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ArthriticHipster
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PostTue Mar 08, 2022 4:00 pm 
Hello fellow NW hikers, After having some nagging pain in my thigh for a couple of years (especially while driving home from hiking, but usually not during hiking), I visited an orthopedist, and x-rays revealed that I have osteoarthritis in one of my hips: the ball-and-socket joint is deteriorating. At some point in the future -- he couldn't say when -- I'm going to need to have the hip replaced. Joint replacement is the only sure-fire remedy, aside from temporary measures like Advil or steroid injections. The diagnosis was kind of a shock, because I'm still in my late 40s and in pretty good health otherwise. I've never had any musculoskeletal issues at all. But nothing says "you're old" like "you're going to need a hip replacement." frown.gif I know it's a pretty routine surgery these days -- and easier than a knee replacement -- but still. I've been told to cut back on activities that involve jumping or a lot of lateral movement (tennis, basketball, volleyball, etc.). But apparently the best thing I can do to stave off the surgery is make sure the muscles surrounding the hip are strong, so "in-line" movement like hiking is good, as long as I'm not stomping too hard on my bad hip. Anyway, I'm bummed about this. Obviously. But I wanted to see if there are other hikers out there who've gone through this. How long did it take to go from symptoms to surgery? What's the recovery time like? And most importantly, how did your hiking/sporting life change after you got the artificial joint? P.S. - I'm not really a hipster, but I wanted to include "hip" in my username somehow!

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Randito
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PostTue Mar 08, 2022 6:33 pm 
FWIW: All the people I know that have had hip replacements regretted not getting it done sooner. The pain and/or impingiment of the grumpy joint made many activities less enjoyable, so they did them less. When they finaly underwent the procedure and got through the recovery period , they were amazed with how much better it was to be able to move pain free. However they then realized how much fitness they had lost during the several years of "procrastination". The joints available now are far more durable than ones available twenty years ago. However if you are in your 40s now -- you should figure that with an active lifestyle, you'll need the synthetic joint replaced before you go on medicare. I would think by then, the available replacement parts will be even more durable and perhaps that would be it (for that side at least)

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MidLifeHiker
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PostTue Mar 08, 2022 10:27 pm 
Hey Hipster, In 2017 I started to have at times severe hip pain. I was only 57 at the time but hiked between 350 and 500 miles a year. The first three doctors I talked to, they told me there was nothing they could do and I would have to live with the pain and to take up another hobby. So I tried to take it easy, but a snowshoe trip up Hex mountain in March of 2018 did me in. My wife found me another doctor and this time he said we have two choices. 1) We can try a Cortisone shot right in the hip and that could help, but if it doesn't you will have to wait 4 months before you have surgery, but if it works, you may not need the surgery. 2) Get the surgery within a month. Well I thought I would first try the Cortisone... It didn't help at all so now I had to wait until July. So I scheduled surgery in July and limped around for 4 months. This doctor does 8 surgeries every Tuesday and I was #3 for that day. I figured that was good, cause he could warm up on the first two, and didn't want to be the last one cause everyone is tired. Most people can go home THE SAME DAY! Yes the same day, but I had a little reaction to the drugs and would pass out when I sat up so I had to stay the night and leave in the morning. Still I was out within 24 hours of the surgery. They said I should use a walker or crutches to get around, but they wanted to make sure I didn't fall for the first two weeks to give things time to set up. Well there was no way in hell I was going to use the walker my wife got me, even though I'm sure for some things (bathroom) it would have been much easier. My fear was that I would age 20 years in a couple days. Now I'm not going to lie to you, the first couple of nights trying to sleep was not fun and it was painful, they gave me some strong drugs but I did my best not to take them, and only used about half of what the prescription was for. Two weeks after the surgery I was back at work on crutches for the first week and a cane after that. I have a desk job so no heavy lifting. The thing I was surprised about is that he didn't recommend any physical therapy, he told me just to walk normal as soon as I felt comfortable. Less than 4 weeks after the surgery, I seldom even used the came anymore and just took my time walking especially going up and down stairs. Eight weeks after the surgery (September) I walked up to the Ice Caves, no problem. The week after that I hiked up to Lake Valhalla from the north side. I tried to get out once a week and just kept is easy. By November I even hiked up Mt Dickerman. Now the hip muscles were still sore but not like a knife in your hip like before. After each hike, things were sore, but just a bit better each week. 2019 I set a goal of 500 miles. I even did a 4 day trip from Buck Creek TH, Little Giant Pass, Napeequa Valley, Buck Creek Pass, Suiattle Pass, Cloudy Pass, Spider Gap and back to Buck Creek TH. The hip was feeling pretty good, actually the hip felt fine, but the muscles did take time to get back to 100%. (Just think of what they have to do to your muscles to get in there.) I did hit my goal and did 516 miles that year. The front of my thigh felt kind of numb for well over a year but slowly got better, but it didn't hurt just felt weird. By last year the funny feeling was totally gone. The surgery was on my right hip and he used the Anterior method. If I started to have similar pain in my left hip (which I don't, knock on wood) I would try to plan the surgery as soon as possible, so I could get through the 2 months of recovery and back out there. I would defiantly go back to the same surgeon again. If I would have listened to the other three I would be limping around feeling sorry for myself today. So bottom line, GET IT DONE! Mark

adamschneider
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ArthriticHipster
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PostTue Mar 08, 2022 11:40 pm 
MidLifeHiker: to me, the most encouraging part of your story is Mt. Dickerman four months post-surgery. If I wanted to GET IT DONE now, I don't think they'd even let me... or at least, my insurance wouldn't pay for it because it isn't "medically necessary" yet. It'll be interesting to see how this summer goes. I did a couple of 900' steep off-trail climbs on Sunday and didn't really have any issues, but the drive home was uncomfortable. (The fact that my car lacks cruise control didn't help.) When it starts really hurting on a daily basis, I guess I shouldn't hesitate. Here's hoping that when the time comes, I'll be able to schedule it for fall or winter.

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gb
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PostWed Mar 09, 2022 8:57 am 
Randito wrote:
FWIW: All the people I know that have had hip replacements regretted not getting it done sooner. The pain and/or impingiment of the grumpy joint made many activities less enjoyable, so they did them less. When they finaly underwent the procedure and got through the recovery period , they were amazed with how much better it was to be able to move pain free. However they then realized how much fitness they had lost during the several years of "procrastination". The joints available now are far more durable than ones available twenty years ago. However if you are in your 40s now -- you should figure that with an active lifestyle, you'll need the synthetic joint replaced before you go on medicare. I would think by then, the available replacement parts will be even more durable and perhaps that would be it (for that side at least)
I have one friend who had his hip redone after an accident perhaps 20 years ago. After a recovery he went on to guide including McKinley for a good 12-15 years further. I guess the only thing for me would be to choose a time of the year where losing that recovery time will be of minimal loss to you.

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MidLifeHiker
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PostWed Mar 09, 2022 8:57 am 
Hipster, It took about a year from when I had my first symptom to where I just couldn't hike anymore. Once after a two day backpack trip, after the long drive home, I couldn't get out of the car it hurt so bad and was on crutches for a couple days after, then it would get better. The Dr said what was happening is that the top of the femur had wore down in an odd way, and would start to absorb moisture and swell. It would swell to the point it didn't fit in the socket and that is what caused the pain. Anyway the doctor (the forth Dr) said my case was odd, it did take several X-rays and MRIs to see what was going on. I could have lived with the occasional flare up, but after about a year and that last snow shoe trip, it slowly became more painful just to walk around the block. Mark

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Randito
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PostWed Mar 09, 2022 9:02 am 
If insurance is reluctant to cover this, #1 the words "severe pain, 10 on a scale of 1 to 10" may be useful. Also even if insurance pays, but your coverage is 80% , you might consider paying for the whole procedure, but not in the US https://www.nytimes.com/2013/08/04/health/for-medical-tourists-simple-math.html

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Schroder
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PostWed Mar 09, 2022 11:15 am 
I had total hip replacement 2 years ago and I'm one of the few that regrets not putting it off longer. I started to notice problems about 7 years ago and began talking to physical therapists. I was getting occasional shooting pain all the way to my foot when I would have a jarring impact on the trail but most of the time I was having dull pain that was tolerable. The pain gradually increased and I started seeing a naturopath that practiced prolotherapy - injections into the hip area to promote natural healing. It worked wonders and got me through 3 ski seasons but the last one only gave relief for a month and I was getting more limited in what I was able to do so I decided it was time. Recovery was slow and I didn't realize the range of motion I'd be giving up. Also that leg is now longer that the other so walking on level ground for long periods of time is irritating (did they do it on purpose so I'd do the other one?). I feel I traded one set of problems for another. I had it done in February and didn't get it any significant hikes the following summer. The following January I was skiing again - not any black diamonds but I was doing okay. When I'm hiking, I feel it first in those quads.

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Slide Alder Slayer
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PostWed Mar 09, 2022 12:35 pm 
My athletic career necessitated a total hip replacement at age 37 in 1987, next month I will be 73 and still have the original parts except for the "plastic cup" that was replaced during a partial revision twenty-two years ago. I'm in regular contact with my doctors at Proliance, not just for my hip but also for knee and shoulder, I mean if you are going to screw yourself over in sports do it right! Having said all that, nothing has kept me out of the mountains either hiking, scrambling, or some light mountaineering. What works for me is regular exercise, aerobic training on the elliptical trainer to keep my hip socket mobile, and smart nutrition to keep the weight down. Hiking poles with also help, even with an operation because the range motion to strength will be off a bit between your legs. Lastly, for myself, I stick with sport oriented orthopedic doctors and clinics. Nothing is more frustrating than a doctor that tells you to stop what you are doing when you have a love for the outdoors without giving you some kind of plan whether it is prescribed physical therapy or in conjunction with limited use of anti-inflammatory medication when you hike that have worked for me. Boredom is seldom a prescription for wellness.

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Gil
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PostWed Mar 09, 2022 5:38 pm 
A bit of an aside but with a point. Back in the 1950s, my dad's best friend was attacked by three brown bears at once. He survived (barely) and mostly healed up, but over the next decade both hips deteriorated to the point that in the mid-"60s he couldn't walk without crutches. Yet he still went trapping in the winter with homemade snowshoes for those crutches and his feet strapped together on a single bigger snowshoe. In the late 60s, he was guiding fishing trips at my dad's lodge even though he could barely get out of the boat. Three doctors from the Phoenix area came up to fish and were utterly blown away by him. They told him they were doing a new kind of surgery and that if he came down that winter, they would replace both hips for free. He did, they did, and he walked on those hips until he died 35 years later. His only complaint was that the wires they used to tie off the femur poked him when he tried to sleep on his side. I'd call that a success story.

Friends help the miles go easier. Klahini

grannyhiker, Chief Joseph, Kascadia
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Sallie4jo
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PostWed Mar 23, 2022 7:26 am 
Yepp..hip replacement surgery can make your life less painful AND possibly less dangerous. For me, I was not experiencing pain BUT for 3-4 years I started to fall..over seemingly nothing (often something 1/4 to 1/2 inch) bump on a trail, on the floor, sidewalk) I had two falls that = fractures. I attributed all to my falls to "lack of paying attention". Then I began paying close attention..telling myself lift your legs..but I still was falling. I was becoming very concerned, esp after 3 falls in two weeks. Worked with a movement person I was told my right leg is dragging. Saw the doc who did my knee surgery. Yes hip replacement is needed.. I had the surgery 2+ years ago, and no more falls. The recovery was really quick and I was backpacking in 3 months I think. All the falls I did not link to my hip cause I wasn't in pain..so do pay attention AND the replacement surgery can be miraculous..but you do need to work to get back your strength. Take care out there.

I choose to live in a landscape of hope. Terry Tempest Williams
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David
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PostSun Mar 27, 2022 6:10 pm 
Hey Hipster, First off, I’m sorry you are going through this. It sucks, particularly when it happens at an early age when it’s not expected. Both my hips burned out in my early 50’s, unexpectedly. I hiked, skied, and occasionally biked. The pain got progressively worse. The only thing I can add to this discussion that hasn’t already been said is a suggestion to think about the type of implant you get. There are straight replacements and resurfacing. The main problem with the standard hip replacement hardware is it removes the top third of your femur and relies on a stem that gets sunk into the canal in the middle of the femur. While this makes placement of the orthotic easier for the surgeon, it has one big drawback in that it shields the bone from weight stress. Weight stress is what “informs” bone to keep building or rebuilding itself through time. This is why it’s recommended that older people lift weights as it keeps the bones calcified and strong. Because of how traditional implants are designed, the implant after 15 or 20 years tends to loosen because the bone around it has grown weaker. When this happens a much more complicated revision surgery is required to fix the thing. When you are young, your chances of needing this revision surgery go way up. If you are 70 when you first have the initial surgery, it’s less an issue. So, I would recommend you do a bunch of research on the hip replacement hardware that preserves the femur and most of its head - this is usually called hip resurfacing. With these devices, a new head is fixed to a femoral head that has been shaped to fit the new head, in addition to a acetabular cup. These typically are much closer in size to the natural hip socket, which makes them more stable, and because the femur continues to be stress loaded, can be better options over the long haul. There was a lot of bad press around twenty years ago about this procedure and the devices that were used, which was generated by metal on metal implants (Cro-moly steel) that were shedding microscopic metal particles as they wore. The issue wasn’t entirely due to the devices but due to the angles and such how they were installed. When not perfectly installed, they did shed particles that with some people caused problems. There are also some ceramicized titanium devices with irradiated polyethylene (PEX, same as modern plumbing) liners that appear to work very well - I have two of them. The issue is these devices require much more care to surgically implant compared to traditional hip replacements. However, if installed perfectly they generally become lifelong installations and suffer no problems with wear. There is a surgeon in seattle who has been doing resurfacing for probably 30 years - probably one of the top three in the world. Not sure about Portland. Hope this helps! Good luck.

adamschneider, Randito
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ArthriticHipster
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PostMon Mar 28, 2022 7:08 pm 
Here's an update from the O.P., a month after diagnosis: hiking season has begun in earnest, and it hasn't been too bad. I've been going out about twice a week, and my longest so far is about 9 miles with 2000' of elevation, mostly off-trail. I'm trying to make sure that if I have to take a big step down, I do it on the good hip. (This requires an adjustment, because I used to lead with my left leg when going down steep slopes.) I think the reason I'm surviving so far is that I stopped playing volleyball. Unfortunately, it was my main source of exercise in the winter, but it's gonna have to end. (I guess I could still play but not jump or move very fast, but I refuse to play half-assed and be That Guy. Easier to just give it up.) Advil is definitely my friend during and after hikes. I'm thinking of finally buying a car with cruise control. So we'll see how the rest of the summer goes. If it really sucks, I'll consider getting the surgery right away, and hope they'll let me.
David wrote:
The main problem with the standard hip replacement hardware is it removes the top third of your femur and relies on a stem that gets sunk into the canal in the middle of the femur.
I do think it's weird how much of the femur they typically lop off. I'm sure there's a good reason, but it seems extreme when you see the diagrams. I like the idea of the resurfacing because it sounds like if you live long enough to need a total replacement in the future, the middle of your femur won't have been desecrated yet. I've requested an appointment with a Portland guy who specializes in "younger adults" and does resurfacing, along with all the usual surgeries; I want to hear about my options.

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PostMon Apr 18, 2022 12:12 am 
I’m a good deal older than you. I’ll be 84 in a few weeks. In early 2021 was diagnosed with aggressive prostate cancer plus learning my left hip pain was a bone-on-bone condition. I got a cortisone injection which helped reduce some of the pain and allowed me to do radiation therapy and hormone therapy for my cancer. That was March, 2021. In September I got a second hip injection for pain management but I fell and ended up with an enclosed fracture of the hip. I was still able to walk but the pain began increasing. I was also rapidly de-conditioning and a very uncertain future. I was rapidly loosing strength and coordination! I met with an orthopedic doctor and told me I was possibly too weak to undergo the hip surgery. I began a brief session with physical therapy but was loosing ground rapidly! X-rays showed my hip to be crumbling away due to my injury which was like an impact injury that compressed the hip joint and flattened the ball. On July 12 the joint totally failed and I could no longer walk. The pain was beyond belief. I went to ER as my only alternative. The operation was performed on July 13 evening and I woke on Cloud 9 with zero pain. The rest is a long slog back to normalcy. I am walking with a cane and am about 60%. At my age I don’t know how much farther I can advance but I am pain free and can sleep again. Before the operation my pain was extremely intense and sleep nearly impossible. I stayed away from strong medicine. I suggest you have the operation sooner than later so you can take advantage of your fit condition and not have something like a fall put you on the fast track plus pain that now seems like only a bad dream. Good luck!

Kascadia, Chief Joseph, ChinookPass, Tom
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timberghost
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PostMon Apr 18, 2022 7:35 am 
Scrambler wrote:
I’m a good deal older than you. I’ll be 84 in a few weeks. In early 2021 was diagnosed with aggressive prostate cancer plus learning my left hip pain was a bone-on-bone condition. I got a cortisone injection which helped reduce some of the pain and allowed me to do radiation therapy and hormone therapy for my cancer. That was March, 2021. In September I got a second hip injection for pain management but I fell and ended up with an enclosed fracture of the hip. I was still able to walk but the pain began increasing. I was also rapidly de-conditioning and a very uncertain future. I was rapidly loosing strength and coordination! I met with an orthopedic doctor and told me I was possibly too weak to undergo the hip surgery. I began a brief session with physical therapy but was loosing ground rapidly! X-rays showed my hip to be crumbling away due to my injury which was like an impact injury that compressed the hip joint and flattened the ball. On July 12 the joint totally failed and I could no longer walk. The pain was beyond belief. I went to ER as my only alternative. The operation was performed on July 13 evening and I woke on Cloud 9 with zero pain. The rest is a long slog back to normalcy. I am walking with a cane and am about 60%. At my age I don’t know how much farther I can advance but I am pain free and can sleep again. Before the operation my pain was extremely intense and sleep nearly impossible. I stayed away from strong medicine. I suggest you have the operation sooner than later so you can take advantage of your fit condition and not have something like a fall put you on the fast track plus pain that now seems like only a bad dream. Good luck!
Now that sounds like one tough gentleman there!!

runup, Chief Joseph
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