Nekko's Hip Resurfacing with Professor Migaud 2011

 

April 13, 2011

My doctor is Professor Migaud, one of the very few surgeons in France that has a strong experience in hip resurfacing. He did (and does) a lot of research about hip and knee reconstruction and revision of infected prosthesis.
I immediately got a great confidence when I met him for the fist time, two years ago. This was not the case for others surgeons I met before, because they were more focused on THP as the common standard.
In addition to this, he gave me very clear answers to my need of "knowing the logic behind the why".
I have stopped Karate due to high pain/stiffness in my hip and I would like to come back in 12 months after surgery.

 

Profile
I am a 52 male, French guy, and was diagnosed with OA on the left hip in 2009. I am also a runner and Karate wado-ryu practitioner and I could not imagine stopping (now) these physical activities.
My first search was about finding on the net the right surgeon in France that can offer some alternative solutions.

Surgeon searching
Resurfacing is not so common in my country compared to UK or USA. Most of the surgeons are "THP" minded and I had to meet 3 of these gentlemen. The last one, Dr Migaud, from Hospital University of Lille, was the right one. He is one of the very few surgeons in France who owns a real experience in hip resurfacing (more than 250 HR) . He has also expertise on hip reconstruction and revision of infected prosthesis. In addition to this, he knows very well the problem of martial arts, dancers, and athletes with early OA. I immediately got confidence with him.

Alternative solution 2 years before surgery
So, in 2009, he proposed me SYNVISCtm (hyalauronic acid ) injections into the hip joint, in order to save some time before surgery. This acts as a bumper but doesn't create any new cartilage. I had one injection every 6 months and it has helped me a to get back some range of motion without too much pain. Unfortunately, pain has increased drastically at the beginning of year 2011 and time has come to apply for a resurfacing procedure. Another reason is that I do not wanted to take anti-inflammatories and pain killers ad vitam eternam.

Before Surgery: helpful things
I must say that this site has been a great help for me before and after surgery. Thanks again, Pat and all of you, resurfaced brothers and sisters.
Another helpful point is to establish a good and understandable communication with your surgeon. Since we are all "wired" differently, we have different behaviour when facing major surgery.
There are those who want to know and there are others who doesn't. As an engineer, I am one of these guys who wants to understand the "logic behind the why".
I know it is not obvious, because most of us are not especially medicaly trained, and I have to get familiar with terms like approach, acetabulum, femoral head, BHR, MoM, THR, and so on....
So, I have sent many questions to Dr Migaud and he answered to all of them, very quickly, with clear explanations.

I did not perform intensive exercises before surgery, just trying to get relax and mentally prepared. The only unexpected event was a (very) hard sinusitis 48 hours before procedure. I must admit this event has put me under stress because of having the surgery delayed for several months.Fortunetely, the procedure has been delayed for only 3 weeks, which was a very good new for me.

Surgery Day
I have been taken off my room around 11:00 am and got some oral premedication.
Surgery started with spinal anesthesia. All the bottom of the body is numb while you are 100 % conscious. Asbolutely painless. This would be my choice again if I had to redo it.
Surgery went well, without complications and lasted about 90 minutes.
I woke up in the recovery room, fully alert with a clear head and no pain or nausea.
I stayed there until I was able to move slighly my toes, meaning that the effects of spinal anesthesia has gone away. It took about 2 hours for this. Then, I was transfered back in my room.

Day+1
Blood drain pipes pulled out from the scar. Wake up (!) , standing and a few walking on 2 crutches (about 10 feet/ 3 meters distance)
Dr Migaud showed me on the X-ray print the device called "Conserve+" he put in my hip. We also discussed about how surgenty went. I got a 52 mm diameter femoral cup.

Day+2:
Infusion needles removed; morphine stopped; walking on 2 crutches (50 feet / 15 meters distance). PT started (one hour)

Day+3:
Walking on 2 crutches (100 feet / 30 meters distance) PT (one hour).
This is Sunday. Dr Migaud came for a visit in the afternoon. Simple and straightforward. Just a really nice guy.

Day+4:
Walking on 2 crutches (200 feet / 60 meters distance). PT (one hour,center feeling, slow weight transfert left leg/right leg)

Day+5:
PT (one hour,stairs climbing / descending using 2 crutches and One crutch + wall ramp)

Day+6:
PT (one hour, tring to walk with use only one cructh. Painful. Got back using 2 crutches)

Day+7:
Back to home. after 4 hours ambulance transfer. No PT today

2 weeks post op:
Now, I can use one crutch instead of two. Pain level is very low excepted on the "rear side" of the knee. I have read on this forum many topics about knee pain after surgery but was mostly about "front side" pain on the knee. I suppose this is part of the healing process...

3 weeks post op:
Still need a cane but pain has gone off. Staples has been removed and shows a clean scar.
Thanks to PT, I have been able to "reprogram" my brain in order to have a 50 % natural weigh distribution on each leg. I have used a weigh scale and a big book with the same thickness as the weigh scale. Left foot on the weigh scale and right foot on the book is a good way to sense the correct position. Next PT sessions will be dedicated to reduce the remaining stiffness I can feel in my operated tight.

4 weeks post op:
Having my muscles under tension. Got serious pain (again) in the rear side of the knee. Perhaps should I ask my PT about more stretching exercises. My immediate goal is to get rid of these cramps and then throw the cane away.

5 weeks post op:
Pain at rear side of the knee has totally gone, thanks to stretching exercises. No need for using a crutch but I am walking with a slight limp. Now focusing of getting more stability / less limp during walking.

6 weeks post op:
Check up with Dr Migaud. ROM tested OK. Got some pain when jumping on the operated leg only. Pain gone after a few hours.

Cost:
With the French health system, all the direct medical expenses are 100 % supported by the "Securite Sociale" meaning that I had to pay only extra costs for having a single room, telephone and TV set (about 60 USD/day). I never had such heavy surgery in my life, but I appreciate our "good old health system" even if I have paid a very small amount of my salary during all these past working years

I got the Wright Conserve+ Cemented version, 52 mm femoral cup diameter

August 14, 2011

I will have my 3 months-post op check soon. Everything is fine when using the bionic hip in "normal" conditions. No pain / no limping.
I just got some heavy groin pain when doing some very moderate stretching of the iliopsoas (see attached). The same pain occurs when I am walking from normal "speed" to faster, just by increasing the length between two steps. When I switch back to "normal" conditions, pain goes off.

 

May 17, 2012

I had my surgery about one year now and before that, it has been postponed for a hard sinusitis. I have just to take some antibiotics and wait for a couple of weeks. You will probably have to do the same. Be patient and you will have you surgery in optimal conditions.
 

May 25, 2013

Just to say that I reach the Two-Year mark now. Still very happy with my C+ hip.

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