Two Questions

[ColinH]

Dear All - I am new to this site and would be grateful for your comments and experiences on two questions.  I am a very keen cyclist: races and time trials at a club level, high intensity work-outs etc.  I am aged 50 and have OA in my right hip. 

What level of recovery should I expect after a BHR say after 3 months and at one year.  Is it realistic to expect to get back to the same level of hard-core (low impact) exercise afterwards??

When is the right time to have the surgery?  Is there a "norm" of the level of discomfort/disability when patients decide enough is enough?  Is it better to go too early or too late?

Many thanks

ColinH

[hernanu]

Hi Colin - not a cyclist, so I'll let other folks who are address that. I know that many here have returned to competitive cycling, either as part of a competition (triathlon,etc.) or in competitive cycling.

Personally, I do high impact sports (tae kwon do, soccer, basketball) and the usual gym stuff (weights, yoga). At three months I could do none of those, although in PT I was on a stationary bike for about 20 minutes.

My limitations were no weights above 50 lbs until six months, no impact sports until one year, running was limited, not by my surgeon but by my personal experience until about nine months. Some have returned to running after six months and were successful and did fine.

The main reasons to avoid impact in the first six months is 1) to let the bone grow into the device and settle well and 2) to avoid the neck breaking before the six months mark.

[mike1966]

Hi Colin,

I agonized over when to have surgery and even cancelled it once. The decision is for each individual based on medical advice and their own feelings about lifestyle and surgery. In my case, the reality sunk in that even though I wasn't crippled in the way some are before surgery, I no longer had the option to live the way I always had and i was deteriorating. My hip isn't the way it was when I was 21 but neither is the rest of me! I completed a 5km 'mud run' with walls, crawls and obstacles last weekend. Before the surgery, I couldn't run so I'm definitely better off. The decision of when is a tough one. Good luck and keep us posted.

Cheers

Mike

[David]

Hi Colin,

You can get back to wherever you want to get back to, depending on your patience with your own body and state that it recovers.  I am at 2+ years post-op, have done a bunch (distance triathlons, 1/2 marathons, longer distance trail races 16+ miles and mountain climbs) and am still not satisfied that I have reached my pinnacle of recovery.  When you are in constant pain without any physical activity, it is definitely time for the operation.  I was on my bike a few days after operation inside and biking after a few weeks outside.  After 6 months the integrity of the device is not an issue.  Muscle recovery and firing properly is the main issue for athletic performance, and I believe that is not something one cannot quantify or qualify across the board.  Everyone will respond and return to activities differently.  I have zero regrets if that is any comfort.

Best...
David
www.jayasports.com

[einreb]

Dear All - I am new to this site and would be grateful for your comments and experiences on two questions.  I am a very keen cyclist: races and time trials at a club level, high intensity work-outs etc.  I am aged 50 and have OA in my right hip. 

What level of recovery should I expect after a BHR say after 3 months and at one year.  Is it realistic to expect to get back to the same level of hard-core (low impact) exercise afterwards??

I'm at 2.5 years.  I did a few crits a little over a year out last summer.  I did 20 road/crit races this season and am gearing up for cross now.  Riding bone pain free is spectacular, much better bike position, more even leg strength, etc.  I will say that one big thing for me was a solid weekly effort at core strength that I started about a year ago.  I do a single kettlebell class a week that really seems to pay dividends.

When is the right time to have the surgery?  Is there a "norm" of the level of discomfort/disability when patients decide enough is enough?  Is it better to go too early or too late?

Impossible to answer.  I was 40 when I had it done and put it off for years. I'm glad I waited as long as possible, but also wish I could have had this life again earlier.  No perfect answer. 

[chuckm]

ColinH, I have been following this site for about 10 months and the overwhelming majority have said they wish they had decided to have resurfacing sooner. I am one of them. But, I sit here with a painful wisdom tooth now for almost a year and have done nothing about it. Just human nature to procrastinate with these things.

Chuckm

[bkeers]

ColinH,
I had my right hip done 9 days ago so I cannot comment on what you can get back to..yet.
But I knew it was time when i was limping in the office and could no longer hike without a
cortisone shot. I had two of them this year and each worked for about 4 weeks to get me
through some trips I had organized. Interrupted sleeping and night and irritability were also
factors in getting it done sooner rather than later. I was able to continue training at the gym
till the week before surgery which seems to have helped on recovery. I was able to leave hospital with a cane and am walking around 1.5-2.00miles, spread over 3 walks a day. Hope this helps.

Brian
RBHR
Dr Keggi
9-23-13

[obxpelican]

You can have a good recovery if you pick a surgeon who has experience and good results.  Assuming you will end up with a hip resurfacing there is no reason that you won't be able to get back into an active lifestyle.

As to when it's time, most of us factored in our work, what we were unable to do and the level of pain.  I was a bit stubborn and I paid for it by waiting.  You want to also know if you are doing damage to your acetabulum and femoral head when you reach the bone on bone stage. You can end up complicating your surgery sometimes by waiting, that answer can only be realized through your doctor.

In the end, don't go to a doctor who does not have good results, ask a lot of questions, ask him how many revisions he's had to do, what is record on cups.  What are the pain protocols, what is the infection rate at the hospital.


Hope that helps.


Chuck

[ColinH]

Thank you all.  I have just finished a UK cycle season - pretty much without pain/disturbance. 
Based on two or three weeks of heightened discomfort earlier in the year I had marked the diary (and the surgeon's) for end October.  Inevitably, the most recent 3 or 4 months have been much better. 
I do not run any more, but have come to accept that, and certain chores (shoes/socks etc) are awkward. 
My sense is that this condition is a little less deteriorated than the average hip resurfacing patient, and I should plan on putting back for another season. 
Colin's dilemma.....

[Granton]

My experience has been that the rate at which the pain gets worse accelerates.

My second hip (the first was resurfaced 14 years ago), started to feel "not right" about a year ago. I could still walk good distances without much trouble up to about four months ago, then it really started to be noticeable all the time. Over the last month, it has got significantly worse each week.

As for cycling, I have ridden a bike a great deal over the last couple of months - not sports cycling but just getting around because it is so much more comfortable than walking.

I have also been doing rides of 25 - 30 miles, just to try to retain a bit of fitness. Even the cycling is starting to hurt quite a bit now. I should add that where I live I am able to ride a long way on the flat - any hills hurt quite a bit.

My operation is next Tuesday. Can't wait to get it done.

If you know you are going to have it done, is there any point in putting it off?

David

[lgbran]

Hello Colin,
I'm a hack cyclist. Used to run but stopped 11 years ago once body started to break down. Hence started road cycling. Hind sight is a wonderful thing. Here I am 4.5 weeks from surgery. What started as sore groin, sciatica, tight it ab band, graduated to struggling to tie shoe laces and putting socks on. Over this period of time tried physio, chiro, stretches , orthotics .xrays revealed OA in the right hip.
Through it All cycled on and off 0ks to 650  ks per week. Over the past 18 months there had been a rapid acceleration in pain in my right hip, leg and back. Circumstances have delayed my surgery til now. I can't wait to be on the other side post surgery and on the road to recovery. I would love to run again( would love to do 1 more marathon), however happy to cycle long and hard and pain free. Do it when you can, it a personal call, however many here and people I have spoken to wish they had done it years earlier. I know  I wish did.
Good luck in your journey.

Cheered
Len

[AlanN]

Hi Colin,
Some great points from others above and I'll just reiterate the "get it done sooner"  point.
I, like you, used to do a lot of excessive and was very fit.
My hip started to deteriorate and I put off the surgery for over two years, surviving on drugs (which made me feel awful) with massively limited mobility and lots of pain.
The worst effect of putting it off for so long was that I could no longer train and put on loads of weight.
It has now been 3 years and from the moment I woke up from surgery I cursed myself for not doing it ASAP.
Just my 2p and the best of luck with whatever you decide...last thing I'll say is you won't regret it