By Tessa Raebeck
After successfully taking him through years of races, triathlons and world championships, Tom MacNiven’s body could hardly get him through a night’s sleep. Like other middle-aged athletes, MacNiven, 56, found his joints could no longer keep up with the active lifestyle he loved.
But now, thanks to his surgical team, a dedicated physical therapist and an abundance of motivation, MacNiven is back on the trails.
Now when he gets on his bike, MacNiven brings five pounds of chromium cobalt with him. At age 50, he underwent a hip resurfacing, a less invasive orthopedic surgery similar to a hip replacement.
As baby boomers age, joint replacement and resurfacing surgeries are becoming increasingly popular, with more than 600,000 knee replacements and 285,000 hip replacements performed in the United States each year, according to the Agency for Healthcare Research and Quality.
Joint centers are popping up around the country and for lifelong athletes like MacNiven, the emergence of specialized doctors and advanced surgical procedures could not have come soon enough.
“I swam my first race when I was five,” said MacNiven. After swimming in college, he joined an ultimate frisbee team comprised of Division I athletes. With them, MacNiven competed in five national championships.
In his early 30s, MacNiven moved to the East End, where he started doing triathlons and racing bikes. In 1999 and 2000, he competed at the triathlon world championships with the United States team. In 2003, he went again to a national championship, this time for cyclocross, an intense competition in which riders run and bike across a variety of surfaces, barriers and obstacles. Approaching his 50th birthday, he was optimistic about being “the young kid” in a new age bracket. “I was all psyched to go to nationals,” he said. “But at the same time, my hips were both hurting a lot.”
MacNiven started looking into Birmingham Hip Resurfacing (BHR), which replaces only the surface of the femoral head, rather than the whole neck and head of the femur (thighbone). He underwent the surgery at the Hospital for Special Surgery in New York. “It was one of the first [to offer the BHR] and definitely no question the best,” said MacNiven of the hospital.
MacNiven’s left hip was resurfaced in 2008. The day of the operation, he was walking with the help of a walker. He stayed on crutches for a week and used a cane for another two weeks. “And then – boom – I was gone off and walking like Forrest Gump,” he said. “Within three months, I felt great. I was in no pain.”
“My bad hip was now my good hip, but my other hip was now my bad hip,” said MacNiven. A year and a half later in the fall of 2009, he had his right hip done. Today, he is back to normal – albeit five pounds of chromium cobalt heavier.
Also an avid cyclist, Nancy Kelley underwent a hip replacement in order to remain active. “I consider fitness a really important part of my life for so many reasons,” said Kelley, 57. “About a year before my surgery, I realized that there was something not quite right with my leg and I was able to do less and less with it.”
Kelley was diagnosed with an arthritic condition and told that she was a candidate. In early September, she had her hip replaced, also at the Hospital for Special Surgery.
“Literally, the next day I was already feeling better and in less pain than I had been in the year leading up to the procedure,” said Kelley. “The procedure is obviously a major surgery and it’s invasive, but it’s done in such a way that you are out and told to get up and start walking several hours after, which was a little shocking, but I did it.”
By late October, she was back to spinning. “Today, ten months later, I feel fantastic,” said Kelley. “I feel so happy I did it. I have no pain at all. It really is a great way to regain the level of activity that you would have never had again if you didn’t undergo the surgery.”
Jack Graves, 73, maintained that activity level throughout his life. “I always played with balls,” said Graves, the sports editor at The East Hampton Star. “I hit them, I kicked them, I passed them and caught them. I did all those things when I was a kid and I continued to do that the rest of my life.”
In his early 60s, Graves’ passion for sports, in particular tennis, hit a wall. “It was all I could do to get out of the car and I was really pissed off,” he said. “If you’re at all athletic, you just can’t stand being idle.”
Graves went to Dr. Eugene Krauss, the director of the Center for Joint Replacements here on Long Island. He had his first knee replaced at age 62 and the second knee done at 66. The replacements were so successful that Graves can’t even remember which knee was done first.
Joe O’Connell, another tennis player and lifelong athlete, had his first knee replaced at age 70 and the second replaced at 74. He found he could run around the court again, but, due to chronic pain in his shoulder, serving the ball was impossible.
“I couldn’t put my hand behind my head and scratch the back of my head,” said O’Connell, who was diagnosed with senior arthritis in his shoulder. In August 2011, at age 76, he received a titanium shoulder replacement, enhancing his tennis serve with seven pieces of metal.
“By Christmastime, I was perfect,” he said. “I threw away my knee braces. I don’t take any Aleve or Advil. I feel like I have a 21-year-old knee like I had in college playing basketball. There’s no pain whatsoever and it’s like it’s brand new.”
The deciding factor of a replacement’s worth is the motivation of the individual in the months following the surgery. Rehabilitation is paramount to a successful joint replacement.
“It’s only as good as the therapy you do afterwards,” said O’Connell, now 78. “People should not undergo the surgery unless they’re willing to devote three months to physical therapy or else you’re wasting your time.”
“Patients have to be very, very motivated in order to get the best out of the surgery,” said Sinead Fitzgibbon, of Manual and Sports Physical Therapy in Sag Harbor. For the first two months following the surgery, patients go to physical therapy at least three times a week.
Fitzgibbon focuses on a therapeutic exercise approach of corrective movements. “The initial phase is focused on getting full mobility back in the new joints,” she said. “The second phase is focused on getting a full sense of function back and that can happen in the third month with the hip replacement and up to six months with the knee replacement.”
Fitzgibbon guides patients through squats, lunges, “pretty much anything that you would see in a modern exercise class…but used in a modified capacity and under strict supervision and progression, according to the phase of recovery.”
“I’ve had patients return back to not just tennis and golf, but back to kiteboarding, biking and surfing after doing replacements,” said Fitzgibbon. “You get out of it what you put into it. If you put in a ton of work and focus – especially in the early three month period – you’re guaranteed a very good outcome.”
“At six months, I was running around the high school field,” said Graves. “And then I began to play tennis again.” Returning to the game in his late 60s, Graves won a singles tournament at East Hampton Indoor Tennis.
“Rather decisively, too,” he said.