If you're active, look into hip resurfacing as an option to full replacement. You CAN go back to high impact activity after resurfacing. The name resurfacing isn't a good name, it's similar to a full replacement but they put a new ball on your existing femur instead of putting a metal rod down the center of your femur. Too much to put here, just start researching the difference, if you're active.
38 here in Scotland 🏴 and just been diagnosed with hip OA. These videos are very informative - thank you! Any advice on the potential of having to get a THR redone later in life if I get this done now/at a younger age?
Surgeons here practically roll you off the table into a wheelchair to bring you to the car waiting to take you away. Pretty much go forth and heal thyself.
What about moderate distance cycling (e.g. 25 miles/day). I imagine that since it is not a jarring impact that is good, but you still have 1hr plus/day repetitive motion. Does that wear out the hip replacement faster?
I need a doctor like the one in this video . He's straight forward and explains everything in detail . He deserves 500Million Subs and 500 Million Viewers !!!!
Different doctors are likely to do different things. Chen-Wein did my knee November 2023 the rehab was easy compared to the knee I had done 15 years ago.
Hi Dr Liew, I had total hip replacement in both hips about a year ago, done three months apart. I had the titanium rod for the femur and porcelain ball. I had a successful recovery and am very pleased with the results. Thanks for this video.
In general - the implant is not as important, I feel, as the approach, and accuracy of implantation. I utilise a ceramic on ceramic articulation which I feel has the best wear characteristics and potential for longevity out of all the articulations.
Why can i bend my leg fully when im walking? If i try to run on th grass, my legs just straight, i can omly move it in the pool, and that's not much either
I got a new hip 5 years ago. I'm a martial artist and a runner. When I run, I strike mid-foot. That being said, my surgeon told me to run no more than 6 miles at a time. And I have held to that.
What about martial arts? I’ve trained in martial arts hard styles most of my life plus working in law enforcement. I’ve done thousands of kicks over the decades and now at 63 am looking at a hip replacement. I don’t want to give up either martial arts or law enforcement just yet. Any advice is appreciated.
@@justabill5780 my hope is to regain flexibility so that I could throw head high kicks like I used to, though I’d rarely do so on the street. Running is less of a priority at this point. I’ve also been told by a martial artist and stunt actor for many years is that days of slamming kicks into a heavy bag are over. At 63 I’d prefer not to have to have the replacement replaced 😀
@@jkadude2010 You should be fine. I can kick as high as I ever did. Getting my hip replaced was the best medical decision I ever made. Just do it as soon as possible. The weaker your muscles become, the longer and harder the recovery
My right knee is bone on bone, huge bone spurs (largest the ortho said he’s ever seen), the meniscus are both torn, ragged or missing, my knee cap isn’t tracking, I have edema of the top of the tibia and bottom of femur, inflamed tendons, 4 ossified floaters, and I’m in misery. I’m 53. Said I haven’t tried enough yet to get a TKR. I got a cortisone shot. Exactly how is that going to do anything but a temporary hold on the inevitable. I’ve fallen twice today because my knee locks. I got the cortisone yesterday morning. I’m so frustrated. I can’t do fun stuff with my three children; my eldest is 13. I am not their fun mom anymore. I don’t limp, I don’t complain because I am tough and I think that’s used against me. I want to limp but for my children I don’t want to appear old. I’m feeling really down.
Every surgeon is different. My feeling is that age is just a number, and all factors should be considered. This includes pain, analgesia etc. I agree that cortisone is generally not a fantastic management option as it is usually very temporary.
I tried to get my surgeon to do the side incisions, but he would not. I can kneel as long as there is some kind of padding between my knee and the hard surface.
The curved lateral incision (I have a video on that) is something that has made a lot of difference in my patients. But it is not the normal incision to do.
One thing not discussed specifically is if a runner prior to surgery can continue to run for training and health. Say 2-3 miles a day, several days a week, at a moderate pace. It makes sense that if you were not a runner, this is not a good idea to run a marathon. But what if you are a runner, and you want to continue to train at a moderate level. New studies are showing how exercise helps the body in ways we didn't understand before. So I am wondering if running in a prudent style would actually help prolong the hip longevity because of the strength and cardio building aspects of the training. Thank you for this video, it is a brilliant explanation.
I would say this: whilst I totally agree that exercise is ESSENTIAL in your overall health and healthspan - running may not be the best option for this if you've had a joint replacement. This might mean that you need to try other things which are just as effective - like rowing or cycling which essentially place no implant on the joint. If you HAVE to run, then ensure your strike is soft rather than a heel strike.
I am a candidate for tkr here in Sacramento, CA. I've just started researching the kinematic approach. My dr. wants to do robotic and when I asked him what the differences were he said this: Please comment: "Kinematic knee alignment is a controversial technique done by a minority of surgeons designed to change the bone cuts to optimize soft tissue balancing. Mako assisted knee replacement accomplishes this same end with more precision by using computer software to make adjustments to bone cuts in real time and optimize implant sizing, positioning and soft tissue balancing. Whatever potential benefit that is offered by kinematic surgery is accomplished with Mako assisted surgery with further benefits not achieved with kinematic alignment alone." He doesn't say how Mako provides further benefits not achieved with kinematic. I read on your website that most people spend 3 to 4 nights in the hospital. Here they get you out in one day or one overnight stay. How long does the surgery take with kinematic? THANK YOU!
I won't go into the discussion and debate - but essentially the difference is this: Mechanical alignment aims to align the knee the SAME for every patient. The patients capsular structures, ligaments and sometimes tendons can be released to balance the knee. Many modalities have been created to achieve the same alignment for each patient (A perfectly straight leg with a 10 degree foot progression angle). But not all alignments are the same. Look at people walking around - some are bow legged, some are knock kneed. Most of those people don't have arthritis and it's their normal alignment. Kinematic alignment reproduces the normal alignment for that patients and therefore does not require ligament or soft tissue releases. Without matching the alignment of a patients own anatomy - the knee will require other soft tissue balancing operative techniques to balance the knee. I respect all surgeons preferences but I would also say that it is the fastest growing method around the work from an alignment perspective, and the results are phenomenal. I would advise you to read research performed by one of the godfathers of kinematic alignment - Dr Stephen Howell.
@@orthopaedics360 Hi Dr. Chien-Wein Liew, thank you so much for your response 🙂 I did call Dr. Howell's office and tried to make an appointment for consult but he does not accept my insurance plan. There are only 1 or 2 other surgeons that use the kinematic alignment technique here. Since Dr. Howell is one of the godfathers of kinematic alignment, I would've thought there would be more doctors using this approach here in Sacramento. In any event, I appreciate your response. (I will be looking into changing my insurance plan during open enrollment.) Thank you.
Can we do advanced surfing after a THR? Because a lot of it, especially going backhand, is in your hips. We surmise the surfer (good surfers that is) is heavily curtailed? And you need to tell us which approach you specialise in too.
Hi I’m having a total hip replacement in 6 days i exercise with rowing and biking and weightlifting every day minimum of 30k and I fast 16-8 every day when should I taper off before my surgery many thanks Shaun
I would recommend having a good protein diet prior and around your surgery. I see that the tie frame of this answer may not be relevant anymore for you. My apologies.
I'm in my 8th week after posterior total hip replacement. I have been running on the mid to forefoot for the last quarter century +. I plan to give it a go after the three month recovery timeframe. I'm 67, it's a bit about going out on my terms. Nothing drastic just 10 to 15 miles a week. If I can't get back on my forefoot then I'm done. I won't risk a heel strike for multiple reasons. When people talk of the "pounding" I generally suspect they have never really stuck with running long enough to get out of the pounding mode and into more of a glide. I used to scare people while passing from behind because I didn't make any noise. I have spoken with my surgeon, a second surgeon and three PA's and all but one PA seem to be quite encouraging. My wife and my sister think I'm nuts. Right now I'm focused on reaching my darned foot so I can tape up and tie my shoes.
Great ☹️. So after my hip replacement I will have a good hip but now cardio will suffer. The only thing that makes me feel mentally and physically on a natural high is my ritual of 7 long fast 100 yard runs. . Now I will have heart issues. This sucks.
If a person has an inkling that their anterior cruciate ligament could be damaged (this could be confirmed by having an MRI), is it better to rest (until the MRI results are available), rather than attempting specific knee- strengthing exercises?
If you have ruptured your ACL, it's best to avoid pivoting style sports until you've had your MRI. Additionally,m mother injuries may occur at the same time, which can cause further damage if you exercise on those injuries (ie meniscal or chondral tears)
Excellent explanation doc, thanks. I had a hip replacement a couple of years back and have since done some running on an anti-gravity treadmill under the supervision of a physio. It's a wonderful feeling to be able to run again but I'm only happy doing it knowing that I'm putting a fraction of the weight through the hip that I would be if I were running on the road. As someone who ran 2/3 times a week and enjoyed 10ks it was hard accepting I'd have to give up running on the road. I'm letting a bicycle take the strain now.
I have concerns with meral being implanted into the body. I understand it is not metal-on-metal, generally, but does the body react to the toxic nature of this unnatural substance in the body? And if so, what can then be done about it?
In general, there are no allergies noted or effects from modern prostheses. To date, we have not come across a single case of metal/substance allergy from prosthetic joints.
I would recommend researching some of the hip resurfacing issues that are cropping up, including Birminghams. We don't have a lot of surgeons happy to put in resurfacing in Australia these days
@@orthopaedics360 What are the issues cropping up? Most of what I've read recently seems to be advocating it even for older, active people now. Of course, that's the way it is with doctors as well. Most appear to be salesmen advocating what they do as the best, making it difficullt to cut through the BS and decide what is best for the layman. I'm in need of a new hip now and going through that unfortunately.
