I am a 56 year old male, who has been a professional athlete for the past 38 years. I have been a top instructor in Sun Valley, ID for 38 years, teaching high-level skiing eight hours a day, seven days a week. In the summer, I have been teaching high-level windsurfing in Hawaii for 25 years. I have had hip pain for over 10 years, currently diagnosed as severe “grade four” osteoarthritis. I had hip arthroscopy performed in 2002, which had a positive 60% improvement, allowing comfortable sleeping at night, and less pain in skiing. My range of motion continues to deteriorate, with sharp pain at limit flexion, extension, or rotation. In the beginning of May, 2008, I underwent an autologous stem cell injection series into the hip, which was promoted in the hope of generating cartilage growth, and a gradual improvement in the joints overall condition. This resulted in an immediate severe worsening of symptoms which continued to worsen over the next five weeks, finally resulting in severely painful walking requiring crutches, inability to ascend stairs, and even the inability to swim in the pool, all of which were new symptoms. After five weeks, life had become so non-functional that I decided to proceed with the hip resurfacing procedure, which I had been considering for the past year.I had met with Dr. Gross in November of 2007, and had decided that if and when I did have a hip replacement, I would go to Dr. Gross for the uncemented version that he had developed. Happily when I contacted his office in June 2008, and explained my new situation, they were able to fit me in on a cancellation.
June 16 Surgery day. Dr. Gross’s staff, and the staff at the hospital, were all very nice to deal with. Prep for surgery went smoothly, though with the expected nervousness. You really appreciate the number of steps that Dr. Gross takes to deal with potential pain, nausea, etc. I do not remember anything from the moment that they started to wheel me to surgery, until I woke up in post-op. I was delighted to wake up clear-headed, pain free, and no hint of nausea. Since I was the last surgery of the day, I did not see the therapist that evening, so I spent a very comfortable night doing slight leg flexions and contractions.
June 17 Still very little pain, and no nausea. First walk down the hall on a walker went very well, with very little discomfort. Afternoon walk was on crutches, and went well. The doctor came in and said everything had gone very well.
June 18 Reality sets in as the pain killer that had been put in during surgery wears off. Very difficult to get the leg in and out of bed, and more pain and stiffness during the hall walks, which are getting longer. There is some popping and clunking during attempts at a full stride. Doc says not to worry. Swelling is limited to the hip area.
June 18-20 Moved to the hotel across the street, where we will stay for three nights before flying home to Idaho. My wonderful wife has made this all go very smoothly, and is both helpful and inspiring. The hip is very stiff and sore at this point, but the pain pills prevent any severe pain, though everything is hard and awkward. The daily shots in the stomach to prevent clotting are no problem. I had one sleepless night wandering the halls, but other wise, nights went okay, with sitting up in bed being the only option.
June 20 The flight home was not that bad, due to pain pills, and first class seats.
Once home, I began the routine. Wake up to half an hour of gentle exercises, go for a ¾ mile walk with crutches, and finish off with some yoga/ tai chi breathing exercises and light upper body weights and exercises. Then nap all afternoon, and repeat the same routine in the evening. Sleep at night is going surprisingly well, considering I am staying propped up in bed all night.
At 10 days post op, I go off the narcotic pain killers, and continue Tylenol and a pain killer the office prescribed. I was finally able to swing my leg in and out of bed, without using an aid, and began using one crutch during most of the walks. The swelling over the past week has moved down my leg into my ankle and foot. There is a lot of stiffness and discomfort in trying to move, but not much real pain. There is definite protest and cramping when first getting up or down, but it improves once I am moving. I am still unable to bear full weight on the leg, and the discomfort on the incision side of the hip continues to be bearable, but constant, during walks with one crutch. Still occasional pop/ clunks, but less often, and almost never when walking after I am warmed up. Still happens when climbing stairs.
Two weeks. Progress is slow. When I first get up from sitting, there is a fair amount of pain and stiffness, and I can barely move without two crutches. Once I get going on my walks, one crutch works fine, and the stride becomes somewhat reasonable, maybe better than before surgery, but there is still pain on the outside of the hip each step, which does not seem to be much less than right after surgery.
At three weeks there was not much change, which was discouraging since I had hoped to be off crutches by this point. Still pain around the greater trochanter when walking with crutches, and no success yet at weight bearing without crutches. Lee Webb suggested having some x-rays taken, which happily showed that everything was still in place. I broke from protocol, and went to a PT in hopes of getting some positive change started.
The PT suggested that I go back to two crutches, shorten the walks, and added some exercises to strengthen around the area.
At the four week anniversary, I started to see some improvement. The swelling in the foot and ankle has gone away, with some residual tenderness. The trochanter pain is starting to improve. Tylenol only at night. At just past four weeks, I had my first success at walking without crutches. Very, very slow and focused, but was able to go for over a hundred yards without crutches. I still need a cane or crutches most of the time, but slow focused walking without them is now possible. Much less snapping and popping, but still some. Major clunking is rare. Still very stiff and slow to move, and sore during most movement, but not much pain. Starting to be able to sleep briefly on my good side with a pillow between my knees.
At six weeks, there was a major turn around. The trochanter pain went away almost over night, and I was able to start walking without a cane or crutches. Snapping and clunking is mostly gone. Started riding the stationary bike, which is great. No pain, and better range and comfort than before.
At eight weeks, walking on level ground is going well. Uneven ground or hills are challenging, and stairs are difficult. Range of motion is starting to improve. Sleeping is still challenging, since I can only sleep on either side for a while, before pain and spasms force me onto my back until they subside. Still very stiff and sore when first starting to walk.
Starting to be able to balance on one leg, and do minimal squats. Stairs continue to be challenging unless using a railing. Sleep continues to be difficult.
At twelve weeks, walking is excellent, and hills and uneven ground are coming along very well. Started doing rapid laps up and down six flights of stairs. Increasing the resistance on the stationary bike and Stairmaster. Starting to increase stretching, and have resumed daily Tai Chi. Sleeping is going much better, but still being awakened in the early morning hours by some pain and spasm, which goes away once I roll to my back. Overall, things are going very well.
At 16 weeks I started back into waveskiing (like a surf kayak). It was great, but I had trouble with the Eskimo roll due to weakness in the hip.
At five and a half months, I am doing 3-4 hour hikes in the mountains everyday. I started adding uphill jogging to my hikes up steep mountain trails. Still some minor clicking and start up pain when walking around the house, but it goes away after a block or so outside
At six months, I started skiing. It feels great as long as the terrain is smooth; groomed, powder or crud. Any impacts into bumps or set up piles are not so good, and elicit pain. High-speed carving was pretty sore the first few days, but is gradually getting better. Skiing is definitely helping my strength around the hip, and stairs are finally starting to feel pretty natural. Clicking is continuing to be more rare, and start up pain is improving. Range of motion is finally starting to improve compared to prior to surgery, but it is slow. The biggest problem continues to be sleeping at night. I am fine for the first few hours, but then I start getting deep aches when sleeping on either side, and end up trying with minimal success to sleep on my back.
Seven Month Update
Lots of positive changes continue to happen. Start up pain is mostly gone, and I can get up out of bed and walk like a normal person in the morning for the first time in years. Stairs, hiking, and walking are all going great, with no hint of the old hip limp that had been an unwelcome part of me for years. Range of motion continues to improve weekly, and is way past what it was for many years before the surgery (though I will never win any flexibility contest). I still get the occasional slip/click feeling, but it continues to happen less often, and never involves any discomfort.
Most importantly, skiing is improving almost daily, and I am back to my intense eight hours a day, seven days a week, teaching schedule. I am getting much more range of motion than in many years before surgery, and the strength is starting to come back, so I am feeling strong and confident in all conditions. I am spending a higher percentage of time in the black diamond rated back bowls, and in moderate bumps; and the hip is performing better than in many years.
I won’t say that it does not get a little sore sometimes, but with eight hours of hard skiing every day, plus and hour or two workout afterwards, I can’t complain about that. Though my initial recovery was slow and tough (which I attribute to the stem cell treatment unrelated to the resurfacing, that put me on crutches and in pain for six weeks prior to surgery), I can now say with confidence that resurfacing was the right thing to do, and I look forward to things continuing to get better and better in the coming months.