Roger Portch is a 56-year-old retired airline
Pilot and was an excellent candidate for metal-on-metal Hip Resurfacing, as he fell into the younger patient grouping, and enjoyed a very active lifestyle.
Roger’s diagnosis was not confirmed for over two years. Two separate consultants and a chiropractor failed to detect arthritis, concentrating instead on the lower back pain which, initially, was the dominant symptom. Indeed, Roger himself never considered the possibility of hip disease; after all, he was only 52 years old, considered himself reasonably fit, and had always led an active life. For over twenty years he played competitive squash, reaching Gloucestershire premier division standard. Eventually, a combination of tennis elbow and a growing passion for mountaineering brought his squash playing days to an end. Always a keen runner, in the 1980's he ran in the New York Marathon and came in at around the 1,500 mark, out of 20,000+ entrants, with a completion time of
three hours 20 minutes. Ten years later he took to road racing again as a means of keeping fit for mountaineering. He also enjoys playing golf and skiing, both to a uniformly low standard.
The turning point for Roger came about two years’ ago. He was climbing with a friend whom he had met two years earlier on an expedition to the North Ridge of Mount Everest. This friend was a doctor and changed Roger’s life with the words, “I don’t know about back problems Roger, you look like a man with arthritis to me.” Returning to his GP, this time Roger asked for a complete assessment starting from new. It took the GP no more than two minutes to confirm what Roger’s fellow-climber had immediately suspected - despite being only 54 years old, Roger did, indeed, have osteoarthritis in the right hip. Roger’s belief is that, as he has no history of ostheoarthritic disease in the family, his condition is due to the
20 years of squash exacerbated by road running.
Understandably, Roger’s first thoughts did not automatically spring to surgery. Instead he went away and carried on with his life. Needless to say, the pain did not go away and, early in 2000, Roger had his first appointment with an Orthopaedic Consultant. Interestingly, he did not advise surgery at that point, as Roger was still mobile and relatively active, he did however confirm that it would be necessary in the future. Once again, Roger went away.
In the summer of 2001, Roger undertook the 100-mile walking tour of Mont Blanc with his wife and two friends. Despite some discomfort, by keeping the pace gentle and the days reasonably short, he was able to complete the circuit in 13 days. However, the pain was slowly but surely becoming more acute and his sleep becoming increasingly disturbed, so he returned to the consultant. A new X-ray showed further degeneration and, this time, it was felt that surgery would be appropriate. As this was to be an elective procedure, despite all the evidence it was a very hard decision to make. Roger’s eventual decision was based upon the fact that, at 56 he didn’t know how many active years remained to him, but he was determined to make the most of them by continuing to participate in the activities he enjoyed so much. To his mind the benefits of a metal-on-metal resurfacing procedure would be the chance to enjoy a near normal physical lifestyle since he would have a mechanically robust joint with minimal potential for wear and scope for revision surgery, should this prove necessary at a later stage.
Roger received a Cormet 2000 resurfacing hip in November 2001 and his operation has been, to-date, a complete success. He will not be running any more marathons or playing competitive squash, but he can run for the bus and was back at the indoor climbing centre within two months of the operation.
Roger’s experience of the operation was that it was uncomfortable, rather than painful. He achieved all his normal recovery milestones within the recommended time. He expressed some surprise at the degree of stiffness in the right knee, but some determined work on the stairs seemed to get things back on track. He acknowledges that his pre-operative level of fitness and decision to undergo surgery at a relatively early stage in the development of his arthritis meant that he felt his post-operative limitations slightly more keenly. However, Roger is keen to point out that these limitations will not be so apparent in those patients with more advanced degeneration who are considering surgery. These aches and pains are minor inconveniences compared to the overwhelming relief produced by the total absence of pain from the affected joint.
