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What Is The Top Recommended THR for Serious Running???

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Hi SMJA,

I get that. When it comes down to it, being out of that kind of pain and disability can be the ONLY priority. I do understand that, although I have not been through the process like many of you folks!

I'm glad also that you're happy with your surgeon. He's done a great job with you. In the end, it is the surgeons who have Saved Our Buts, and for that, gratitude and respect HAS to be part of the picture.

Having said that, a lot of people have told me or posted they wished they HAD done more research.

Again, I am very sure your device will work out just fine, given your great experience. The vast majority of devices successfully take people out of chronic pain and back to an active life. Seems you have a fine surgeon and are doing great. Hats Off To You.
 
The stats will bear it out - eventually. But the time between now and then will probably be the usual 20 years!

I'll probably be dead by then so you won't be able to sue me for misleading you! :th_heehee:
 
I spent the first year after my THR trying to convince myself that I was okay with not running. I did every other form of cardio I could think of, just to keep myself distracted from running. That was fine, as far as it went, but it wasn’t the same and I still missed running a lot.

One day, when I was about 15 months post-op, I was waiting for a step aerobics class. The instructor was having some trouble with the tunes, so she told us run laps around the studio to warm up while she worked on making the music happen.

Well, that was the end of me being a “former runner”. I honestly wasn’t planning to go back to running but, once I started, I was hooked. So, now I run (outdoors, not in dance studios :th_heehee:), but with nothing like the volume or intensity that I used to do.

I know that there are people who are happy just to be able to walk or do household chores or babysit after THR. That is great for them, but I’m not one of those people. At least not today. Maybe in 20 or 30 years, when I closer to the traditional age for joint replacement. Even then, I’d like to imagine that my horizons will be a little broader. Walking and doing housework are part of simple existence. For me, really living involves a lot more than that. Having come close to death three times in the nine months before my THR, I believe I am here to live and that is what I intend to do. :thumb:
 
Thanks, Dingbat.

Josephine, LOL, one of the great things about voicing even an educated opinion on cyberspace -- no one get's sued!! Seriously, you've been pretty clear there is no guarantees with respect to impact sports, so anyone will have to do that at their own risk. But still that perhaps even a majority of surgeons privately feels running is fine with THR or resurfacings (properly fitted and barring the major issues like femoral neck fracture) is encouraging news.

Believe me, you WILL be around to see the news. Afterall, if you're gone, who would be around to administer Bonesmart and keep us all informed and in line??? You can't die within 20 years -- not without permission from all us Bonesmarties! :hissyfit:

Good also to hear it affirmed that Derek McMinn's commendation can be taken to the bank. BHR with Dr. Bose still my #1 preference. But I'll try to hang on a few years to find out the results of the British inquiry into MoM.

At this point, I don't plan on letting my hip(s) restrict my activity post BHR in any way, provided my body responds to the surgery as intended. Other age related factors might restrict things, but not the prosthesis. With precautions (hip strengthening exerices, etc), I will not hold back on running or anything else.

If the BHR needs revision and I get a THR, it will be many years from now, and we just might have those needed stastics, plus more advanced technology, and it will be time for a new decision on whether the hip (or hips) are to limit activity. I speak for myself only.

Personally won't wait until severe pain and disability. Had that in 2011 and decided not to let that happen again. If I can't complete low-impact workouts even with painkillers, time to get the surgery.

AlexTheCat: That's a wounderful story. Doesn't it feel wounderful to run? You are inspiring. So well said.

Linda, hope things are going well after your July surgery. Are you running already? Will have to do another search on your recommended threads.
 
The surgeon who did my hip replacement does a lot of resurfacings, I think more than any other in upstate NY. I don't think he discourages running for resurfacings at all ... I'm not sure about total hip replacements--you seem to be leaning towards a resurfacing??? That seems like it holds up better to impact sports than a total hip.

I'm not a runner, but he has told me that I can do anything I want with my total hip replacement (not resurfacing) including my passion--horseback riding, which to many is too dangerous of an activity to do after a hip replacement. I get told that a lot. But, I'm just going to kind of do what alexthecat does with her running--adapt to my riding to make it safer because riding itself is fine ... until you fall off--talk about high impact!! I'm going to be very careful of the horses I ride, the places I ride, and the company I ride with--basically just be safe as I can be. But, I'm still going to ride. It's part of my life and part of who I am.

I hear you about your passion. Just try to be reasonable about it, though, so you don't end up wearing out your hip in a short period of time. They can only do so many revisions ...

Dorothy
 
Hi Dorothy, so who is your surgeon in upstate New York? I live in the Toronto area. . .

One thing about horseback riding -- potentially high impact. Nothing like falling off a horse. But as long as you can stay safe, there's no limitation. Not a bad situation.

As far as revisions, I'm no expert, but there do seem to be a number of "bone conserving" THRs. Past one of those, it would be good to know what factors dictate when the restrictions start piling on. Clearly bone grafts are to be avoided. I wouldn't want to take many risks after getting a first THR, frankly, unless there was sure to be enough bone etc. to allow yet another device that permitted cycling, hiking, swimming, etc. Even then, obviously surgery and recovery is gruelling and it can't be good for the body overall to go through that including with the anesthetic and other drugs.
 
I am just about to starting to run again - I've had a setback recently (not due to running) but am ramping up slowly again - last spring early summer before my second femoral head collapse I was up to 10K's...I fully expect I will b there again by fall :) I don't know if I'll ever run another marathon - tho I do expect I'll complete one in the future just may b primarily speed walking, tho not sure - who knows in 5 or 10 years - right now too difficult to train w/ such young children and I believe I need some more time before I think about that kind of mileage again...hope you are having a good day :)
xoxo,
Linda.
 
My surgeon is Dr. Michael Clarke at Syracuse Orthopedic Specialists. Website is www.sosbones.com He's very experienced and has been doing hip resurfacings since the mid 1990's when he was practicing in the U.K. Moved to the U.S. later and started doing them here. He also does hip replacements and other hip procedures, of course. He only does hips--and a lot of them. There is a video interview with him and Vicky Marlow on the Surface Hippy website under "Top Hip Surgeons" from an ortho conference in 2009, if you want to see what he has to say about hip resurfacing. He's probably adjusted a few things since then, but he's a pretty steady-Eddie type and not likely to make any radical changes without good reason.

I've been very pleased with Dr. Clarke. It took a little while to figure each other out, but I think we have a very good patient-surgeon relationship and I trust him completely. As long as he is available, no one else will ever work on my hips. I highly recommend him.

Good luck with whatever you decide to do.

Dorothy
 
I love it - "nothing like falling off a horse, potentially high impact" !!

I have had a high impact event with my THR in the latter part of 2010 when i came off my bike again at Brands Hatch (yet again but i love the place.....!!). As with most falls / injuries the outcome is more to do with how you fall, and also more down to luck than anything else.

There are so many negative people out there who try to tell you how to lead your life.

I would say you got to live it how you want to live it, and do what you are comfortable with - it's really down to your perception of if the benefit outweighs the risk in a given activity.

Good luck and stay positive Paul
 
OK, I'm probably going to be shot down for this but I must sound a note of caution. Years ago there were always challenges with the young adult hip - mostly because such cases were more demanding of their implant. Today, techniques and devices have improved remarkably. Resurfacing was one of the answers to the young adult because you could always revise it into a standard total joint - so the believe went. Any revision is demanding on the surgeon and the recovery team. Many surgeons tell their patients that they will be painfree and active after a few months - but those surgeons who have had implants know it may well be 18 months before they achieve the best outcome. Serious running, in my opinion, is out if you want your device to last.
 
I watched the video of Michael Clarke and contacted him. Definately an interesting character. It's clear that he's got a good heart, someone who does this work to help people in his way. I think he wants to be one of the best hip surgeons in the US if not the world. He's on his way and I'd feel comfortable having my surgery with him. Price is a bit high for me, however, as I'd have no insurance help.

Brands Hatch is in Kent, England. A motor circuit. You gotta do what you love. Sure, a fall on a bike like that risks the THR. But it also risks your other hip, and the rest of your body. Fact is, high impact is going to put everything at risk. Singling out the surgeried hip is like refusing to drive on the highway in a hatchback because it will fold more than an SUV in a collision. I agree with your decision because it seems sound and you're comfortable with it.

Not sure why people like to warn against impact sports so much. I think their writing to themselves as much as anyone else. My post is pretty clear: I'm asking about evidence for the optimal device, not what kinds of activities I should do. We're all generally in different places with things and I guess our opinions and what seems most important is shaped by that.
 
Ice, Too bad it's too expensive for you to have Dr. Clarke do it. I've grown to have SO much faith and trust in him. He's the only one I will let touch my hips now. I went into my hip replacement surgery just knowing it was going to go well, and it did. He's really excellent at what he does. I find myself thinking that if I need to have a revision done in, say, 15-20 years ... will he still be practicing. Egads!

BTW, in your discussion with Dr. Clarke, did you get his opinion on running with the hip resurfacing or replacement. I'm curious about what he had to say. He's told me I can do anything I want to do and I had a total hip.

Good luck with your search.

Dorothy
 
Hi Dorothy, yes he did give me information about running and resurfacing in particular. He said that we have little statistical information as of yet but that he notices no effect in his series. I DEFINATELY got a strong sense I could trust him, that he's not trying to exaggerate or anything like that. I think he should be more widely recognized than he is, actually.
 
Ice, yes, Dr. Clarke will tell you something straight up, albeit politely, even if it's not what you want to hear. I think he's a genuinely good person in addition to being a great surgeon. I was having a little trouble figuring him out at first and I almost went to another surgeon, but I'm glad I stuck with him. I'm still amazed at the number of surgeries he does in a day--crazy--but he came to my room to see me before leaving the hospital (9 the day of mine) looking fresh as a daisy after all of that. Wish I could say the same for myself at that time, lol.

Again, good luck with your search.

Dorothy
 
Canadian-Ice,
I read your post and the subsequent threads with great interest. Although I am a little older than you I have always been active and very disciplined about my physical activity. It was with great fear and a lot of lengthy research that I finally took the plunge.

Found a surgeon here in Portland Oregon who specializes in the minimally invasive approach and so far my experience has been exceptional. Tomorrow is five weeks since the operation and I am back in the gym, working, traveling and for the most part free of pain. Truly remarkable. As Josephine correctly points out each surgery/patient is different. However, if you are interested in a second opinion/consultation I would be happy to pass along his name.

I too looked closely at the BHR because I was determined to continue my rock climbing, skiing and hockey. However, the body of evidence and anecdotal reports coming from OS's specializing in reconstructive surgery frightened me away from MOM. I should add that my father just went through a revision on his knee where there was a lot of tissue removed and blamed on metal shavings. In the end I elected to go with metal and a polyethylene liner. My OS is confident that I can return to skiing and climbing. Hockey may be over but hey, I'm walking without pain!

The information and options can be daunting but it is reassuring to see the number of people who report rapid an pain free recovery. I think Josephine is onto something regarding the skill and experience of the surgeon. Good luck with your journey!
 
Hi Canadian -Ice, I can offer my experience.

First off, I completely understand where you are coming from. I am now 41 and have been an athlete all my life. I got in the best shape of my life right around the age of 38. I played competetive tennis (singles) in tournaments all the time, ran all the time (I mean for miles, sprints, agility...etc, lifted weights...you get the picture. I have lived my entire life with exercise and it is a great stress relief for me, not to mention the competetive juices that I loved to get flowing with those tennis tournaments. I was so thrilled to be back competing again in my late 30's. I am also an ex-cop who was on a SWAT team and constantly training as well. I am only telling you this so that you know you are talking to a fellow lifetime "physical activity lover".

Now, I have had some trouble with my right THR (metal on metal issues) but I can still take off running if I have to. I could play tennis if I wanted to as well...however, I do not like the sport as much not able to move like I want to. I know that people can do amazing gthiongs with their hip replacment....just look at "Bo Jackson". However, when people bring "Bo " up, I just smile and say "yes he did, and he has had that hip revised 3 times". If I were a teaching tennis pro, I would be playing every day to make my living...but I am not. If I were a pro baseball player or in another job that required impact activity on a regular basis for survival, I would do it and take what comes. However, I would do it knowing that I am "mostl likely" shortening the life of my replacement. To not believe that would be to be in denial despite the science.

My OS told me that I could do almost anything I wanted to for exercise, but advised me that running on cement would be the worst choice I could make. He did not say to NEVER do it, he just said to avoid it as a "regular" form of my physical fitness program. And that surgeon is a great surgeon and young as well...very progressive. He advised me to play tennis on clay if I could and to try to learn to play smoothe (which I hope to do this spring and summer).

Here is the bottom line...your choices of exercise will probably have a direct influence on how you get along with your replacement. If having it not last as long is not as important as running on cement, then go for it.

I had to take a step back and realize that this surgery has changed my life at least somewhat, and that if the metal did not adversely affect me, I wanted my replacement to last as long as it could...so, I comprimised what workouts I do. I still lift light weights, I have an elliptical machine that I love and a small trampoline that I rin in place on...I can still work up a huge sweat and I have actually run on the grass (sprints) and it felt pretty good (don't do it often). I also really like to punch my heavy bag. Of course,I also have two 13 year olds and a wife that figure into the equation...make the hard core tennis and running on cement less important. It has been a difficult thing for me to admit that I don't have the ability to do anything I want as hard as I want...but it has been necessary (I believe) to accept it and make the most out of it.
 
Ice,

Those of us on the "other side" are really good at offering opinions:biggrin: I will add one more then pipe down. I can't resist because I truly know how important the exercise thing is so here goes.

It is a difficult decision and each person has to sort out how they want to live their life. I was fortunate to put off the my first replacement until age 52 (two weeks shy of 53), but I knew it was coming for a couple of decades. In my 30s and 40s I continued to play city league basketball and old man hockey despite knowing I was on borrowed time. However, I had decided that is something I wanted to do and loved so..... you only live once. I would not do anything different if I had to do it over again. The true bone on bone pain came on in a hurry about a year ago and after my recent surgery I am enjoying walking pain free so will probably avoid the high impact but never give up my workouts or my skiing as I enjoy the stress relief.

Regarding the debate over implant materials, out of fairness I should add to my last post. While I was at my last pre-op doctor appointment I visited with a woman who was getting ready for a revision because the plastic (polyethylene) liner between the ball and socket had cracked. The point is, none of the materials are trouble free and although it may not be our preference, revisions are becoming more and more common.

Good luck Ice. I know that once you get it taken care of regardless of the procedure you will be pleased with the results.
 
Hi Rusty, thanks for the notes.

I was wondering what the "body of evidence" on MOM is to which you referr? From what I've gathered anecdotally, and it's hard to ascertain this from the journals themselves, is that known MoM reactions are from a tiny percentage of people with an allergy, and imperfectly placed devices from average surgeons. McMinn's argument is that properly placed devices will not have a problem. Wear follows excessive interaction between compenents especially when the cup is placed outside the optimum angle range. So far, I haven't found any evidence to the contrary. Raw data for McMinn, Bose, Gross just don't show any metal problems (if you trust this information is complete). Reportedly the metal itself was first used in the 1960s, but my biggest worry is about the risks on the 50 year time line.

I'm glad you're back to rock climbing and skiing and your recovery is so unproblematic. Giving up hockey not the biggest problem. Hey, you can still skate as well. This, from a guy who can do neither.

That's pretty amazing you were able to put off surgery for about 20 years despite continuing with basketball and hockey! I'm sure you made adjustments as time went on, but, what did you do to protect your hip that length of time?

I quit glucosamine because of the cost and lack of evidence supporting it except that funded by the lousy companies. I spent a couple thousand on PT and do the exercises and am slowly starting with Tai Chi. Otherwise, eat a healthy diet, hydrate, etc.

Day Atcheson, who has a website about his mini-hip experience with Dr. Snyder, lasted 18 years rock climbing and doing Tai Chi, from 36 to about 54.
 
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