For runners who have had knee/hip replacements..what did you do wrong?

I ran and raced for forty years though I dropped my mileage considerably in my 30's -- job, wife, kids, house; my priorities changed. Wore orthodics beginning in my mid-20s. Left knee had stage 4 arthritis by age 50, continued running for another half-dozen years. Knee replacements at 63 and 67. So now I walk, bike, play tennis and when possible XC ski; all of which I do without the pain that I endured for fifteen years. It happens, we just move on.

I'm 64, and was born with club feet. Back then, they corrected this with braces followed by corrective shoes. In spite of this, I was blessed with the ability to run competitively in high school and collegiately, and eventually up to age 50. Due to my birth defects, my running mechanics were really bad, so both knees eventually wore out.
Last winter, I had total knee replacement on both knees, 7 weeks apart, and the results have been great. My post-surgery recovery went extremely well, as I was up and walking without a crutch after 2 days. Two major keys are prehab/rehab, and positive attitude (refuse to feel sorry for yourself, there are many people out there worse off). Before my surgeries, I did as much strengthening as my knees would allow, and post-surgery, I hammered the therapy, and continue to do lower body strength training 3 days/week. I also stayed off of the opiate pain meds. I managed the discomfort with icing (tons of it!), and general anti-inflammatories and Tylenol.

A few weeks ago I went backpacking (not real heavy pack) over very hilly, rough terrain for 2 days (about 25 miles total), with no pain or ill effects. For aerobic training I'm doing rowing, elliptical, biking, and walking about 1 hour, 6 days/week. The way I feel, I know could run now, but I want these new knees to go the distance and last 20-30 years, rather than the 8-10 years I'd probably get if I ran.

Anyway, for me, getting my knees replaced has been one of my best ever decisions. First time in decades I've been pain free and able to do whatever I want.

One final point. As others have alluded to, it's not the running that causes arthritis, it's running with less-than-optimal mechanics, which is most often due to heredity. Runners do not have a higher incidence of arthritis than the general population.

That's impressive! Do you know the make/model of your prosthetics and whether they were they cemented or uncemented? Maybe you have low bodyweight which helps.

Some hip replacement history:
I recall reading a study of some woman 80+ yrs old complaining of hip pain and extreme Trendelenberg signs. They eventually discovered her hip had dislocated and found records to prove she was one of the first in the US to get a hip replacement some time in her 20s. The femoral head shell was made of glass! Germans first led the way in the late 1800s using ivory. Anyway, her hip replacement had lasted for over 50 years (YMMV) but she weighed very little and was not athletic. US hip replacements started in 1925 by the American surgeon Marius Smith-Petersen, who first used glass but due to shattering, switched to stainless steel and bolting to the bone. I met someone who had a ceramic hip, but it squeaked so bad when he played racquetball or squash that no one wanted to play him anymore, so he claimed.

I’m guessing that you wrote your reply to provide anecdotal evidence to refute the claim made originally, by the study supplied, that moderate running was best for arthritic protection.

Firstly, as I previously stated, the poison is in the dose, and everyone has a different level of tolerance and robustness, along with all the other factors mentioned such as running mechanics. So an anecdotal point of one, doesn’t really prove much…

Plus your point actually proves the study’s claims, so it appears. You seem to train with running quite a lot for your races, but eventually succumb to injuries from that running volume, which in turn only relents when you switch to another cardio modality. It’s a boom and bust, roller coaster experience with running for you.

Putting aside the idea that maybe including a bit of strength training would be possibly protective, if done properly, perhaps if you had taken a more moderate approach to the running, then you wouldn’t have been injured as often and therefore been more consistent?

Perhaps sustaining minor injuries and incorporating breaks for cross-country skiing and elliptical workouts is the key to his running longevity at 80?

It could be attributed to lower lifetime mileage and reduced impact. Many runners I know solely focused on running seem to experience quicker breakdowns compared to those with seasonal hobbies. In their 60s, my few friends who are still formidable runners often engage in skiing or biking regularly. I'm inclined to believe this theory, especially since I spend most of my winter cross-country skiing and structure my running as uphill intervals on the treadmill hoping to prevent as much damage as possible.

You may be correct…but however the routine was structured it still points to the fact that running in moderation ( in relation to your own robustness) is still the best policy for overall long term health and joint longevity. Whether this is via moderate levels of running ( in terms of volume, frequency and intensity) do e on a consistent basis, or via a more aggressive approach with breaks to ensure adequate recovery of the connective tissues.

Not being a risk taker myself, I prefer to walk on the side of caution. The problem is, that most to absolutely none of us know that we’ve pushed it too far until something finally gives way, and then it’s often too late. A bit like playing Russian Roulette with your own body.

My knee clunks on full extension in the morning, it worries me...

I'm going to try and do the FULL year of training on grass this year. Only doing races on road, maybe 6-8. So almost all running on forgiving surface.

Sports fields in the UK are so soft it's really hard training currently, but when I run on the roads its so easy and fast.

Still think my knee going to need attention later in life.

Glad you seasoned guys are all doing OK.

I am 68 years old and have run over 135,000 miles. What did I do wrong that required both hips to be replaced over the past 4 years? The right hip was replaced when I twist broke my leg cross country skiing tearing my hip labrum, the left was a result of hard bike crashes. My surgeon told me I would never wear out the replacements so go ahead and run. Ran 2500 miles including a half marathon and several sprint/Olympic triathlons on the right before replacing the left. At two years the X-ray showed zero wear. Plan to run the Atlanta half the end of feb one year post op on the left.

So for me, if I wanted to get thru life with no replacements, I would sit in my ez chair and do nothing…..but that’s not me and I don’t plan on going to the grave looking pretty:-)

Advice…not sure you can avoid it if you have a family history of mechanical issues, but if you do you can add in mobility and strength routines for the areas of concern. And if you still need replacements, it’s not the end of the world. With today’s technology, bigger sockets and balls, cross linked polys you can still maintain a very active lifestyle. Many of use mechanical athletes are. Check out the hiprunner website or Strava group for proof.

My point is that you can't take your present good luck with your health for granted. At 65 it could change at any moment. I thought you might have come to see that, with age, good health and being pain-free is a better option than trying to maintain the remnants of what you were best able to do in your youth. When you can no longer run it will be pain that stops you, and it is likely that running competitively when your body is wearing out will have brought it on. I knew a very good runner whose bad knees stopped him in later life. He had them replaced and started competing again. It didn't last. Racing damaged the new joints. There is a time in life for everything and wisdom is knowing that.

Keeping my eyes on this thread as I have a screw going through my knee.

Most runners should know this but we see that with many top athletes it is injury of some kind that ends their careers. I saw a documentary about Mary Decker and that once wonderfully gifted athlete now shares the same kind of infirmities that some on this thread have recounted. If you train and compete like an elite athlete you run the same risks of wear and tear. But it is also clear that the biggest component in all of this is - quite apart from management or mismanagement of our health - is luck; your genes. Some of us age badly and prematurely, others see off virtually every kind of infirmity - until the last. The Ed Whitlocks of this world are freaks - in every sense. But the rest of us do what we can as we age - even if it isn't much and hurts a lot. But, I, for one, could do nothing of what I remain capable without the advances of modern medicine. That is something to be grateful for. Correction: something else to be grateful for. Still being alive after many years is a good start.

Hah. This does seem to be the major issue. I can tell you I see people who have had or are having TJR (knee or hip or shoulder) every single day. It is RARE that they were a runner or athlete. The ones that were athletes do seem to be hitting sports. I don't doubt that running a crap load of miles your whole life can speed up DJD, but that genetic influence is strong. Most of my TJR patients are extremely obese. They also have arthritis throughout their body (genes). The exception is the guy who gets in a vehicle accident or a severe injury in soccer or football or occupational and ends up with severe post traumatic arthritis in that one knee or hip or whatever. But otherwise they are fine. But that is the exception.

FWIW, if you are considering it, my patients are almost universally over the moon about the decision. Infection is the enemy.

Dont do it unless you need it, but nearly everyone I talk to says "I wish I had not waited so long".

Take home message here is traumatic events! Its well know that traumatic knee (or hip or wrist or ...) injury sets you up for DJD down the road way more than running miles within a normal ROM. Genes of course trump all of this.

Just a quick pubmed search, Obesity seems way more bad for you than running:

pubmed.ncbi.nlm.nih.gov

Obesity and osteoarthritis - PubMed

This paper provides an up-to-date review of obesity and lower limb osteoarthritis (OA). OA is a major global cause of disability, with the knee being the most frequently affected joint. There is a proven association between o...

Open link

ncbi.nlm.nih.gov

Obesity increases the likelihood of total joint replacement surgery among younger adults

We conducted a retrospective review of medical charts of patients, aged 18 to 59 years old, who underwent either a total knee replacement (TKR) or total hip replacement (THR) from January 2002 to December 2004. Of the 204 stu...

Open link

I’m not an orthopedic surgeon. I am an anesthesiologist. Most of our joint replacement patients are not runners. In fact very few. As has been mentioned, obesity and a sedentary lifestyle is a high risk activity. All the non runners who love to utter ‘you’ll ruin your knees’ are ignorant. That said, if you have some preexisting conditions, running may exacerbate your joint problems.
My 83yo father ran for a few decades. He attributes his early hip replacement at 49yr to non running injuries in his younger years. The replacement is still solid. He did not run after his replacement.
YMMV

I was not injured more than most others, nothing serious or disabling for more than a few weeks. I have raced 10 times or more almost every year for 70 years. But I did decide to eschew marathons, which entailed more training than I had time for. The advent of elliptical machines helped a lot for keeping in shape while suffering nagging injuries from time to time.

That's remarkable, thanks for posting.

I guess hip replacements last better than knee replacements when it comes to running afterwards. Though I have a good friend who had both hips replaced and doesn't run really much anymore, due to doctors orders.

I'm looking at knee replacements some time in the future and recently talked briefly to a division president from Stryker. They do like 40,000 knee and hip replacements a month and he said that the fit and outcomes are much better now with robotic surgery. I asked about running and he said it was a no no but people are doing it now. Though he said probably not marathons. My orthopedic doctor is old school and he doesn't agree.

You all thinking about doing joint replacements and want to wait. For what? When you are older and it will be harder to recover. I have never met one person that said I should've waited to get it done later in life, yet everyone that I know has gotten them done has stated I wish I would've gotten in done earlier. They have the science down on these procedures now. My anterior approach replacements were done in 75-90 minutes each. I was walking that day for each of them.

But the sprinting in spikes didn't cause this, it was always there but the spikes triggered it?