Should You Run After A Hip Resurfacing?

Osteoarthritis is the gradual degradation of a joint. It can lead to pain, stiffness and swelling. One of the most common joints to be affected is the hip. In 1940 Dr Austin Moore performed the first total hip replacement (THR) and the technique was later refined by Dr John Charnley. Modern replacements consist of a metal stem and head that is inserted into the top of the femur. It fits into a plastic cup which is cemented into the pelvis. Post surgery, patients usually experience less pain and enjoy greater range of motion. However, several studies have shown that the prosthesis wears and loosens prematurely if excessive running and impact activities are undertaken. This can lead to another operation to revise the THR with the associated risk of complications.

More recently, hip resurfacing was developed by Dr Derek McMinn as an alternative to THRs. It requires less of the femur to be removed. A metal cap is placed over the head of the femur and a metal cup is placed in the socket. The advantages of a hip resurfacing compared to a THR are numerous: bone preservation, less chance of dislocation, less leg length inequality, better lower limb alignment and easier revision to a THR if necessary.

A recent article in Reuters has quoted work done by Dr Julien Girard in France. Hip resurfacings were performed on 40 physically active patients. Their average age was 51 years. After surgery, 90% of the patients returned to running. Three years later 33 out of 40 were still running albeit they had decreased their mileage from 24 miles per week to 16 miles per week. The study didn’t look at the long-term effects of running on the implant.

An article in today’s Medical News Today summarises research presented at the 2012 Annual Meeting of the Academy of Orthopaedic Surgeons.  Over 10 years, 445 patients (average age of 49 years) who had undergone a hip resurfacing were monitored. A correlation between higher activity scores and revision of surgery was found and it was concluded that impact activities such as running and tennis were harmful to long-term success.

In conclusion, although a return to running and impact sports is possible after a hip resurfacing…even to high level competitive sport…it does bear risks…such as the untimely wear and deterioration of the prosthesis. This would require further surgery…and possibly a total hip replacement. With that in mind, my advice for anyone with a hip resurfacing, wondering how much they can or can’t do…would be to stick to non-impact exercise such as cycling, rowing, cross-training, etc. That doesn’t mean that you shouldn’t run at all…I wouldn’t want you to miss that train…but it should remain occasional.

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