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    Satisfaction in judoka after joint replacement

    Cichorei Kano
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    Post by Cichorei Kano on Wed Apr 24, 2013 10:28 pm

    Over the past years some of our Judo Forum friends (AnnMaria, DustyMars) have shared their experiences as judoka regarding joint replacement.

    Recently, what I believe to be the first scientific article addressing precisely this topic, has appeared in press. The study conducted by means of questionnaires in over 200 senior French jûdôka, identified 36 hip joint replacements, 10 knee replacements, and 3 shoulder replacements. This total of 49 procedures was performed in 38 patients hence showing that some patients underwent multiple joint replacements.

    The results were interesting and indicated that a little over 76% of those people returned to judo after approx. 4 months of recovery, although 66% had been recommended by their treating physician to quit judo altogether. Of those judoka who previously still competed in master's or other contests, all stopped competing after joint replacement. Satisfaction rates in the judoka with their joint replacement was approx. 84%.

    You can read the first page of the article here:

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    finarashi
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    Post by finarashi on Thu Apr 25, 2013 1:03 am

    I have several frends (who are not old; over 50 is not old?) who have went through these kind of operations. AFAIK all who have got theirs in past 10 years are satisfied with their replacements and none compete in shiai divisions. However some compete in kata and most do randori.

    I believe there was European level problems with some previous hip replacement arts.


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    afja_lm139
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    Post by afja_lm139 on Thu Apr 25, 2013 1:38 am

    While it has been three and a half years since total knee replacement my mobility is 100% and no problems appear to be present as a result of the surgery. My Judo days ended years before the replacements, but I pondered what would happen on the mat now. It may be like taking up bicycle riding after years away from it, Judo was very much a part of my life for decades, so it would most likely not take long to get back into practicing good Judo. The only problem is I was slightly “knock-kneed” before the new knees and now my legs are straight up, so what affect that would do to my Judo techniques? Strange question to be sure, but one problem occurred in therapy was re-learning to walk properly without wandering about or stumbling. That dissatisfied state ended in a few weeks, but it was a problem.

    afja_lm139 (aka dustymars)
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    icb
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    Post by icb on Thu Apr 25, 2013 5:57 am

    Very interesting. Thanks for letting us know about this CK.

    I'd also be interested to find out if any judoka have received implants with telemetry systems, such that loads could be measured during different judo activities. See http://www.orthoload.com/ for more details about a database that a German research group is developing on data from such implants.
    JudoSensei
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    Post by JudoSensei on Thu Apr 25, 2013 11:52 am

    The participants in this study were all over 60 and the average age was almost 72. The majority returned to judo, but how much judo is a person doing at age 72 anyways? I would be interested in a similar study with younger judoka.

    I'm surprised only 66% of doctors suggested that the patient stop judo. I would have guessed it would be 100%.

    I am not yet 60 and have had both my hips replaced. The first one was 9 years ago and I was not satisfied, so I had it replaced again last year. After all 3 hip replacement surgeries, I returned to judo in a few months. My level of participation, however, is somewhat reduced from where I was before -- mainly I stay away from big white belts in randori. I am still comfortable doing randori in most situations, but try to avoid too much risk.
    Cichorei Kano
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    Post by Cichorei Kano on Thu Apr 25, 2013 12:25 pm

    JudoSensei wrote:The participants in this study were all over 60 and the average age was almost 72. The majority returned to judo, but how much judo is a person doing at age 72 anyways? I would be interested in a similar study with younger judoka.

    I'm surprised only 66% of doctors suggested that the patient stop judo. I would have guessed it would be 100%.

    I am not yet 60 and have had both my hips replaced. The first one was 9 years ago and I was not satisfied, so I had it replaced again last year. After all 3 hip replacement surgeries, I returned to judo in a few months. My level of participation, however, is somewhat reduced from where I was before -- mainly I stay away from big white belts in randori. I am still comfortable doing randori in most situations, but try to avoid too much risk.

    About 25 years ago among the general population seen in European orthopedic departments for total hip replacements about 15% of the patients was younger than 40 years, and about 35% younger than 60 years. The number of younger patients since has been steadily increasing. This is, however, in the general population.

    I do not know what the proportions are in judo and how they have been evolving, and it is almost impossible to speculate about it more or less reliably. It is known from several studies that judo --since it represents substantial weight-bearing exercise-- improves bone mineral contents. Thus one might expect the proportion of younger jûdôka candidates for hip replacement below that proportion in the general population. However, far more factors than just bone mineral contents mediate the health of the hip joint. Deterioration in cartilage and arthrosis are affected by genetics, body position, job, etc.

    For those reasons I think that your questions are to the point, and I too would be interested in knowing that information. I recall a few other younger people here on the forum who underwent hip resurfacing or similar procedures.

    Although 'only' 66% of treating physicians suggested their patients quit judo, that does not necessarily mean the other 34% suggested their patients continue judo. I assume that simply a number of physicians did not really address the question.


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    afulldeck
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    Post by afulldeck on Fri Apr 26, 2013 10:38 am

    I would be extremely surprise if one could return to judo with a shoulder replacement--- it goes against every thing I've been told by surgeons about shoulders.


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    Stacey
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    Post by Stacey on Fri Apr 26, 2013 10:42 am

    I'm more interested in the stat dealing with the number of judoka who ignored their doctors and did what they wanted to do anyway.....................
    Cichorei Kano
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    Post by Cichorei Kano on Fri Apr 26, 2013 11:16 am

    Stacey wrote:I'm more interested in the stat dealing with the number of judoka who ignored their doctors and did what they wanted to do anyway.....................

    They're either insane, dead, or lawyers. Should be an interesting research project and not difficult to pull of because studies on lawyers do not require prior ethical approval since no human subjects are involved.


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    "Quand on essaie, c'est difficile. Quand on n'essaie pas, c'est impossible" (Guess Who ?)
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    Quicksilver
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    Post by Quicksilver on Fri Apr 26, 2013 11:39 am

    Cichorei Kano wrote:
    Stacey wrote:I'm more interested in the stat dealing with the number of judoka who ignored their doctors and did what they wanted to do anyway.....................

    They're either insane, dead, or lawyers. Should be an interesting research project and not difficult to pull of because studies on lawyers do not require prior ethical approval since no human subjects are involved.

    In all seriousness, though, isn't it likely that a good percentage of physicians would advise no return to Judo simply to err on the side of caution and limit potential liability?


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    JudoSensei
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    Post by JudoSensei on Fri Apr 26, 2013 12:09 pm

    Quicksilver wrote:
    In all seriousness, though, isn't it likely that a good percentage of physicians would advise no return to Judo simply to err on the side of caution and limit potential liability?

    That, combined with a lack of understanding of what judo involves, accounts for most physician recommendations. After hip replacements the risk of dislocation in increased, so it is reasonable for a doctor to tell the patient to do everything possible to reduce the risk. Most older patients doing judo already take precautions to reduce the risk of injury, so it is also reasonable for us to better understand the risks of participation in judo than the doctor. In addition, there is a positive side to maintaining fitness, strength and flexibility. For those of us who have devoted our lives to judo, it would not be easy to switch to some safer physical activity. Since I don't have hip pain, and I have greater flexibility in my hips now, I actually enjoy judo more than I did in the years leading up to the surgery. The reason most of us have replacements to begin with is so that we can do the things we enjoy.
    Cichorei Kano
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    Post by Cichorei Kano on Fri Apr 26, 2013 12:18 pm

    Quicksilver wrote:
    Cichorei Kano wrote:
    Stacey wrote:I'm more interested in the stat dealing with the number of judoka who ignored their doctors and did what they wanted to do anyway.....................

    They're either insane, dead, or lawyers. Should be an interesting research project and not difficult to pull of because studies on lawyers do not require prior ethical approval since no human subjects are involved.

    In all seriousness, though, isn't it likely that a good percentage of physicians would advise no return to Judo simply to err on the side of caution and limit potential liability?

    Indeed, spot on, same reason why so many clothes manufacturers put on the label "handwash/dry cleaning only, no detergent, no tumble dry, no ironing". People have too much work and no time available to stick to such detail, all too much of a hassle, and the manufacturers know that, so they save their own butts because for the least loss of color or size or anything else going wrong with the fabric, they can then blame the customer and avoid refunds or law suits.

    JudoSensei has correctly pointed out the other reasons.


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    genetic judoka
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    Post by genetic judoka on Sat Apr 27, 2013 1:05 am

    afulldeck wrote:I would be extremely surprise if one could return to judo with a shoulder replacement--- it goes against every thing I've been told by surgeons about shoulders.

    there are 3 judoka in my town who've had shoulder replacements who still train regularly. one of which has had both shoulders done. and he's one of my favorite randori partners! he no longer does the morote seoi nage he used to be known for, but he's developed one hell of a yoko tomoe nage to make up for it.


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    afulldeck
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    Post by afulldeck on Sat Apr 27, 2013 5:12 am

    genetic judoka wrote:
    afulldeck wrote:I would be extremely surprise if one could return to judo with a shoulder replacement--- it goes against every thing I've been told by surgeons about shoulders.

    there are 3 judoka in my town who've had shoulder replacements who still train regularly. one of which has had both shoulders done. and he's one of my favorite randori partners! he no longer does the morote seoi nage he used to be known for, but he's developed one hell of a yoko tomoe nage to make up for it.

    Very interesting. How are their shoulders when caught in ude-garami or juji? Can they or do they take that kind of abuse?


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    genetic judoka
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    Post by genetic judoka on Sat Apr 27, 2013 7:29 am

    afulldeck wrote:
    genetic judoka wrote:
    afulldeck wrote:I would be extremely surprise if one could return to judo with a shoulder replacement--- it goes against every thing I've been told by surgeons about shoulders.

    there are 3 judoka in my town who've had shoulder replacements who still train regularly. one of which has had both shoulders done. and he's one of my favorite randori partners! he no longer does the morote seoi nage he used to be known for, but he's developed one hell of a yoko tomoe nage to make up for it.

    Very interesting. How are their shoulders when caught in ude-garami or juji? Can they or do they take that kind of abuse?
    I didn't learn that he'd had them replaced until we were practicing ude garami. as we were beginning the conversation went something like this:
    "don't go too far with it, my shoulder is fake"
    "should I switch to the other side?"
    "that one is fake too."
    "so is it really a good idea for me to do ude garami on you?"
    "yeah it's no big deal, just don't crank it too hard. I'll tap when it hurts"

    and it's not like he was even tapping all that early. it did not seem to be that big of a deal to him.

    he never said anything about juji gatame being an issue. to be fair though he's easily one of the toughest human beings I've ever met.


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    afja_lm139
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    Post by afja_lm139 on Mon Apr 29, 2013 7:17 am

    Back in the days when teaching mostly kids Judo I went to my doctor for some aches and pains and other stuff, so he took a look at my leg with some black and blue lumps and came unglued. He asked and I told him, he warmed me to stop Judo soon. SO I warned my students not to kick the hell out of my legs trying out ashi waza! Even tried and true sensei can get punished with death dealing aliments. Being sensei for kids can be quite interesting and dangerous at times.

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