Back on the track after hip replacement surgery
WalterOstrinski has run 67marathons. He cycles, hikes, and generally tries to stay fit, but running is his life. At least it was until he could no longer move his hip. “I’mactive in every way, and I just started having pain, and I thought itwas sciatica, and eventually it got really bad,” Ostrinski said. “This happened over the course of a couple of years. It’s a running community, so everyone gets certain things, and pretty much everything you get from running, you can circumvent with a stretch or a different exercise. I’ve never had anything I couldn’t stretchmyway out of.” This was different. Ostrinski had arthritis in his hip, and, unknowingly, he let it get to the point where he couldn’t move. He needed a total hip replacement. “If I had not had the surgery, I’d probably be in a wheelchair now,” he said. “With as bad as it was before the surgery, I could not run. I’d take four or five steps, and it was horrible.” He phoned Dr. John Irving, an orthopedic surgeon at Hartford HealthCare St. Vincent’s Medical Center. Dr. Irving performs more than 300 hip and knee surgeries a year. “It’s important that people understand what arthritis is,” Dr. Irving said. “The most common is wear- and- tear arthritis. It’s like losing the tread on your tires. The process is a loss of cartilage, associated with pain as well as function loss.” Catching the symptoms early can help to avoid surgery, but many people, like Ostrinski, can mistake the pain for something else until it gets unbearable. Pain placement can also be misleading, according to Dr. Irving. “The first sign of any hip disease is the pain,” he said. “But pain in the hip joint is located in the groin or the outer upper pelvic area. Tenderness on the fascia hip area is more likely to be something else.” Dr. Irving said that true hip pain in this sense can comewith loss of range of motion, meaning problems putting on shoes or socks, being unable to sit in a figure- four position, or difficulty getting up and down stairs or up from a chair. It starts to impair daily living, he said, and people can start to compensate for it by overusing their other joints. “As the joint stiffens, people can compensate for onesided hip arthritis through their opposite hip and their back, so eventually, the stiffness can lead to a gait disability, back pain, and affect the other hip,” Dr. Irving said. “InWalter’s case, this is what happened. He had hip and low back discomfort. Specifically, with Walter, his ability to pursue one of his passions became very difficult for him.” “Runningwas my stress relief. When I had a bad day at work, I went out to run. If I got to be cranky at home, my wife would say, ‘ go for a run,’” Ostrinski said. “Runners think they’re bullet proof, but it caught up with me.” Ostrinski had the surgery in July 2020 at St. Vincent’sMedical Center, where Irving says patients receive holistic care from an entire team of specialists. The patient’s care is coordinated through a nurse navigator and a physical therapy navigator. They contact the patients a month before surgery to coach them through the process and help them set up their home for a successful recovery after transitioning home from the hospital. There are also pre- op and post- op classes that are available online or over the phone. Patients can sign in every day and answer a series of questions about their health and the state of their joints. They can access physical therapy exercises and see the benchmarks they should be achieving. “We consider it concierge medicine,” Dr. Irving said. “Education for total hip has been shown to improve results. The more you know, the better you do.” He says it’s important that the patient is in control. Does the pain and disability affect your lifestyle? Are there things you normally want to be doing that you can’t or don’twant to because your joint hurts? Does the pain cause safety issues, are you losing your balance or is your limb giving out on you? These are the things to consider, he says. “There is no absolute. The patients drive the train,” Dr. Irving said. “They make the decision about when they are ready to have that operation.” The hip joint is a mechanical joint, Dr. Irving says, and the parts that attach to the bone aremade of titanium. The bearing surfaces aremade of an industrial ceramic ball against a long- lasting plastic. Hip replacements can last for up to 50 years, according to Dr. Irving. “Walter’s surgery used the advanced, most contemporary, hip implants,” he said. “Itwas done with an anterior approach to the hip, which I’ve been doing for over 20 years. This is the least invasive, and it’s totally muscle- sparing. It offers the patients the fastest recovery from their surgery.” “I truly didn’t knowwhat to expect,” Ostrinski said. “When you experience the pain of bone on bone, you find it impossible to believe that pain could go away, but I had heard phenomenal things about hip replacement.” St. Vincent’sMedical Center is undergoing extensive renovations, meaning in addition to the complete care before during and after surgery, patients will have a five- star experience while in the hospital itself. “This will be one of the most exemplary places in the state, with large patient rooms with tremendous views of Long Island Sound” Dr. Irving said. “We have totally redeveloped all the surgical programs and hired quite a few new personnel.” As for Ostrinski, he was back on a bike within a couple of months, and now that he’s more than six months out, he can go on hikes and even jogs, as long as he keeps it light. “Acouple ofmonths ago I went to seeDr. Irving, and he said I could start running — everything had healed perfectly,” he said. “I asked if I could run a marathon, and he fell short of givingme permission to do that. But eventually, maybe?” He’ll have his other hip replaced in the next few years as well, and he’s not concerned at all after this experience. This is just one example of Hartford HealthCare St. Vincent’sMedical Center bringing more specialists and providers to the community. Tune intoHartford HealthCare St. Vincent’s Medical Center’s Facebook Live discussion, where you can ask your questions, Thursday, January 28 at noon. And for more information, log onto stvincents. org/ ortho or call 745.210.5409.