Bush walking after hip replacement

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Re: Bush walking after hip replacement

Postby davidmorr » Sun 10 Sep, 2017 2:56 pm

A keen backpacking friend suffered for years with a troublesome hip. He took anti-inflammatories before every trip, but still suffered a lot of pain. At age 55, he decided to have his hip replaced. Unfortunately, after it healed he pushed it a bit too soon and too hard (tough backpacks) and partially detached the joint from the pelvis bone. The metal joint itself was then moving against the pelvis and wearing the bone away.

He eased up a bit, but put off doing anything about it for several years. (More anti-inflammatories.)

When he finally did get it done again, the bone was so thin that any shock could have broken through to the intestines. He could have ended up with peritonitis which can be fatal. He needed a bone transplant to reinforce the pelvis bone.

The technology has improved since then. Once the bit that went into the leg bone was a taper and the joint was just hammered into a hole in the bone. This meant that over time, the bone was likely to split from weight pushing the joint harder into the bone. And because of this friction fit, it could sometimes come loose. These were the main causes for having to get it replaced.

Nowadays, as I understand it, there are joints which do not use a taper, but a pin goes down into the bone, and a mesh surrounds the top of the bone. New bone material grows through this mesh making a much stronger joint. They also last much longer, maybe 20 years or more.

My friend and several others are back to backpacking after knee and/or hip replacements.

So if you are looking for a joint:

1. Make sure your surgeon knows the type of activity you do. Joints are available for a range of activity levels. If they think you are fairly passive, you will get a cheap, weak one. Make sure they give you a good, strong one. Medicine is ruled by accountants now. (Digressing, for a hernia, if they think you are past it, they just cut off the testicle and sew up the hole in the membrane because that is cheaper. If you have an active sex life, make sure you tell them so they do it properly.)

2. Let it heal properly. Some weight-bearing will help the bone to regrow, but overdoing it will break the fragile new bone.

3. Be very focussed on light weight so as not to overdo it.
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Re: Bush walking after hip replacement

Postby photohiker » Sun 10 Sep, 2017 3:11 pm

Watching the UK 'SuperVet' on TV, he replaced many knee joints for dogs and cats, usually forces the prosthetic joint into the bone marrow with force, and usually has a mesh on the prosthetic so the bone grows into the new device, adding more strength than a friction fit and some screws.

Don't know if the same process is used for humans, might have to get the best solution from the vet to replace the joint :)
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Re: Bush walking after hip replacement

Postby davidmorr » Sun 10 Sep, 2017 3:42 pm

Peaksnik wrote:
A lot of people swear by turmeric. Have a talk to your GP.


But the research evidence took a significant hit in January of this year following a critical review in the Journal of Medicinal Chemistry:
http://pubs.acs.org/doi/abs/10.1021/acs.jmedchem.6b00975
The problem with many medical studies like this is that they are looking for the wrong thing. What they want is a single substance to fix a single problem. At best, what they usually get is a substance that fixes a *symptom* of an underlying problem, and claim that as a success. It is how drug companies have become so rich.

The underlying problem in many cases is poor nutrition leading to mineral imbalances and nutrient deficiencies. The way to fix this is to eat real, healthy food like meat, fish, vegetables, dairy, some fruit, legumes, etc, as humans have for tens of thousands of years. Modern - often nutrient-poor - processed foods are the cause, particularly if they are a major part of the diet. Unfortunately, it is for so many people nowadays. :-(
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Re: Bush walking after hip replacement

Postby rcaffin » Sun 10 Sep, 2017 4:02 pm

The underlying problem in many cases is poor nutrition leading to ...

Darwin.

Cheers
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Re: Bush walking after hip replacement

Postby Neo » Sun 10 Sep, 2017 4:43 pm

rcaffin wrote:The underlying problem in many cases is poor nutrition leading to ...

Darwin.

Cheers
Roger


:)
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Re: Bush walking after hip replacement

Postby GPSGuided » Sun 10 Sep, 2017 5:26 pm

davidmorr wrote:Nowadays, as I understand it, there are joints which do not use a taper, but a pin goes down into the bone, and a mesh surrounds the top of the bone. New bone material grows through this mesh making a much stronger joint. They also last much longer, maybe 20 years or more.

It's never that simple and never any magic. Mesh and other surface modification are never without other considerations. We are talking about a big rigid device implanted into the body, never forgetting that our bones are not static but remodels constantly. As such and despite a lot of research, there's no perfect replacement. There will always be prosthetic fractures, bone fractures, infections, wear and eventual failure. How well the device suits the particular patient, variables at implantation and post implant use all contributes to the outcome. Carry big weight and forces will invariably lead to premature problems.

Care and preservation of what we have is always best.
Just move it!
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Re: Bush walking after hip replacement

Postby Moondog55 » Wed 13 Dec, 2017 11:51 am

After waiting in the queue for this long all I can say is that walking with a replacement has got to be better tan not walking at all.
Even if they only last 10 years I'd be happy, if they last 20 I'll be dead anyway
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Re: Bush walking after hip replacement

Postby Moondog55 » Tue 19 Dec, 2017 6:34 am

Well I saw the junior surgeon yesterday and i have an appointment with the department head on Wednesday at 0830
Junior surgeon wants to use a Birmingham resection but I am over the cut-off age so he has asked his boss for a second opinion. Turns out the junior surgeon is a Telemark skier and thinks I would be better off with the Birmingham resection if I want to keep back country skiing
I get big brownie points for being a non-smoker / normally a non-drinker and not being fat and unhealthy. All of which make surgery less of a risk for me
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Re: Bush walking after hip replacement

Postby kicyclist » Tue 19 Dec, 2017 12:10 pm

Hi Moondog,
Spot on about the non smoking, not overweight and healthy lifestyle being a big plus for you.
The surgeons were eager to get started on me when I needed them back in 2014. Just before my accident I was very fit and adapted to rehab well on 3 occasions.
At middle age there is a wide variety of body shape, health & fitness to be found out there, age is far from the only factor.
I wish you well with the appointment tomorrow and the operation as needed.
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Re: Bush walking after hip replacement

Postby Moondog55 » Tue 19 Dec, 2017 12:37 pm

Thanx kicyclist
I will be so glad to get off the drugs/ analgesics treadmill
I'm on a combo of Paracetamol plus Tramadol plus Endone at need at the moment and sometimes I feel a total zombie
That fact that I am trying to finish the renovations on the house and need to be up and down ladders and scaffold platforms all the time isn't helping either.
Being my beloved primary carer when she needs it is why I've been shunted to the fast track tho, not my pain levels. Say something about medicare funding tho when the fast track means a 3 year wait.
I take note of the OP tho and I guess I will need to do something drastic about my pack weight now or go back to summer walking for a while, perhaps both and use those old ski poles as walking sticks too
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Re: Bush walking after hip replacement

Postby rcaffin » Tue 19 Dec, 2017 1:43 pm

I guess I will need to do something drastic about my pack weight

www.backpackinglight.com
(Disclosure: I am the moderator there.)

go back to summer walking for a while

That might be OK in Vic, but today in Sydney it is 35+ C. I suspect most of the State will be shutting down about now for bushwalking.

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Re: Bush walking after hip replacement

Postby oldpiscator » Tue 19 Dec, 2017 1:59 pm

40 deg. here in LARA Vic at the moment.
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Re: Bush walking after hip replacement

Postby Warin » Tue 19 Dec, 2017 2:37 pm

rcaffin wrote:
go back to summer walking for a while

That might be OK in Vic, but today in Sydney it is 35+ C. I suspect most of the State will be shutting down about now for bushwalking.

Today it is only a fire danger of 'very high'. Tomorrow it is a 'total fire ban' day for the Sydney area - means you cannot go walking in a National Park .. they have signs up on trails advising that they are closed on total fire ban days. The fire rating is still only 'very high'.
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Re: Bush walking after hip replacement

Postby Moondog55 » Sun 24 Dec, 2017 1:15 am

Well I will let you all know in about 3 weeks or so
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Re: Bush walking after hip replacement

Postby Moondog55 » Mon 22 Jan, 2018 3:20 pm

I think the 3 weeks are up
4 days post-op and I'm getting around quite well, in fact it's now just past 1600 and time for my Clexane anti-clotting jab. I've been home for just over 36 hours now, just 3 nites in the orthopedic ward.
If people have their doubts about having it done I can tell you that while intense the post operative pain is very manageable and after day 4 quite tolerable with only moderate doses of analgesics, for me the hardest thing is not being able to rest or sleep on my side
The most important thing is doing all [ and i do mean ALL] of the exercises and dieting needed so that you can become independent more quickly.
I only lost 2.6 kilos in the 2 weeks before the operation but even that small amount seems to have kicked my body into rebuild mode
A huge bonus for me is that my spine is no longer twisted to one side and my lower back pain is much diminished and I'm taller having regained the 20mm or so or ground away bone and tissue that used to be my hip joint
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Re: Bush walking after hip replacement

Postby Tortoise » Mon 22 Jan, 2018 7:36 pm

Thanks for the update, Moondog. Great you've got that new hip! I suspect you'll be pretty motivated with that rehab - which will help enormously. All the best for getting back on the track/snow.
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Re: Bush walking after hip replacement

Postby Moondog55 » Tue 23 Jan, 2018 11:55 am

Damned elbow crutches are going away as from now. I can walk with out them and they confuse my gait. I also think that the hospital rehab PT are doing my shower entry wrong, why do things the hard way when I can simply lean back a little and step in. I have a feeling that their lowest common denominator data is set very, very low
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Re: Bush walking after hip replacement

Postby Moondog55 » Tue 23 Jan, 2018 1:19 pm

OK Day 5 and I have been walking around the house without the elbow crutches since lunchtime. I think I'll give myself a pat on the back. All the hard work Pre-Op is really paying off and I'm really glad I did all of the stuff I was advised to do, my hamstrings are going to be so tight tho that I am not looking forward to all the stretching that will be needed
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Re: Bush walking after hip replacement

Postby stry » Thu 25 Jan, 2018 7:19 am

Good news MD. :D

Being fit beforehand, eating well, following advice for rehab and exercise. Basic stuff, but some don't do it and pay the price.

No surprise that you are embracing the recovery phase. Well done ! :D
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Re: Bush walking after hip replacement

Postby Moondog55 » Thu 25 Jan, 2018 7:41 am

I'm impatient but I seem to be swapping between a set of elbow crutches and a stick depending on the time of day and my balance and pain levels. I didn't expect my pain levels to be still so high a week out
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Re: Bush walking after hip replacement

Postby ofuros » Thu 25 Jan, 2018 9:24 am

I'm grimacing just thinking about it.
Give the recovery a red hot go Moondog & your clodhoppers will soon be pounding those tracks. Good luck mate.
Mountain views are good for my soul...& getting to them is good for my waistline !
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Re: Bush walking after hip replacement

Postby stry » Thu 25 Jan, 2018 5:04 pm

Moondog55 wrote:I'm impatient but I seem to be swapping between a set of elbow crutches and a stick depending on the time of day and my balance and pain levels. I didn't expect my pain levels to be still so high a week out


There is a need to strike a balance between embracing the recovery phase and pushing too hard and too soon :)
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Re: Bush walking after hip replacement

Postby GPSGuided » Fri 26 Jan, 2018 11:43 am

Well done MD55 and good to know that you've conquered the major hurdle. One suggestion is, be patient and do follow the PT/OT's advice as they have safety foremost in their instructions. At this early stage of post-op recovery, one needs to be aware that bone's remodelling will take months to year to stabilise, and then continues slowly for a lifetime. Despite the cement/screw fixation that you may have, you don't want to have a fall and induce damage to the prosthesis and the fresh bone interface. Do what the team instructs diligently and carefully and give time for it all to settle. Will look forward to seeing good recovery from you. Yes, keep up your weight reduction regime (both body and walking gears) as that's the best way to improve prosthesis longevity.

PS. Bone health also comes in the form of calcium and vitamin D. Plenty of sunshine.
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Re: Bush walking after hip replacement

Postby Moondog55 » Fri 26 Jan, 2018 12:06 pm

I just did my mid-day set of PT exercises
PT sets are only 10 reps so I stopped there but that is only a quarter on my normal Pre-Op sessions and I feel as if I could do a lot more
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Re: Bush walking after hip replacement

Postby rcaffin » Fri 26 Jan, 2018 12:16 pm

Yeah, but it would be a pity to damage the metal/bone joint this early!
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Re: Bush walking after hip replacement

Postby Moondog55 » Fri 26 Jan, 2018 12:33 pm

I expect to be limited to low impact and body mass only exercises for the next 6 weeks and perhaps the next 12
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Re: Bush walking after hip replacement

Postby GPSGuided » Fri 26 Jan, 2018 12:36 pm

10 is no magic number but is one that has worked on average at this phase of recovery. The key is that you do it in moderation and not over stress those tissues. The key objective at this early stage is to keep those joints mobilised, lest they get contracture and lose their full range of movements (frozen). So gentleness and range are key. Strengthening can come later. In the meantime, don't forget to exercise your other joints and muscles. They have been rested and you don't want to waste them. So with the extra energy, work those other parts of the body, will help your weight reduction too.
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Re: Bush walking after hip replacement

Postby kicyclist » Sat 27 Jan, 2018 2:54 pm

Thanks for the updates Moondog.
Keep up your vegies, lean meat and fish.
If you have a chance I would recommend hydrotherapy exercises. Try walking long slow strides in about 1m of water. I used the ocean with some trips to the pool when the weather was cold. Swimming is also good. The hip is a painful part of the body to heal but within your next 6-12 weeks I hope your pain will have subsided.
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Re: Bush walking after hip replacement

Postby Moondog55 » Sat 27 Jan, 2018 3:17 pm

ofuros wrote:I'm grimacing just thinking about it.
Give the recovery a red hot go Moondog & your clodhoppers will soon be pounding those tracks. Good luck mate.

I'm finding that giving myself that Clexane injection everyday at 1600 hrs isn't getting any easier
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Re: Bush walking after hip replacement

Postby Moondog55 » Tue 30 Jan, 2018 8:57 am

First Post-Op PT session this AM, got told to slow down just a little and give my body just a little more time to heal but all good otherwise, GP this PM to have the dressings removed and all the remaining glue cleaned off
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