Hip replacement & dive training

[Hoomi]

Hi all. I asked this question of a friend that dives, and she recommended I pop over here and ask, in case someone here has experience with this issue.

My wife has expressed interest in learning to dive. She's 45, and a few months back had a total hip replacement. There are still a few leg positions she is supposed to avoid, but overall she has far better mobility now than she's had for several years. I have a call in to her orthopedist to ask, but he may not be familiar with Scuba, and might ask additional questions that I, as unfamiliar with Scuba also, would be clueless about.

Have any of you dealt with students after hip replacement surgery before, and did it cause any issues with either the training or open water diving? My wife's birthday is late August, and if nothing precludes doing so, I'd like to surprise her with the Open Water diving course at our local Dive Shop (here in the middle of the Arizona Desert, far from any real open water...).

The course I'm looking at is this one:

The Dive Shop - Open Water Certification Course

With their 2 for 1 deal, I can take the course with her for just the cost of the training materials, and then the cost of the certification excursion down to Mexico.

Thanks in advance for any insights or opinions you can offer. We've both done some snorkeling before, though it's been a number of years for either of us, but now that our kids are grown up we can look into some of these long-time aspirations. I figure some research ahead of time pays off in the long run.

 

[FireDiver443]

I can't speak for a total hip but my 43 y/o wife had a total knee replacement a few years ago and had no problems getting back in the water. Depending on sea conditions she sometimes has to doff her weight-integrated BC prior to getting back on the boat or heading into shore, but other than that, her return to diving has been without incident. Depending on the composition of her prosthesis, tell her to be prepared to get the TSA "Grand Tour" every time she flies. My wife's cobalt-chromium knee pegs the magnetometer, so we've become used to the increased scrutiny every time we travel. I joked once that she should carry our reg bag when we fly... there's no sense in BOTH of us getting tied up in security.

Good luck to your wife in her recovery! See you on the bottom.

 

[rickyd]

Glad you asked Hoomi. I will soon need either a total hip replacement, or hip resurfacing ( BHR ). I too wonder about the impact on my diving.

 

[Hoomi]

For the first few weeks, she had very strict limitations on how she could move the affected leg, so that the prosthetic would have time to seat well. She could not bring the thigh up beyond a 90 degree angle to her abdomen, could not swing it back behind the hip, had limited swing out of the leg to the side, and with three months since the surgery, she is still under a limitation of not being allowed to cross the affected leg over the center line of her body. However, she is back to full load bearing on the leg (first few weeks were limited, and she had to use a walker).

I really doubt there should be any problem, but with cases like this, it's better to ask first than it is to find out after the fact that something about the training puts undue stress on the new joint.

What is your issue with the hip, RickyD, if you don't mind my asking. My wife has osteoarthritis brought on by congenital hip dysplasia, and by the time of the surgery she had no cartilage left in the hip and it was on the verge of dislocating all on its own (ouch!). The surgeon was a bit reluctant to do a replacement on someone her age, but after looking at the x-ray, determined we couldn't put it off any longer. Truth be told, my wife was ready to have it done anyways, as she was in such constant pain that it was reaching the point of hip replacement or wheelchair. Her other hip is still okay, and we hope with care to keep it from getting as bad.

 

[fisherdvm]

My father in law fractured his hip replacement slipping in a parking lot, and the crude attempt (the best they can do) to tie the mess together looks like someone trying to fix a old barn with a roll of scotch tape. Fortunely, it held, but looking at the frailty of a hip prosthesis... I am not sure if I would say it can handle a jolt of a dive boat ladder on the leg of a diver with 60 lbs plus of gears.

In the same way, when my wife had her right hip replaced, the orthopod said that her bone was as soft as chewing gum. I am not sure I would want her to consider diving ever.

I think as a man, with larger bone mass, and lower risk of osteoporosis, one can attempt scuba without problem. But with a woman, who might be at risk for bone loss, and hip replacement - I would say diving should be reserved for the most ideal tranquil environment.

My brother in law, who has a bad ankle and leg, will remove his weight integrated BC and tank prior to reentry on a dive boat. The crew or myself would retrieve the BC/Tank/weight - nearly 65 lbs or more, so he doesn't have to bear weight while climbing the ladder.

I would say, she can still dive, but you'll have to find a suitable dive environment for her, and pay enough tip so the crew will help her on and off. All it take is a rogue wave, and an improperly placed step, and a second painful and risky surgery will need to be performed - which might not even take very well. All you have to do is see my father in law's xray of the fractured femur and prosthesis - and you would understand why I have such reservation about diving and hip replacement.

 

[Chipmon]

I plan on having a total hip replacement in the next couple of years. I have spoken to my orthopedic surgeon about this, and he said that he sees no reason why I can't be diving as often as ever within 6-9 months post op. I also spoke to a 45 year old man in the waiting room whop had one done when he was 35, he shoots hoops 3-4 times a week and is very active with no ill effects other than knowing he's going to have to have it re-done in a few years when the prosthesis wears out.

 

[Noboundaries]

I'm having my left hip replaced on 8/4, planning on my part so I can convalesce while watching the Olympics. I'm walking bone on bone due to a dislocation in a motorcycle accident 29 years ago. I almost walk like Grandpa Walter Brennan in that late 50's-early 60's show The Real McCoy.

Docs are always overly cautious (for good reasons), but my orthopod (a sports specialist), said I'll be back golfing in six to eight weeks and diving again as early as two to three months after the surgery (nominal recovery). He's actually amazed that I've been able to continue diving as long as I have with the bad hip. It isn't the diving that's the problem, its the added weight of hauling all the gear around that's the issue. Then again, that's why she has you Hoomi

One of the guys at my LDS, around age 50, has had both hips replaced and dives several hundred dives a year. To avoid putting undue weight on his hips (creating additional wear on the prosthesis) he says he often puts his gear on in the water.

What will really determine if she's ready for diving is her confidence in her hip. It she's fully confident, not overly so, she'll adapt fine. You're totally weightless under the water, conserving energy. Until she gets enough experience, if she's diving in calm conditions or a one-way drift dive, piece of cake.

Hey, guys and gals are coming back from Iraq and Afghanistan with missing parts and they're taking up scuba through an organization called SUDS; Soldiers Undertaking Disabled Scuba. http://www.sudsdiving.org/ They're an inspiration to those of us who just wore things out or were born with challenging genetics. If they can do it, so can we.

 

[Hoomi]

My wife, as previously said, is 45 years old. Her recovery has been quite rapid, partly because she has very strong, healthy bones. Hip replacement patients of more advanced years often have brittle bones that are slower to heal and easier to splinter.

At this time, our biggest concern is that some aspect of the training might extend the new joint beyond the current limitations she has on her mobility.

This is something she has always wanted to do, and I'm hoping we're actually able to learn.

 

[TSandM]

I really don't know the answer to this question, but if her bone density is good, there is no reason why she can't participate in ANY activity which is within the range of motion limitations that her orthopod has put on her. The best course is to talk to him about it -- Explain the loads she would be expected to carry, and the kinds of stresses she might encounter.

BTW, the majority of people who dive, either from shore or off boats, aren't dealing with enormous stresses reboarding or landing. I dive off boats in Puget Sound, and if we have two foot swells, we are having a bad day. If you can walk up a slope with your gear on, you can reboard a boat. So I wouldn't be afraid that she can't manage the stresses. But only her surgeon knows what her bone quality was, and he is best able to advise you.

 

[fisherdvm]

To me, what is written below essentially rule out diving:

The American Academy of Orthopaedic Surgeons in its website for patients http://orthoinfo.aaos.org/topic.cfm?topic=A00356
states thefollowing: "Acceptable activities include dancing, golfing (with spikeless shoes and a cart) and bicycling (on level surfaces). Avoid activities that involve impact stress on the joint such as tennis or badminton, contact sports (football, baseball), squash or racketball, jumping or jogging. Lifting weights is not a problem, but carrying heavy awkward objects that cause you to stagger is not wise, especially if you must go up and down stairs or slopes. Plan ahead to have a cart, dolly or hand - truck available".

A concensus guideline was published this year...based on a survey of the Hip Society and the American Association of Hip and Knee Surgeons. Both professional organizations include orthopaedic surgeons who specialize in total hip replacement surgery. Response rate was 72%. One - third of the surgeons "recommended returning to acceptable athletic activities at 1 to 3 months after surgery...90% agreed that patients could return at the end of 6 months. Most orthopaedic surgeons agreed that patients could return to "low - impact activities such as golf, swimming, or low - impact aerobics. They...recommended against high - impact activities that involve acceleration and deceleration such as running, racket sports or basketball".