Patient Stories:
life after a joint replacement
Before and after stories of Anderson Orthopaedic Clinic
patients with hip and knee replacements

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After hip replacement: Exercise Trainer Gets Back in Class

Changes in the polyethylene used in acetabular cups have improved prospects for young patients who need total hip replacements.

In the past five years, we have seen the results of improved polyethylene in acetabular cups ... we are confident that rapid wear will no longer occur.

In the articles below you'll learn about two 47-year-old women who have had total hip replacements. At one time, orthopaedists would have considered these young and physically active patients part of a "challenging population."

Pam Marks, who rides horseback competitively in her free time and runs an insurance business with her husband, had a hip replacement 14 years ago. Cynthia Cooper, a personal fitness trainer, had her hip replaced just one year ago. She now starts her day at 5 a.m. with her own exercise routine before she goes on to teach exercise and dance classes for the next eight hours. Both women demonstrate the possibilities total joint replacements now offer relatively young, active patients.

Until recently, orthopaedists were reluctant to perform total hip or knee arthroplasties on such patients, because of concerns that early wear on the polyethylene (plastic) acetabular cups might cause failure and necessitate additional surgery. This, in fact, was the case with Pam Marks, who had her replacement in her early 30s. After 12 years, the polyethylene in her cup failed, and she required revision. Fortunately, her revision has been successful.

However, the outlook for youthful and active patients is changing. Because of improvements in materials and designs, current implants are lasting longer. The wear rates of polyethylene have been decreased to less than 25% of the wear rates that existed at the time of Pam's first surgery. In the past five years, we have seen the results of this improved polyethylene, and for patients like Cynthia, we are confident that rapid wear will no longer occur.

Even so, AORI, other research institutions, and manufacturers are continuing research and development efforts to further address the issue of polyethylene wear. We appreciate the help our patients have given towards these efforts by supporting our database, implant retrieval bank, and annual campaigns.

Now to hear what our patient's have to say...


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Living Her Dreams

For Pamela Marks, having a hip replacement meant being able to live out a childhood dream.

"I would have
to sit down halfway to the barn because of the pain," says Pam. "It was give up riding and my horses or have a total hip replacement."

Pam Marks

 

 

 

 

 

 

 

 

Pam Marks knows her priorities. When her husband of 18 years proposed, he asked if she wanted to pick out an engagement ring, but Pam told him she would rather have a new horse. Horses were already a part of Pam and Doug's lives. They went horseback riding on their first date, and their first purchase together was a horse. Her "engagement ring" was their second horse. Now, the Marks family includes three four-legged "children," all of whom Pam and Doug care for when they are not working at their insurance business (Marks Insurance & Associates).

Pam started riding in her early twenties, when she became involved in "eventing," a timed riding sport that included Dressage, a course with jumps, and stadium jumping. However, 14 years ago, it appeared Pam's competitions might end because of hip pain from congenital unilateral hip disease.

"I would have to sit down halfway to the barn because of the pain," says Pam. "It was give up riding and my horses or have a total hip replacement."

There was little choice.

"Riding my horses is my favorite thing in life," Pam says. "Had I not had a total hip replacement, I would have had to sell my horses, and that would have devasted me."

For Pam, having the hip replacement was a quality of life issue - being able to continue the activities she most wanted to do.

"When I woke up the day after surgery, I didn't have any more pain. When that happens, it is as if the whole world opens up, and you can get back to normal again," Pam says.

Initially, getting back to normal was slow, as Pam strictly followed her post-operative activity restrictions. It also meant giving up jumping and switching to a different form of competition at her doctor's request.

"I chose to do Dressage because of the training required for the horse. To be able to take a 1,200-pound animal and convince it to trust you and to perform the required movements takes a bonding unlike most sports I've been involved in," Pam says.

In Dressage, the rider leads the horse through an intricate series of maneuvers by slight movements of the hands, legs, seat, and weight. Doing it well requires frequent practice, special training for both rider and horse, and becoming one with the horse.

"The practice is not only for myself, but for the horse, as he also is an athlete. For the rider, riding is a feel. The more you practice the better you feel the horse move beneath you; then you can help the horse by asking him to do what you want properly," Pam explains.

What does Pam love most about the sport?

"I love the people, the bonding with the horse, the competition, and all that goes with it, but most of all I love being able to accomplish something that has been a dream since I was a little girl."

"I also would like to say that my success in the show ring would not have been possible had it not been for Dr. Charles. His compassion for what I wanted - and what I didn't want to lose - went well beyond just being a doctor. He truly understood my passion," Pam says.

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The first time Cynthia Cooper saw Dr. Charles Engh, she told him, rather emphatically, that she was simply investigating doctors and that she was definitely not having a hip replacement until she was at least 60 years old. Although she could not bend at the hip and was in terrific pain because of advanced osteoarthritis, the 46-year-old personal-fitness trainer returned to teaching daily aerobics and weight-training classes the next day. However, two months later, she was back in Dr. Charles' office in pain and feeling defeated and scared.

"I finally chose to have a hip replacement, but I was sure life as I knew it was over, because the only people I knew who had hip replacements were much older than me and did not lead active live," Cynthia said.

Being physically active and creative have been intrinsic to Cynthia's life. In her 30s a spinal problem ended her ballet career. She fell into despondency for a year, left home in Natchez, Mississippi, and migrated to Washington, D.C., where she got a job on Capitol Hill. It was several years before she could return to her beloved lifestyle. When she did, she did so with a vengence, teaching aerobics, ballet, and other exercise classes 8-to10-hours a day. So it was with great resistance and trepidation that Cynthia considered surgery.

Today, a year after her dreaded surgery, Cynthia is bending this way and that. She starts her day at 5 AM with her personal aerobics and weight-training, and then it is on to group and private classes of Pilatis (a type of yoga exercise), aerobics, weight-training, step, swimming, and ballet.

"I feel so much younger," Cynthia says. "I cannot believe it's me when I see myself in the mirror during class.

Another change in Cynthia's life is the type of clients she now instructs. Rather than lifting 50- and 60-pound weights while instructing male clients or pounding her feet into floor during high-impact aerobics, she decided to put less stress on her body. So when she started taking clients again this spring, Cynthia took mostly middle-aged and older women. Her oldest student is 93. The change has been rewarding for teacher and students.

"Older women often have health problems, such as osteoporosis and arthritis. Working through my own pain both before and after surgery has helped me understand them better. It also improved my ability to advise and instruct them."

Cynthia believes that Pilatis exercises, which build both strength and flexibility, are especially helpful to older women in preventing osteoporosis or other health problems associated with menopause.

"For example, women's shoulders tend to atrophy if they are not used by about age sixty. Pilatis is helpful for posture and does a lot to strengthen the lower back and reduce back pain. It also helps strengthens bones."

At the same time as Cynthia's clients are benefitting from her experiences, she also is gaining from theirs - learning that a life of activity can continue well beyond middle age.

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