Re: 6 weeks (almost) post op RHR by Koen De Smet

[Tim Bratten]

    Tomorrow will mark exactly six weeks since the morning I got my right hip resurfaced by Koen De Smet. It has also been a bit more than two years since I had revision surgery on my left hip. For anyone who doesn't know the story, nearly four years ago an Argentine doctor botched his attempt to resurface my left hip. A year and a half later I went to Koen De Smet for the revision and his team fixed me up with a large ball ceramic on ceramic THR. Maybe I should mention that I am an active rock climber and after the revision I was able to return to a good level (for me) of climbing/bouldering in spite of the OA in my right hip.

    I'm thinking my current condition should offer an interesting perspective on the differences between the two sorts of procedures (revision to a THR a la De Smet and HR). I guess the first thing I have to say about this, so far, is that the recovery from my HR surgery has not been any easier (objectively speaking) than recovery from the revision surgery. In fact, psychologically speaking, the new surgery has been more difficult than the revision, mainly because I was worse off before the revision surgery and afterwords, almost everything felt like improvement. This time around I wasn't so bad off before and I feel more heavily the weight of trying to recover from yet another hip surgery (three times in less than four years).

    It seems the fact I have a lot of muscle around the hip made my surgery a bit tricky. When De Smet came to see me the morning after, he seemed kind of intense. He said (more or less): "You know, metal on metal is a procedure than can work quite well. However it must be done with absolute precision". Then he told me: "For your surgery I was lucky to be working with my colleague from Rome, who is one of the best surgeons in the world". Then he took out the post op x-ray of my hip and showed it to me with obvious pride. Later, when I asked De Smet's assistant, Bart, if he knew why my leg should feel sorer than it had after revision surgery he told me I had a considerable amount of muscle protecting the hip and this made it quite difficult to get a good cup placement. I recall my Argentine surgeon had complained about exactly this, after his attempt at HR. I guess I'm glad I went to the best this time.

    At this point, I'm roughly at the same place of recovery as after the revision. After the revision surgery, I began to practice in my home climbing gym 5 weeks and 4 days after surgery. This time my first day in the gym was 5 weeks and 3 days post op. After sessions in the gym on Saturday and Sunday I´m ready to return for more training, tonight after work. Meanwhile, as before, I'm also going for some good hikes (around 5 miles), using trekking poles. That's where I was six weeks after revision. The one place I may be a little slower to recover at this point is walking unassisted. I still have a pretty good hip waddle, when I walk unassisted (especially if I try to walk quickly), but this is definitely improving each day now. Also, my leg feels pretty stiff, for example, when I get out of the car after the 70 minute drive to work, and it takes a bit to warm it up afterwords, but I really wouldn't say I am experiencing anything like pain (or even irritation) in the hip or leg.
    Cheers
    Tim Bratten
         

[whyme]

Hi Tim,
I hit my 6 month mark only few days ago, HR done by Dr. De Smet too. He is quite a character. Now it seems 6 weeks post-op wasn't very much time at all...
At 6 weeks I could have long walks (as you do) just using 1 crutch, but between weeks 6 and 8 got rid of it and the limping went away.
I'm amazed you are already able to practice on the climbing wall! Very impressive...
I used to climb since my early teens, although I haven't in the last 10 years. For some reason, I'm  still attracted to it, and have been playing with the idea of a comeback. I guess once a climber, always a climber... But the fear of falling (which I always had, by the way!) and possible consequences has been more powerful so far.

Regardless of how it felt the revised THR for you at this point, I'd say you're doing quite well.

[Tim Bratten]

Today is exaclty seven weeks post op and there was lots of improvement last week. I now feel like I'm walking unassisted pretty well and I can walk a couple of miles around town like a regular guy, no problem, pretty much without any limp or waddle. Meanwhile I am continuing with the long hikes in the hills using trekking poles (after the revision surgery I used trekking poles for almost a year on these long hikes). I also have trained six different days in my climbing gym and I'm starting to feel stronger there, as well. The plan (if the weather permits) is to start climbing outside the weekend after next (roped climbing, no bouldering yet).

I would say I'm doing at least as well as I did seven weeks after the revision, and really feel like I've  crossed over the hump. Right after surgery I was a little down, because it caused a pretty big setback from where I was just before. But now I feel I have estabilished a good rhythm rehabiliting, my hip doesn't really bother me at all, and I think I can get back to where I was in a just few months.

Cheers
Tim

[Tim Bratten]

Hi Hippys
Just thought I'd check back in. I'm almost four months post op on my RHR and I have to say I'm doing VERY well. At first the resurfacing was a bit more painful than my revision surgery had been, although by two months I had reached more or less the same level in my recovery with the HR as I had with the revision. Right now, however, I would say I've advanced months ahead of where I had been with the revision surgery. This may be because the revision followed a difficult year-and-a-half coping with a poorly placed implant, bone infection, etc. and may not have anything to do with the THR/HR debate, however my right HR is working very well at this point. I have basically returned to the level of climbing I had presurgery and I continue with my hikes in the hills (trekking poles still!). 
Good luck to eveyone else!
Tim

[Mike D]

Great progress, Tim- sounds like you're flying along after all the grief you had with the revision.
To be back climbing at 4 months seems like a rapid recovery to me, keep up the good work!

[Tim Bratten]

Thanks Mike D. How are you doing? My ceramic on ceramic is working fine (two years and three months: knock on wood). Not ony that, but I see I've finally become an honest-to-goodness "full member". Boy, that took a while.

[Mike D]

Doing fine, Tim.
Over 18 months now and the hip feels strong. I've spent a lot of weekends over the last year pounding the Yorkshire coastline- Whitby, Runswick, Robin Hoods Bay etc. All types of terrain and no great issues, just the normal twinges so all is good.
I think 'full membership' is looming for me as well-the early arthritic feelings are sneaking in on my other hip but I'm hoping I'll be a HR candidate for that, as and when.

[Waterman1]

IT is an inspiration reading your story and updates. I am six weeks post op LTHR. I am back in the swimming pool with breaststrokes and excercise, although my right hip is killing me, I just kinda drag it around. On JUne 23, I should have a new BHR of the right hip, from a surgeon with 1800 plus under his surgeon's belt. My surgeon tells me the BHR will be from the anterior approach which is less pain, less recovery time than the posterior THR I received from a different surgeon six weeks ago. Do you all believe the anterior approach in BHR can be less painful than posterior THR - sounds too good to be true. I can have a BHR with less pain and less recovery?  YOO HOO!! What is the correct wordage about my hips - I am a hybrid bilateral hippie? I feel blessed right now...

[whyme]

There are a few resources on this site (inc. various surgeons' opinions) on Anterior vs other surgical approaches, and even a heated debate on the wiki only a few months back ...
As always (in my view), when you select a surgeon you take the whole "package", that is his surgical approach, his chosen device, anesthetic, recovery period, recovery rules and restrictions etc. You can't just pick and choose (unless they ask you).

There are pros and cons on every procedure, the main thing is the expertise and good hands of the surgeon with his chosen technique.

In my case, Dr. De Smet used the postero-lateral approach.

[Evan Thoms]

Hi Tim,
I am 2 weeks post-op from a LBHR and a fellow climber. Besides avoiding bouldering, at least for now, do you take any other precautions such as avoiding hard stemming or weird foot jams?

Can you top rope on your home wall or do you just never jump off or try hard enough problems that you fall?

Your story is inspiring. I had been thinking it would be a while before I got back on a wall, but maybe not! With the advent of parenthood a few years back my wife and I stopped climbing as much as we used to, but the kids are a good age now to start taking to the the gym regularly and I am really looking forward to it.

[Tim Bratten]

Hi Evan Thomas
First off I should emphasize that I am not recommending that anyone do anything that I've done! However, I've had a very satisfying recovery from the revision and now the HR. At almost eight months post op I boulder outdoors, jump down from the top of my home wall (pads three layers deep) and have led dozens of routes (both trad and sport) including some 5.11s. Thinking that someone who climbs might be interested to see what is possible with revision to THR and/or HR (and what will be the consequences of my approach) I started doing a blog that is mostly pictures but also answers questions about how my recovery has evolved (it only goes to five months so far, but I'm working on it):

http://timbratten.blogspot.com.ar/


 

[Evan Thoms]

VERY cool Tim! Thanks for the link, the pics are great and are making my palms sweaty!