Broken femur - anyone with experience?

[Wahine]

Clinically, I would say that early onset OAS is more frequently seen in weight bearing sports and occupations. But I have seen it in people at a relatively young age that do not participate in high impact sport. For eg, last year I saw a 56 yr old male post bilateral hip resurfacing surgery (this is a technique to deal with hip OAS that is less invasive than a total hip and has a very good success rate in the younger population). He was a professional kayaker, still runs a guiding and instruction company. He was also a cyclist, both road and mtn. So no high impact sports, no major trauma. No clue as to why he had such severe arthritis at such a relatively young age.

I did find this excerpt from an abstract on The American Journal of Sports Medicine:

Men with high exposure to sports of all kinds com bined (in hours) had a relative risk to develop osteoar throsis of the hip of 4.5 compared to those with low exposure. Track and field sports and racket sports seemed to be the most hazardous to the hip joint. Men who had been exposed to high physical loads both from their occupation and sports had a relative risk of 8.5 to develop osteoarthrosis of the hip compared to those with low physical load in both activities. Potential confounding factors, such as age, body mass index, and smoking, were considered.

Long-term exposure to sports among men seems to be a risk factor for developing severe osteoarthrosis of the hip; this is increased when combined with heavy load from occupation.


In your particular case I would say that any alignment changes will result in faster degeneration of the joint. To the extent that you can decrease the forces going through the joint, you will decrease the pain and slow progression. A shorter crank arm would help significantly with this as it decreases the amount of torque required to turn the crank. In addition to this, staying in a gear that allows you the highest possible efficient spin would also help.

[Ogresse]

Hi Eden,

I bet it would be useful to have a PT or someone in the know spot you as you do your step-ups to make sure your knees are aligned properly. I have no training in this area - just a ton of rehab experience! - so it's a layperson's $.02. But if you're already wedged and canted as much as you are in the bike that might be a good thing to do (and consider orthotics which correct for varus/valgus and all that). As part of my rehab I treated myself to a superdy-duper (as my 7-yr old says) pair of trail running shoes. I tried to find the most stabilizing shoes possible and found an (expensive!) pair of Salomons that have helped me do lateral lunges and stuff like that without feeling like I'm going to fall into the refrigerator. Of course, I could always do them some place other than the kitchen...

Trisk - thanks for that note. I'd already seen that High Sierra site and eyed the one-piece wedges with great interest. I'll see how it goes with this next approach (I bet I'll end up with 165 on the right and 160 on the left/shorter leg - if it's even possible to find a single left 160mm Shimano crank!) and will definitely keep Tom in mind for a consult.

Wahine - thanks, also, for that info. I'll see if I can find the article you quote from. I've also heard about a surgery (osteotomy?) where they cut a deeper or different angle in the socket so the ball can rotate correctly once again. Lots of invasive things to do. Hoping to find something non-invasive (like maybe some kind of torture stretching device that can reposition my leg out and up!). The "funniest" ( ) comment I've heard so far is that if I do have to have a hip replacement, they can also lengthen my leg...

Hope everyone can get in a ride today! It's 40s and very sunny out here in New England and my legs are itching for it. Thanks for your help.
O.

[Triskeliongirl]

You don't need the wedges. Those are for folks with smaller LLDs. For small LLDs, approaches like blocks, shims, and creative cleat placement can work, but for large ones like ours, I believe that a dropped pedal is the best approach.

http://www.hscycle.com/Pages/cantsandwedges.html

While I had him build me an entire crank set, it may be possible for him to build you a single crank arm with a dropped pedal for your long leg size that would be comptable with any crank set.

[LBTC]

I have to say, not that I am a bio-engineer, or anything, but I think the idea of the dropped pedal on equal length cranks makes very good sense. This guy sounds like he really knows what he's doing.

Good luck, Ogresse.

Hugs and butterflies,
~T~

[Ogresse]

Trisk - I just sent an inquiry to Tom at High Sierra, so thanks for that tip.

It would help if you could, when you have a chance, describe how the dropped pedal works on your longer leg. I'm having trouble visualizing it.

Many thanks!

[Triskeliongirl]

Look at the picture in the link. The dropped pedal pivots throughout the pedal stroke. Both crank arms are the same length, but on the long leg side is a pivoting extension the size of your LLD, say 1", and the pedal is built into the bottom of that. Its lets the length of the crank arm continually adjust throughout the pedal stroked. Tom is more of a phone guy than email guy so try ringing him up.