osterochrondral graft

[mher]

Hi!

I have scheduled my hip surgery for later this month. I had a core decompression last May and found out this past March the surgery did not work, there were signs of collapse in the right hip. I have two choices...repair it using my own cartilage or do a THR.  I am 25 years old and feel the need to try to repair it if there is even a slight chance it may work. I've gone to three doctors and they all have told me to do the THR because it is the most reliable and there is more longevity. Also, there is a higher chance it may not work the second time around. However, I believe that our bodies are resilient and that it can heal itself. Most of family and friends agree that I should do the THR and not the repair because if the repair doesn't work, then I would have to do surgery again. In addition, my kidney function is at 25%. This factors into my decision and the recovery process. Even after all of this, I am still adamant about repairing it. There is a chance and I want to take it. I cannot fathom the idea of a prosthetic body part in my body at this age.  Has anyone gone through this surgery? What were the outcomes?

Thanks!

Mar

[jjmclain]

Have you considered resurfacing? Has it been mentioned by any of your doctors?

[mher]

I am not a good candidate for resurfacing. I am in my child bearing age and people who have kidney problems are not good candidates. My options seem to be limited.

[ScubaDuck]

Maybe I don't understand the differences between HR and THR completely.  I don't think either of those two situations will make HR worse than THR.  In both cases you will have an artificial hip joint.  The only thing might be the option of materials for THR over HR because of kidney issues.  In general HR seems to be a better route for younger active individuals.

Have you actually consulted with a HR doctor?  Almost everyone on this site has heard "You're not a good candidate for HR because (fill in the blank).". Only a surgeon that has done a lot of HRs will know.

Good luck.

Dan

[Lori Cee]

I am of child bearing age and pregnancy and birth were things that I discussed with my surgeon before we chose to do any surgery.  Some of the old literature indicates that it is not recommended that we get MOM implants however there are no studies to support this.  One of the only studies I could find was on six women and that was still concluded 'extremely low risk' and had no negative outcomes. The risk of the medication that I was on for the arthritis was far more a risk and now I am no longer need the meds.

I think the kidney issues may have more to do with the surgeon's recommendation. I have read somewhere that it is the kidneys that help the body process and eliminate the metal ions and thus MOM implants are not suggested if kidney function is severely reduced.  Whether this is more propaganda, I really don't know as it wasn't an issue that I needed to discuss with my surgeon (who is one who's answer I would really trust).  The reason I'm unsure is because they lumped it in with the 'child bearing age' thing, which I know isn't a good reason for rejection.

I'd still ask for a bit more information before jumping into a total hip.  Revision is something that will be in our lifetimes even if we do the 20 years plus out of our devices.  Knowing for sure that it is ruled out needs be a part of the decision making process.  

If a good HR surgeon rules out resurfacing and you are prepared to take the risk on the graft even if it is a possibility that you will require an additional surgery, I'd say stick with your gut.  It's your body and you need to be comfortable with the decision as you are the one that will be dealing with the consequences, good or bad.  

I'm not sure what would do if the BMHR were ruled out and I had a choice between total hip and a surgery that might not work.   If it came down to HR and the graft, I'd probably pick HR.  Total hip is a whole other ball game in my mind.  Sending you positive thoughts and best wishes while you contemplate this difficult decision.  

[Lopsided]

I cannot fathom the idea of a prosthetic body part in my body at this age.

Why not? Those of us who have resurfacing do not consider it alien, but something that returns us to feeling human.

[Lori Cee]

Totally agree with lopsided here.  

The thought of my my old limited movement joints and the pain associated with them isn't a particularly happy memory.  The new ones, however, are the best working parts in my whole body! Maybe I'm a bit of a geek but I think its kind of cool to have some metal parts  ;D    

I don't feel anything 'foreign' inside there.  They are part of me. The reason that I know that they are there is that there is no pain any more and they actually move.  I'm still early days and there are absolutely no regrets.