or Connect
EpicSki › The Barking Bear Forums › On the Snow (Skiing Forums) › General Skiing Discussion › Need some input on bad hip - stem cell or hip replacement
New Posts  All Forums:Forum Nav:

Need some input on bad hip - stem cell or hip replacement

post #1 of 25
Thread Starter 

Hi,

I could really use some input from those who have had some experience in this area concerning a deteriorating hip condition. My problem started significantly impacting me last summer when I went backpacking and carried too much weight for my age over a tough 7.5 mile hike. That said, now with a better understanding of my condition, I had some warning signs for the last year which at the time, I just blew it off to aches and pains associated with aging. I am 59, going to be 60 this summer but lead a very active life style generally skiing 40 to 50 days a years and also been guiding fly fishing and elk hunts for the past 8 years as a second career.

 

Since my backpacking trip, it has really put the brakes on what I can do. Guiding elk hunts this fall was not an option. Through PT, massage therapy and continued training in the gym, I got to a point where I thought I would give skiing a try. Therefore, I skied November through mid January with some pain but was able to have some fun focusing on limiting my days to soft snow and a couple of days a week. However, after a trip mid January to Jackson, I decided it was time to stop skiing as despite the EPIC conditions, I found myself falling (which I rarely do) and struggling in conditions / terrain which used to be my strength. 

 

In any case, my right hip shows little to no cartilage left but the bone shape and socket is not yet deformed with the exception of a couple of spurs that impact my range of motion. I've done a lot of homework on both total hip replacements and stem cell. My aspirations are to get back to my normal activity level for skiing and hiking (guiding elk hunts) with of course, being smart about how much weight I carry on my back and staying away from hard snow conditions. The good news is my leg strength is still pretty good in my right leg as I am  able to work out legs in the gym with no negative impacts as low as I stay away from traditional squats (do goblet squats with a dumb instead) and lunges. I should also say daily stretching and rolling on my RAD roller is mandatory to keep pain to a minimum and maintain some flexibility  (some days multiple times).

 

I would great appreciate any advice, input and experience anyone has had in this area. I'm leaning towards giving stem cell a try given my hip is not deformed yet but would feel better if I knew of more success stories out there. The doctor I'm seeing for Stem Cell feels I am a good candidate and have a good chance for success (given my bone is still in reasonable shape). My traditional orthopedic doctor just says there is no unbiased evidence yet to support stem cell. Appreciate your help and thoughts / input....

post #2 of 25
I had stem cells fur my knee and big toe, with good results. I've had grade 4 cartilage loss in my l knee for 12 years, and I'm still skiing with no pain.

I'm also doing ha injections.
post #3 of 25

[this is second hand based on my dad's hip replacement about 6-8 years ago]

 

Can't comment on stem cells vs a replacement but the one thing I will say is that it's very important to not get out of shape before you get it fixed.  Apparently one of the big issues with hip injuries is that they are frequently slow deteriorations, so the patient gradually gets more and more out of shape over years, and by the time they finally get it fixed they're so physically worn down that rehab is a major problem.

 

My dad was "lucky" in that his hip joint basically self destructed almost overnight.  He went from no hip problem at all to "can't walk up a flight of stairs" within about 2 months, and had surgery shortly thereafter.  Because it happened so quickly, his overall fitness hadn't had time to go downhill sharply, and therefore his rehab went quite well.

 

He was in his mid-60's when this happened, and SINCE the hip replacement he's still skiing 1-2 months a year in the French Alps, along with substantial multi-day hikes between Alpine refuges in the summer, and specific trips to and hiking around Macchu Picchu, Antartica.  He even did a multi-week trek 3 years ago from Lukla Nepal to near Everest base camp, and was going to go back this past Spring and go all the way to base camp before the earthquake cancelled those plans.

 

So you can definitely get a replacement and stay very active, but whatever treatment approach you take stay in the best shape you can leading up to any surgery so the rehab will go well.

 

Good luck!

Bob

post #4 of 25

You are in Colorado, you need to Call Steadman Clinic get an appointment, or get your X-rays and MRI reviewed by Dr. Marc Philippon

 

At your age they are more likely to recommend a hip replacement, than doing anything else.  If you were under age 50 they would try to put off the hip replacement.

 

Having had Micro-fracture in my right hip, the torn labrum repaired, cam and pincher reshaping, along with repairing ligamentum teres

 

Dr. Philippon is the best in the world with hip injuries, he doesn't do replacements.  I had PRP (plasma rich platelets) placed along with the micro fracture to generate new cartilage in the hip.

 

The recovery and  rehab is very intense, and lengthy.  Especially compared to a total hip replacement.

 

The hip replacement should last you 20 to 35 years, depending on how active you are, and the older you get the less active you will be thus adding more life to the replacement.  So at age 60 that should get you to age 80 to 95, thus at most you would need to get it done again one more time late in life.

 

Good luck with whichever way you decide to go, but I wouldn't do anything until I got an opinion from Dr. Philippon in Vail.

post #5 of 25

Have you looked into resurfacing?  My good friend had both of his hips resurfaced and is doing great 10 plus years down the road.  Dr. Gross -see link below did his. I was impressed.

 

http://www.grossortho.com/ 

post #6 of 25
I'm three years post op THR and do just about anything.
post #7 of 25

Call Steadman Clinic, don't jump into hip replacement.

post #8 of 25
I sent my X-rays to Dr. Phillipon and filled out a questionare.
Just got a v-mail back from an assistant, "you're not a candidate". No explanation, no nothing.
post #9 of 25

Reterwilliger

 

Couldn't tell you anything about stem cell work but we are both roughly the same age and I had a total hip replacement a month and a half ago.  My hip was gonzo and I HAD to do something about it.   Like you,  I'm in pretty good shape ( OK not guiding shape but decent,) and that made a big difference- I was mobile the next day after the surgery ( real shaky but mobile.)  Hip replacements are real common these days, it's amazing what the people in the Medical Profession can do these days.   They wanted me up  and moving as soon as I was able, and I worked with some great, very experienced Physical Therapy people to get my back on my feet.  I'm not 100% but seems like i'm progressing all the time.  Went from a walker, to a cane, to hiking poles, now I'm getting around unassisted.

 

I'm so fortunate that I live in an area where there are some fantastic Medical People - top notch Surgeon, Hospital Staff, Physical Therapists.  As far as skiing goes, see how it goes in the spring, early summer with some mellow touring in the Cascades.  I have no interest/ need to deal with a freaking heavy pack anymore, so I will just have a day pack for some hiking.  The thought of hiking DH with a lot weight makes me shudder.

 

Best Of Luck

post #10 of 25
Thread Starter 

Thanks for the input thus far and some good points! I have considered resurfacing and saw Dr James Rector in Boulder, CO who is supposed to be one of the best in state. He reviewed the pros and cons of resurfacing but in the end, he recommended a replacement vs resurfacing for me (perhaps given my age). 

 

I am hoping to get some more insight on stem cell in that it can work. My fear with it is to take the time to try it and not work which puts me further from real recovery. I know it's real trade off in this decision between taking a chance I get feeling better without surgery and back to normal activity vs go the route of surgery which is more proven but will take longer. 

 

In either case, I am not concerned about the PT. I know it is hard work and  can be painful. However, been through it before in various flavors including recovery from a torn bicep tendon, tore cartilage in my knee, etc... I am gym rat that lives to work out when I'm not in the backcountry or skiing so I can continue to do what I love most in life. Just want to gather as much insight as I can before making a decision on the next step....

post #11 of 25

This is not really the sort of situation you should be seeking the opinions of random strangers on the internet. Individual good and bad experiences with either form of treatment don't tell you anything about the odds of good and bad results. You've seen several orthopedists which is good. They've given you several different opinions, which is confusing but not unusual. I would put a fair amount of stock in your traditional orthopedist's opinion that the stem cell procedure is not yet supported by unbiased evidence, which I take it to mean that the reported studies are not controlled trials and/or are funded by someone with a financial interest. It's easy enough to do your own research on Pubmed (see my post on the first page of the injury etc forum). You are looking for studies of fairly large numbers of patients, preferrably comparing them to patients treated with other modalities. Pay careful attention to who paid for the study.

post #12 of 25

You're plenty young enough for hip resurfacing.

 

http://surfacehippy.info/

post #13 of 25

Haven't piped in here for a long while but just thought I would do so more for encouragement than to give advice.  Old goat is right about medical advice on the internet. That said, I am a lifelong 

skier and had  a THR done in 2010 at age 56.  I had gotten to the point where skiing was way too painful to be fun and even riding my bike was getting hard. Went into the operation stll in relatively 

good shape and recovered very quickly.  Back on the bike 6 weeks later. Took one year off of skiing (operation was in October) and then resumed.  Really happy that I can ski again at a pretty

decent level.  Going up to Whitetail PA tomorrow Am as a matter of fact.  Best of luck whatever you decide.  

post #14 of 25
Quote:
Originally Posted by msprace View Post
 

You are in Colorado, you need to Call Steadman Clinic get an appointment, or get your X-rays and MRI reviewed by Dr. Marc Philippon

 

At your age they are more likely to recommend a hip replacement, than doing anything else.  If you were under age 50 they would try to put off the hip replacement.

 

Having had Micro-fracture in my right hip, the torn labrum repaired, cam and pincher reshaping, along with repairing ligamentum teres

 

Dr. Philippon is the best in the world with hip injuries, he doesn't do replacements.  I had PRP (plasma rich platelets) placed along with the micro fracture to generate new cartilage in the hip.

 

The recovery and  rehab is very intense, and lengthy.  Especially compared to a total hip replacement.

 

The hip replacement should last you 20 to 35 years, depending on how active you are, and the older you get the less active you will be thus adding more life to the replacement.  So at age 60 that should get you to age 80 to 95, thus at most you would need to get it done again one more time late in life.

 

Good luck with whichever way you decide to go, but I wouldn't do anything until I got an opinion from Dr. Philippon in Vail.

+1. Dunno why Shredhead got the brushoff.  Steadman Clinic is top notch, and Phillipon might be the best hip doc in the world.  Get his opinion.  Period.  Son had PRP therapy plus had both torn hip labrums (labri?) repaired by Phillipon.  Can't say enough about the guy.  The sports jerseys from pro athletes he's helped that adorn the walls and halls of his office will tell you everything you need to know.

post #15 of 25
I would try to see Phillipon.
I was just passing on my rather unprofessional experience.

Rector has done BHR's on several of my freinds in Aspen and they are all happy with the results. If he's recommending THR, there is probably a good reason.

I looked at stem cell therapy, but the science just doesn't seem to be there yet.
I'd find the best surgeon and have the procedure they recommend.
post #16 of 25
I had stem cell treatments on my left knee in Oct 2014 as I could still ski if conditions were perfect and I didn't hit any bumps or firm snow. Didn't ski much last year due to procedure and then lousy firm conditions, but I'm having a great year this year. I realize now that I had no strength in that leg and would just sort of lock it and hold on in turns, especially in crud and chopped powder/ firm off piste. I was skiing defensively and couldn't absorb or extend at all. This year I can bend my knee and absorb terrain, and am able to ski aggressively again, extending to really bend a ski. My leg isn't as strong as I want yet but it is so fun to actually be able to use it properly again.
post #17 of 25
Where did you have it done?
post #18 of 25
Dr Joseph Albano in Salt Lake City.
post #19 of 25
Thanks,ww. I tried to look online, but no info.

Did he use stem cells from bone marrow?
post #20 of 25
http://www.utahorthopediccenters.com/joseph-j-albano-md/

He used both bone marrow from my pelvis and fat. Dr Albano is an endurance athlete who skis, and many of his staff are serious skiers. He also works with the Real Salt Lake pro soccer team, US Speedskating team, and some U of U teams.
post #21 of 25
Thread Starter 

Thought I should provide an update on my situation in appreciate for all the good input that was provided to me. I appreciate it. Just as important, I'm thinking my feedback can help others who encounter issues with their hips too going forward who might reference this post.

 

I will start out clarifying the intent of my original post meaning what I was really looking for on the forum?...First off, I had done my homework on my orthopedic surgeon and was convinced he could do a great job if I decided to have surgery. I also investigated stem cell which sounded promising but still no guarantees.  Therefore, what I wanted to better understand and validate what I'd been told to date by seeing what others who have been through this had experienced. More specifically:

 

1) Were there any success examples out there where folks had, had stem cell treatment for a deteriorated hip? Specifically, had anyone received treatment and were able to return to a normal quality of life including skiing?

 

2) For hip replacements, a similar thought... being is it realistic to return to a high level of skiing and quality of life after a hip replacement? Doctors I visited told me I could expect to...however, I still wanted to hear it from some real skiers!

 

My conclusions from the input I received here on the forum, 3 different doctors I visited, my old college roommate who is one of the top guys at Styker Orthopedics and reviewed my case / xrays with 2 of his top surgeons at John Hopkins Medical Facility, and other sources who have had hip replacements are as follows:

 

1) Stem Cell likely has a future but is not proven and results are still very much variable (some recover, some recover partially, many have no improvement). 

 

2) Hip Replacements offer the opportunity to regain your full quality of life back assuming you are committed to preparing for the surgery and following through with the required rehab. The negative here is the expected life expectancy is about 20 years depending on wear and tear. However, the replacement could even last longer as current technology hasn't been out there long enough to fully evaluate.

 

I was seriously considering stem cell even with the significant out of pocket costs but given the potential it may not help me along with the fact that it would mean having to wait another 3 months before they would want to perform surgery (in the event stem cell didn't work) was a real deal breaker for me. My hip was getting worse every day and I've been on the bench since last July trying to battle this thing. It was time to move forward and get my life back.

 

Therefore, on Tuesday - February 23rd, I went ahead and had a hip replacement. While every case is different of course depending on your physical condition and your body's tolerance to pain (which is not a sign of how tough you are but more something we are born with as I understand), I will share my experience to date which is currently 11 days after surgery.

 

1) My surgery was in the afternoon and by the time they got me out of recovery and up to my room in the hospital, it was about 5:00pm. 8:00am the next morning, physical therapy (PT) showed up to get me going. I was able to immediately stand with no problem and walk around the floor of the hospital with no real pain (on pain killers at this time) with just some quad soreness. They also had me do some stairs. In the early afternoon, PT came again and we did the same thing but this time 2 laps around the hospital floor! After which they told me it was time to go home! Hard to believe I could have major surgery like this and be released within 24 hours!!!!

2) The next morning (Wed) after getting home that evening, I decided I didn't need the pain killers. They were throwing my stomach off and frankly I really didn't have pain...more just muscle soreness. From here on I started taking just extra strength tylenol. I was up and walking around the house several times a day with a walker.

3) On Friday - Feb 25th, I was feeling pretty good and decided I didn't need the walker and started using a cane. I also started walking outside short distances.

4) Currently, 11 days out from surgery...I am feeling pretty darn good! Taking walks with my cane outdoors for 20 minutes 2X per day and also doing my PT exercises of course! I can normally go up and door stair no problem and my normal walking gait has about returned. No pain, still some muscle soreness but less of it, swelling is now minor and limited to just the incision area!

 

As you can imagine, I am a very happy guy right now and I'm very optimistic about my future! My expectations for recovery based on discussions with my doctor and assuming no set backs are as follow:

1) Back to the gym for seated upper body exercises only this monday

2) Riding my horse again in 3 months.

3) Guiding fly fishing again in July

4) Guiding elk hunts again in Sept

5) Skiing again this November!!!! Here of course, I plan to very gradually work back to getting back to the level I am accustomed to skiing at!

 

Last but not least I want to share some things that helped me through all this to date for those who might be able to use this info:

1) Do seek out many opinions about your condition and expectations about recovery from all sources (several medical and folks who have been through it). This is a key part of mental preparation for what you need to do!

2) The advice given to me in this forum string about not waiting too long for surgery is so true! I was able to maintain real good leg strength in the gym prior to surgery which is paying dividends now and will continue to! That said, my condition was deteriorating quickly the final day prior to surgery and it is easy to see that if I waited much longer, my leg strength would be going down fast! My surgeon told me my hip had deteriorated from last Oct where I was bone on bone (but no bone deformation)  to at surgery where the femur head starting to deteriorate significantly (I was now wearing into the bone!).

3) Strictly follow advice of your doctor and PT folks. There is a strong likelihood you will feel way better after surgery than expected but don't over do it!!!

4) I learned quickly that for hip replacements "being off your feet" means lying down and getting your heart level with your hip with icing 4X per day (especially after being up for a while walking and PT). This has been key for me in getting rid of swelling. Initially I was just sitting down and icing but had some moderate swelling. After talking with my doctors nurses, I better understood being off your feet means lying down and it has made a huge difference!!!!

 

In summary, I want to thank all of your for taking the time to offer your input. You did help me mentally prepare for what I needed to do. I also thank God for the positive outlook and new hip I have in the interest of getting back to what we all love so much! Not trying to show off here at all just being positive to show what my end game is by the end of next ski season: https://www.youtube.com/watch?v=7_qYaK6UXxE  Thanks again for all your help and for those that might reference this for a hip problem, I am hopeful you find this post helpful! 

post #22 of 25

I'm 59 and had a total hip replaced last December.  My right hip socket was bone on bone.  It was even hard to buckle my boots!  I had the anterior replacement where they don't cut through muscle.  I highly recommend this procedure!!  Much faster recovery time.  I could have easily skied last March, but we had a terrible, "for skiing",  March!  I was, however, riding my Harley with no issues when I wish I could have been skiing!  Skiing this year has been great, with absolutely no issues.  In fact, it's much better than before because I have no pain, no anything to worry about, and buckling my boots is a piece of cake.  It's like being young again!  In my honest opinion, the damage to your hip  is done, and all the other procedures are just buying time until you do what needs to be done.  I confidently endorse an anterior procedure!

Good luck!

Hawk

post #23 of 25
Thread Starter 

Thanks for the feedback Hawk! I am 59 as well and have the same procedure. I am amazed at how well things have went since the operation and looking forward to next ski season! At the moment, not missing much here in Colorado as things have dried up and been pretty warm since early February...

post #24 of 25

Reterwilliger

 

Sounds like you are doing a lot better than prior to your hip being overhauled-  Great!  I'm almost 3 months with my hip overhauled ( posterior)   and I'm pretty back to normal.  Lot better than before hand, that's for sure.    I'm back at work, where I do a lot of movement sometimes and my hip get's a bit sore, but otherwise I'm fine.   Last summer couldn't get on my road bike due to pain, and last few weeks been riding a little  ( 15 miles or so) and have no problems at all.   As far as skiing, going to give a shot end of April, May with some mellow skinning/ skiing and see how it goes.

 

Like you, I am in decent shape, that made a big difference with recovery.  And I was so fortunate to be able to hook up with some great Medical people, based where I live,  that were top notch.  Sounds like you are dealing with some great Medical people also.

 

I'll let you know how it goes when I get back on skis

post #25 of 25
Thread Starter 

Thanks wuz a skier and good luck! Hope it goes well! Please do let me know how it goes skiing!

New Posts  All Forums:Forum Nav:
  Return Home
  Back to Forum: General Skiing Discussion
EpicSki › The Barking Bear Forums › On the Snow (Skiing Forums) › General Skiing Discussion › Need some input on bad hip - stem cell or hip replacement