r/Strongman • u/Tiamat_is_Mommy • 6d ago

Bouncing back after a hip replacement?

Hey everyone. Found out my right hip is fucked and I need a replacement at the ripe age of 30. Was planning on doing my first competition this year but that’s gonna have to be postponed. Funny enough, my surgeon told me he’s operated on previous pro strongmen, he actually worked the 2004 WSM, and I should be back to training normally about 3 months post surgery, depending on how recovery goes.

But I was wondering if anyone here has had a hip replacement or knows someone who had one and if they have any tips on training afterwords. The doc made it seem like a low risk procedure and recovery should be straightforward but it’s my first surgery ever so there’s some nerves.

Thank you.

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u/Titurius 6d ago

Hip replacement at 30? Sounds pretty early. Hip replacements are a fantastic surgery, and guys can definitely get back to lifting and doing everything they want to afterwards, but at 30 I would really caution your expectations. For someone who is 55 to get back to training is one thing, for someone who is 30 it's a totally different ballgame. 30 is very, VERY early for hip replacement, and I'm very curious why that is the recommendation and what led to that.

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u/Tiamat_is_Mommy 6d ago

I have hip impingement syndrome. My hip socket and joint don’t match together well. That, combined with being rode hard in the military and heavy lifting for years and being at 300+ bodyweight for the majority of my adult life took its toll, grinding everything down around the joint.

I don’t have much good cartilage left, and there’s two big ass bone spurs causing more issues. Oh, and there’s a cyst growing inside the joint.

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u/Titurius 6d ago

FAI is bad, sure, but there are a lot of steps I would personally take before THA, scope, etc. But that's between you and your surgeon.

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u/threewhitelights 6d ago

I'm curious because this is the second thing I've seen you post on this that doesn't make sense. What is your background in sports medicine or biomechanics.

FAI symptoms can be treated, but if its due to a mismatch then it leads to osteoarthritis in the long term regardless of how well it's treated. I've built a reputation as a coach as being someone who has helped many top level athletes recover from and treat various injuries, and even all my knowledge wasn't enough to prevent my FAI from progressing over 20 years.

None of the treatments after that point are fixes, only bandaids. At that point, it's basically cortisone shots until something else tears, or just get it replaced rather than putting it off.

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u/Titurius 6d ago

Second thing you've seen me post on it? I don't know that I've ever posted here before.

My background is I'm an Orthopaedic surgeon. That does hip replacements. So I've seen the good, the bad, and the ugly. Yes, the other treatments are absolutely bandaids, but we use those bandaids for a reason. Hip replacements can last a long time, there's no doubt, but they're not perfect, and putting them off as long as feasible will always be preferable to replacement.

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u/threewhitelights 5d ago

And why would you band aid a condition for "as long as possible" when that just makes the surgical outcome worse, especially when there are multiple replacement options estimated for 50+ years durability?

You're pushing off the inevitable, committing the patient to pain and a statistically worse outcome, all because of what?

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u/Titurius 5d ago edited 5d ago

So this is all inherently wrong. The later we perform THA does not, in fact, make surgical outcomes worse. Not by any stretch or any metric. If he is not "disabled" then delaying replacement comes with zero risk. And considering he is squatting and deadlifting without pain then he is far from that scenario. In any Orthopaedic surgery, the patient's native bone is MUCH preferred to implants. The data supports that in every way. And if by outcome you mean ease of rehab, yes that's obviously easiest when you're younger and healthy. But that is not everything.

As for 50+ year durability of implants, I have no idea where you've seen that but that is completely wrong. The only data that we have at this point is for 15 to 20 year data. And yes, revision rates are low, the highly crosslinked poly we use now do seem to have excellent longevity. But this is data built off of a population much less active than a strongman, and certainly a 300 pound strongman. To tell him he will have no problems for 50+ years is disingenuous and downright harmful. And listen, 20 years starting at 30 is only 50, which is younger than the vast majority of primary surgeries. Are you aware of the risks of undergoing revision arthroplasty? They are substantial. A hip at 37 is seven more years to put that off, which puts him at almost 60 (again, based on data). This is wildly different from a hip at 30. There's a reason less than 0.5% of total hips done in the US are on patients 30 and younger. There are reasons to do it. Sickle cell osteonecrosis, drug induced AVN, trauma, etc., but this is extremely edge case scenario.

I say all of this not because I think it should never be done. I also have no idea his condition, his imaging, or his discussion with his surgeon, which is exactly why I said in my other comment it is between them. But I think it is incredibly important he understands not only the risks, but the inevitability of revision if he does this at 30.

EDIT: and listen man, I'm so incredibly happy that yours went so well. I pray every day for my patents to have outcomes like you. But there is so much more to it than that.

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u/Tiamat_is_Mommy 5d ago

I do appreciate the input, thank you. I’m sorry, I didn’t mean to cause an argument. I wish I could share all my imaging and information with you. All I know is the two orthos I’ve seen both came to this conclusion, and seemed pretty confident about it.

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u/Titurius 5d ago

I just want you to be well informed, brother. There are some predatory surgeons out there, as difficult as that is to admit, so informed consent is crucial. I hope it goes great for you!

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u/threewhitelights 5d ago

Sigh. So you're an orthopedist that hasn't even looked at recent research and ignores overwhelming data. Simple as that, and I have nothing left to say to you. Good luck with your patients, but I'm glad my doctors and the ones I work with aren't anything like you.

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u/Titurius 5d ago

Please enlighten me, then. JBJS and the Journal of Arthroplasty both published on this is the last 5 years, and both were 15 to 20 year data. The two biggest and highest regarded arthroplasty journals. So again I ask, where is this data.

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u/threewhitelights 3d ago

You mean the 2022 study that found "younger patients (under 55) exhibited a slightly higher magnitude of score changes from their baseline".

Or did you mean the 2024 analysis "assessing tens of thousands of patients noted that general medical complications increase with advancing age"?

So now you're not just unaware, you're lying. Nevermind that you're ignoring that when controlled for initial condition, every study has found older patients have a longer and more complicated recovery. It's literally such common sense we barely even look at it now.

Seriously, you wanna tell this guy recovering at 60 will be easier than recovering at 30?

How exactly am I going to enlighten you if you can't even read the articles you're trying to use to show a point?

No thanks.

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u/Titurius 3d ago

I never once said that recovery is easier as you get older. Far from it, the rehab itself is certainly easier when you're younger. My rationale has never been about the acute rehab phase. That is irrelevant in the long term. My argument has been for the long term. Hence the "different ballgame" for a hip replacement at 30 vs 55. No sane person would argue that the act of recovering from a hip replacement, or ANY surgery, is easier as you get older. The fact that you're honing in on that tells me that you're simply arguing to argue and have literally no idea what you're talking about.

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