I am a 51 year-old male and am now 1 month post-op, having had a RBHR (Right-side Birmingham Hip Resurfacing) by Dr. Hozack of the Rothman Institute in Northeast Philadelphia. I’d like to share my story on this outstanding website so it can hopefully help others who may be facing the same dilemmas I faced when trying to decide on the surgery.
I am an active adult, love hiking and have always played a lot of basketball (mostly on blacktop) several times a week up until just this past year. I consider myself healthy and in good shape at 5’7” and 145 lbs. Over the last dozen years I noticed that I often had a severe pain in the right hip joint that occurred after playing basketball. The pain showed up after play, not during, and was the worst the morning after play, especially when first planting the leg after getting out of bed. The pain was sharp but fleeting and would cause me to sometimes let my leg “give” to relieve it – mostly out of surprise because of its sudden onset. The pain would then go away after warming-up a bit. I dealt with this for a long time and noticed that it seemed to be gradually getting worse. I also started to notice pain during long hikes – the pain seemed to be located both in the groin area and the outside of the hip – again, not too bad since it would just come and go.
I did not think too much about it until an event happened while playing touch football on Thanksgiving Day. While running, I bent down to pick up a fumble and had what felt like a tear in the hip joint. From that point on I had pain every day and the pain was felt in the groin and all around the hip, sometimes radiating down the leg to below the knee. I went to my primary Doc, who ordered X-rays and was quite surprised that I had moderately severe Osteoarthritis in the right hip (left hip was clean). My Doc told me that my basketball days were probably over. I said that would be fine but I just would like to be able to continue hiking!
My primary Doc referred me to a local Orthopaedic Doc in my area (Lehigh Valley, PA). First step he tried was physical therapy, which after several weeks did not seem to help too much. (I also had been doing core-strengthening exercises beforehand). He then included 200 mg of Celebrex along with the PT. I can’t really say if the Celebrex helped my hip but I did notice that it eliminated my occasional back pain! After a few months with no improvement and actually some worsening of pain, the Ortho Doc recommended a Total Hip Replacement. Since I was familiar with the Hip Resurfacing technique (from a friend who had fantastic success with a bilateral BHR by Dr. DeSmet several years ago in Belgium, and who turned me on to this website), I asked him whether the procedure could be a fit for me. His response was completely negative, to put it nicely. He had no faith in the procedure and I immediately lost faith in him! My search for a resurfacing Doc was on – I wanted someone who was an advocate of the procedure.
I went to see Dr. Mont in Baltimore since he has done well over a thousand of these surgeries, is well-liked by his patients, and is an active contributor to this website. The consultation with Dr. Mont went very well and he was gracious and open – he even gave me his home phone number if I had any burning questions. He thought I’d be an excellent candidate for a BHR. The only issue was that my current Health care plan in work is Keystone Health Plan East and Dr. Mont does not participate in that network. If I wanted Dr. Mont to do the surgery I would have to wait several months until I could change my coverage. I decided not to wait and to try to find a more local surgeon that participates in the KHP-East network. I used this website and found Dr. William Hozack of the Rothman Institute. I posted an inquiry about Dr. Hozack on this website and was able to communicate with a recent patient of his (thanks Brian!) who helped me decide to move forward. I decided to have a consultation visit with Dr. Hozack.
Dr. Hozack does a wide range of surgeries and appears to do many more total hips than resurfacings. My impression is that he is more discriminating than some other resurfacing Docs in that he seems to limit the resurfacing candidates to males between 50 and 55 years old (just my impression). He is very busy but took an extra amount of time with me and answered all the questions that I brought to him – he actually sat down with the list I printed-out from this website and wrote-in his answers. I was very impressed with both him and his staff – a very professional, well-run organization. I subsequently found out that several professional sports teams use the Rothman Institute, including the Philadelphia Eagles. Every person I talked to about Dr. Hozack, both his current patients and all staff at both Rothman and Nazareth Hospital (where the surgery was performed), gave him their highest recommendation. I was won over and decided to schedule my surgery as soon as possible.
After being cleared by all the pre-op testing (cardiology, nuclear stress test, etc.) and having set aside a pint of blood with the Red Cross, my surgery was conducted on a Tuesday morning. Doc thought the surgery itself would take ~ 1 hour. (I still don’t exactly know how long it actually took but I’ll find out soon at my 1-month follow-up visit). The anesthesia used was a spinal block (not bad at all – a very fine needle), and a sedative (a morphine-based mixture). I did not wake up at all during the surgery (which I’m told can happen sometimes). I woke up in post-op and my wife and daughter visited briefly. Dr. Hozack had telephoned my wife and explained that everything went smoothly. The incision is 8” long and was closed with 40 staples. Dr. Hozack uses the posterior-lateral approach.
Day 0 – I was brought to my room later that afternoon and was still feeling the effects of the anesthesia – a little bit nauseated but not too bad. I asked for a basin just in case and they gave me something for the nausea. They had me do some mild PT (ankle pumps, etc.) that evening and got me out of bed to sit in a chair. I also walked the hallway with the aid of a walker.
Day 1 – The next morning they had me up and sitting in a chair but my blood pressure dropped too low (70/40) and I got dizzy (evidently a normal thing). They got me back into bed and increased fluids by IV, which stabilized the BP just fine. The catheter was removed, which was painful but over in a matter of seconds. I went to two sessions of PT on a different floor of the hospital that day. The morning session involved exercises while the afternoon session focused on walking and climbing stairs (with crutches). My post surgery appetite was great and all food tasted fantastic – I must have needed the energy for healing!
Day 2 – Went to PT in the morning and walked the hallways using crutches, climbed up and down stairs with the aid of a crutch, did some PT exercises, and learned to use some of the assistive devices (sock putter-onner, etc.). Only problem I had was with the tape used in bandaging – I developed some blisters from the tape. I would recommend using paper tape, which is not as aggressive and does not leave a residue. To help remove tape and also remove adhesive residue, a product from Smith&Nephew called Uni-Solve wipes (#402300) was recommended to us and worked great. To heal the blisters the hospital gave us a product called Xenaderm ointment, which also worked great. I was discharged that afternoon and my wife drove me the 1.5 hr trip home. I was fairly comfortable but was ready to get out of the car after that drive. The hip stiffens-up pretty good during extended periods of sitting.
During week 1 – I woke up often at night during the first few nights at home and sleeping was difficult due to limited positions to sleep in (I am used to sleeping on my right (operated) side). I also had some very severe headaches, mostly at night. I don’t know what caused the headaches but staying hydrated and using Tylenol helped. Although I was discharged with Oxycodone for pain, I only took a few of them since I did not like the reaction I experienced (intense, disturbing dreams). I relied on Tylenol for pain, although most of the pain was related to specific movements and there was not much pain when sitting still. The first week was really great since improvements in movement came very fast. I did not have a lot of swelling but did have bruising as far down as my calf – almost to the ankle. Continued to eat like a horse and slept off and on throughout the days. I was watching for signs of infection and did notice that my temperature would rise, especially at night – maximum temperature was a little over 100°. I also had a couple occasions of night sweats. All this calmed-down with time and no infections occurred. I am walking fairly good distances with two and occasionally one crutch but notice that a sharp, fleeting pain in the groin or front of the thigh tells me I’ve done too much.
During week 2 – Swelling is down quite a bit and the pain I have now feels like muscle pain. Quads are very tight, hamstrings OK. Glutes are lousy and weak – glute squeezes are very difficult but improving every day. Some PT exercises were impossible to do at first (hip abduction, for example) but are improving quickly. I started walking with one crutch and by the end of week two I am just using a cane. The staples were removed at the end of week two and the leg feels better although it still feels like I am laying on a thick rope if I lay on the operated side. Steri-strips replaced the staples to lend some support for the incision, which is healing nicely.
During week 3 – I went back to work at the beginning of week three, exactly 14 days after surgery and the day after the staples were removed. Although I am in the field about 50% of my time and still am not cleared to drive, I can spend the first couple weeks back doing desk work and only go out in the field in the company of a coworker, who drives. My greatest concern with starting back to work was staying awake all day and having enough food with me to make it through the day! I was very tired at the end of the first few days back to work and was really ready to get home in the late afternoon. I am mostly walking with a cane, although I can do short stints without assistance if I concentrate on not limping. I do notice a “clunking” or “clicking” in the hip joint but no pain is associated with it and I understand this is normal and will subside with time.
During week 4 – At the beginning of week four I am now walking almost entirely on my own with no assistive device but still keep the cane handy just in case. I can do a mile unassisted but have to watch about over-doing it – the leg lets me know. I am also doing some work around the house without much difficulty. The steri-strips have all come off and the incision looks good. Post-op medications continue to include 200 mg Celebrex, a multivitamin, two iron gluconate supplements, two 325 mg buffered aspirins for blood thinning, and Tylenol if needed for pain.
1 Month post-op meeting – Today I met with Dr. Hozack and his exceptional assistant Amy Lewis at my 1-month post-op meeting. X-Rays were taken and showed the device to be well placed. My range-of-motion and muscle strength were determined to be fine, all medications can now be stopped, and I was cleared to drive. Dr. Hozack stated that I could continue with outpatient PT if desired, or could simply do the appropriate exercises at home. I have no restrictions as far as range of motion but was warned against doing any impact exercises or sports for the next six months to guard against potential fractures. They also recommended using a vitamin E lotion and massaging the incision to help break down the internal sutures and scar tissue. I don’t need to follow-up with Dr. Hozack for another six months, at which point X-Rays will again be reviewed.
I had an excellent experience with Dr. Hozack and his team at the Rothman Institute and Nazareth Hospital and would give them my highest recommendation!