have less problems with their hips and a lot of pain. We are all so different.

I can tell you that most of us were never able to run 5 miles before our surgeries.  I could sit in a chair and could not even get from the parking lot of WalMart into the store.  I took vicodin at night and it would not stop the pain.  I could not sleep.  I couldn't walk or move without pain.  It was taking my life over.  If I had been able to run 5 miles or even walk one mile, I would not have considered a hip replacement.

So that takes me to the point that you do have pain.  Perhaps you need to try steriod shots or NSAIDS for the pain.  As long as you can be as active as you are, then it sounds like your hip is not deteriorated enough for surgery - but again, I am not a surgeon and can't tell you that for sure.  I am just listening to your story.  Perhaps, you need to back off on your activities a bit so you are not in pain as much.  Many people that overdo their activities sometimes need rest, icing and time off.  I know you don't want to hear that, but if you can't find a surgeon to replace your hip, you need to find a solution to the pain and sometimes that means less activity.

I would get several other opinons, but I think if you tell them you can run 5 miles before you  get pain, they probably won't think there is too much of a problem.  I would just tell them you have pain when you are active and let them read your x-rays.  That way you can let them determine the shape of your hip.  If you can't get a resurfacing or THR now, then you will have to get some shots and takes meds or change your activity level.  Unfortunately, we all start to age and we have little control over how our joints tend to wear.

Try getting several other opinions and if replacement is not an option now, get some meds and treatments for your pain.  Eventually, you will become a candidate.  You will need to get input every year or so because you can miss the window of opportunity to have a resurfacing.

Good Luck.

Pat

[curt]

       I echo some of what Pat says too...I thought I was fine when I was running 5 miles with pain.  It wasn't until I couldn't sleep or walk 5 minutes without pain that I finally submitted.
      Also, the "nerve pain" you mention is common with most of us that had deteriorating hips, might be a nerve, but more commonly, the imflammation is bad enough to trigger the nerve pain.  Also, lower back issues can come from compensating for the hip/knee/whatever, and that leads to the hip and leg nerve symptoms too.  Xrays and an opinion from an HR doc wil certainly narrow it down.  For what its worth, Curt
     

[triathlete98]

Thank you Pat for your input.  I just want to say that a few months ago I could run 26.2 miles after biking 112.  So five miles to me is a warm up with no disrespect.  I am no stranger to pain. I have had 9 surgeries.  I have done several ironman triathlons, one of them was 6 months post op for a discectomy and another one year post neck fusion.  So I am sure there are others who are worse of then I am.  But I do have pain all the time, but it becomes unbarable when I run.  I was just wondering at what point do they consider the BHR, is there anyone who is in the same boat as I am where I don't have the clinical diagnosis but maybe still warrant a BHR based on symptoms?  I have had several injections includeing synvisc to try and lubricate the joint to no avail.  NSAID's do not even touch my pain, besides they wreak havoc on my tummy. 

[triathlete98]

I've also recently have had a MRI of my lumbar spine as well as an EMG which was normal, and the MRI was unchanged and I don't have any lower back pain to speak of, since my last Microdiscectomy of L4, L5

[Pat Walter]

A hip resurfacing with a BHR Birmingham Hip Resurfacing Device, or Wright C+, or Cormet or Biomet is done for the same reason as a THR.  It is just a different device than the THR devices.  A surgeon would not give you a hip resurfacing if he/she felt there was not enough hip deterioration or problem.  It is not a less serious surgery than a THR or used for less degenerated hips. 

I know you seem to be indicating that a hip resurfacing could be done because your hip was not deteriorated enough for a THR, but both resurfacing and THRs are done for the same reason.

I know all of our suggestions are just that - you really need to get input from the top hip resurfacing surgeons to help you find out if you are a candidate for a hip resurfacing.  Some people have hips that are too deteriorated for a resurfacing and require a THR.  You must have good bone density to have a resurfacing and only a surgeon can tell you if they fell it will solve your problems.   I wish we could tell you more, but we can't.

We will be here to support you in whatever you decide to do after getting further input.  I do know a handful of athletes that did have resurfacing and returned to Ironman and even did a marathon at 3 months post op - which is not a good idea.  So there have been many with similar problems that did have resurfacing and returned to their sport.

Pat

[triathlete98]

thank you for the support and insightfulness.

[David]

Well, I can tell you I was "able" to run 2 months up until my BHR.  Did 3 half IM's early this season with my bone on bone pain.  Dr. Su said he wondered how I was walking into his office.
Not that I'm proud of my stubbornness, but it can be done if you are used to disregarding pain.
Kevin there is nothing like being without pain.  I hope you discover the root of your problem soon...and if you find you are a candidate for BHR...go for it.
David
Going for IM #13 as soon as I am able...

[triathlete98]

Congrats David.  My third IM I had very little cartiledge and will continue to race, however, I am very close to qualifying to Kona, but my hip pain stops me from doing quality runs.  I hope I can be without pain soon, but will undoubtably continue to try and qualify.  Thanks for the reply!

[jjmclain]

There are plenty of us crazy athletes on this forum who continued to race and train even with bone on bone arthritis. Everyone has a different tolerance for pain. We can push ourselves exercising with the pain, but then walking and/or sleeping can be unbearable!

Hopefully you will find out what is wrong. As others have said, send your x-rays to one of the top resurfacing surgeons to get another opinion. That way if they say you are not a candidate for resurfacing, you will know for sure.

I will be one year post-op next week and plan to race again next year. I could have raced at the end of this season, but decided to be very conservative during this first year. I am running pain-free and feel better than I have in years. I wish you luck.

June

[triathlete98]

Awesome...congrats on your return!  Hope to one day run pain free. 

[curt]

      Kevin, hope to hear the diagnosis when you get one.  For me it was clear-cut...bones spurs and mostly bone on bone.  It must be driving you crazy to not be able to know the root cause of your pain.
      For a large number here, their activity was/is their addiction which is why most got the HR...to be pain free and return to the sport or activity that they love and looked forward to each day.  For me it was running.  Not close to being an elite, I plodded along in the 8:00 regime.  Marathons and Halfs, which became Halfs and 10Ks, which became daily fitness runs, which became every other day...you get the point.  Anyway, despite everything else I tried (rest, ice, massage, chiro, PT, injections) it got worse and got in the way of my addiction.
     I hope to return to distance running, but as someone smarter than me once said, your level of desperation (or pain) will drive your tactics.  Its going to be great to get back to 5 miles as a walk, then a long run and then hopefully just a warmup.    I hope a surgeon can give you an accurate eval and get you back on track.  Good luck, Curt

[23109VC]

You ought to send your X-rays and info to some of the top surgeons that are discussed on this website.  Most will happil give you a consult.  I know my surgeon, Dr Gross will do it for free. Made what a few of them say.

I could. It run before surgery.  I used to run.... Not like you.. No marathons... I would do 2-5 miles for exercise.... It got to a pony when I hit bone on bone that any runnin was painful and my gait when I ran looks like the hunchback of notre dame trying to run or something pathetic like that....

I couldn't tie my own shoes without assistance some days.... That was the point when I decide to fix it.  Sounds like you've tried a lot of stuff.. If you have cartilage problems... I would thInk a hip reserfacing would be a very helpful procedure... It's meant for active people with good bone quality. But arthritis, and loss of cartilage... That was exactly
Me.

[triathlete98]

Yeah i have a hard time tying my shoes as well.  I hope to find something out soon, see a specialist in a few weeks.  I been told by past Dr's that i have too much bone and not enough disease..but i don't have much of a labrum left so kinda suck in the middle.

[Woodstock Hippy]

I don't think you are stuck. You just haven't found the right doctor yet.  I feel for you and I understand your loss right now. Just seeing a specialist isn't going to cut it.  Keep looking, you'll find someone who can help you.

In the mean time, how is your swimming?  Can you kick?  I haven't been able to for two years but after my surgery I'm going to focus on my swimming and celebrate my recovery by doing Waikiki Rough Water Swim.  Since you won't be doing IM for a while, think about doing Waikiki.  It is one of the races that inspired Ironman.  Maybe I'll see you there.

[triathlete98]

Yeah i swim all the time. I don't really have a pronounced kick, it kinda just facilitates my hip rotation.  I can do the IM swim in an hour non wetsuit so most of my off time will be biking.  Yeah I am hoping that one "doc" will understand that i may not have the look, but symptomatically I am,  fingers crossed.  I may attempt an ironman next year and just have them wack my hip full of cortisone, whats the worst that can happen, i have to have resurfacing done lol from the degeneration of my labrum, lol.