Cannulated Screw hip repair

General cycling advice ( NOT technical ! )
Si C
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Joined: 1 Sep 2012, 5:03am

Re: Cannulated Screw hip repair

Postby Si C » 1 Sep 2012, 5:06am

I had a fall on Sunday while out on a pre-race warm up ride. Monday I had surgery for a fractured upper femur and 3 screws put in.

There was me thinking i could be back to full strength time trialling by next Spring...I could cry after reading this thread.

markowe
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Joined: 23 Jul 2007, 6:29pm

Re: Cannulated Screw hip repair

Postby markowe » 1 Sep 2012, 12:12pm

Si C wrote:I had a fall on Sunday while out on a pre-race warm up ride. Monday I had surgery for a fractured upper femur and 3 screws put in.

There was me thinking i could be back to full strength time trialling by next Spring...I could cry after reading this thread.


Ouch, I know, it's a bummer, but yeah, I think that might not be realistic, sorry. The injury is actually quite a serious one - I kind of underestimated it too, initially - because pins get put in all sorts of bones and you figure well, things will heal up in a couple of months and out will come the pins. But this is a bit more involved - hips are tricky, there is the risk of complications and the need to make sure things grow back perfectly, hence the conservative weight-bearing regime. We should actually count ourselves lucky that this procedure exists, otherwise we would be faced with a hip replacement, and then it would be curtains...

But look, I did my hip in late July, was finally off crutches in mid-October and by late October I was on the bike in the gym. Riding outside was off the menu, mostly because I was unsure what damage I could take if I fell, and it gets icy round here... The pins weren't coming out any time soon, so I just had to live with the slight stiffness and limitation in lateral movement they give rise to. But that gave me 3-4 (admittedly somewhat boring) full months in the gym, before I finally headed outside in around March time, going through a toned-down Friel-type regime (Base, Build etc.) By February I was certainly not up to the endurance performance of previous years, mostly because pedalling for 4 hours in the gym just isn't realistic (2 hours was about the most before I would go crazy) and I didn't put in anything like the 12-15 hours/week that I had last year (a lot for a 38 year-old with a family, I assure you!). But I wasn't at all bad. By May I finished a cross-country marathon halfway down the field, which is as good a result as I have ever had in that kind of race. I reckon you could get back to reasonable form by Spring for time-trialling - after all, it's mostly riding in a straight line, right? Less sudden movements and taking risks that could lead to a fall, especially in comparison to mountain-biking..!

So, obviously go with your doc's advice, of course, but don't write yourself off for next year either. Oh yes, and you've GOT to do the physio post-op - if your health insurance or health service or whatever you have doesn't provide it, look up some static (non weight-bearing) exercises for hip recovery and do them like crazy, twice a day, it will hugely speed your recovery and take your mind off the fact you are not training.

Si C
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Joined: 1 Sep 2012, 5:03am

Re: Cannulated Screw hip repair

Postby Si C » 1 Sep 2012, 4:07pm

Mark. Thank you for taking the time to post such an in-depth reply. Currently, as expected, I feel very downbeat. Infact, I'm going to sell all but my road bike. I just can't stand seeing that TT bike sitting on a rack, not knowing if I'll ever get back to a decent race pace.

Perhaps I can post progress on here and get some advice from you fella's who have been through it.

goatwarden
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Location: Bristol

Re: Cannulated Screw hip repair

Postby goatwarden » 1 Sep 2012, 5:51pm

Don't sell any bikes.

It is highly unlikely that you will not be able to ride as well as before so long as you try hard to recover. Look at it as starting your winter break early; by March you should be back to riding quite strongly again.

snibgo
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Re: Cannulated Screw hip repair

Postby snibgo » 1 Sep 2012, 7:39pm

Si C: you have my sympathy, as a fellow 3-screws sufferer.

Si C wrote:There was me thinking i could be back to full strength time trialling by next Spring.

Depending on the injury and, more importantly, your recovery regime, I don't think that's a totally unrealistic goal. It's worth explaining this goal to your physiotherapist.

markowe
Posts: 11
Joined: 23 Jul 2007, 6:29pm

Re: Cannulated Screw hip repair

Postby markowe » 1 Sep 2012, 9:05pm

Oh man, yeah, don't go selling any bikes, it's not THAT disastrous. You ought to be very close to your previous form by spring, and those screws will be coming out before you know it (hmm, I still have at least a year to go, hoping it will fly by..!)

Si C
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Joined: 1 Sep 2012, 5:03am

Re: Cannulated Screw hip repair

Postby Si C » 2 Sep 2012, 10:27am

Thanks for the support all. Crap night lastnight, lot's of pain, so I hit the Tramodol :lol:

Your responses have given me a clear picture of what I need to discuss with my consultant next Friday.

markowe
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Joined: 23 Jul 2007, 6:29pm

Re: Cannulated Screw hip repair

Postby markowe » 2 Sep 2012, 11:30am

Si C wrote:Thanks for the support all. Crap night lastnight, lot's of pain, so I hit the Tramodol :lol:

Your responses have given me a clear picture of what I need to discuss with my consultant next Friday.


Good show - the pain shouldn't last long, I only had pain for maybe 3 or 4 days after the op. The swelling lasted a fair bit longer, of course...

I am sure your consultant has seen plenty of athletes come through his office who are chomping at the bit, ready to get back into the game, so I am sure his advice will be realistic, if on the conservative side, which is probably the best side to err on anyway...

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Here2eternity
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Joined: 18 Mar 2011, 5:57pm

Re: Cannulated Screw hip repair

Postby Here2eternity » 3 Sep 2012, 5:19pm

Had 3 screws removed on 26 June in the hope this would relieve pain I have suffered since hip fracture in March 2011. Pain and immobility much worse than ever and a deterioration in leg length difference ( now around 4cm). I am now to have a total hip replacement on 18 September. My target now is to be riding 50 miles by Spring 2013 - it feels like I have lost 2 years of my life - and at 61 they are all cherished!
I would take care with Tramadol - it helped me sleep initially but when I stopped taking it I had some real difficulty. :(
My thoughts are with anyone who has hip problems following accidents that prevent them getting on with life - just be patient and remember this too will pass :)

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Here2eternity
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Re: Cannulated Screw hip repair

Postby Here2eternity » 3 Sep 2012, 11:39pm

Marlowe wrote;
We should actually count ourselves lucky that this procedure exists, otherwise we would be faced with a hip replacement, and then it would be curtains


Was a bit concerned to read this - my understanding is that prognosis for hip replacement surgery (including getting back on the bike) is good - although I appreciate it might not be such for someone as young as you; I am 61 and the surgeon is only doing it as a last resort where pinning has failed to solve the problem. :?:

goatwarden
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Location: Bristol

Re: Cannulated Screw hip repair

Postby goatwarden » 4 Sep 2012, 4:21pm

Si C and Here2Eternity, I don't wish to insult you, especially if you have already done it and not found the information you hoped for, but have you read the entirity of this thread? I believe it's well worth reading as it contains the detailed experiences of many people who have suffered similarly.

I was very surprised to find that it was potentially such a serious injury, and that, medically, I was still considered young at 45. I only learnt about the potential for avascular necrosis some time after my injury, which lead me to resent the medical people who neglected to inform me of the full risks at the earliest opportunity. I am now close to two years beyond it and, whilst I am still aware of the injury every day, I am largely capable of everything I was before, although now extremely cautiou when descending or when I see wet or gravelly surfaces.

One thing not previously mentioned here, and rarely suggested by any medical people, is care of your scar. I would recommend massaging it, using aqueous cream or chamois cream, gently as soon as it is sufficiently healed to minimise scar tissue. Keep doing this for as long as you remember to; I still do mine sometimes and I still believe it helps in diminishing the scar and improving the skin tone. This should reduce the risk of accidental injury in future as scar tissue is fairly fragile. My wife recently broke her wrist (much better prognosis; likely to be as good as it will ever be after three months) and is putting honey on the scar, following advice from a friend who did this and has a barely noticable scar now.

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Here2eternity
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Re: Cannulated Screw hip repair

Postby Here2eternity » 5 Sep 2012, 1:50am

Thanks goatwarden - I dont know where I would find any of your advice or comments insulting - I have read the whole thread and also started another thread in March 2011 to which you contributed some useful and encouraging thoughts. I am certainly aware of the seriousness of hip injury, having been in constant debilitating pain since the fracture 18 months ago. Today I can only walk short distances on crutches or, on a good day, a walking stick. I cant put socks on or lace shoes and have to have a special chair to sit on. I sleep very poorly due to pain in the joint - note that i am writing this at 1.45am. This after having 3 screws removed in June. My hopes are now pinned on a total hip replacement on 18 September. I recently met with the surgeon who detailed all the risks associated with the procedure both in the short and longer term.
This will be the third time in 18 months that I have had my hip cut into by the surgeon and I have previously used olive oil to keep scar site in good condition.
I have found the forum of great value in showing that while there is huge variation in the time taken and procedures to get through most of us will be able to get back on our bikes - this is what keeps me going these dark nights.

markowe
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Joined: 23 Jul 2007, 6:29pm

Re: Cannulated Screw hip repair

Postby markowe » 5 Sep 2012, 9:01am

Here2eternity wrote:Marlowe wrote;
We should actually count ourselves lucky that this procedure exists, otherwise we would be faced with a hip replacement, and then it would be curtains


Was a bit concerned to read this - my understanding is that prognosis for hip replacement surgery (including getting back on the bike) is good - although I appreciate it might not be such for someone as young as you; I am 61 and the surgeon is only doing it as a last resort where pinning has failed to solve the problem. :?:


I didn't mean to be dramatic, I just meant that with a hip replacement it would be pretty difficult to return to the same competitive level you were at before, if indeed you could get back into serious competition. It's just not the same having an artificial joint, especially after a pretty invasive surgery too. You have to get lucky for the fit to be absolutely anatomically perfect. Even if you get back to your old fitness level there is the danger of a fall which could really mess things up, plus the issue of wear-and-tear: how long does a hip replacement last these days? 15-20 years tops with a fairly sedentary lifestyle. Imagine how quickly it gets worn out if you are cycling 10-20 hours a week!

Not being pessimistic, just realistic about the prospects - a hip replacement for a top-level athlete would 99% likely be a career-ender. For the rest of us, there is always hope :)

P.S. I must admit I thought they didn't even try to do pinning for anyone above 55 or so just because the prognosis gets progressively worse for the success of that procedure depending on age. I guess at least they tried! And hip replacement is still one of those modern miracles in terms of getting people mobile again, so I am not down on it in any way, I just mean doing the TdF with a hip replacement is most likely off the cards :)

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Here2eternity
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Re: Cannulated Screw hip repair

Postby Here2eternity » 5 Sep 2012, 5:04pm

Thanks Marlowe
I was 59 when I fractured my hip after being knocked off my bike by an 85 year old at fault motorist. Surgeon told me that if I had been 70 he would have gone for THR.
I am not a competitive cyclist - the limit of my aspirations in what I hoped to be a healthy retirement were short tours and leisure rides. I am optimistic that post surgery I will be able to pick up where I left off. In June 2011 I had planned a solo camping tour of the Normandy landing beaches. I have never cancelled the ferry booking but simply rescheduled it 6 months at a time, as a gesture of intent. My dream now is to complete the ride at leisurely pace in June 2013 (6 months after THR).
I may have to rethink camping and look at hostels/B&B as I might not reach the pegs!
I will follow the TdF without envy.
My surgeon says that 90% of ceramic hips last at least 10 years and 85% for 20 years. He is happy for me to cycle on the basis that it is not load bearing and will not compromise the hip but really advises to avoid falling off.

snibgo
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Re: Cannulated Screw hip repair

Postby snibgo » 5 Sep 2012, 9:11pm

My consultant said something similar to me: cycle but don't fall off.

On weight-bearing: I suspect it's okay to do whatever cycling doesn't exceed whatever other exercise is allowed. For example, when they said "no load-bearing" so I had to hop on the other leg, I reckoned cycling was okay provided I didn't pedal with that leg (or fall off, of course).