Hip Arthritis, Minimally Invasive Hip Replacement

You don’t need to actually play a game of squash to grasp the intensity. Just looking at it makes you sweat.

Though it’s more popular in Europe than in the United States, Charlie Baker, from Philadelphia, started playing when he was 12 years old. He’s now 90.

“That’s a lot of years,” he laughs. “I just love the sport.”

Over that time, during the cooler months, he’s consistently played squash three times a week for at least an hour each session. He’s even competed in several national tournaments. In the warmer months, he switches to tennis and plays for longer sessions.

But back in June 2005, around his 80th birthday, something happened that made Charlie wonder if he’d ever play again.

Spasms, Twinges and Pain

He’d started to notice spasms of pain in his right hip. “When I overdid it, playing too hard or too often, I would suffer a lot of pain,” explains Charlie, a retired non-profit director.

“For instance, if I moved in one direction where I was putting a lot of pressure on the right leg, I would feel a sudden twinge that would interfere with my ability to move,” he says.

Agility and hip movement are not negotiable in squash. The game involves constant shuffling, pivoting, twisting, leaping forward and lunging backward.

The pain got so bad that Charlie started to second-guess himself before a move. “I’d anticipate that I’d have a difficult time if I pushed off on my right leg,” he recalls.

Sure, he could go to the doctor, but he was afraid that could mean the need for open surgery, months of rehab - and retirement from squash.

Then, a fellow squash player who’d a similar problem told him about a minimally invasive hip replacement that wouldn’t involve as much time off.

“That definitely sparked my interest,” says Charlie.

Problems and Answers

Even though Charlie’s treatment was 10 years ago, he and Charles Nelson, MD, Chief of Joint Replacement at Penn Orthopaedics, vividly remember each other.

Charlie had found him through an online search while looking for “an expert in minimally invasive hip surgery”.

The problem: Charlie’s right hip had severe arthritis and the joint was nearly bone grinding on bone. An X-ray and MRI clearly showed that the protective cartilage that helps the bones glide over each other had been significantly worn.

Despite the damage, Dr. Nelson was quite familiar with Charlie’s priority to stay active.

“People have expectations that they should be active, independent and enjoy doing things even in later years,” Dr. Nelson explains. “Even if they are older, they are more likely to be less accepting of limited mobility.”

“I figured at my age, the recuperation was going to be difficult,” Charlie echoes. “But I wanted to be out of action for as short a time as possible.”

The answer: Minimally invasive hip replacement.

Back on the Court

Under X-ray guidance and spinal anesthesia, the procedure involves one small incision at the front of the hip and another toward the back part of the hip. Instead of the muscles being detached around the hip joint, they are parted like curtains to access the joint, explains Dr. Nelson.

“Preserving the muscle structure appears to allow more rapid rehabilitation,” he says.

Dr. Nelson replaced Charlie’s hip with a durable type of plastic that’s unlikely to wear or fracture for at least 15 years of activity.

Charlie’s rehab began immediately. He walked, climbed up stairs and eventually jogged around his local track.

Only eight weeks after the surgery, Charlie was back on the squash court. “There was a ball that I had to run for, and I had to get it,” he recalls about his first post-surgery match. “I was apprehensive. I didn’t want to do anything to louse up the surgery.”

Not only did he get the ball, he’s since gone on to win first place in his age group at five squash tournaments.

A decade has passed, but Charlie says his hip replacement still feels like new.

“I’ve had no issues with my hip,” he says. “I’m trying to make sure I get that guarantee of 15 years.”

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