Dumb question

[midiowa]

i understand why the slow healing process, but could you actually dislocate or move the new equipment just by over working it, bending over? iam feeling gun shy on the new hip but don't really feel like i should.try  it feels good,i want to try more rm  but i don't want to over due it so early either.

is it all about the muscles now or going easy on bone ? 

[Neild5]

There are 2 issues with hip restrictions, first is the 90 degree and the rest of the dislocation warnings for typically 6 weeks.  This is to allow the muscles and tendons that were cut or moved during surgery to heal.  The breakage concern is from all the work done on the bones, if the surgeon nicks the neck of the femur it will put a stress point that can break the neck.  Also the reamers for both the femur and acutabulum  disrupt the blood supply to the bones and the femur is at its weakest at about the 3 month PO point.  At 6 months the fracture risk  has dropped close enough to zero.

[WTW15]

Thanks - my concerns as well.  Was not sure about the blood flow / fracture issue.  3 months is the risky time. I will definitely keep that in the FRONT of my mind! 

[midiowa]

me too! gonna be a slow year, thats the hard part for me.

[WTW15]

Exactly Mid - me too.....  Feeling better means wanting to increase activity, especially watching everyone else "do stuff"  but - in the long run and I keep reminding myself of that - it will be worth it to Totally Heal Correctly!  I'm at 6 wks and having that paradyme of where on one side I think I should be farther along and on the other side looking at what the surgery was, I am doing well with my progress and should just be happy with that. 

Yes, it's going to be a long year!  but no O/A pain!! 

[hipnhop]

I'm not one to dispute research but a year wait, to me, seems a little long. Here's my two cents. The longevity of the device for very active patients seems to be about ten years. So waiting a year is 10% of the lifespan of your device.

Increase loading on your bones is good for bone strength.  As we get older we grow at an increased risk for bone loss and weakening.

Maintaining a good heart rate is key to fitness. I'm not saying you can't get your heart rate up through non-impact activities but it is much harder.

A key to returning to running is weight loss and natural body size. I am a natuiral light person. I gained 20 lbs between surgeries (got up to 200). I am down to 185 and plan to gt to 170 before hitting the track.

Today I am 4 weeks post op and walking two miles, stationary cycling 1 hour and engaged in an aggressive P/T program.  I got clearance to do light running two months post op (no more than a 5k at low pace).  By six months I plan on beginning an intense endurance running program.  I don't know if I will be able to pull out 7 min miles but I hope to work up to it.

I would like to hear from others who have, or are planning to, push the agenda. 

[midiowa]

Hip,  your pretty hardcore, iam gonna go little easier than that, but i do agree use it, but  i plan on min 15 -20 years with it, but good for you sounds like you got it whipped.

[Neild5]

Hip,

Not being quite as aggressive as you, but do plan on being able to do 2 miles walking at 4 weeks.  After 6 months my Dr said my only restriction is common sense.

[Tin Soldier]

My surgeon said he's never had a patient that dislocated the HR from overdoing the 90 degree restriciton and he's done over 2000 HRs.  Not saying it can't happen.   It sure would suck, if it did. 

A few weeks into recovery is mentally a little hard because the hip generally feels pretty good, but you still need to take it easy and stick to the restrictions.  I think the restrictions also keep you from straining healing soft tissure, regardless of popping out your femur.

[hipnhop]

Neld, I agree. So much of it is common sense. If it hurts, stop!  I will walk off a course in a minute if the hip gives me problems.  Maybe I can push it a little but I wont risk it.  I know the difference between general pain and something foul with the HR.

I'm just concerned, based on my experience, that people will gain too much weight, bone quality and loss of cardio vascular capacity if they are not doing their key exercise.  Runners do not want to get in the pool and swim 3400 yards for a good 1 hour cardio workout. ANd, for others, sitting in the saddle of a road back is a pain in the ass (literally)! I guess my message is not to sit on your butt waiting for the one year mark. Get moving and get the heart rate up and weight down.  You'll thank me later.  Now off to Wing Stop

[Neild5]

I see the operation did not affect your appetite  . 

[John C]

Hi hipnhop,
You mentioned something in an earlier post on this thread that may have been misworded. You said "The longevity of the device for active patients seems to be about ten years".
Most studies show survival rates of well over 90% at ten years, with some up in the high 90s, and the worst I saw was a study that showed active patients at around 89% survival rate. That means that, conservatively speaking, 9 out of 10 are still going strong at ten years, and can hope for much longer life out of the prosthesis, though there is not much data beyond that point. It is true that some THRs in young active patients have shown higher failure rates at around 10 years, but that is the very reason that we have chosen resurfacing.
While it is true that a few people may need a revision in the first ten years, results so far would show that for the vast majority of active patients, the longevity of resurfacing devices goes well beyond ten years. Though it is still too soon to know just how long we can keep that survivorship up around 90%, I have not seen any evidence yet that would indicate that it could not continue for many years or decades. The only glimpse we have into the possibilities is Dr Pritchett's report on early MOM resurfacings that showed nearly 100% survival at 20+ years. That report is available on Pat's site, though much of the information in it is probably not too relevant to modern resurfacing prostheses.
Just don't want active people to get the impression that they can expect their resurfacing to need revision at 10 years, since that is only in a small minority of cases at this point.

[midiowa]

I like the sound of that, i can be active without pounding the crap out of my new hip, hell my jobs bad enough & farm.  i want this baby to last ,but we done it to do all the sh#t we couldn't do, theres the mental side of it for me. will i be able to jump down off machinery? etc.  climb ladders?  trust the hip?worrying about screwing it up.    that's my state of mind  right now. Brad

[WTW15]

I think Hipnhop missed my point - I'm not sitting around waiting.  I'm doing my PT and walking and all, but like most of the others on this site, I want to return to my (potentially) high-impact beloved sport of riding dirt bikes and if getting good bone growth takes a year, I'm willing to wait. That doesn't mean I won't snow shoe or mtn bike when cleared to do so, but that for the long run, my goal is to be able to throw the leg over the bike again, which I haven't been able to do due to ROM limits from o/a for over 2 yrs. 

For now, walking my 1.2 mile loop when the weather cooperates will suffice.  And when the weather doesn't cooperate, a few reps up and down our interior stairs (23 steps) will have to do.  That's just where I'm at.

Hoping for 2 things at my 6wk appt tomorrow; 1) Ok to get on the stationary bike and 2) ok to snow shoe.  Conditions are prime right now and if I can't ski, I can hope to at least get out on the snow shoes. 

Brad- from all the posts - I think we are gonna be able to do all the stuff in due time.  hard to believe at this point given the healing takes so long and the restrictions seem like they are going to last "forever".... LOL 

[midiowa]

i think your right! onward!

[john206]

Naw, you aren't losing a year!
My doc Prichette gave me good advice. "take it easy the first 3 months but do whatever you want." adding "You won't be able to do what you shouldn't because it will hurt." That was true. I had a fairly painful start, probably worse than usual,  but once off the meds I got to the gym. I was careful about the 90degree thing for the 6 weeks but still did stuff. After that I started officially training as best  my body could stand it which was more gradual than i wanted but.... <6 months later I did a couple of hilly century bike rides and then the 200mile Portland to Seattle (STP) bike ride easily.  That same summer I made some alpine climbing attempts which showed me I had some work to do but was having fun. Got into yoga etc and kept at it. It did take my body and hip a year to get truely solid but thats not to say I wasn't out there having fun with biking and climbing, even cyclocross racing in the mean time. You're not taking a whole year off dude. Just modifying. Be sensible.  I had gained some weight which makes a difference and takes time to get rid of. And I had some adaptations to make due to illio-psoas pain and external rotator issues post op that I still work on.  Then there's the usual old man issues to fight.  So I continue to improve now even on my 4th year and keep going beyond what I thought possible for me Pre-OP.

[WTW15]

Thanks for the note John- it really hits home today as I went to my 6wk check up and was told "no restrictions"!  What you just wrote is what I was imagining going forward.  "As tolerated" and my body will let me know my limits.  I have already tried to go past 90* and well, it's tight - so I know where I need to do work.  I am hoping at 6 months I can throw a leg over the moto and ride.  But if not, I'll work on it till it's right.  But just knowing that I can get on the stationary bike now, I can move around more freely and I can sleep on my stomach is a big step towards getting back to normal.  Yoga is on my list to start here too. 
Thanks
Denise