“An Outpatient Hip Replacement Allows Avid Runner to Quickly Return to What He Loves”
Kai Syvertsen runs marathons. So many marathons he's lost count. But for much of the last 10 years, running marathons also meant near-constant hamstring and glute pain. In his late 30s, Kai was diagnosed with a moderately to severely arthritic right hip.
With physical therapy, he felt well enough to run for several more years. However, it didn't fix the root of the problem so the arthritis progressively worsened.
"In November 2019, I ran the Philly Marathon. After that, I just never really recovered," Kai says.
Soon thereafter, the pandemic forced the cancellation of most marathons around the world. Kai was in no shape to race anyway. He was having trouble just walking. It was then Kai knew it was time to seek help. In the summer of 2020, Kai received a second opinion from Neil P. Sheth, MD, FACS, Chief of Orthopaedic Surgery at Pennsylvania Hospital.
Dr. Sheth informed Kai that his arthritis was the result of an impingement that developed because of a physical abnormality with his right hip. For that reason, his condition was only going to get worse, even if he continued seeing a physical therapist. Dr. Sheth recommended an outpatient total hip replacement to treat Kai's condition. This meant that he would be discharged from the hospital the same day as his surgery.
At age 44, Kai was young and in good health so, Dr. Sheth believed he was an ideal candidate for the procedure. The fact that he was highly motivated to get better and had a spouse who could help with his recovery at home only furthered his cause.
Just What He Needed To Hear
For an avid runner like Kai, there are few phrases as devastating as "total hip replacement."
Following Dr. Sheth's recommendation, Kai researched the procedure online. He turned to an online platform for runners and that's where he found a sub-community called the "Hip Runners." Each of its members had undergone a hip replacement, and many of them also received the same-day procedure Kai was considering.
He asked what their experiences were like. What he really wanted to know was whether he would ever run competitively again. They assured him he would. Dr. Sheth agreed.
"Dr. Sheth always made me feel like he was excited to be working with me," Kai says. "On top of that, he was really encouraging and supportive of my goals. He told me I'd get back to my normal mileage and racing again."
Kai says once he agreed to have the surgery, things moved quickly.
Kai's surgery took place at Pennsylvania Hospital on August 12, 2020. Several hours after surgery, he was taken to the hospital's Rapid Recovery Unit. There, both Kai and his wife met with a physical therapist, who tested Kai's ability to walk with a walker and get to a bathroom on his own.
Typically, this session is used to simulate as much of the patient's home life as possible. That can mean getting in and out of a car, maneuvering around with a walker, using the bathroom, and ascending and descending stairs. Sam Kim, PT, DPT, a Good Shepherd Penn Partners physical therapist in the unit, describes it as "activity tolerance."
If they've passed all their clinical evaluations, Dr. Sheth allows his patients to decide if they feel comfortable going home the same day as their surgery or if they prefer to stay the night.
Based on Kai's ability to successfully complete his physical therapy tasks, and the support he would have at home from his wife, he opted to go home after his physical therapy session that day, a decision that was supported by his providers.
From a Walker To a Marathon
The day after his surgery, Kai started working with a physical therapist regularly. Three days later, he replaced the walker with a cane. Two weeks after that, he was walking without any assistance.
Just three weeks after his surgery, Kai climbed on a treadmill during one of his physical therapy sessions and went for his first run on his new hip. A week later, he ran a mile without stopping.
"I definitely felt a little wobbly at first. But there was no pain. Before, I was in agony every time I ran," Kai says. "It took a little while to get to where I was fully comfortable running and my stride felt smooth, but training and working with the physical therapist helped."
In addition to adjusting to his new joint, Dr. Sheth says that it was a matter of enabling the surrounding muscles to catch up with Kai's sudden improvement. "An arthritic hip doesn't move and the muscles, in turn, become a little shorter and tighter," he says. It can take some time to restore them to full function again.
That fall, a couple of months after his hip replacement, Kai was running 15 miles a week. By the start of the new year, he was back up to 20 to 30 miles a week.
He ran his first race on his new hip almost a year after his surgery. It probably would have come sooner if not for the pandemic continuing to wreak havoc on the race calendar. Kai ran the Philly 10K at a 6:40 pace. Two weeks later, he ran the Philadelphia Half Marathon in preparation for the London Marathon, which he ran two weeks after that.
Kai crossed the finish line at 3:20.28. He missed the qualifying time for his age group at the Boston Marathon, a race he ran nearly every year, by a mere 28 seconds. Normally, he would have been crushed. But he was back to doing what he loved, and he felt great. That mattered much more. And, anyway, now he could say, "There's always next year."