Updated 10/1/2014I was very honored to attend the 2nd Annual Hip Resurfacing Course in LA on Oct. 24 & 25, 2008. The course was to teach new surgeons about hip resurfacing and to allow experienced hip resurfacing surgeons to share their experience. Allied medical professionals also attend the course such as physical therapists, surgeons not performing resurfacing and medical device companies. I hardly have enough words to describe the wonderful experience. I spent two intense days learning about every aspect of hip resurfacing. I attended sessions about approaches to surgery, patient selection, femoral cementing techniques, metal ion issues, learning curve issues, special uses for resurfacing, bioengineering information and many more topics. I found much of the information fascinating since I am a Mechanical Engineer. I now have an even greater appreciation of the experienced surgeon’s hip resurfacing skills. They are not only surgeons, but engineers and artists.
Faculty Panel Discussion
Front Row: Dr. Gross, Dr. Mont, Dr. De Smet Dr. Murry Back Row: Dr. Stulberg Dr. Kreuzer Dr. Amstutz Dr.Tuke Dr. Barrack Dr. Metta Dr. Beaule Dr. Jinnah
The more I learned about resurfacing, the more I realized each doctor has his own approach. Even when surgeons are using the same surgical approach, they don’t do much of the surgery in the same way. Some surgeons place the femur cap first, while others place the acetabular cup first. Some do it by using their experience while others use x-ray assistance or even computerized assistance.
Each surgeon uses what is the best method for them. There is no way anyone could say what is correct or best for hip resurfacing. Each surgeon is an individual and no two seem to proceed the same way. Each doctor has their own opinions why their approach or method is best, but there always seem to be another surgeon with a different opinion.
So we as patients really need to choose a surgeon and then trust their decision and judgment as to what surgical approach and hip resurfacing device is best for us. We would never have the hands on experience they have to be able to choose what is best for ourselves. We can read and learn, but when you listen to how experienced surgeons approach resurfacing, you realize a patient can never truly understand what the surgeon knows.
I don’t think there were even two doctors that could hardly agree on any subject. Each surgeon has great outcomes, but individual techniques. It was fascinating to listen to the surgeons discuss how they would approach various cases. There are surgeons that almost always opt for a THR when possible, while there are others that will try to do a resurfacing no matter what. Then most doctors are somewhere in-between. There is a great variation on patient selection between the experienced surgeons.
There is a lot of variation on what hip device surgeons prefer for certain cases. It seems that most hip resurfacing devices work fine as long as they are placed by the experienced surgeons.
So the most important thing I learned was to trust the experienced hip resurfacing surgeons. This was the same opinion I had acquired over the last three years while running my website, but it was reinforced very strongly at the conference. I have an even greater respect for the hip resurfacing surgeon’s skill. We all come to know and love our individual surgeons as patients since they give us a pain free, active life. However, as I learned more and more about how technically difficult hip resurfacing surgery was, I had an even greater respect for these doctors that take away our pain and give us great metal on metal hips.
Yes, there is really a steep learning curve and as with any major surgery, always a possibility of problems. I did learn that these doctors are very compassionate and concerned about their patients. They not only think about how they will perform the surgery, then place the new hip device during surgery, but they continue to remember the patients long after they have recovered. The doctors are concerned about the hip devices they use, the metal ions released from the devices and the possible revisions that could be required many years down the road. All of the surgeons want more medical studies for many aspects of hip resurfacing. They want good statistical information to help them make good decisions.
I learned a great deal of technical information, but the biggest lesson I learned was to choose an experienced hip resurfacing surgeon and then trust their judgment. It is the same message I had always passed on to potential hip resurfacing patients, but my opinions were reinforced many times over during the resurfacing course.
Patricia Walter and Dr. De Smet of Belgium