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Climbing/ mtb'ing post- joint replacement?

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 Wee Davie 29 Jun 2020

My right hip is knackered. I'm on the waiting list for a total right hip replacement (once surgery resumes up here in Scotland). At the moment sports action is pretty limited, mainly due to post- activity pain levels. I'm hoping the new joint will sort that. My question is- for those that have had joint replacements- have you managed to resume climbing etc to a decent level? I've been very active throughout my life and would like to think I'd be able to get trad/ Winter leading back to same levels or better and do some enduro racing on mtb. Any thoughts?

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 petemeads 30 Jun 2020
In reply to Wee Davie:

You should be OK if you get a surgeon who is happy to give you what you need to be active, there are some who would prefer to fit cheaper/less capable prosthetics then warn you not to subject them to impact loads. My sister-in-law has been given an Exeter hip with cemented stem and has been told not to run or jump about.

I went for an assessment 6 years ago with a surgeon known to fit the Birmingham metal resurfacing (Andy Murray style) and told him that this was what I wanted, to remain active in the hills, and he agreed to do the job despite my being at the upper end of the age range. I was jogging at 8 weeks and bouldering soon after, this was nearly 6 years ago and everything is still fine. 3 years later my bone was not good enough to do the same for the other hip (it snapped during the op) so I was given a ceramic on ceramic large ball THR which he assured me I would not be able to break, so I was back jogging within 6 weeks and biking 50+ miles within a couple of months, bouldering took a little longer to get this weaker leg back to full power. 

There are websites to check out - SurfaceHippy and Hiprunner, both American, and the McMinn Centre in Birmingham if you want more reassurance that modern devices can let life continue as normal.

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 BruceM 30 Jun 2020
In reply to petemeads:

Is it possible to ask for different-priced treatment options like you describe for NHS surgery, or did you have all of that work done privately?

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 Wee Davie 30 Jun 2020
In reply to petemeads:

Thanks for your reply.

My hip is too far gone for a re- surfacing and the surgeon’s talking about a ceramic/ ceramic replacement. Glad to hear that was what you had and you resumed activities quickly.

The surgeon is aware of what I get up to and has given me a warning that if it deck out on a route the new joint bits will likely fracture my femur etc. I got the impression he was just giving a ‘worst case’ warning to keep my expectations realistic. Can’t wait to get it done as I’ve gone from 100 mile sportive level in 2017 to quite restricted now.
 

Anyone else with any experience of these please reply.

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 kevin stephens 30 Jun 2020
In reply to Wee Davie:

This topic comes up regularly, maybe a sign of UKC’s ageing demographic? A search of previous threads may give you a lot more insight?

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In reply to Wee Davie:

I had a left total hip replacement 14 months ago. (I stopped climbing over a decade ago, but still walk a great deal). I made very rapid progress for the first 6 weeks, but then it took almost exactly a year to come more or less back to normal. 98-99%. I still get some slight aches some days. But you won't be as agile again, and as your surgeon says, you will need to be very careful (the horror of dislocating it is just too great). So I'm afraid your climbing will be inhibited / never quite the same again. If you treat it as 100 per cent normal, you're asking for trouble. 

PS. I am still amazed how Andy Murray can still play tennis the way he does....

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In reply to Wee Davie:

Nothing helpful to add but really sorry to hear that Davie. IIRC from way back when, you were in the Strathclyde uni club whilst I was in the Glasgow one so we must be pretty much the same age (I'm 46). Does that make you particularly young to need a hip replacement? Total ignorance on my part, but I've always associated it with older people. My mum is deciding whether to have a hip replacement currently but it's all complicated by her Parkinson's. 

Best of luck and I bet you'll be back to circumnavigating Aran and the like in no time! 

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 Bob Kemp 30 Jun 2020
In reply to TobyA:

Accidents and particular kinds of wear and tear can lead to an earlier need for replacement. Farming in particular is associated with it, partly because farmers often 'inherit' the profession and start working and carrying heavy loads in childhood.

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 Tyler 30 Jun 2020
In reply to Wee Davie:

I had mine done before Christmas, I've not done much climbing since (3 top rope sessions) but that is nothing to do with the op though and from what little climbing I've done it is obvious I am moving better than before. I am doing a bit of cycling and that is problem free.

I got a plastic into ceramic joint which, the surgeon told me, was the best for active people. The only thing he warned me off doing is running but that's because it will accelerate the wear process and not because it won't work (although the odd bit of jogging I have done seems very odd and that definitely isn't back to normal but that may be because they cut through a lot of muscle which has visibly atrophied). I've not yet jumped off the top off a bouldering wall (the most impactful thing I did before) but no reason to assume I can't.

Post edited at 12:09
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 AlfaPapa 30 Jun 2020
In reply to BruceM:

> Is it possible to ask for different-priced treatment options like you describe for NHS surgery, or did you have all of that work done privately?


The NHS in England (different in Scotland) will allow for more expensive / bespoke prostheses on the basis of individual need. A Consultant will usually need to apply for additional funding through and Individual Funding Request (IFR) process. Patients usually need to meet certain criteria to have IFRs approved by the commissioning panel - being active and wishing to resume similar levels of activity would count towards the criteria, as well as being younger, healthy BMI, non smoker etc.

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 Wee Davie 30 Jun 2020
In reply to Tyler:

Thanks everyone.

I’m not sure if I’m unlucky or what- but being 47 with a job that (used to) require me being on my feet 12 hrs a day plus being active all my life & road running may have been a bad combo?
I don’t have any regrets as such but definitely won’t want to return to runs on hard surfaces. I was never particulary good at it anyway! 

If I’m honest I’d just be glad to be able to get to sleep easier as right now it’s uncomfortable in almost any position. If I can pootle up some punterish trad and winter routes it’ll be a bonus. 
 

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 Wee Davie 30 Jun 2020
In reply to TobyA:

Cheers. I was Cali uni back then but yes, same generation of Weegie student climbers!
 Got letter through today saying hip should get done by September which is brilliant news.

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 BruceM 30 Jun 2020
In reply to AlfaPapa:

Thanks for the info. 

Good luck Davie!

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 petemeads 30 Jun 2020
In reply to Wee Davie:

I can confirm that falling off a road bike can fracture your femur, my mate Chilton did exactly that with his first THR and had to spend 5 days in hospital waiting for the new bits to be fitted- long stem and lots of cable ties holding the bone bits together. He still cycles, has done a hundred miler, but does not run at all.

My biking is all on-road, my attempts to mountain bike scared me as a fall is much more likely. I run on the roads and towpaths and in the hills - downhill, anyway. Indoor bouldering is V4 max on a good day, I have fallen from the top of the wall several times and so far landed ok but there is a bit of a risk in a twisting fall. Outdoors, I have managed E1 on grit a couple of times, age is my restriction rather than hips...

Dislocation is very rare with larger-ball devices, once the soft bits have regained their strength. Are you sure a Birmingham hip is not possible, or is your surgeon one of those who does not do them or believe in them? It makes for a better mechanical repair but does require decent bone and a femoral head that has not become necrotic. And a THR revision later is an easy option...

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 Richard Popp 30 Jun 2020
In reply to Wee Davie: Hi, as someone has already said it is worth doing a forum search, there is one particular thread with a video link which helped me keep going.

I had a total hip replacement in mid-December, ceramic on ceramic with the biggest head that he could fit. I have had a bit of a bumpy time climbing over the past few years and have still led a couple of (soft probably) 6b+'s. I am hopeful that I can bump this up a good bit further.

The end of my recovery coincided with lock down and I am wondering how to get my anaerobic side up. I have never been a strong runner so the extra wear is not worth it for the small amount of enjoyment I get. I love cycling for commuting but the idea of doing it as training is not very attractive, my bike is 20+years old and whilst I love it it is not really that good for getting out. So thinking of getting some swimming lessons and using that. Currently walking up the steepest longest hill in town, which does get a sweat up but....

The Andy Murray documentary is a good watch-think it is called Resurfaced and is on Netflix.

Good luck, I cant believe how well it has worked out.

Rich 

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 Timmd 30 Jun 2020
In reply to Wee Davie:

The only person I've come across with a really bad experience of hip replacements is somebody who has has a rare disease (if that's the right term) where the blood supply to her bones doesn't work anymore, and she has to chew pain killers to make life more livable.  I used to know a man with both hips replaced and he managed to go out walking on long walks just like everybody else did.

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 Wee Davie 30 Jun 2020
In reply to petemeads:

Hi my surgeon said he felt a Birmingham hip was a temporary solution with a THR being inevitable in the end. I’m no expert so I just went with his recommendation. 

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In reply to Richard Popp:

> Hi, as someone has already said it is worth doing a forum search, there is one particular thread with a video link which helped me keep going.

This thread, probably - https://www.ukhillwalking.com/forums/rock_talk/hip_replacement_and_climbing-699074

And, more importantly - this link which helped me a good bit too, although it is worth reading the caveat! - https://www.youtube.com/watch?v=elRDkpVczR4& "My vid puts a positive spin on things but I can absolutely assure you there were dark days when I could barely get out of bed. The bad days gradually become fewer and farther between. Keep the faith."

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 petemeads 01 Jul 2020
In reply to Wee Davie:

It sounds like he is one of the unbelievers, and probably does not do the operation (which is more technical than a THR). Temporary? At least 20 years - the current device dates to 1997, I have a friend with an original one. Professor Meek in Glasgow comes well recommended as a Scottish surgeon fitting Birmingham hips to runners, on the NHS. Do a bit more research, you are young for a THR. Ceramic bearings will last forever but the idea of a long spike stuck in your femur which does not load the bone properly does cause me concern. The McMinn Centre website has lots of good information, the only downside of the Birmingham hip is the slight risk of metallosis because of sensitivity to Chromium or Cobalt, most likely with women. Smith & Nephew have stopped surgeons using the device on women because of this. In men, with a good surgeon, 98% still ok beyond 15 years - and easy conversion to THR if necessary. I have no connection with the industry but have done the research, it's a big decision...

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 Wee Davie 17:30 Wed
In reply to petemeads:

Thanks- appreciate your input. It isn’t cut and dried exactly who or where I get treated. I may end up going to a waiting list initiative hospital due to the backlog from Covid 19. If that happens the other surgeon may suggest alternatives. I’ll eat what you have said in mind and do further investigation. Cheers 

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 Wicamoi 22:51 Wed
In reply to Wee Davie:

Hi Davie!

Semi-relevant. My dad had one hip replaced in his 60s and the other in his 70s (not sure what type, but I know his surgeon was aware that he was a keen runner). He ran a marathon less than six months after his first operation, and continued running marathons for some years after his second. Glad you've got a date at last. You're still young - reckon there'll be plenty more climbing and biking left in you.

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