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Gdavis
November 20th, 2004, 05:36 AM
I'm a competitive masters swimmer (mid 40s) with an osteoarthritic hip. It's a question of when not whether I'll need to get a replacement. Are there any swimmers out there who have personal experience, advice, insight which would help with the making the choices of what to do and when to do it? It would also help to hear where the best sources of research information are which might help answer questions like - "will I have difficulty with racing dive starts, tumble turns or breaststroke kick (ie actions which place high stress forces on the hips)?"
Thanks and happy swimming.
Guy

Ian Smith
November 20th, 2004, 06:17 PM
Guy,
Given a good surgeon and a little time, a hip replacement should not have much effect on your swimming.

This opinion is based on my own experience with a hip replacement at 58 and yet, at age 61, still managing a 27.80 for a Long Course Meters 50 free and 30.15 for fly.

A short course meters time of 27.18 at 62 would seem to indicate that turns are not too much of a problem either. (nevertheless, every flip turn remains an adventure as before)

Breaststroke does not hurt my hip (just my knees - as before) but not being a breaststroker, I’m probably not doing it right anyway.

The only advice I can offer is that your orthopaedic surgeon has some adjustment capability with the replacement hardware. Knowing I swam and did tumble turns, my guy adjusted the joint so I could bring my knee closer to my chest than he usually allows.

Any slowdown on my part in starts and turns is just due to becoming old and feeble; the hip is no excuse (I have plenty of other normal excuses available for use). If your hip gives you pain, don’t wait; it is a quality of life improvement all round.

Ian.

Gdavis
November 21st, 2004, 02:59 AM
Hi Ian
Thanks for your encouraging and useful feedback. And way to go on those times! A quick follow up. Did you consider hip resurfacing as an option?
Best
Guy

Ian Smith
November 21st, 2004, 05:23 PM
Guy,
I’m not exactly sure what “hip resurfacing” is. My surgeon did not offer any option other than strongly recommending a “metal-on-metal” load-bearing surface (as opposed to ceramic or polyethylene?). He felt all these added surfaces break down over time and cause the bone to migrate to the detritus caused by the break down with the result that the part attaching to the thighbone gets loose. (I remember seeing this on the web somewhere at the time)

He did look at possibly rotating the ball of the femur to see if there might be a position in the socket that caused no interference. This turned out to be not possible in my case.

The concept that looked interesting after I had the replacement was putting a steel cap on the ball of the femur which would go in a steel socket attached to the pelvis. This saves cutting the femur and the need for a long insert into the thighbone. Apparently this method is used in Europe and now also in Montreal but I have no idea of the success rates, risks, etc.

Whichever way you go, I recommend getting into the pool as early as your MD permits, get in a slower lane and work on technique until you are up to speed; it pays off.

BTW, I just remembered there are a couple of excellent articles in the Nov/Dec 2003 Swim Magazine (p.12) on the ins and outs of hip replacements and swimming - well worth reading. Nadine Day's article on 'Returning to Swimming' (after a hip replacement) is quite comprehensive and informative.
Ian.

jim thornton
November 21st, 2004, 07:14 PM
Guy--

Not a doctor, but I did an article on hips a few years back for GQ magazine. Have you been checked out for a labral tear? Supposedly, this can cause a lot of problems, and some surgeons are correcting these arthroscopically. You said you were diagnosed with osteoarthritis, so I may be sending you barking up a wrong tree. But it's worth looking into just in case. If you live at all near Pittsburgh, there's a top notch hip guy, Dr. Marc Phillipone (spelling?) at the UPMC Sports Medicine Center whose done labral repairs on a bunch of big name pro athletes including, I'm pretty sure, golfer Greg Norman.

Hi to Ian, by the way!

Gdavis
November 22nd, 2004, 12:57 PM
Thanks Ian for the further input and Jim for your thoughts. Ian your reference to "putting a steel cap on the ball of the femur which would go in a steel socket attached to the pelvis" is , I think, resurfacing. I have been looking into web info on this - see http://www.activejoints.com/resurfacing.html Not yet FDA approved but seems to be getting there. The aspect that seems particularly interesting are the claims regarding "athlete" experiences with this approach. See http://www.midmedtec.co.uk/case_studies.htm
However, I feel the need to be cautious because there can't yet be much long term experience.
Jim, will look into hip labral tears - which I had not heard of. This was a good starting point for me.
http://uconnsportsmed.uchc.edu/patientinfo/whathurts/hip/
G

bckstrker
November 23rd, 2004, 09:36 PM
Guy, you might also check into the so-called minimally invasive hip replacement. The recovery period is much less painful and is much faster than with regular hip replacement surgery. Also, the potential for dislocation of the hip following surgery is less with this approach.
Good luck with your decision making.:)