Sunday, March 29, 2009

So, I'm getting a new hip

I finally got to see the ortho doc this week, actually two of them. The first reviewed my case and performed an exam. He felt like I would likely be a good candidate for a hip resurfacing or replacement. He said an athroscopy was an option but likely wouldn't be much relief. He recommended I see a hip specialist ortho. I was able to see him the following day.

The hip specialist performed his own exam and went into more detail on my options. He was very thorough in describing the options with pluses and minuses on each and what he felt would be the better option. One option is to do nothing and continue to live with pain.
The weight-bearing portion of the femoral head (ball) and acetabulum (socket) essentially has no cartilage left due to excess bone growth from the break years ago and the severe arthritis that I've dealt with over the years. I've unknowingly had bone-on-bone grinding for quite some time, and because of this, the pain is only going to get worse. He said he could give steroid shots that would likely limit or eliminate pain for 2-3 months at a time, but it's really only a mask and wouldn't allow me to get back to an active lifestyle.

The next option is an athroscopy where a surgeon would shave off the excess bone and remove the damaged cartilage. The problem is there would really be no cartilage left over, and there isn't such a thing as artificial cartilage that could replace the removed, damaged cartilage. So, in effect the arthoscopy would be of minimal help and further surgery would have to occur at some point anyway.

That left options of hip resurfacing or a total hip replacement (or arthroplasty). He said either option would be a good choice for me. The resurfacing leaves more original bone in place and the main risk is that the femoral head could break. Judging by my x-rays he said the break had healed well and strong and would take the resurfacing nicely. The one problem he saw is that my right leg is about 3/4 inch shorter than my left due to the break. He said the resurfacing hardware could potentially add maybe 1/8 to 1/4 inch but no more.

That led to the discussion of total replacement. He said he could fix the length discrepency and I would still be able to live an active lifestyle. Fixing the leg length would also likely help some of the lower back problems I've had over the years due to my overcompensation of the leg lengths. At that point it was a fairly easy decision to decide on the total hip replacement.

I have done a lot of research over the past month and felt comfortable with either solution and in my heart knew I was going to have to have the resurfacing or the replacement done at some point. It might as well be sooner rather than later, because the pain has been getting worse each week. Medicine helps, but only so much.

The bad part. My running career is pretty much over. While the doctor said I could potentially run again, the risk of causing damage to the impant is greatly increased. The same goes for pretty much all high-impact activities like tennis, basketball, etc. He did say I would have no problem with lower-impact activities such as cycling, swimming, golf, etc. A few weeks ago when I felt things were really getting bad I had already given serious thought to switching to cycling. The fact that I can safely get into cycling after I've healed and completed rehab makes me happy. The thought of living a sedentary lifestyle is sad, so I'm more than happy to focus my efforts toward cycling when I am able.

While I would really love to run again and I'm going to miss the sport terribly, I would rather be able to use both my legs later in life without pain.

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