Question
Hi,

My question is about walking for exercise after hip replacement.  My husband had his first hip replaced in the late 70's after falling from a tree.  This hip wore down over time, and 25 years later got a new titanium hip replacment.  My question is about walking for exercise.  It has been about 3 years since this latest hip replacement.  My husband says he needs to not walk much or far because it will then hurt or ache, and he thinks the more he walks on it, the sooner this replacement will wear out.  I would like to know if this is true, or if walking is encouraged and can help strengthen the hip?  I cannot find any information one way or another, and his dr. does not accept emails, so I thought I would see what your thoughts were, or if you knew where there was information about this - is walking for exercise good or bad?

Thanks!

Answer
Hi Lynn

I am assuming that his first replacement was a cemented hip.  Cemented hips were the best technology in the 70's and used extensively in replacement surgery.  Those last, as your husbands did, about 20 years or so.  The only problem with those were that in many cases the full prosthesis had to be removed and re-implanted during revisions.  

Unfortunately when hip is revised, a revision does not last as long and you may have different pain issues.  Have your husband get his legs measured.  If he is experiencing pain, it may be due to his legs being different lengths.  If there is a difference of more than 1/4 inches between the legs, he should get a shoe lift made and insert it into his shoe.  He can measure the leg length himself too.  Have him lay on his back on a bed.  Take a tape measure and measure from the outside of the hip joint to the ankle bone and see if there is a difference in the lengths of the legs.  If so get a lift made.  

If he has more at least a 1/4 difference in length, that would cause pain in the thighs, back and spine areas.  If he gets a lift made, that will definitely help the pain and he will feel the difference immediately.

The other thing he can try is Trigger Point massage.  It's a specialized massage technique that can help in pain relief, but be certain to let anyone who touches him know that he has had THR surgery and a revision and be sure his precautions are not violated.

Walking is encouraged.  If he does not walk, his muscles will atrophy, and fortunately even revisions of total hips wear very well these days.  Many of the new replacements have parts that snap in and snap out so that he may not have to have the full hip revised if he needs another revision in the future.  Most times it's just a matter of replacing the liner of the cups, which do wear out.  He is not doing himself any favors by limiting his walking and should continue to walk or swim or do whatever exercise he likes and whatever exercises have been approved by his doctor or physical therapist.

I do think that if he has not seen his doctor in at least one year, he should go and see him, especially if his is having issues with pain.  This way his doctor can X-ray the hip and just be certain that the prosthesis is stable.

I have had four revisions on each hip and the revisions do cause the hip not to wear as well as the first replacement.  
That is pretty much a fact we all have to live with.  But please encourage your husband to express his concerns to the surgeon.  It might even be worth your while to get a second opinion on this too.


Sharon