Total hip replacement

[Matti]

Hi, another hip issue.

First my situation: I have been barbell training regularly for about seven years. Five years ago I was pulling 180 kilograms in DL, squatting 140 and bench pressing 120, and improving, at a body weight of 82 kilograms. I was 36 years old and life was good. I had some back pains however, between the DL reps especially, and went to the doctor. After some examination and an x-ray I was diagnosed with hip arthritis in the right hip. As I don't have any other joint problems I think it probably comes from a traffic accident when I was 13, long time ago.

Since then I have been training with lighter weights, not doing maxes. Due to work issues I could not train regularly last Winter and that could also have affected the hip condition. Today I visited the doctor as I have noted increasing pain in my right leg now for some months. He would directly OK me for a hip replacement. In public health Finland that means a total hip replacement, no fancy metal-on-metal resurfacing. The risk with metal particles coming loose is considered too big. The total hip replacement would have a ceramic surface, as I directly opt out of any plastic alternative. The doctor said ceramics are as strong as metal ones, apart from when it comes to sudden hard impacts, like tackles in ice hockey or football.

Is there anyone here with experience of this?

Since the resurfacing was shot down some years ago, the hospitals here have not been keen on new inventions, but there might be a bigger ball coming for the ceramic implant. How big would the ball need to be in order to squat properly, below parallel? I understand the logic is that the bigger the better, and ideally it should be the same size as the natural femoral head. But anyone training heavy also with a smaller ball?

Regarding the shaft, the so-called stem, will this hold for squatting let's say 120 kilograms below parallel? I think I know the answer, but just for reassurance. The doctor said they use Zimmer-Biomet components and that these have proved to be reliable (apart from the metal-on-metal resurfacing). The ceramics would come from CeramTec and at least by looking at their web pages it seems like they know what they are doing.

So if there is some hard core lifter here with an interest in hip replacement mechanics, I would be thankful for advice.

[Nate9]

Don't know much about the topic but Ed Coan could still do some heavy squats after having his hip replaced

Ed Coan squats 312.5kg x 3 PTC HQ - YouTube

[Grundsey]

Matti,
I am not a hard core lifter, but I did have a hip replacement last November. I opted for a ceramic head (36 mm) with highly cross-linked polyethylene acetabular cup liner. This combination has pretty good wear characteristics in testing and also in the somewhat limited data available on actual replacements. I believe the components are Zimmer-Biomet also. My orthopedic surgeon recommended against the ceramic cup liner due to brittleness of the thin liner material. It's true the ceramic material is very strong, but it's brittle, not tough, especially when very thin. If it shatters, you end up with many small pieces that need to be cleaned out before a replacement can be put back in. I didn't want to be in a position where if had to jump down from even a small height or got involved in a car accident that jammed the hip, that the cup might shatter. I also understand that a significant number of the ceramic-on-ceramic replacements squeak when walking (something like 20% of them, as I recall). I once had a pair of shoes that squeaked and I threw them out 'cause they bugged the heck out of me.

[Matti]

Thanks, Nate9. Coan is great and a great inspiration. If replacements hold up for that, I'll be safe for a long time.

That is also my reasoning for the moment, Grundsay. I read some on the bodybuilder icon Clarence Bass' site and I understood he got a polyethylene cup also already many years ago and that was the best alternative at that time. And the new ones should be even better. Also the risk of smashing a ceramic lining is a rather critical factor as it is hard to clean up. Not to mention squeaking. Thanks for your input.

[Matti]

Just an update here.

One year has passed since the surgery, and now I squat with 90 kgs, a bit more than body weight. For the time being I stay at this weight and do more reps, like 6-8 per set. I have not noticed any pain, however I do not go really 100 % parallell, but keep it a little bit over. I do longer sets, like 8 reps, with 120 kgs for DL, but I also tried 130 kgs, no problem.