Clean Run - February 2015 - 44

Agility After

JOINT REPLACEMENTS
By Jan Manning

About this article: When I began
researching this article I solicited
comments from throughout the agility community. I want to thank those
who responded via email and the Clean
Run discussion forum on Yahoo. Each
story was inspiring. Out of about 50
responses, only one voiced negative
results from a joint replacement, and
this case did involve extenuating circumstances. The information in this
article isn't meant to replace advice
from health professionals, but simply to
impart optimism in the minds of agility
handlers who are facing joint replacement surgery.
Your knee hurts. Your hip aches. You've
really started noticing it at the end of a
run when the throbbing stiffness comes
crashing down on you like a triple-bar
jump. You hobble back to your crating
area, knowing you must now take your
dog out for a rewarding game of fetch,
and you start dreading the thought because it hurts so badly to just walk. Or
stand. Or sit. But there's still one more
run today, so you pop a couple more
Aleve to get you through the afternoon.
Maybe the aching will subside enough
so that you can get some sleep tonight
without having to ice the inflamed joint.
Maybe it's time to call your surgeon
again and get an earlier date for that hip
or knee replacement she recommended,
but you fear that will be the end of your
agility career.
44

Fear not! For a huge and rapidly growing segment of our agility community,
joint replacement surgeries have become almost a normal part of the aging
process. Go to virtually any agility trial
in the country and you're going to be
surrounded by handlers sporting artificial knees and hips. You won't even
know it, because most of them will be
moving as well as-or better than-
their peers who haven't yet gone
"bionic."
A huge percentage of agility competitors in the U.S. are between 40 and 65
years of age. That's the age when most
adults start experiencing at least mild
twinges of joint disease. Some cases
are exacerbated by injuries or genetics,
but nearly all adults fall prey to some
degree of arthritic changes as their
joints age. We wear down the cartilage
that cushions the bones. Inflammation
caused by friction reduces the amount
of synovial fluid that lubricates the
joints. The inflammation also eats away
at the bone in the joints, causing once
smooth surfaces to become rough and
irregular, leading to more pain and less
range of motion.
As recently as 20 years ago, joint replacements were widely considered
radical surgeries appropriate primarily
for older and basically inactive patients.
Doctors were reluctant to do joint replacements on younger patients because

they knew they would wear out and
need replacing, thus necessitating more
major surgery and more risk of infection
and failure. Arthritis sufferers were told
take NSAIDS, do therapy, try cortisone
injections, and just put off joint replacement surgery as long as they could,
even if it meant curtailing their favorite
activities and living with chronic pain.
Today joint replacements are commonplace for much younger and active patients. The attitude has changed among
many orthopedic surgeons who are,
themselves, in the same peer group as
their new clients. The new philosophy is
about helping patients of any age enjoy
quality of life on their own terms. If a
42-year-old's greatest passion in life is
dog agility, and severe osteoarthritis in
his hip joint is making the activity too
painful, he should be entitled to a new
hip joint now, rather than having to wait
for another 25 years because a surgeon
says he's "too young and should wait."
The 42-year-old may indeed wear out
a new hip in anywhere from 10 to 25
years, depending on how active he is.
But today's surgeons are prepared to
replace those parts, if and when they're
needed, using surgical techniques that
literally evolve and improve daily.
Between research and recommendations, you should be able to find a surgeon who's willing to work on active
younger people. "At about age 50
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