Back to running after total hip replacement!

“I consider myself a regular guy, living a regular life. But in some ways I am not so regular. One of those is that I have had a right total hip replacement (THR) in April, 2017.”
…CHD2015 (BoneSmartie)

My name is Scott and at the time of my surgery I was 58 years old, 5′ 11″ and 180 lbs.  For most of my professional career I have worked in Human Resources (HR) management.  I have been fortunate to work for a large global oil and gas service company that provided me the opportunity to live and work abroad for 5 years.  For the past 20 years, I have worked in a variety of HR roles in the US from the west coast to the east coast and I presently live in San Antonio, Texas.  Throughout my life I have been reasonably active and an on-and-off runner.  While running in my late 40’s, I began to have some aches and pain – mostly in my knees.  Having had no serious injuries, one doctor told me it was probably osteoarthritis.  Reducing my activity levels would generally resolve the aches and pains but almost always led to weight gain.  So I experienced the “yo-yo lifestyle” where you increase your activity and lose weight only to put it right back on when activity drops.

Around the middle of 2014, I began a low carb diet to try and lose weight.  I was not running at the time, but otherwise was reasonably active.  Through the diet, I was able to drop from 220 lbs to 180 lbs.  I felt it was time to start running again and decided I wanted to train for a marathon.  In early 2015, I began running and registered for the Honolulu Marathon on December 5, 2015.  The training went well at first, but around September I started having pain on the outside of my right hip and in the groin area.  I began visiting a chiropractor to try and address the issues I was having. It helped enough to allow me to finish training and complete the marathon.

Over the course of the next 4 months, I had an x-ray and an MRI of my right hip.  The diagnosis was hip dysplasia with bone on bone osteoarthritis.  I suspected I would be facing a hip replacement, but I wanted to find a surgeon who offered a solution that would allow me to remain active.  I visited 4 orthopedic surgeons and each did recommend a THR.  I researched approaches and implants.  I wanted to have a hip that would last a long time.  My father had 2 metal-on-metal hip replacements at the age of 85 and they caused him a fair amount of discomfort.  I knew there was no guarantee of a good outcome.

During my research, I found and joined the Bonesmart forum.  Bonesmart provided access to great resources as well as a community of other people who had gone through or were experiencing a similar situation to mine.  I could ask questions and have discussions with individuals who were willing to share their experiences, both positive and negative.  This greatly helped my decision process.

One surgeon told me I wasn’t ready yet because I wasn’t experiencing tremendous pain.  Indeed my pain level was moderate – a 3 to 4 out of the 10 point scale.  However the x-ray showed a lot of damage.  Another surgeon looked at the x-ray and said he couldn’t believe I ran a marathon on that hip.  My dilemma was that I could put off surgery and accept reduced activity with no running, but the hip would not get better and at some point I would need a hip replacement.  Getting the surgery done sooner might provide the best opportunity to get back to full activity, however surgery is a risk and there is not a 100% certainty of getting the outcome you want.

I discovered that you need to decide what is important to you – your lifestyle, surgical approach, wear surface, etc. – and then select an experienced surgeon that is aligned with what you are looking for.  You don’t want a surgeon to use an approach or implant they are not very familiar with.  They probably wouldn’t agree to that anyway, but you don’t want them to be operating outside their comfort zone.  I decided I wanted an anterior approach, as I felt that would give me the best opportunity for returning to my lifestyle.  Also I wanted the toughest, longest lasting wear surface available.

Scott Keenan: Corin Implant

I found a surgeon who used the anterior approach.  He recommended a Corin Mini Hip which was well suited to active lifestyles.  He felt a ceramic-on-ceramic wear surface would be best for me, but this configuration was still in clinical trials for the US.  So I would have to wait.  I actually did wait for a year and then decided to go forward with the surgery using the Corin Mini Hip with ceramic on poly.

While I was waiting, I came across a trainer device called a Zero Runner.  This is an exercise machine which allows you to have a natural running gait with low impact.  This machine enabled me to run for at least an hour a day right up to my surgery.  I also walked up 9 flights of stairs to work every day.  I believe keeping in good of shape and maintaining muscle tone really helped me during my recovery.

Scott Keenan WalkerApril 8 – three days post surgery

On April 5, 2017, I had my surgery at Memorial Hermann Joint Center in Houston, Texas.  The surgery was routine with no major issues.  Pain afterwards was moderate and controlled with non-narcotic pain medication.  They got me up on my feet the day of surgery and I spent one night in the hospital.  The next day I had a group PT session and then was released to go home.

I followed all my post-surgery directions, which included bilateral support (crutches or a walker) for the first two weeks.  I was back to work after one week and able to work at my computer and use crutches to get around as needed.  After 2 weeks, I went down to one crutch or cane for support.  It was a month before I was free of all support.  This was due to the post-surgery directions for the Mini Hip.  My surgeon has determined that the initial healing is better if some support is used for the first month.  After 6 weeks, I was back using my Zero Runner and elliptical machine.

I do have numbness in the front and side of my right thigh which I understand is common with the anterior approach.  However, the area of numbness has reduced over time even though after a year and a half it’s still not fully resolved.  I have a sensation of a little difference in leg length which has lessened, but not completely gone yet.  During this time, I have been able to rely on my Bonesmart community to reassure me that my recovery is normal and the twinges and tingling are experiences others have had.

After 6 months, I had a full release from my surgeon with no restrictions.  I have gradually introduced running back into my weekly activity.  I run outdoors 2 to 3 times a week and use my Zero Runner for the other days.  I even completed my first marathon on my Zero Runner by running 26.2 miles in under 4 hours.  Nine months after surgery I went skiing in Salt Lake City, UT and had 3 full days of skiing.  I was very comfortable and even tackled a black diamond for the first time.  Well…okay…it was only one section of a double blue, but I still felt very good.

While participating in a 5K Wine and Beer Run in San Antonio in 2018, I smoked my previous personal best and finished 4th in my age group.

At more than a year post surgery, I am comfortable running 8-12 miles with under 10-minute mile pace. My right leg is stronger than it was and stronger than the left leg. I have lost some flexibility but nothing that would prevent me from any of my normal activity.

For me, the Corin Mini Hip with ceramic ball was the perfect solution for my arthritic hip!

Questions/Comments

If you have questions or comments you’d like to make regarding CHD2015’s Spotlight story and his recovery, please click on this link and post in his recovery thread on the BoneSmart forum.
https://bonesmart.org/forum/threads/all-done-6-days-post-op.40853/

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