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Hip Pain, Hip Resurfacing

Schnably 620

Published: August 2010

When Mike Schnably, 46, of Honey Brook, a former college tennis stand-out, took up the sport competitively again a few years ago, he never imagined he would be ranked fifth nationally in the over-45 age group by the United States Tennis Association (USTA). He also never imagined the physical challenges he would have to overcome to get to that level.

In the early 1980s, Mike was a Division II All American tennis player at West Chester University. He says he continued playing tennis "socially" after graduation, but life became busy over the next decade as he built his career, earned a master's degree, got married, and began raising his two young daughters. Today he is a senior vice president at Citadel Federal Credit Union and those two daughters are 14 and 16.

"Really, it was my daughters getting a little bit older that freed up enough time that allowed me to think about playing tennis more seriously again in my early 40s," Mike says.

He began playing in USTA-sanctioned tournaments and soon found himself ranked 39th in the nation among 40- to 45-year-olds. He had no plans to slow down until he took a spill on a grass court during a match in September 2008 and experienced severe pain in his left hip.

"I thought it was just a bad strain, but it kept getting worse," Mike recalls. "By Christmas, I knew it was not going to get better. Even walking became difficult. I felt as if I had a bruise deep inside my hip and every step hurt."

An X-ray ordered by his primary care physician soon revealed that Mike had no cartilage remaining in his left hip, and the top of his femur bone (upper leg bone), while strong, was slightly out of round. His doctor sent him to Chet Simmons, Jr., MD, a board-certified orthopedic surgeon with Chester County Orthopaedic Associates in West Chester. Dr. Simmons confirmed that the hip was not going to get better: the years of playing tennis and other sports had weakened the joint, and the misshapen femur head likely had worn away all of the cartilage over time. Mike tried cortisone shots for the pain, but those provided only temporary relief. So he and Dr. Simmons began discussing surgical options.

Because Mike was relatively young, his bone was strong, and he wanted to play tennis again, he was a good candidate for a newer procedure called hip resurfacing. Unlike a traditional hip replacement, which removes the entire head of the femur bone, hip resurfacing shaves the head into a rounded shape and covers it with a metal cap. In both procedures, the socket in the pelvis is lined as well. This puts an end to the bone-on-bone rubbing inside the hip socket that causes so much pain.

"I listened to Dr. Simmons review all of my options -- in fact, I was surprised at how many there were -- and then went off and researched them," Mike recalls. "I knew that with a regular hip replacement, he would take off the femur head and secure the replacement with a metal rod that goes down into the remaining bone. Over 15 to 20 years, that has a tendency to loosen, so by my mid-60s I could have a problem. With the hip resurfacing, the bone structure would not be compromised, so I could still have a traditional hip replacement in 20 years if I needed to." Hip resurfacing also would allow Mike to continue high-impact sports such as tennis and basketball, which are often discouraged after total hip replacement because of the risk of loosening.

On June 15, 2009, Mike had his left hip resurfaced by Dr. Simmons at The Chester County Hospital. The recovery process was challenging but worth it, he says, as he is now living pain-free and playing better tennis than ever.

"The first and second weeks were pretty tough," he says. "Initially I did physical therapy in the Hospital, and then outpatient for 30 days, and I had to be careful not to bear full weight on my hip for 30 days." Mike was back at work in two weeks and walking without crutches in four to five weeks. Within six months, he was playing tennis again, which he took slowly at first.

"The tendons and muscles that are cut to access the hip really need time to rejuvenate," he says. "I still do my physical therapy exercises on my own every day."

Now, just over a year after his surgery, he finds himself ranked fifth nationally for his age group by the USTA -- something he says he never expected.

"After the surgery, it almost became a challenge to see how well I could do with my tennis, but my aspiration was not being fifth in the nation. I have to believe I'm probably the highest-ranked player with an artificial hip," he adds with a laugh.

Mike's one-year follow-up appointment also went well. His healing is progressing nicely and the bone is growing into the metal cap to help secure it to the femur, just as expected. For that he credits Dr. Simmons.

Mike says he is incredibly grateful to have his life back.

"I was just 44 when this all started, and the thought of not being able to do normal everyday things any more -- walking, running in the yard, having fun with my daughters, playing basketball and golf -- was just so discouraging. The fact that I can do all of that without limitation again, and play tennis, is pretty amazing."

By Kristine M. Conner

Cheston Simmons, Jr., MD

A member of Chester County Hospital Medical Staff since 1994, Dr. Simmons received his medical degree from Jefferson Medical College of Thomas Jefferson University. He completed an internship at Graduate Hospital, a residency at Thomas Jefferson University Hospital, a research fellowship at The Rothman Institute in Philadelphia and a fellowship in joint replacement and spinal surgery at The New England Baptist Hospital in Boston. He is past recipient of the Everett J. Gordon Award for Clinical Excellence in Orthopaedics and previously served as a staff physician with the New England Baptist Hospital. Dr. Simmons is Board Certified in Orthopaedic Surgery and is a fellow of the American Academy of Orthopaedic Surgery. He has been in private practice with Chester County Orthopaedics Associates, Ltd., since 1994.

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