I am 32, Urgently Need Surgery - Need your help

[db]

Hi,
Ok, so I had a severe case of Ankylosing Spondylitis when I was in my late teens. The disease has been more or less under control since about the age of 21...and my spine and neck seem to only have very minimal damage / fusion. But my hips are both totally fused and I cannot walk and am almost completely bent over using crutches to walk.

I spent 13 years trying to heal my hips without surgery and recently a major 180 degree shift in perspective hit me like a million lightning bolts. I finally understood that surgery was my best and possibly only option. I was on a 4,800 day spiritual mission and the climax of that mission was / is acceptance.

I have so many questions. My main objective is to be as active as humanly possible after surgery; martial arts, jogging, climbing etc etc

And so I want to get the surgeon, proceedure, and device that will allow this!!

I have been in touch with a few doctors in India, though am still waiting to hear back from Dr Bose.

Due to the fusion it seems unlikely that a double hip resurfacing will be possible,
One surgeon suggested a metal on metal "short stem" would be possible and would allow me to pretty much do the activities I listed above.

So my questions for you guys are:

1) Has anyone had a double (both hips) metal on metal replacement? And if so what type of device "Proxima" or something else etc?? And what was the result?

2) What is the best device to get in my situation? the one that will allow the most activites

3) How significant are the metal debris / ion risks??

4) If a ceramic short stem replacement is used can the activites i list above be done?

5) I cannot stretch my legs out straight due to the fusion of the hips, so i sleep with my knees up etc, will this influence the surgery and the way the surgery is done? Will it increase the risks?

6) I am male but have a small pelvis and presumably small hip joints / sockets, will this mean that my risk of creating more metal debris is increased after the surgery?

Thats all i can think of for now, if you can help with these questions I would really appreciate it!

many thanks
db

[Pat Walter]

Hi db

Welcome to Hip Talk.

am sorry to hear about your hip problems as such an early age.  I do know of one lady that had a fused hip and did have a hip resurfacing.  She does well, but it has taken her years to get back to normal since she never had much of normal.  It takes a long time to retrain the muscles and body after getting the hip replaced.  The joint feels better right away - but the rest of the body has to heal and adjust.

Most of your questions will need to be answered by Dr. Bose or other surgeons you talk with. Dr. Bose is one of the best hip resurfacing surgeons in the world.  He also does the BMHR plus THRs.  So he will have a few choices to use if you can't have a hip resurfacing.

Over 125,000 people have MOM BHRs and few have metal ion problems.  That occurs when the surgeon does not place the acetabular cup properly which causes additional edge wear resulting in high metal ions.  It is not that the device causes the metal ions - it is the incorrect method of the bearing rubbing that causes the problem.  Stick with the top resurfacing surgeons and you won't have to worry about metal ions.  Since your case if very diffiuclt, I would stick with surgeons like Dr. Bose of India, Dr. De Smet of Belgium, Mr. McMinn of the UK, etc.  ONly the very top surgeons.

All of the resurfacing surgeons also to THRs.  They are very skilled since resurfacing is a very diffiuclt surgery.  They have all done many THRs too and are just as skilled at THRs.  So you can believe what Dr. Bose tells you.  ONly a surgeon will be able to tell you what device is best for you.

All of the MOM or ceramic THRs allow a patient to be really active with few restrictions.  It is the old fashioned small ball metal/plastic THRs that cause many problems for active people.  The people I know that have MOM THRs do the same things as people with hip resurfacing.

Again, you have a very diffiuclt problem and will need to ask all the questions you can think of when you talk to Dr. Bose or other surgeon.  Only they can give you the answers. We are only patients here and not medically trained.

We will support you and listen to your thoughts as you travel down the path of getting your hips fixed.  We can't tell you what to do - you will know after you talk with some of the top resurfacing surgeons what will be right for you.

Pat