Karen, Ballet Dancer
For Karen, 59, dancing is her passion and her profession. So, it was particularly devastating for her when the pain in her hips forced her to retire early from dancing.
She first noticed a problem with her left hip several years ago when she was teaching dance classes. “Every once in a while, I would feel for a moment as though my left leg was going to buckle as it took my weight,” Karen said.
After about a year, she had an X-ray taken of her left hip, which showed some cartilage damage. Karen’s doctor at the time told her that she should consider dancing less, but did not tell her to give it up completely, so she continued teaching and performing. When she began instructing students at a performing arts high school with a harder dance floor, she noticed that the pain became worse. “Every day after class I would be in considerable pain as I walked to the car,” Karen said.
To cope with the pain, she began seeing a physical therapist regularly. She also had custom orthotics created for her, and went to see an acupuncturist once a week. While these activities helped her feel and move better, Karen said the pain always returned.
She gave up dancing completely in January 2004. By this time, she said she had pain radiating down her neck and the right side of her back. Her right hip had also begun to ache, and an X-ray showed cartilage damage in this hip as well. “I gradually became more and more limited,” Karen said. “Eventually, my life felt like it was centered around stretching and going to physical therapy and acupuncture appointments.”
By 2006, she was ready to consider surgery, and X-rays of both of her hips showed no cartilage at all. “Athletes are of the mindset that if you just work harder or make your muscles stronger you can accomplish anything,” she said. “I finally realized that I wouldn’t be able to make this better on my own.”
Karen’s surgeon, Joel Matta, MD, recommended replacing both hips at the same time using an alternative surgical technique called the anterior approach. The anterior approach is a tissue-sparing option for hip replacement surgery; it allows the surgeon to approach the hip joint from the front, as opposed to the side or back. Using this approach, the surgeon can work between the muscles without detaching them from the hip or thigh bones or cutting large muscles. As a result, these large and important muscles are left relatively undisturbed and are typically spared from a lengthy recovery process.
Karen said she was initially concerned about having both hips replaced at the same time, but was convinced that this was the best approach when she was told that rehabilitation may be easier on two new hips rather than trying to walk with one hip that still hurt. “Since much of my pain was due to muscles overcompensating, from my neck all the way down to my calf, this pain would most likely continue until the second surgery,” Karen explained. “The opportunity that my hip replacement with the anterior approach gave me, of fixing both hips at the same time and not aggravating my other muscles further, was very appealing.”
Karen underwent surgery on both hips in October 2006. The day after surgery, she was exercising in bed and staying mobile with the help of a walker. Within three days, she was able to leave the hospital using just a cane. “I had to be careful getting in and out of the car and could not do extreme stretches, but Dr. Matta told me that any other activities, within reason of course, were on a can-do basis,” she said.
“Surgery is always scary. The idea of losing my own hips, however dysfunctional, was unsettling,” Karen continued. “But here I was, just a few days later, alive and barely feeling at all that I had artificial parts. I was giddy with relief and excitement!”
Other than some post-operative swelling in her legs, Karen said her recovery period went quicker than expected and quite smoothly. Today, she can work out for seven minutes on the elliptical machine and 30 minutes walking on the treadmill, which is twice the amount of time she could do before surgery.
Karen’s message for others who are suffering from hip pain is simple. “If it’s affecting your quality of life and not getting any better, then I would certainly recommend talking to your doctor about hip replacement with the anterior approach,” she said.
The performance of a hip replacement depends on your age, weight, activity level and other factors. There are potential risks, and recovery takes time. People with conditions limiting rehabilitation should not have this surgery. Only an orthopedic surgeon can tell if hip replacement is right for you.