Back in action!

[Eric Sedletzky]

I was so surprised at how small the hip ball that they took out of me is -- just maybe about 1" diameter! I thought it would be about twice or thrice that.

- Bill

I asked my doctor about that very same subject of why the new hip ball is so small, and his answer was that they can't really ream out the socket big enough to place a metal carrier and delrin sleeve big enough to accomodate a ball the same size as an original OEM part.
There isn't enough bone material on the socket side to be able to do this, otherwise they would be making the structure too thin and weak. When they ream out the socket with the half round bit they only clean it up big enough to set the carrier. He made it sound lime they remove only enough, about 1/8" or less. Then the carrier is probably 1/8" thick so that takes up room, then the teflon or delrin bushing is about 3/16" or 1/4" thick. So by the time you add up all the thickness of the parts for the socket that only leaves room for a 3/4" ball. In my case it might be about 7/8" because I'm pretty good size so they used fairly large parts.
I was hoping for big rig sized front end parts but
Unfortunately that's not the case.
So with this smaller ball, that's why we have restrictions, because it's not a huge ball like an original and it's not quite as stable. Plus at the extreme end of a stretch the new parts will bottom out on the edges and then it will tend to want to pry out the ball from the socket.
This is also why with an original stock hip joint it's so bad to power up a joint to full capacity at the very far reach of a stretch (like pushing like hell on a full stretch with weights) because the surface area is at it's least at that angle and there is the least amount of surface area distributing the weight across the joint.
Those wall climbers that contort their legs way out of normal range to get a foot hold then flex and power up to get another step up need to realize this. They put their joints in the most vulnerable position when they do this.
This is the birth of bone spurs along the edges of hip joints. The body is kind of stupid, it uses calcium to try and repair everything, but calcium is a lousy joint material for a fix.

 

[billt4sf]

That is excellent info! THANKS!!!!

 

[johnny sea ranger]

I asked my doctor about that very same subject of why the new hip ball is so small, and his answer was that they can't really ream out the socket big enough to place a metal carrier and delrin sleeve big enough to accomodate a ball the same size as an original OEM part.
There isn't enough bone material on the socket side to be able to do this, otherwise they would be making the structure too thin and weak. When they ream out the socket with the half round bit they only clean it up big enough to set the carrier. He made it sound lime they remove only enough, about 1/8" or less. Then the carrier is probably 1/8" thick so that takes up room, then the teflon or delrin bushing is about 3/16" or 1/4" thick. So by the time you add up all the thickness of the parts for the socket that only leaves room for a 3/4" ball. In my case it might be about 7/8" because I'm pretty good size so they used fairly large parts.
I was hoping for big rig sized front end parts but
Unfortunately that's not the case.
So with this smaller ball, that's why we have restrictions, because it's not a huge ball like an original and it's not quite as stable. Plus at the extreme end of a stretch the new parts will bottom out on the edges and then it will tend to want to pry out the ball from the socket.
This is also why with an original stock hip joint it's so bad to power up a joint to full capacity at the very far reach of a stretch (like pushing like hell on a full stretch with weights) because the surface area is at it's least at that angle and there is the least amount of surface area distributing the weight across the joint.
Those wall climbers that contort their legs way out of normal range to get a foot hold then flex and power up to get another step up need to realize this. They put their joints in the most vulnerable position when they do this.
This is the birth of bone spurs along the edges of hip joints. The body is kind of stupid, it uses calcium to try and repair everything, but calcium is a lousy joint material for a fix.

Hi,

I am scheduled for a hip replacement soon. Don't know if it will be anterior or posterior, but I am being cautioned not to flex over 90 degrees even after the 3 months intensive physio, no matter which way they go in. It seems to be getting out on a ladder on a windy day a diver may flex more than 90 degrees. Do you have any tips for any part of the dive process? Is the restriction really 90 degrees, or with proper exercise (and I do a lot of yoga) have you safely extended range beyond 90 degrees?

 

[Eric Sedletzky]

Hi,

I am scheduled for a hip replacement soon. Don't know if it will be anterior or posterior, but I am being cautioned not to flex over 90 degrees even after the 3 months intensive physio, no matter which way they go in. It seems to be getting out on a ladder on a windy day a diver may flex more than 90 degrees. Do you have any tips for any part of the dive process? Is the restriction really 90 degrees, or with proper exercise (and I do a lot of yoga) have you safely extended range beyond 90 degrees?

I just had my six month check up and I'm right on track. I can bend past the 90 degree precaution now and do pretty much everything I did before. It's almost spooky how pain free and normal it is. I have to remind myself sometimes that I indeed have bionic parts and probably should remember that, although I don't do anything that really puts me at risk, so I just enjoy being completey pain free. I can hike tanks down to the beach and do it all, it's wonderful!!
The only thing I'm still working on is getting to my left foot (operated side)
to clip toe nails and put on socks. I'm still not able to pull my foot up like indian style sitting to get to my foot. So I still usd a sock installer and use slip on shoes or flip flops. Interestingly though, I can get a dive booty on, zip it up, and pull on fins. The important thing to remember is to reach inside your leg and let your leg/ knee swing out. They said because my replaced hip was bad for so long with such limited mobility because the muscles all tightened up, that it could take up to a year to get full range of motion back, but I have to work at it.
They recommend against starting to try and stretch and break precautions too early because it will stretch out the capsule before it's fully healed up.
I couldn't get the anterior approach but many people who do swear by it. More risk though with a steep learning curve for the surgeon and special tools. Find a very good doctor with many successful surgeries if you choose this method (if you qualify).

 

[billt4sf]

Hi,

I am scheduled for a hip replacement soon. Don't know if it will be anterior or posterior, but I am being cautioned not to flex over 90 degrees even after the 3 months intensive physio, no matter which way they go in. It seems to be getting out on a ladder on a windy day a diver may flex more than 90 degrees. Do you have any tips for any part of the dive process? Is the restriction really 90 degrees, or with proper exercise (and I do a lot of yoga) have you safely extended range beyond 90 degrees?

I have, but I don't recommend it.

Frankly I don't see how I could dive without doing so (though I try to avoid it). Let me give a few examples: (1) sitting on the side of the boat getting ready for a back roll -- usually puts me >90 degrees right there. If I lean over to put my fins on (which I don't do), then it's nearly 180 degrees. (2) Coming up the ladder (I take my gear off in the water) will put your hip >90, unless you use the non-operated leg first. (3) Drop something on the floor, I have to ask someone to pick it up for me. (4) Sitting on the toilet (unless you are short, or bring your medical seat with you ).

I am six months post-surgery, I had a revision of the replacement (which they said would be more painful and I believe it now), and I'm 65.

- Bill

 

[DiverGrrl]

QUESTION for Eric and other hip patients:

As you know, after the surgery we are not supposed to cross the legs, bend more than 90 degrees at the hip, or go pigeon-toed.

How do you deal with these restrictions while getting back into diving? Bending at the hips not a typical diving motion, but crossing one's legs to put on a fin is.

My doc was pretty wary of me putting on fins, he said that with fins the leg could twist into a pigeon-toed position more easily. I have yet to put them on (2 1/2 mos post-op).

Of course ultimately it's a matter of time until the capsule (whatever THAT is) is fully healed. I find myself slowly accommodating to a full range of motion - very slowly, as I am in developing country and I sure don't want to have a dislocation here!

Just curious what your experience is.

- Bill

I asked someone else (my husband/ buddy or divemaster on the boat) to put it on and take it off for me!
Janeen

 

[billt4sf]

QUESTION for Eric and other hip patients:

As you know, after the surgery we are not supposed to cross the legs, bend more than 90 degrees at the hip, or go pigeon-toed.

How do you deal with these restrictions while getting back into diving? Bending at the hips not a typical diving motion, but crossing one's legs to put on a fin is.

My doc was pretty wary of me putting on fins, he said that with fins the leg could twist into a pigeon-toed position more easily. I have yet to put them on (2 1/2 mos post-op).

Of course ultimately it's a matter of time until the capsule (whatever THAT is) is fully healed. I find myself slowly accommodating to a full range of motion - very slowly, as I am in developing country and I sure don't want to have a dislocation here!

Just curious what your experience is.

- Bill

Here's my update 11 months post-op (hip REVISION to the replacement which was 20+ years ago). Age 65.

I would say nearly full recovery. I still take care to not bend more than 90 degrees at the waist if I can avoid it, or to cross my operated leg fully, but I still do so from time to time. Until a few months ago I would get some pain from bending, but no more. Doc said it wold take a year to fully recover and he was right.

Took lots of recent dive trips around Indo and did a few things differently. I no longer carry the gear. I no longer bend at the waist with the gear on to put fins on. For shore dives I put my gear on in the water. For shore and boat dives, I take my gear off in the water. I use my non-operated leg to get started on those short ladders. It is not a problem to have the crew do these things for me but I do have to tell them. I tip the boatmen and the crew after trips.

In the last week, after conclusion of a great trip, I have developed sciatica in the non-operated leg. VERY PAINFUL and debilitating. Maybe it was overuse combined with (ahem) old age. So now I am out of action, but I sure hope to get back at some point!

Anyway the operated hip is woking fine....

- Bill