Patient story - what does a hip replacement mean for an active lifestyle?

We meet James, a Complex Hip Surgery patient, to understand what having a hip replacement was like for him - and how it has helped him return to his very active lifestyle.

James had a hip replacement in his 40s due a cam lesion on the head of his femur. He talks us through his experiences.

Tell us a bit about yourself?

I’m James Forbes. I’m 48, and work as a strength and conditioning coach, personal trainer, nutritionist and studio owner. I’ve been coaching health and fitness and nutrition for over 28 years, working with clients of all ages and abilities all over the world.

I was always active growing up, playing tennis and swimming and I competed in martial arts for many years. I keep fit with weight training and enjoy walking, hiking and camping outdoors with my family.

I also enjoy gardening and landscaping and pretty much anything physical. I like to teach my philosophies to all my clients on how to stay active and mobile. Keep our bodies strong and eating healthily will promote longevity and help us enjoy an active and stimulating lifestyle.

How did your hip problems start?

I had never had any previous major health issues or serious injuries, but in early 2020 I started to notice a hip strain and a slight pinching feeling in the front of my right hip. I thought this was just a slight strain or muscle pull from my martial arts and weight training.

However, it didn’t seem to go away, even with targeted hip mobility drills. Over a six month period it got progressively worse until it felt like there was a deep pain in the joint. This made my work very difficult, limiting me in many movements.

Walking, stepping up, climbing the stairs and putting on socks was painful, and it prevented me going out for walks with my family. The hip pain also affected my posture. It started to give me lower back pain and nerve pain down my right leg and even a throbbing ache day and night.

How did you seek help?

I made enquiries through my health insurance, which led me to an MRI scan. I was informed that I had a cam lesion on the head of my femur. This thickened area of bone had been gradually wearing out the cartilage on the head of my femur and acetabular rim of my pelvis, causing damage. I was informed that I would need a full hip replacement.

This was a shock to me, as I considered myself to be young and healthy. I was informed the cam lesion could have been genetic. I went to see Professor Hart through personal recommendation from a family member, as he was considered to a leading UK expert.

Professor Hart was the second consultant I went to see. I was more reassured with the procedure he offered - he would perform a minimally invasive surgery, not cutting through any major walking muscles which would help me get back on my feet sooner and with fewer problems post-operation. That was important to me in my line of work, especially teaching clients, mobility, drills and weight training exercises.

What was involved in the surgical process you agreed to?

I agreed to a full hip replacement using a posterior approach, having a titanium spike cap with a ceramic ball fitted into a polymer cup within my hip socket.

A CT scan was used to choose the correct sized implant to match my unoperated side. This would avoid a leg length discrepancy. This option was not offered to me by the first consultant I saw.

I spent four days in a private hospital where I had the procedure. The level of care was excellent, and most importantly, my physio started on day one - a great introduction to my recovery.

I was fully managed for pain relief, medication and alongside my physio, the hospital was a safe environment for learning how to move around, get dressed and shower in the early stages of my rehab.

What physical state were you in before the operation?

Before the operation, I tried to keep the muscles of my glutes and legs as strong as possible. However, the pain in my hip did limit what I could do. If you are in need of a hip replacement, I’d recommend not to wait too long, as the muscles in the legs and glutes will become weaker if you are in acute pain and less able to use them.

How were you feeling before the surgery?

I was feeling nervous and apprehensive before the operation. But because I was in a lot of pain it was limiting everything I could do physically, and preventing me enjoying time with my family.

I was fully prepared to have the operation so that after rehabilitation, I would not be in any pain any longer. I wanted to return to my activities and work. I was fully confident in Professor Hart. He was excellent in explaining the procedure and what the process would be, including the aftercare.

How did you feel immediately after the op, and what was the recovery like?

After the operation, I was taken back to my room and was constantly checked on by the staff. I wasn’t in any pain, as this was managed exceptionally well. The facilities were very good and the daily physio was a fantastic start to my rehab process.

With my procedure taking a posterior approach, I was informed not to bend from the hips more than 90° for the first six weeks. I was also shown how to use two crutches and how to walk initially until I felt more confident. I was also shown how to use the stairs, how to get up and down off a bed or chair and how to use mobility aids.

I continued with physiotherapy and hydrotherapy once a week to assess my recovery. I kept up with my rehab exercises on a daily basis and incorporated short walks. I used crutches for the first 3 to 4 weeks and then reduced that down to a single crutch for a walk and no crutches in the house.

After 12 weeks I was able to sit down on my heels in a kneeling position. I regained full mobility over the first 3 to 6 months, although I was careful not to add any jumping or plyometric movements.

From 6 months, I was back to full activity in my normal day-to-day life.

How are things different now?

I’m so much happier to have had the operation and not be in pain. My replaced hip now feels great. I am back to doing all of the activities that I enjoy - whether that be landscape gardening or picking up heavy objects at home - including the kids!

I am back lifting weights. I feel healthy and strong. I almost do not notice that I’ve had an operation at all. The surgery has been life-changing for me.

What have you learned from having gone through the whole treatment process?

What I’ve learned from having a hip replacement is that, for whatever reason you may need one, finding a good consultant like Professor Hart is essential.

Your quality of life can and will return to where it was before that pain.

What advice would you offer to anyone considering having a similar op?

I would advise anyone previously in my position to consult with Professor Hart. You will be in very safe hands and have the best quality of care.

Your life will be changed for the better - you will not be in any pain and you can return to an active and healthy quality of life.

Is there anything else you’d like to share about the experience?

The technology in joint replacements and surgical procedures are far ahead of where they used to be.

I felt confident throughout that I was in safe hands. I am so happy I had the procedure and that I could return to my active lifestyle - for both work and family.