A new hip, but without the limp

BY ERIKA ROSE, Times Correspondent
NW Indiana Times, Date posted online: Monday, February 25, 2008

Jack Callahan is about as active as a person can get.

The 52-year-old Hammond firefighter trains professional boxers, works out six days a week and has quite a collection of marathon and half-marathon medals.

Hard to believe he's kept up this pace even with his hip held together with metal hardware.

Like Callahan, the Baby Boomers are coming of age. And whether they're suffering the consequences of an overly active lifestyle, or their hip joint has deteriorated for whatever reason, they're simply too young for a total hip replacement, not to mention unwilling to accept the physical restrictions that come along with it.

Dr. Mitchell Sheinkop, director of Joint Replacement Surgery at the Neurologic and Orthopedic Hospital of Chicago, says hip resurfacing is an alternative to the traditional total hip replacement, providing an option for younger people in need of a new hip but not willing to give up their active lifestyle.

Staying active

The wear and tear of an active life had begun catching up to Jack Callahan right about the time he celebrated his 50th birthday.

His passion for running, which he sometimes did twice a day seven days a week, had eventually been derailed by pain in his hip, an annoyance he struggled with for about a year and a half.

When X-rays revealed bone-on-bone, his hip joint deteriorated from arthritis, two doctors both concluded a total hip replacement was the solution.

A total hip replacement, in which the worn cartilage and part of the bone is removed and replaced with an artificial joint, would mean Callahan could likely carry on without pain but certainly not without restriction. Because of a certain amount of instability inherent with hip replacements, resuming his current level of activity would be impossible and he'd have a higher risk of dislocation.

"I was depressed," he says, thinking, "I'm too young for this."

Unwilling to accept this blow to his lifestyle and threat to his career as a firefighter, Callahan went to see Dr. Mitchell Sheinkop at the Neurological and Orthopedic of Chicago who has done more than 320 hip resurfacing operations.

In hip resurfacing, instead of sacrificing much of the bone, the femur is reshaped and capped with a smooth metal ball. Among the advantages to this method, Sheinkop says, is the fact that this creates a longer lasting hard-bearing surface of metal on metal rather than the soft-bearing metal on plastic method of the hip replacement, providing better motion and less restriction on activity.

Also, preserving the bone is critical because of the likely need for a repeat operation decades later. Resurfacing rather than replacement makes these revision surgeries more successful.

Sheinkop says surgeons typically shy away from hip replacements in younger people because of the number of years they have to last and the likelihood of resulting complications.

"In the past, if a 30- or 40-year-old came to me," Sheinkop says, "I'd say take a pill and wait until you are 65 or 70 ... " With the approval of improved technology by the Federal Drug Administration in 2006, proven in Europe to provide better fixation, better metallurgy and better results, younger, athletic patients now have an option they didn't before.

"With hip resurfacing, because it is hard-bearing, there are little restrictions inherent," Sheinkop says, "hence; somebody who can undergo resurfacing can live basically a normal, full life in the workplace, in activities of daily living and in their recreation."

That means high energy people like Callahan can go about their lives as planned, he says, "without concern of premature failure of the prosthesis."

Callahan says the procedure involved a five-inch incision on the upper part of his leg, two days in the hospital and six weeks of rehabilitation. After two months, he says he enjoyed a 100 percent recovery, resuming his strenuous workouts and going back to training boxers and firefighters, although he's opted to trade running for stair climbing in hopes of protecting his other hip.

Sheinkop says hip resurfacing is ideal for younger people with osteoarthritis, also known as degenerative arthritis, but not those with rheumatoid or inflammatory arthritis or a traumatic injury. Women of child-bearing age or those with deformities of the pelvis also are not good candidates. Women near menopause must have a bone density test to rule out osteoporosis.

For more information about hip resurfacing at the Neurologic and Orthopedic Hospital of Chicago, visit www.neuro-ortho.org or call (773) 250-1009.