GetUpnGo

I'm reporting on my hip replacement in case others wonder what you will be able to do and when after your surgery. I wasn't able to find this information when I was planning my recovery, so I hope it will help others. I found a lot of conflicting information on the internet. Much of it refers to posterior replacement, which has a longer recovery period with more restrictions. I had a full replacement using the newer anterior approach.

Many healthcare providers work with older sedentary people and are sedentary themselves! They tended to overestimate recovery time and restrictions, as in "You won't be able to bike or kayak for one year and you will never ski again." Just imagine what happens to an older person who sits around doing nothing for a year! Turns out they were wrong.

The first five days after surgery were miserable but progress was surprisingly fast after that. Here's how it went:

Day 7: Able to go up and down stairs without a cane.
Day 9: Walked 1 mile in 29 minutes with hiking poles. Very slow, awkward gait, but felt steady.
Day 10: Drove (automatic car)
Day 12: Walked 45 minutes on road and in snow. Minor pain in hip.
Day 18: Walked 1 mile in 21 minutes. No pain.
3rd week: Walked 3 miles in 1h 10 min with hiking poles. Returned to the gym for upper body exercise.

4th week: Began walking without hiking poles.

7th week: Hiked on a mostly flat but rocky trail 2 miles. Stopped using cane completely (used it for several years before surgery). Now walking 3 times a week, 1h each time, plus gym twice a week. ***Began sports-specific physical therapy for biking, kayaking, and preparing for lower-body weight machines at gym.

8th week: Able to use stationary bike and elliptical machine at gym. Got on my hybrid bike by leaning it way over. Rode one mile PAIN FREE. This was just a small test to see if I'm ready to bike. I am!

I'm very pleased with this pace of recovery and with the success of the surgery. It feels like a miracle to be pain free, able to stand up straight, no back pain, and swing my arms freely when walking without a cane or hiking poles.

Further info from my surgeon: The bone and prosthesis are fused after about 3 months. At that point I can return to day hiking, backpacking, kayaking, lower-body machines at the gym, and kneel down to enter a tent.

Getting on the bike is problematical. My surgeon emphasized that the movement most likely to dislocate the hip is extending the leg behind you and turning it outward. He modeled the fencing stance as an example. Not sure if I will ever be able to mount by putting my leg over the back seat, but swinging it forward over the top tube should be possible at some point. At the moment I don't have enough range of motion for that.

The two best things I did for myself were to get in the best possible shape in the year before the surgery and to request sports-specific physical therapy when I was strong enough. I learned much more from the sports therapist and did much more effective exercises than with the very brief PT right after surgery, which only addresses functional things like going upstairs.

At age 50 I was biking up to 2000 miles a year. I have no aspirations of returning to that mileage. I'll be very happy if I can do 25-mile exercise and pleasure rides. I'm dreaming of returning to touring and I think that will be possible.

JanMM

Good report and congrats on your progress.

OldsCOOL

That's inspiring! Thanx for sharing.

10 Wheels

You may want to test ride some trikes.

Barbara has been doing 100 mile rides after her hip replacement.



Workman makes a neat ride that can have an electric motor to help with hills.

BobbyG

My buddy (active, but not a cyclist) had a hip joint replaced, and was back on his Nordic Trak and hikes in pretty short time. Unfortunately he has had some other joint issues, but keeps recovering more quickly than the doctors expect for some one his age. It really pays to keep moving!

bikeclub

Thanks for this, I am mulling over a hip replacement myself. I was wondering what effect it will have on bicycling, since it is my main mode of transport. Did the doctor give any bicycling-specific guidance other than risk of dislocation?

GetUpnGo

Naw. Prior to the surgery I was able to ride 25 miles on a normal bike. I had to stop every 5 miles to rest the hip. The pain is completely gone now, so I expect to be biking better than before, so no need for a trike.


Bikeclub, many people who've had a hip replaced say they should have done it years before. I confirm that. Yes, it's major surgery, but I delayed it because it seemed like such a huge thing and I thought the recovery would be long and painful. It was neither. I'm referring specifically to the anterior approach, in which no muscles are cut. You can end up with numbness in the thigh (as I have), which I think is a small price to pay for being pain free. You can also end up with one leg longer than the other. I have a 1/4" difference which does affect my gait but it's tolerable and within acceptable norms.

To answer your question, my surgeon asked me to start by biking 30 minutes at a time on easy terrain. Our main concern was mounting and dismounting, in part because my bike is a tad too big (1/2" or less top bar clearance) and I keep my seat fairly high (leg hardly bent at all; I've ridden like that my whole life). People in this forum taught me to mount by laying the bike on the ground and stepping over the frame, which is pretty easy to do.

The other concern, of course, is falling off the bike and breaking the prosthesis. You have to find a balance between reasonable caution and not being fearful of normal activities. You could break the prosthesis in many different ways in normal daily life. That's not going to keep me off the bike but I'll be more cautious than before. No more roads full of pot holes, turning around in narrow spaces, jumping curbs, or sandy roads.

One last thing: I wasn't allowed to use my indoor trainer this winter because the trainer and the front wheel support raise the bike up another two inches, making mounting even harder.

stardognine

Congrats on your good fortune, in being able to mobilize yourself so well so soon. It's kind of a gamble, noone knows ahead of time how these things will turn out. But a good positive attitude definitely helps.

Old coach

I think you'll be surprised at how well you'll return to your old mileage.

I had a total hip replacement in early June 2014; minimally invasive anterior surgery. By the end of July, my doctor removed my hip precaution limitations. By August, I was back on the bike on easy rides at first and laying it down to get on. Several weeks later on my first clipped in ride, I fell on my surgery hip. Luckily no damage! I gradually increased mileage each week; listening to my body.

By May 2015, I could ride 20-25 miles per ride and had 1000+ total miles. I wasn't as strong as 10 years prior, but I could pedal pain free.

I then went in for a total knee replacement on the other leg. But that's rehab is for another thread.

Good luck!

GetUpnGo

Old Coach, that's a great story. Thanks for your encouragement. How do you get on your bike at this point? What did your surgeon say about swinging your leg back over the seat? I haven't been able to do that in years.

Some people suggest mounting with the good leg but that doesn't help, in fact it's worse because the new hip won't bend out to the side enough. Hard to describe but maybe you can picture it.

At this point, what's your main limitation for mileage? Is it your hip or overall fitness?

I don't feel motivated to do high mileage anymore. I suspect that pushing myself too hard in several sports (especially biking, backpacking, running, and weightlifting) led to premature arthritis at age 50 that turned severe pretty fast. My doctor says that's not what caused it but I can't let go of my feeling that I just did too much, and it wasn't all fun. A lot of it was grueling. At this point I want to be healthy and enjoy biking for the landscapes and the joy of riding, not the miles. 1000 miles a year will probably always be in the back of my mind though because it's just so satisfying to see that number on your cyclometer, eh?

GetUpnGo

Update: Biked over 11 miles today 8 weeks after surgery. Nothing to brag about; I just want to record this for others who are thinking of having the surgery. No pain whatsoever in the hip.

eatontkd

I had a Total Hip Replacement back in October of 2007. To be honest; to experience life again PAIN FREE was such a plus that I seldom think about it anymore. There are times when I'm doing something ( I teach TKD) and I wonder "should I be doing this" and my Doc's voice in comes to mind, "if it's not hurting, it's not injuring. Enjoy the life you have Eaton...". I ride with no pain or discomfort at all. Now, if I could get Greg Lemond legs from the 1980's....

BlazingPedals

Stepover height on my avatar bike is something like 8 inches. I've done the over-the-handlebars mounting technique, but never got comfortable with it.

RonH

Kudos on your progress.
Can you lean the bike toward you at about 45 degrees (or maybe lower) so you don't have to lift the leg so high?

I'm 71 and some days it seems harder to lift my leg up and over the back of the bike so I lean the bike toward me. Makes it much easier.

GetUpnGo

Yup, that's what I'm doing. Leaning waaaay over. That get's harder as the bike gets loaded up for long day trips. I'm hoping to do a tour this year and wondering if I should consider a trailer.

tobey

Glad your doing well and wish you the best in getting back to touring. I'm 64 and had a hip replacement two years ago using the anterior method.
Did my first 20 mile ride after 5 weeks and rode about 1,000 miles that year. Definitely had to figure out how best to get on and off the bike but over time that got easier but even now I'm not back to normal.
For anyone wondering whether to have the procedure or not for me it was the best thing I ever did after living with pain and delaying surgery for 3+ years.
Rode 2,500 miles last year. One thing that helped was in addition to riding was going to the gym and continuing with strength exercises.

Old coach

I get on the bike by slightly angling the frame towards me and swinging my good hip over it. My surgeon and PT encouraged me to do lots of range of motions exercises which helped a great deal. When I am done riding if i am very tired and I don't have a stable support (garage/car etc.) that i can rest on, I while lay it down to get off. I am more cautious when i am tired.

My biggest limitation is not the hip or my overall fitness, its the knee on my opposite leg that I had replaced last summer. I've had to raise my seat more to accommodate the lack of knee range of motion which has made me even more cautious getting on/off the bike.

Take it slow and listen to your body-it's worked so far for me.

richart

Thanks for sharing your story. I finally had to give up riding about a month ago due to hip pain. I had gotten to the point I had to lay the bike on the ground and lift it up under me. I am scheduled for a hip replacement in four weeks, however I will be having the posterior approach. My doctor assures me that after six weeks there is no practical difference between the two approaches and that I will be back on the bicycle in a couple of months.

rnothog

I had anterior THR of left hip about 16 months ago at 58. They got me up and walking after the groggy wore off post op. Went home the following day. No huge discomfort. Swelling, yeah...and positional pain, on occasion. Used the walker for about a week, I guess, maybe less. Then a cane for a couple of weeks. Back to work in just over 2 weeks.

PT for 4 weeks. I was back on my Harley Electra Glide for a short ride within 6 weeks. Then, steady progress until I rediscovered bicycling about 9 months after the surgery. Bicycling has helped more than anything else when it came to sealing the deal. My gait is back to normal, save for the right hip starting to go haywire (it was a toss-up which would be first - left or right).

The right one is getting done in January. The only thing I'll do differently is take more time off work.

BTW, I do lean the bicycle over to get on and off, but it really hasn't been a problem for me.

kb9kre

Im glad you are doing great post surgery. You were very smart to prepare yourself prior to surgery. I had knee surgery for a torn meniscus, damaged femur and bone fragments in the joint. I am iimproving post surgery and your story will help and inspire others. Paul

bruce19

That is an excellent recount of your experience. Very helpful to others. Thanks and congrats

TCR Rider

I fractured my hip in 2011 and because of the location of the break it required a total hip replacement. My recovery went well and I was back to riding without limitations within 4 months. The only activity I had to give up was running which would shorten the life of the joint due to the impact. I did ride 9350 miles last year.
Unfortunately my story didn't end there. Last October I tripped and fell while walking and fractured my pelvis in two places. Initially x rays didn't pick it up and the pain subsided for a time. In May the pain returned and my leg got swollen. More x rays and a CT scan showed the fracture which by this time did not heal correctly, mal-union. The location of the pelvic fracture affected the hip replacement so I had surgery to realign the pelvis and a revision of the hip replacement on June 9.
Recovery was more complicated than the initial replacement and could not bear weight on it for. I went to a rehab for a week when I was discharged from the hospital after 6 days. Walking with a walker first then crutches followed by one crutch to a cane. Did my first light spin on the trainer July 12 and had the Hip Precautions lifted after 8 weeks. Did my first outdoor ride Aug 14.
I've made good progress on the bike. I'm riding slower but I've done a long ride of 56 miles and did a total of 184 miles last week. I can manage to swing my leg over the seat and clip in to the pedals. I have my final PT session tomorrow and after that I'll keep working on my recovery on my own.
I was blessed to have 2 outstanding surgeons work on me, one for the pelvis and one for the hip and I work very hard on my rehab. I strongly believe that after the surgeons do their job it's my responsibility to make the most of their work.
I'm glad you had a positive result with your procedure. Nothing like being pain free.

bikeclub

This thread was particularly helpful this spring, so I'd like to report back on my (successful!) hip replacement surgery.

I'm actually in my early 40s, but had an arthroscopic surgery about 7-8 years ago that was unsuccessful, and had nagging pain in my right hip. After seeing three specialists in different hip preservation techniques, I saw one who said, "you basically see a number of people and then you reach somebody at the end of the line who says that this hip is done. I'm that guy". His diagnosis from my history and the imaging, was convincing and I decided to get the hip replacement at the beginning of June.

Since this is kind of like the other parts discussions elsewhere on this forum, I'll volunteer that it was anterior approach, with a titanium ball and shaft embedded in the top of my thigh, a ceramic socket attached to the hip with a screw, and a super-dense polyethylene liner on the socket. Generally, they say that you should go with whatever approach the surgeon is most comfortable with. I find this somewhat unscientific in terms of technology, but makes sense from a practical or testing perspective, since many of these surgeons do a few hundred operations a year, and I've been told that you do want a person who has perfected their technique by repetition, and so the actual hardware is a smaller part than the proper installation. The lifetime on the hip is generally said to be 12 years and expected to be 20+ years for most people, but since I'm young and more likely to be more active, I'm just hoping to get it to something like 20 years (which is still only when most people have their hip replacement).

After surgery, the main problem wasn't pain or soreness, it was fatigue. As expected, they found a lot of bone fragments and cartilage bits in my hip, and so I was open longer than expected. The chief consequence of that was that I lost a lot of blood, and so couldn't really walk the first week or so without exhaustion. This persisted until I began to work on rebuilding my blood by just lying down, drinking a lot of electrolyte, and eating as much iron as possible. Sometimes you can only recover by admitting that you need to rest.

Once I began at-home physical therapy (PT) in the second or third week, things went much better. It took awhile to be able to walk on crutches, but by week four I was going to PT at the clinic. I did a lot of rubber band exercises, stretching, and weight machines at the PT clinic for the next two weeks, and was cleared to ride (and do anything!) in week 6. I kept on doing PT until week 8 or 9 and then was completely discharged.

In terms of riding, at first I was weak and not limber. It is amazing how quickly you lose muscle mass -- when I looked at my thigh after a week or so of lying down, it was about 2/3 the size of the other. However, this was probably also a consequence of the pain before the hip. Despite riding being my main goal, it took awhile to feel strong enough all over to feel like I could be on the bike and strong enough to balance, put a foot down, and so on.

I do think that the toughest thing in PT is to do just what they say, and not too much. At first I tried to do double PT to get back on the bike quicker, but that doesn't work if you get exhausted or have poor form. I found it was much better to do PT the first thing in the day, before anything else, and then stretch the rest of the day -- that way I got it out of the way, but could monitor my energy/exhaustion level the rest of the day.

Now that the PT is a couple of months behind me, though, it is everything that people have said about it. It's like I have a new (or natural) hip! There's no less range of motion in my right hip than my other left hip, though I really need to stretch both more. I can hop on the bike just like before, and throw my leg over the back. After going for some 40-50 mile rides, I was tired but amazed at the complete absence of pain in the hip itself.

In short, it was tough the month after I had the surgery, and I had my doubts about whether this was all worth it. Now, with PT behind me, I can say that it was completely worth it and now I just hope to manage the hip and stretch it's life out as long as possible.

The one bike-riding hitch I had was last week. Going for a slow ride on a wide trail, I had a completely fluky fall / crash on my bike while climbing at slow speed. I caught my front wheel on a little ditch, and since I was clipped in, I went down immediately... ON THE NEW HIP. I felt pretty annoyed and dispirited by it, because I landed hard enough to bruise the hip, lose my breath, and break my rear derailleur (though on packed dirt, thankfully). Lying on my back looking up at the trees, I was wondering how careful (or more careful, really) I should be to maintain the hip for the rest of my life. A week later, though, I have a better perspective on it. Like my original (biological) hip, the new hip is a rather inanimate object with a design life. I figure that I'm going to crash again if I keep on riding to work, for fun, and to the grocery store -- which I will -- but will just try to minimize my risks. There's not any more risk if I get hit by a car, since the prosthesis is stronger than all of the bones around it. I'm just going to do everything I can to avoid bad risks, but still ride and have a life, and make the best of it.

Hope that helps.

OldTryGuy

OUTSTANDING reports from a bunch of geezers who are active. Makes recovery faster and yields better final results.

New right shoulder joint for me 1 week from tomorrow. Pain free sounds pretty appealing. After shoulder should be 2 knees then left wrist needs some attention.

bobwysiwyg

This thread is of particular interest to me right now. Been cycling a bit more than two years after quitting smoking. I ride a hybrid and average 40-60 mi/week. I've set a 100 mi weekly goal which I've met three times and a 2,000 goal for this year and I'm running ahead on that one.. or I was. Oh, I'm 73.

My wife and I went up to the U.P. for a vacation on 9/26. I had planned out a ride around the lake we stay on, about 38 mi. Never got the opportunity. Freak accident on a rainy, windy day on Lake Superior shore left me with a clean femur break. No cell service there so my wife had flag down two bird hunters. They couldn't help I was in excruciating pain. They drove to the ranger post in the Porkies and four of them returned in a pickup with a backboard to get me up to the road at least. Two long ambulance rides later I found myself in Laurium in a 15 bed hospital. Great care at this faciliy, Aspirous-Calumet. Had to give them a shout out.

Sorry this is so long, first time I could bring myself to think it through. Had the reduction surgery 9 days ago and my wife and I got back to Ann Arbor two days ago, I'm using walker, started PT the second day post-surgery and have some local follow-up appointments this week.

I get the impression this surgery is more serious than a hip replacement?? Some research suggests full recovery for my surgery could be as long as 4-6 months? Everyone I've come in contact about this has been impressed with my progress. I'd be interested in the experience of others who've had this same procedure. Thanks for listening.