when is the right time to do the hip?

[rdharris]

I was diagnosed with arthritis 8 years ago and informed at that time that I will need a new hip. The doc said he did not know if surgery would be needed 2 years or 10 years and I have been delaying the process as long as possible. Upon the diagnosis i stopped running due to the pain and discomfort and also stopped other activities (primarily cycling). I've had pain off and on and typically have some pain daily but not consistently. I've been riding over the past couple years though have limited ability on hill climbs.


Over the past 8 years pain has ranged from very frequent to limited with walking and I sometimes walk with a limp and sometimes pain is sufficient to prevent me from going out for a walk. I experience pain at night while sleeping on occasion, it occasion will be uncomfortable enough to interrupt my sleep.


I have been spinning 5 - 6 days/week over that past 3 months and surprisingly this seems to reduce the pain, however, if I do not spin for a couple days then pain will return. Clearly, there are benefits to this activity.


Having said all of this I do find that pain is more frequent, but I often feel fine and maybe better than i have at times over the past 8 years. I do find that I can't pull up on my pedal (left leg with arthritis) and I find that I am not doing some things that I would like to do (walks/hikes) and I feel that my cycling will continue to decline over the coming season (spring/summer).


I've read that many people opt for surgery when the pain is so persistent that they can no longer stand it and that the pain of things like getting in/out of the car is very uncomfortable. I am not at this point.


I feel like getting surgery now would allow me to be more active with activities that I enjoy and to resume activities that i have stopped doing.


A little more background - I am a 54 yr old man and was formerly a marathon runner and now a road cyclist. I have given up tennis and golf. I also enjoy fly fishing and generally standing has not been a problem, but hiking steep terrain is, as is wading in streams with slippery rock bottoms.


I realize that this is a very individual decision and I am looking for some perspective from others on when they opted for surgery and how whether they were OK with the decision after the surgery.


In part I feel like doing surgery now will allow me to continue activities that I enjoy and will not need to further reduce activity ahead of surgery which I expect is 12 - 24 months away.


I appreciate any any input that can be provided.

[Pat Walter]

Welcome to Hip Talk.  I am sorry to hear you have hip problems.

Sometimes we personally don't know exactly when to have hip surgery.  Only a surgeon can tell you that is it time and if you wait too long, you can miss the window of opportunity to have a hip resurfacing.

Many people have written hundreds of times on the forum that - "They only wished they had done it sooner"

The advantage of hip resurfacing is that you can do it at an early age.  There are people that have now had their hips 15 or 20 years.  I am going on 10 years myself.

It is very sad to put your life on hold because you are in pain and unable to do normal activities and the many sports people love.

Best way to find out is to send some emails about to the top surgeons and get some more input to make a good decision on. 

This list indicates in RED which of the top surgeons do free email consultations.

http://surfacehippy.info/hip-resurfacing-surgeons/

Good Luck.  I am sure many people here will give you some encouragement and support.

Pat

[chuckm]

I don't know anyone on this forum who said they should have waited longer - including me. It's always a resounding "I wish I had done it sooner". It's like going to the dentist. You wait until the pain is so bad and then you realize there was no reason to wait.
Plus, the resurfaced hip will become very strong and you might start thinking of marathons again.

Chuckm

[Quig]

rdharris, I'm about 15 years your junior but our stories are remarkably similar. I started to have hip problems while running about 8 years ago and that led to being diagnosed with arthritis brought on by FAI. I too was told I would need a new hip (maybe two) and to put it off as long as possible. I quit running and over the years slowly made many concessions to my hip(s). I discovered mountain biking a few years ago and noticed it seemed to help. I've ridden A LOT for about 3 years and until recently it has been very helpful and FUN! Over the course of the last 6 months or so things have deteriorated to a point where I am now scheduled to have bilateral resurfacing done by Dr Gross in about 6 weeks.


If there was one common denominator among the doctors I visited for it was that each told me "You'll know when it's time" to have your replacement(s). The last few years have not been easy. I'm extremely active and have a high tolerance for pain and am stubborn as hell. I finally met that 'time' when I 'knew' on a hike about 4 months ago. I threw in the towel and decided it was go time. I was tired of making concessions and living in pain. I did TONS of research and talked with a couple doctors and made the decision to fly to South Carolina from California to have the procedure.


So maybe that's a really long winded way of saying, "You'll know" when it's time. As others above mentioned if you spend some time reading through the experiences many on this board  have had, you'll have a very hard time finding anyone who said they wish they had waited. On the contrary you'll find plenty of folks explaining that they wish they'd acted sooner...


I can't help you with any first hand post-surgery opinions yet but I'm optimistic I'll feel TONS better in a few months!


Good luck with your decision!

[blinky]

My life had been shrinking slowly over a period of years, too. I gave up running distance and was happy just to run a mile or two. I tried to like swimming more. Lifting weights and stretching regularly, I hung on to the abilities I had. I wasn't in a ton of pain, but I was waking up at night. My blood pressure was creeping up, I guess from the background noise of the pain, the not sleeping, drinking more coffee to cope with not sleeping. It was hard to sit through a movie in a theater. When I realized I was avoiding doing simple tasks like walking down to the mailbox, I decided I had to do something: how had I gone from a woman who ran four marathons a year to someone who wanted to drive to the mailbox?


There is a time past which resurfacing isn't an option. You have to have enough femoral head to cap. Do be careful not to wait too long. I almost did. (Stubborn, high pain tolerance, thinking I could just work harder and overcome this problem...)


Okay with the decision after surgery? So far so good! I am almost fifteen weeks out. Less pain and better ability to move already. There are still some things I can't do, like run, but I am out walking three-four miles a morning with no pain.

[Tri Hard Alan]

Interesting to hear you are struggling on hills when cycling because I found that too. And not aware of others having same problem. I also found it slowed my running down too.


In terms of when to have it done, as soon as you can not do something you enjoy doing. There is no benefit to waiting. Any reprieve on the symptoms will only be temporary and in the meanwhile the root cause can only get worse. And as others have pointed out if you leave it too long there could be too much damage and the option of resurfacing is gone.


Selecting the right surgeon is crucial. Search on here for one recommend by others that has thousands rather than hundreds of resurfacing's and is practical to get to. If you are in the UK Derek McMinn and Ronan Treacy are the best,  I went to the latter, he lets you run sooner. I am 4 months post op tomorrow and start running again next week.

[JHippy]

It wasn't pain that drove me to surgery. Like you, my pain wasn't really that bad most of the time. I couldn't even dream of running though. Cycling and walking did help, a family doctor told it was because it lubricates the joints.

Little by little my world kept getting smaller. But I was still hopeful I could cure or at least manage it naturally. I didn't like the idea of surgery -- you can't undo that. Even though the risk is very minimal when you have the right surgeon, there is still a risk and I didn't feel it was one worth taking.

By the time I consulted with the doctor I could see where I was headed. My life had already shrunk and obviously was just going to get worst and fast. The turning point was seeing myself walk in a video. I thought I was hiding my limp when in fact it was painful to watch and my whole body was obviously affected. I knew my back and knees would suffer if I didn't do anything. After a several more months of procrastination and flip flopping I finally decided to do it. Consulted with a couple of surgeons and booked the surgery. Dr. Gross and staff fixed me up. Having this surgery by that surgeon was the best decision I ever made.

[petemeads]

Hi rdharris - I was 10 years older than you when I went to see my orthopaedic surgeon for an opinion about my hip arthritis. I had some pain and a lot of stiffness, running was limited to a weekly 5k parkrun but I did no training. Biking was OK, skiing painful, walking could hurt sometimes and be OK others, the main thing was I was getting more and more miserable about getting old and infirm.
Fortunately I had kept up my health insurance after retirement, and I knew someone who had a BHR ten years before. I found the McMinn website, watched the operations, digested the various statistics and chose my local surgeon (who is a hill-walker/diver) to tell me if I would be suitable (on the edge of the envelope for age and bone quality). He said he would operate on my left hip but the right one had a couple of years to go.
Having been told I could get what I wanted I then spent a month worrying about just how much I wanted it!
Then I made the booking and was fixed up a month later. Read my posts for more details but I was jogging slowly at 8 weeks and running properly within 4 months, having done more than 50 5k runs and trained up to 13 miles, as well as biking 60/70 mile days, since then.
Still got the natural hip to slow me down but I am basically back to normal, climbing well indoors, biking, running and distance walking in the hills - and the whole process of dynamic recovery from the operation was a great experience, for once things were getting better (most days) rather than slowly getting worse!

See a quality surgeon, get an opinion then get it done!

Pete

[rdharris]

Thanks, everyone, for the fantastic feedback and perspective that you have shared. It is really helpful to understand how others have addressed their hip procedures and I now feel more comfortable planning my surgery, which I have scheduled with Dr. Brooks at the Cleveland Clinic. I don't feel like I should be waiting until I dread the thought of getting in/out of the car or as one person commented walking to the mail box. Your comments have convinced me that having surgery sooner rather than later will minimize the time that I can't do the things that I enjoy. And while I thought that I would never run again, I am now considering the possibility of running


I can't tell you how helpful it is to have a support group, which i will explore in more detail and will also check back in post surgery. With much gratitude - rdharris

[PMac]

I went for six years in constant pain, not terrible but nagging pain managed by cortisone injections but as others have said it got to a point when I knew the time had come. I was struggling to walk long distances (well any distances really) and it got to the stage where I figured whatever happened it couldn't be any worse!


Well next Friday will signal the four month post surgery and my life is virtually back to normal with the added benefit of no pain! And yes I wish I'd done it a long time ago!


Good luck and keep us posted

[badbone]

I understand your dilemma.
I was in the same predicament as you are in now, and like you, I consulted this wonderful resource and the many wonderful people that make up this site.

They all said the same thing.  I am an ex lacrosse player, extreme skier etc...and have put my body thru the ringer.  As Blinky said, "when it interferes or prevents you from doing the things you love" then its time.

I could manage the day by popping ALEVE like chicklets, but I didn't want to continue on oral meds.  I wanted to treat the CAUSE not the symptom.  I did exhaust all my options, as I did have 2 surgeries on the same hip.  FAI and labrum fixation.  Both surgeries extended my hip a total of 10 years.  I am 50 and understood the shortcomings of a THR.  So I wanted to prolong my existing god given hip for as long as I could. 

I go in for mine in 4 weeks.  I cant wait.  I was walking around  the block, and after 1/8 of a mile, my hip was in serious pain.  I hobbled back home...and knew it was time.  The next day I had no pain.....but now its not a questions of IF, its a question of WHEN.  I did my research and decided that it was time to do it. I was young enough to make the recovery easier, and I didn't want to risk damaging my femoral head enough to prevent me from a BHR.

As others have stated, don't wait to long (consult a specialist for this) as it could affect whether or not you can have the BHR.

Good luck..and consult the professionals.  As others have said....."you will know"

[Paul_D]

My decision was when my quality of life had deteriorated to a point where I could not join in activities that my friends were doing and also when household chores became too difficult and painful. Shopping and feeding the cat were difficult as I could not walk more than 300m before I had to sit down or I could not bend over to put food in the cats bowl. Knowing that it will just get worse I promptly made the appointments and got both hips done.


Now 7 months after I walk about 6km each day and now on weekends I will jog a part of this as well. Looking forward to summer to get back into life again!

[MattJersey]

The first surgeon I saw said you will know: when it is disrupting your sleep then it is probably time.


I hadn't realised that my getting up to go pee 3x a night for 10 years wasn't a bladder issue or over-hydration or too much coffee. It was my hip. Realised this after starting to take pain killer before bed.


So another benefit for me post op is ... sleep quality is dramatically improved, and I'm not annoying my wife 3x a night either!

[hipnhop]

When you have a lot of difficulty putting on your socks. That was the final straw! 

[JaxHippy]

I consider myself a wimp compared to what so many folks suffered through on this site.  I suffered for less than a year before I made the decision for might right BHR.  I was very worried I was going too soon, as I had really only suffered for less than a year before making the decision.  As soon as I was not able to play tennis anymore that was it for me.  A key item for me was that all of the work I was doing prior to surgery, all of the physical therapy, was only slowly preventing a more rapid decline, and by no means treating the root cause of the issue.  What is so wonderful with this surgery is you are fixing the root cause of the issue, and all of the effort put in post surgery is going to move you closer to being "normal" again.   At 4 weeks post surgery I had significantly less pain than pre-surgery.  I'm now 8 weeks post op and can't believe how good I feel.    Good luck with your decision!

[karlos.bell]

  Hi RdHarris sounds like your on to it and know your body. Some flaws I found if you leave it too long.      Bone issues femur (poor bone stock due to osteoarthritis).
Muscle format changes adductors and or iliopsoas you may then need releases.
Ongoing groin and tightness.
Age criteria, sleep deprivation, other issues that cannot solve due to the pain overriding in your hip or hips.

But leave it as long as you are comfortable due it is your body and surgery is not a hell of a nice.
I found while your fit and can still do some exercise get it done due you recover a hell of a lot better if it was 10 years down the track.
Surgeon make sure he plants them in correctly and get it checked. Make sure their track record is excellent.
You should be able to run I can and had both done. After being on crutches for 7 years running it was a dream I thought it would never happen but I enjoy it so I will do it, life is too short to not complete some dreams and make them a reality. The surgeon said go for it....................
Other than that good luck. Great site great people to help you out.....
Cheers K

[LMS]

And most of all, from my experience: if you have to go through a doctor to get to be seen by a surgeon: push the issue!!!!!  Or go elsewhere!


I was a candidate & when my hip started to not respond like usual (to make the pain go away for example & things started going downhill fast, taking the good hip along for the ride), I started to ask to be seen by my surgeon because "it was time".  And they (my GPs, I went through 3 before someone finally took an x-ray) kept putting me off for well over a year (I'd say close to 2 years) & it's now too late for the resurfacing, I'm not longer a candidate for HR.

[Arrojo]

Do it as soon as possible.  Do not wait.  There is no valid reason to wait.  My hip was only bothering me when I ran.  It did not hurt to walk.  But I still had it done and I am so glad I did.  The main reason is that I was in better shape for the surgery, which in turn aided a quick recovery.  If you are limping around for months or years, then your body develops bad habits that makes recovery more difficult.  In addition, you want to go into surgery in the best possible fitness you can - an extremely painful hip is not conducive to that.

I trained for my surgery like it was a goal race, so that my recovery went very well.  So well that I medaled at the CT Senior Games in the 50 meter dash one year after surgery and ran the Boston Marathon 2 years after surgery.  There's no question that had I delayed having this done until walking was painful, I never would have been able to recover so quickly.

Good luck to you.