Need help finding my way. Suggestions wanted?

Hi…..  I am a 65 year old life long runner.  Figure I’ve run around this earth at least once (25,000 miles) in my life and probably a lot more.  Early this year, January, I woke up one morning with a severe pain in my right hip.  I had been on the treadmill running the night before and on the Stair Master almost everyday before that.  I was shocked by the pain that morning and limping very noticeably heading into work.  Since then I’ve been around the block visiting my physician, PT, chiropractor and a sports medicine orthopedic surgeon at the Cleveland Clinic who is an assistant to the Cavaliers.  Bottom line is I need a THR.  In addition, I have talked to several friends who have had successful THR.  Here is my question:  What type of replacement material should I get and which procedure is best for an active person like me?   Surprisingly, my friends had no clue what type of replacement they had.  They just know where the scare is and that they are happy with the result.  Most of the posts on this site take about the procedure, the result and the general type.  But, few posts take about the material the surgeon used.. i.e. metal on metal, ceramic on polyethylene… etc.  For anyone that took the time to look, there are over 40 different medical codes for the different procedures.(http://www.zimmer.com/content/dam/zimmer-web/documents/en-US/pdf/medical-professionals/reimbursement/Coding-Guides/hip-systems-coding-reference-guide.pdf)   Each code is for the type of material, glue and approach.  The Cleveland Clinic surgeon recommended a ceramic on polyethylene THR for me.  But, he said that metal on metal was better for a very active person and may come with potential complications.

So, back to my question:  For those of you who feel your THR has been successful, what type of material and approach did you have?   And, likewise, which materials have you found to be unsuccessful?

Thanks for your input, I look forward to your comments.  –  Kelly

25 thoughts on “Need help finding my way. Suggestions wanted?

  1. Hi Kelly! Welcome to the HipRunner community and your journey. I had a THR about 2 1/2 years ago — I was just shy of 43. I had ceramic on poly — I have been very happy with my results. I am also a very active person and I took the rehab nice and slow and did a half marathon about 16 months after surgery. But, I was walking/hiking long distances just 4 months after surgery. I had posterior approach b/c that was my surgeon’s preference — my father (at age 77 the same year had his) — anterior. We both had a good recovery. I think I probably spent more time rehabbing muscles that were cut in the surgery/more time getting strength in the joint than my dad but I’m happy with my result.

    I lived in pain for more than 10 years thanks to severe congenital hip dysplasia — I wish I had done the THR sooner! It’s an amazing blessing to be pain free. Best of luck and please keep us posted on the process!
    Aimee.

    1. Thank you so much Aimee.! Your thoughts are just what I need to give myself some direction and confidence going into this. I really appreciate it! – Kelly

    2. Thank you so much Aimee.! Your thoughts are just what I need to give myself some direction and confidence going into this. I really appreciate it! I’m really glad your THR has been successful for you. Life is good!! – Kelly

  2. Hi there Aimee! I just started the journey of a million questions about surgery. I had my first appointment with the surgeon yesterday… this was after about five weeks of talking with people who had THR surgery and people I knew in the OR and lots of online information. I had a list of questions for the surgeon. The appointment was taking quite long…he showed the plastic model to me but I didn’t have time to get the specifics of the material and brand. I’m going to email him next week and get the exact name and material. I look forward to what other people say they’ve used and if they continued running after the surgery. Mary

  3. Hi Kelly! Welcome! I had my THR last May after being in pain for 15+ years. Doc wanted me to wait as long as possible and at 54 had it done… SO glad I did. I have a titanium system (made by Styker) and had the anterior approach. I was back to work in 3 weeks. My surgeon swears by it! He even left Yale NH Hospital because they were forcing him to use another system. Surgery was at 7:30am I was home by 5pm – first week was tough as I also went cold turkey without painkillers- (had been on oxy for 3 years prior and was SO done the pills) anyway- I promised my surgeon I would not run for at least 6 months as he was worried about impact fractures in my femur – so I aced the PT and walked miles and miles on the TM. At 6 mos started run/walk intervals and to date I have done a several 5 & 10ks. Still “slow” but my times are coming done… Being married to an “Ironman” I struggle with “not going the distance” but as Aimee said it is AMAZING to be painfree. My left hip is about 5-8 years behind the right in progressing with arthritis but I will not wait till I am in agony. I would encourage you to “shop” around.. I was initially scheduled with another surgeon who only does posterior approach and switched when I met my surgeon. I think there are pluses and minuses with any system and approach. Much luck to you! you deserve to live painfree!!
    Grace

    1. Hi Gracie! Thank you so much for your response. Your comments are both helpful and reassuring. I have heard of the Styker system and based on your comments, I plan on doing more research on that approach. Like your husband, my girlfriend is a runner and cross fit regular. I was right beside her up until this issue arose. Now she’s looking at me l’ve been poisoned. She’s a great supporter but we both can hardly wait to get back on the road. Health and fitness is our common link. Thanks again. Your thoughts are greatly appreciated! – Kelly

    2. Hi Grace! Thank you so much for your response. Your comments are both helpful and reassuring. I have heard of the Styker system and based on your comments, I plan on doing more research on that approach. Like your husband, my girlfriend is a runner and cross fit regular. I was right beside her up until this issue arose. Now she’s looking at me l’ve been poisoned. She’s a great supporter but we both can hardly wait to get back on the road. Health and fitness is our common link. Thanks again. Your thoughts are greatly appreciated! – Kelly

  4. I feel no pain, but I’m always holding back slightly. I used to push through as that’s what distance runners do. I only feel limited in that I don’t want a revision. I’m riding road and Mt. Bike upwards to 250 miles a week, and running upwards to 20 miles a week. And can still run near 6:00 pace. I’m super happy to still be active!
    You’ll get through a THR just fine! My advise is to take the first 3 months super easy to allow the body to heal properly.
    I had a posterior approach, with ceramic on ceramic. And really kind of wanted a anterior approach because I thought recovery might be better with it. Not really sure that it mattered. I recovered just fine. Also was opting towards ceramic on poly. But my Dr. thought that ceramic on ceramic would last me my lifetime being active so that is what we went with. I had my procedure while I was 49. Best of luck to you!

    1. Hey Stan, great advice!! And, most impressive! Your level of fitness is incredible!! Based on your comments along with Grace and Aimee, I’ll plan. On taking it easy for a few months afterwards. Thanks! – Kelky

    2. Hey Stan, great advice!! And, your recovery has been most impressive! Your level of fitness is incredible!! Based on your comments along with those of Grace and Aimee, I’ll plan on taking it easy for a few months afterwards. I’m glad things are good for you. Thanks for your thoughts! – Kelly

  5. Ceramic on poly, here, right hip. Dec 2nd. Uncemented.

    I believe, but I do not know, that uncemented has an advantage in that the bone grows onto the prosthetic, whereas cemented is like a fence post in concrete. Possible loosening in future, but am not totally sure.

    Cemented will allow quicker rehab? Unsure.

    At 65, will you be outlived by Titanium or whatever materials are used?

    Personally, at 50-almost-51 when I got it done, I said, I don’t care if I need a revision in 10 years if I can get 10 great years out of it. I’d rather have 10 great years, than 25 mediocre. After rehab…still working on the rehab, I don’t feel any different about my decision. I want to live.

    Two nights ago a neighbour kid was throwing a football around, 12-year-old. Good kid. I joined him, booted a few punts….ran a little as a wide receiver…..good times. Two nights before that I was at a Canada Day bbq at a friends, played bocce after, chased his dog on the baseball diamond a little.

    Just so happy I can do that…..

    I have a friend who is 79 and he has completely thrown caution to the wind, but of course he could go tomorrow….

  6. Corin mini-hip with trinity ECiMahighly cross linked polyethylene cup, anterior approach. Four years now, running with no issues

    1. Great info Mark. Thank you. As an engineer for 40 years, I learned a long time ago that details matter. Your info gave what I needed to research the manufacturer other pertinent information I need to ask the surgeon the right questions. Very nice!! – Kelly

  7. Hi Kelly. I have a metal-on-metal resurfacing on my left hip since Nov 14 and a ceramic/ceramic right hip since May 17. I am 66 and getting back to running and biking already. I chose the Birmingham hip because it made more sense to me, being active (and a rock-climber so did not want a dislocation risk) but metal has had a bad press in the last few years, and in the last couple of weeks, and Smith & Nephew have restricted their devices to men and sizes 48mm plus (mine is 48) so that option does not exist if you are female or small. There are American, Indian and Belgian surgeons who still have the materials to resurface small women but I suspect THR will be the way to go.
    The UK Joint Registry shows that the current most popular fitting is ceramic with highly crosslinked polyethylene, with all-ceramic losing favour. I suspect this is due to cost to the NHS. Polythene will wear eventually but will not shatter, ceramic will not wear but has shattered in the past. The latest versions are less likely to (Biolox Delta from CeramTech) due to their fancy crystal structure that arrests incipient cracks.
    Both my incisions were direct lateral (Hardinge method) so I have long scars but recovery was quick (no icing used) and I ran at 9 weeks after my first op and 6 weeks after my second…
    Good luck,
    Pete

    1. Hi Pete… It’s nice to see there are some others out there my age that believe life is just beginning. My orthopedic doc suggested that metal on metal was an option but comes with some potential for complications based on size and then the metal shavings getting into the blood. He said the possibility is very low but said the MOM THR offered the most durable answer. He also said that they don’t perform the ceramic on ceramic THR based on the potential for cracking. Interesting for me is that I work in the underground utility profession and High Density Polyethylene pipe is one of the strongest available. Your quick recovery was phenomenal!! I’m happy you are doing well and hope to be following in your steps soon!! Thanks for your comments and thoughts. They are encouraging!! – Kelly

  8. Hi Kelly. Ceramic/poly/anterior/unglued for me. I have heard that ceramic on ceramic will last forever. Good luck to you! You will be back in no time!

    1. Hi Tom…. Can’t thank you enough for putting together this great forum for us to share our thoughts. I have been quite encouraged by what others had to say. I truly do appreciate your efforts. – Kelly

  9. Hi Kelly, I know you have a million questions about your THP. I did too. I’m 60 now, had the THP 6 months ago. I’ve been an athlete all my life. As a football coach I continued lifting and running, to try to inspire my athletes. Weighing 250 lb for the past 30 probably did my right hip in. I wasn’t a long distance runner but I knocked out 9 to 12 miles a week since college along with lifting sessions. I probably went through 10 years thinking I had a tight groin so after doing a few days of serious lunges the ache would go away. Well after retirement I became a football official. Not a lot of running but enough short spurts that I made sure to keep training. One game I had to chase down a 17 year old who intercepted a pass in the end one and headed to the other EZ 100 yards away. I beat him to the goal line, but the next morning I could hardly walk. The pain was intense. Went to my old team orthopedist and he suggested PT. After a month of no relief I fussed enough that he sent me for a MRI. Within hours he called me with the news. I had the anterior, titanium/poly , glued version. After a few weeks PT was progressing, pain was minimal, especially compared to before surgery. Dumped the walker after 1 day, 3 weeks for the cane and golfed 18 holes 4 weeks post surgery. Almost 6 months have gone by and Im running a mile every other day. You’ll have concerns because the new hip will feel strange, but your confidence will grow and you will be good as new before you know it. The funny thing was my thinking was that I’d be totally fixed even better than before the pain crept in. Well the hip pain is gone, but the other 60 year old joints and muscles still have various issues. Which I can deal with. Good luck with your surgery/rehab. Whatever method and parts you go with Im sure you’ll be happy. If someone gave you a choice between a Porsche or a BMW how could your decision be a wrong one. By the way, this site is great to recap how my recovery is going on. Sorry about the novel, but it’s therapeutic. 😬

    1. Hi Anthony, Thank you for your encouraging words. Your “novel” is therapeutic for me too!! I am expecting that I will follow your footsteps almost to the end. So hearing and relating to your story is confidence building. My surgery is in a couple of months. It will get better from there!! – Kelly

  10. Hello Kelly,op 24/10-16 THR ceramic and crosslinked pe,did my first ultra 50km after five months and today i have done 3 ultra and two halfmarathons,and next week a backyard ultra. I never had a bad day with my new hip it is so good that i can run again. Hope you choose the best method for you and fast recovery.
    Best regards Anders Jelander/Sweden

    1. Thanks Andes…. Your words are encouraging! I’m getting close to my decision. Like you, I will have a ceramic and crosslinked pe THR. Looking at late September for surgery. I’ll have all winter to recover and prepare for my entry back into the running world in the spring. Having you and the others on this site as mentors is awesome!! – Kelly

  11. Hi Kelly, I had my THR (right side) done in Nov of 2014. It was ceramic/poly at my request. I was 62 at the time. The surgeon used a robot assist and I have been very pleased. The day before the surgery I had an MRI and he used that with an application to identify exactly where to cut and the angles. When they opened my up they put specific markers on my bones that allowed them to pinpoint the cut. The surgeon did the work, but the robot and application did all the calculations. In the typical manual version the surgeon is like a woodworker who trims and adjusts to get the right fit. In the robotic case, there is still some work, but it is much more accurate from the start. I think my quick recovery had a lot to do with that.

    I am back to running on a regular basis. May not do a marathon again, but I do several half marathons a year and run with a group on weekends. We typically do 7-12 mile runs in the hilly Connecticut country. I also changed my running style to a more natural style (check out: http://naturalrunningcenter.com/ ) and that has been a big change.

    I will say that I still have pain from the scar tissue when I push longer distance. I have found that doing a set of mobility exercises is critical. It is more about making sure your whole body is ready to run. I am certain if I had found this mobility regimine earlier in my running career along with a natural running form I would have avoided the osteoarthritis that led to my THR. I don’t do any meds and no painkillers. I am enjoying running again and don’t worry about time, just having a nice run

  12. Great advise! Your story is very encouraging. I like the robotic aspect of your procedure. My surgeon is the woodworker you referred to. I’ll checkout the natural running site you mentioned. I’ve heard and read this is a better way of running. I’ll have to give it a try. I’m glad you’ve had a successful recovery. I’m looking forward to the day I”ll be able to share a similar story. Thanks for taking the time to respond. It means a lot to me! – Kelly

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