Introduction

How do you know when it’s time to get your painful hip replaced?

If you have surgery, how will you feel the next day? After a week? Two weeks? A month?

How soon can you drive a car or push a grocery cart? How about ride a bike, play golf, tennis, hike—or ski?

What will the surgery cost?

As an active, 70-year-old facing total hip replacement, I had trouble finding answers to these questions. So I wrote this book.

Mostly it is one man’s experience—mine. It’s written for patients, not doctors, so I have glossed over some medical complexities. Still, to broaden and deepen my story, I have consulted medical literature, profiled eleven other hip surgery patients, and coaxed insights from my surgeon, who performs hundreds of hip and knee surgeries each year. He edited me and wrote an inspirational Afterword.

This book is about how to prepare for surgery, get home soon, and manage your recovery. It’s also a heartfelt tribute to the people who make this surgery possible; they’ve saved countless people from living on crutches or wheelchairs.

One cautionary note: my account is not a substitute for professional advice. Any hip-replacement patient should rely primarily on his or her medical team and physical therapist.

Nevertheless, a trip is easier if you have a map—one that shows where you are, where you go next and how you get there. I hope my story will serve as that kind of map. If you’re facing hip surgery, it may help you anticipate and understand the path you’re traveling—from your first hip pains, through the operating room, to a return to your active life.

Hip replacement surgery is commonly hailed as a remarkable success. One study gushed that it is, “widely considered to be one of the most important orthopaedic interventions developed in operative history.”[1]

In my case, I had little pain after the surgery. In fact, my hip immediately felt better than it had before the operation. I don’t like taking drugs; I took only one mild narcotic pill. I threw out the rest at the local police station. I went home the day after surgery and started physical therapy the next day. I was walking with a cane on the fourth day and taking short hikes in the second week. The walks grew, and after four weeks, my surgeon gave me the green light to do, “anything you feel comfortable doing.” I started with golf and moved on to road biking and mountain hiking.

My new parts

 

Four months out of the operating room, I figured I was almost back to full strength. My wife and I made plans five months ahead for a 41-mile hike across southern Patagonia’s Torres del Paine National Park.

I was lucky. I had advantages to speed my recovery. I started lean and free of health problems; I had anterior surgery, a talented surgeon, a patient physical therapist and a mostly tolerant wife.

My surgeon and physical therapist said my recovery was very good for a person my age. Was it typical? The doctors tell me everyone is different. So I have sprinkled profiles of other hip replacement patients throughout this book. Their stories suggest my recovery wasn’t unusual. Of the patients I interviewed, most had experiences like mine. All swore they’d do the surgery again.

“Don’t dread the operation,” advised one hip arthritis sufferer. “Do what you have to do. You’re going to change your life.”

To expand beyond anecdotal accounts, I’ve included references to medical literature. These vary from randomized controlled trial studies—the gold standard for medical research—to news stories and product promotions. Though some suggest a medical consensus, no one study should be taken as the final word. As my surgeon put it, paraphrasing Winston Churchill, “doctors rely on medical studies somewhat like a drunk relies on a lamppost, more for support than illumination.”

As they say in the drug ads, your results may vary. If you’re older, overweight, take narcotic pain medicine before surgery, smoke, or have diabetes or other medical issues, your recovery may take longer than mine. On the other hand, if you’re younger, fitter or have better genes, you may leave my rehabilitation in your dust, as did Eric, who is profiled here.

Whatever your experience, I believe the vast majority of hip replacement patients come out ahead. All the patients I have interviewed say they did. Steph got both hips done twice, and still suffers from pseudotumors from metal contamination from the first, defective pair of implants. Despite the problems, she declares: “I’m much better off than if I had done nothing.”

[1]Cary MP, et al.: Changes in Payment Regulation and Acute Care Use for Total Hip Replacement: Trends in Length of Stay, Costs, and Discharge, 1997–2012. Rehabil Nurs. 2016 March ; 41(2): 67–77. doi:10.1002/rnj.210.