For almost a year, 53-year-old Jim Irvine, a highly competitive cyclist, was sidelined due to chronic hip problems. "I spent most of 2018 on my sofa, gaining weight," he says. "I lost a lot of ground." With the help of an innovative bone-sparing hip replacement technique performed by Fondren Orthopedic Group orthopedic surgeon Ugo Ihekweazu, MD, however, Irvine is back on his bike and stronger than ever.
A former collegiate hockey player, Irvine suffered from several hip-related conditions. As Dr. Ihekweazu explains, "Irvine was likely born with an abnormal hip anatomy called a cam lesion, where excess bone growth on the femoral head (head of the thigh bone) can cause impingement (abnormal wearing and contact) on the hip socket. Over time this can lead to damage of the labrum and cartilage, ultimately leading to degeneration of the hip joint."
Bone-sparing hip resurfacing
Hip injections in 2016 and a hip arthroscopy in early 2018 provided temporary relief, but within a few months, Irvine was back on crutches, unable to walk. In September 2018, Irvine was referred to Dr. Ihekweazu, who specializes in a special hip replacement technique called hip resurfacing.
As Dr. Ihekweazu describes, "In a traditional hip replacement surgery, the surgeon replaces the femoral head and the socket into which it fits, replacing the socket with a metal one. In hip resurfacing, the surgeon leaves the top portion of the femur intact and caps it with metal. The capped femoral head glides smoothly within the new hip socket."
An option for some high-level athletes
While hip resurfacing is a good option for a small percentage of patients, Dr. Ihekweazu says it is definitely not for everyone. "For most people, the overwhelming recommendation is a standard hip replacement, which can help them resume moderate activities - such as doubles tennis, golfing and light jogging - that they were doing before developing arthritis. But for a small percentage of the population - typically male athletes under the age of 60 - hip resurfacing can allow them to regain their competitive edge, without having to worry about the hip wearing out too soon," says Dr. Ihekweazu.
"Hip resurfacing is more technically demanding from a surgeon's perspective," adds Dr. Ihekweazu. "It's a difficult operation to perform if you're not comfortable performing those operations. So only a few surgeons around the country do these types of operations."
After performing a medical examination and reviewing Irvine's X-rays, Dr. Ihekweazu determined that Irvine was in fact a good candidate for the procedure. He discussed the procedure with Irvine, including associated potential benefits and risks. Irvine was immediately on board.
Successful hip resurfacing surgery
In October 2018, Dr. Ihekweazu performed the hip resurfacing operation on Irvine at Texas Orthopedic Hospital. Two hours later, Irvine was up and walking. The next day, he was released from the hospital. And two weeks later, he was doing 15 to 20 minutes of light indoor cycling. Uncharacteristic of most hip replacement patients, Irvine never required a walking aid, such as a cane or walker, or physical therapy.
Irvine is eight months post-surgery. A member of a Houston-area cycling team, he's training again. "I have no hip pain at all. I am working out so hard. I feel amazingly strong. My numbers are mind blowing," says Irvine.
Irvine is grateful for having been given the option of hip resurfacing. "Before I was referred to Dr. Ihekweazu, I had no idea of what my options were. The whole experience was great. Dr. Ihekweazu, the team of nurses, the anesthesiologist, the hospital. They were all fabulous. I have already referred three or four friends to Dr. Ihekweazu," says Irvine.
Discuss your options with your surgeon
Hip resurfacing is not for everyone, but a skilled surgeon can help a patient find the treatment that's right for them. "Every surgery is not for every patient. When weighing your options, have a detailed conversation with your surgeon about what your options are and the associated risks and benefits. Working with your surgeon, you can determine the treatment that will give you the best chance for a pain-free hip that restores your function," says Dr. Ihekweazu.