Medical care can be a journey. It was for Gary Richter, for whom that metaphor could hardly be more fitting.
Richter, 59, is a United Airlines aircraft mechanic, grandfather of five, outdoor athlete, and adventurer. Richter’s mechanical expertise spans nose to tail, wingtip to wingtip: airframe, avionics, engine. His athletic endeavors have been no less expansive. He’s finished the Leadville 100 mountain bike race five times; he’s avid road cyclist and dirt biker; he kayaks, hikes, lifts weights, wake surfs, scuba dives, cross-country skis, and snowshoes.
On the adventure side, he had ridden his BMW R1200GS touring bike thousands of miles to touch oceans lapping shores south, east, and west the North American continent. Now, he wanted to dip his fingers in the ocean to the north. His body seemed determined to prevent it until a UCHealth orthopedic specialists put him in a position to drive way, way north.
A hip replacement and road to recovery
A few years ago, the occasional pain in Richter’s lower back became nagging. His primary care doctor in Fort Collins – not far from his home in Johnstown – pinned the problem on a pinched piriformis muscle. Tramadol and physical therapy seemed to calm things down for a while. But soon it returned, and he was having trouble slinging that left leg over bicycle and motorcycle seats. To make matters worse, Richter’s right knee was also giving him more trouble than had been the case for many years (he had torn meniscus decades earlier).
For the knee, he made an appointment with Dr. Martin Boublik, a UCHealth Steadman Hawkins Clinic – Denver cofounder, orthopedic surgeon, and sports medicine specialist who is also the Denver Broncos’ head team physician. At Steadman Hawkins, Boublik asked Richter not only about the knee, but also whether anything else was bothering him. Richter told him about his back. Boublik considered this for a long moment and said, “Sounds to me like your hip.”
“No, the doc said it was the piriformis muscle.”
Boublik nodded and asked, “Do you have time for an X-ray?”
When the results came back, Boublik showed Richter images the right hip, then the left.
“I’m just a mechanic,” Richter recalled, “but I’ll tell you, it was kind of like looking at a piston with a bad ring.”
Candidate for hip replacement
The left hip was bone-on bone. Richter was a candidate for a hip replacement. The timing wasn’t great, though. It was June 2018; in July Richter planned on setting off on an 8,000-mile, solo, round-trip motorcycle journey to Alaska’s far north. He aimed to touch the ocean to the north – the Arctic Ocean. Plus, UCHealth Steadman Hawkins physicians prefer to exhaust nonsurgical options before moving to the operating room. Boublik called in Jeremy Smith, a physician assistant who works for UCHealth Steadman Hawkins orthopedic surgeon Dr. James Genuario. Smith administered a cortisone injection into Richter’s left hip. Within two hours of arriving at Steadman Hawkins for a look at his right knee, Richter had received a diagnosis and treatment for his left hip.
Within a couple of days, the pain was gone and he could again swing his leg over various two-wheeled machines with ease. That July, he rode north stocked with a couple changes of clothes, camping gear, freeze-dried food, two quarts of water, a single-burner camp stove, bear spray, and a one-man tent. He took his time, the journey being as important as the destination.
“When you take a trip like that, it gets the wind out of your sails. I get to contemplate where I am in life, where I’m going in life, and what I want to do for retirement,” Richter said. “You’ve got a lot of time to think.”
Richter was aiming for Prudhoe Bay, but he wouldn’t get there. Road construction slowed him down and he missed the tour bus that was the only way up to the water. He had to turn around. But on the long ride back down, he ran into a guy in Fairbanks’, Alaska, who told him, if the Arctic Ocean was his goal, he could get there via Inuvik, Canada, no buses required. That planted a seed.
Addressing hip pain
The cortisone shot wore off in October 2018. The hip caused enough pain that mountain- and road biking were out of the question. On a spring 2019 dirt-biking trip to Moab, he had to stack up rocks next to his KTM and use them as a step just to mount his ride. Richter, a former dirt bike racer, described that trip as “miserable.”
In June 2019, with his second attempt at the Arctic Ocean imminent, Richter got a second cortisone shot in the left hip, again from Smith. In July, he commenced another four-week, 8,000-mile adventure, camping roadside along the way. He drove under steel skies through vast permafrost expanses, stopping at Dawson City, Fort McPherson, and Inuvik, occasionally slowed by such Northwest Territories hindrances as herds of bison warming themselves en masse on the asphalt.
“They’re like, ‘You’re in our country, champ. If we’re going to sit down in the middle of the highway, that’s what we’re going to do,’” Richter said.
From Inuvik, he rode the 150 miles round-trip to and from the ocean side town of Tuktoyaktuk. This time, he touched the Arctic Ocean before heading back south.
The second cortisone shot wore off faster – he started feeling his arthritic hip again soon after his return. It was time for a replacement.
Boublik, Genuario, Smith, and colleagues at UCHealth Steadman Hawkins Clinic – Denver are sport-medicine specialists who, when it comes to joints, focus largely on repairing and rehabbing ligaments and cartilage damage. Joint replacement is a specialty unto itself. For this, they turned to UCHealth joint-replacement specialists. They recommended Dr. Ryan Koonce, who had established himself as a go-to UCHealth Steadman Hawkins Clinic – Denver partner for knee and hip replacements.
Severe hip joint arthritis
In October 2019, Richter met with Koonce at UCHealth Highlands Ranch Hospital. Koonce, who does more than 200 hip replacements a year, recognized a man with severe arthritis in the joint. Richter described his day-to-day pain as an eight out of 10, and that’s after Richter had described himself as a person with a high pain threshold. Koonce asked him about his interests; Richter walked through his litany of athletic endeavors.
“We’re going to get you back to doing what you like to do,” Koonce told him.
Koonce and his team also explained the details of the surgery and recovery in-depth, such that “you don’t leave there with pretty much any kind of question,” as Richter put it.
Prior to the Nov. 7 surgery at UCHealth Highlands Ranch Hospital, Koonce mentioned to Richter that he’d gone on a bike ride that morning.
“I’m like, ‘This is my guy,’” Richter said.
Recovery from hip replacement
The surgery went well, and Richter was on his feet and walking stairs before being discharged the next evening. He was back on his road-bike trainer in two weeks and getting back into weight training four weeks after surgery. While Richter’s recovery was quick, it wasn’t that out of the ordinary, Koonce says: most patients have no limitations after three months – though he advises against running to minimize the impact on the artificial joint.
“Hip replacement has been called the ‘operation of the century’ for a reason,” Koonce said. “It really returns people who were debilitated to a very active lifestyle. I think Gary is an exceptional patient, given his enthusiasm, but I think his outcome is what we expect a lot of the time.”
Richter said he’s thankful for Koonce’s expertise as well as his and the UCHealth team’s taking the time to listen to his story and explain the details of the surgery and recovery process. More generally, he called his time at UCHealth Highlands Ranch Hospital “an awesome experience.” He’s looking forward to a much different dirt-biking trip to Moab in the future.
“I’m going to take each day as it comes,” he said. “But you know what? I’m going to go right back to being me.”