Resurfacing versus Mini-hip

[Tin Soldier]

I'm looking for the paraphrase-it-for-me-paleeease! button, I need to go to bed.

Here's a thought with regards to trusting your surgeon.  If I didn't trust my surgeon to tell me the truth about his experience, I don't think I'd trust him to cut into me arse.  Although I do think a registry would be an excellent way to get some really valuable data.   

BTW - I think this topic is very engaging and I like it when folks get fiery, once in awhile.  Thanks folks. 

[Dannywayoflife]

Here's one for you. There may not be any proof about HR patients being more active than THR patients. But how Many people like say floyd landis or Corey fulks would be able to return to there level of activity with a THR? I mean there are even guys on here who probably wouldn't be able to do what they are with thr's.

[Lopsided]

Proof!

I just don't understand.

If there is something wrong with the surfaces of your hip joints, what do you do:

    A.)    Resurface.

or

    B.)    Cut the bone off and replace it with a compound system of various materials with multiple variables for error.

[Dannywayoflife]

Well as far as I'm aware I may well be wrong but I've not heard of a study that proves scientifically that RS patients are able to be more active than THR patients but lets face it as you say lop it makes more sense why chop off perfectly healthy bone? And surgeons must be confident it's more durable as they would impose restrictions to cover there backsides otherwise. I was told by Mr Treacy when I asked what restrictions he would imposed on me with a BHR and he said "I don't like patients running  marathons and playing rugby but plenty of my patients haven't listened to that and are still fine". Could you say that about a THR?

[obxpelican]

As I said before it's not conjecture, it's a simple fact, an resurfacing patient can be far more active doing activities that THR patients can't do. 

Just ask any quality doctor who does/did both THR and Hip Resurfacings.

And to say that THR surgery is the same or nearly the same as a Hip Resurfacing surgery is just plain foolish, the only part that is the same is the cup.


Chuck

Here's one for you. There may not be any proof about HR patients being more active than THR patients. But how Many people like say floyd landis or Corey fulks would be able to return to there level of activity with a THR? I mean there are even guys on here who probably wouldn't be able to do what they are with thr's.

[Dannywayoflife]

I believe the term the results speak for them selfs sums it up quite well.

[Lopsided]

Danny, we do need proof, and you can help, as you have not had the operation yet. We need a controlled experiment. You might want to contact Mr. Treacy beforehand to agree to this.

This is it:

You get both hips done at once, the bad hip gets a resurfacing, and the good hip (the control) gets a conventional replacement. Then you can report back about the recovery and life afterwards, and provide the rest of us with definitive proof.

Now, I know this is not what you were envisioning. But considering your GP originally recommended you get a THR on your bad hip, not necessarily by an experienced surgeon, you would actually be getting significantly more.

Plus, you would be given all us other hippies a good laugh, I mean some useful information.

D.

[Dannywayoflife]

Hmmmm let me think......... Much as I like the idea of pushing the envelope. I'll have to pass on that mate!
;D

[Lopsided]

No! You don't want it do you.

But if I was offered a resurfacing on my good hip, I would take it.

[Dannywayoflife]

Hell no I hope that when I'm done that I never need a THR! The thought of all those restrictions fills me with dread!!!!

[einreb]

Re:  "As a whole most people with succesful HRs end up having a more active life with less restrictions.  This is not just conjecture but it's a fact."

Dude, I'm sure you are a nice guy and all, but sorry:  As of Sept 28, 2011 it totally is conjecture, and not fact at all.  My sincere hope is that sometime in the future we will have some real objective data in this area.

http://www.orthosupersite.com/view.aspx?rid=83509

[Dannywayoflife]

I stand corrected!  :)

[Lopsided]

Re:  "As a whole most people with succesful HRs end up having a more active life with less restrictions.  This is not just conjecture but it's a fact."
Dude, I'm sure you are a nice guy and all, but sorry:  As of Sept 28, 2011 it totally is conjecture, and not fact at all.  My sincere hope is that sometime in the future we will have some real objective data in this area.

http://www.orthosupersite.com/view.aspx?rid=83509

I am getting confused now. Which way is this thread going?

[Dannywayoflife]

I thought we were debating the merits of HR and mini hip.

[obxpelican]

Danny,

That's the first thing we can agree on.   ;D

Yes, this thread has come to the end of it's usefulness.  At this point it's locked, if Pat wants to unlock it that is fine.

This is a Hip Resurfacing site dedicated to promoting this wonderful sugery.  I'm sorry, but a total hip surgery and a resurfacing are not the same, with the exception of the cup.  And if you get a chance look up what the really skilled doctors are saying about the benefits of hip resurfacing, many of them have done and still do total hip surgery.  Ask them about the limitations of both.

As to who you choose as a doctor, please, pick and choose wisely.  Search this site, search the yahoo surfacehippy group with the names of the doctors you are looking into.  If you do not pick a doctor with lots of experience or one that has had a lot of failures you are playing with fire.  I'm sure Vicky would be happy to tell you how she feels about various doctors too.  IN the end, be the best patient advocate that you can be for yourself.


Chuck

[Pat Walter]

I am going to make the last post on this thread because it is very important for new people to understand that hip resurfacing is not the same as a total hip replacement.  Resurfacing only requires that the femur ball be reshaped to accept the femur cap that has a very short stem that is used to place the device.  A THR requires that a large part of the femur bone be cut off, a long hole be drilled into the femur and a long rod be pounded into the long hole.  Here is an x-ray showing the different between the large amount of bone removed in a THR compared to a hip resurfacing:



Here is a sketch I did to better show the difference between a THR and a BHR.  It is clear that the bone is conserved.



As the bone is conserved, it means that the gait and all actions of the hip are still operating in a normal placement.  There are medical studies showing there is a more natural gait after resurfacing than a THR. 

http://www.surfacehippy.info/gaitstudy.php


When a long THR stem is used, the placement of the femur cap and action of the hip is different than when the natural bone and surrounding tissue is in place.  If you want to understand the negative reaction to the long THR stem, listen to several of Dr. Brook's video interviews. Videos number  4 and number 12 by Dr. Brooks explains why cutting off a large portion of the femur bone, drilling a long hole into it and pounding a long stem into the bone  keeps the bone from functioning properly.  Pounding the long stem into the femur bone also creates a large amount of pressure to your blood system and your heart.  Mr. McMinn had a relative die during this procedure due to the increase in pressure thru the heart valve.  This has not been studied much, but is an interesting reaction to such high pressure caused by pounding the long stem into the femur bone.

The best way to learn about the difference between a hip resurfacing and a THR is from viewing the video interviews of the top surgeons.  They do an excellent job of explaining the difference and explaining why they prefer to give patients hip resurfacings, when possible, instead of  THRs. 

http://www.surfacehippy.info/shvideos/videosdoctor.php


I would also like to add that a mini-hip, as I understand, is still a version of a THR since a portion of the femur bone must be cut off.  The BMHR is not a THR in my opinion because although there is a larger stem than a BHR, a large portion of the femur bone is still conserved and does not have to be cut off.  To me the real difference of resurfacing devices and THRs is how the femur bone will react after the device is in place and how much of the femur bone must be cut off.  Any device that is placed deep into the femur bone prevents the bone from reacting normally. We can discuss this for a long time, but since the website is about hip resurfacing, I want to continue to concentrate on the advantages of hip resurfacing.

This website is my personal project to help people learn about hip resurfacing.  I have a BHR placed in 2006 and know of thousands of others with great outcomes of their hip resurfacings.  I am very pro hip resurfacing and that is the purpose of this website.  I understand people want to learn about all options and don't mind discussions about resurfacings, THRs, devices, doctors and outcomes.  I don't, however, like to dedicate too much of the website to trying to convience people that THRs are better than hip resurfacings.  For the large majority of us who received hip resurfacings, we are very happy with our outcomes and want to share our stories with other perspective patients. 

Pat

[Vicky]

Hi Chuck,

Yes, I think it is in my nature to ALWAYS be a fiery pistol!  Always have been and always will be.  LOL.  Thanks for the kind words about my new hip.  This recovery has been nothing short of amazing.  I agree with many of your points.
Hope you are doing well.

Here is an excerpt from that article, you need to purchase it to get the full article
"The results of conventional hip replacement in young patients with osteoarthritis have not been encouraging even with improvements in the techniques of fixation and in the bearing surfaces. Modern metal-on-metal hip resurfacing was introduced as a less invasive method of joint reconstruction for this particular group.

This is a series of 446 hip resurfacings (384 patients) performed by one of the authors (DJWM) using cemented femoral components and hydroxyapatite-coated uncemented acetabular components with a maximum follow-up of 8.2 years (mean 3.3). Their survival rate, Oxford hip scores and activity levels are reviewed.

Six patients died due to unrelated causes. There was one revision (0.02%) out of 440 hips. The mean Oxford score of the surviving 439 hips is 13.5. None of the patients were told to change their activities at work or leisure; 31% of the men with unilateral resurfacings and 28% with bilateral resurfacings were involved in jobs that they considered heavy or moderately heavy; 92% of men with unilateral hip resurfacings and 87% of the whole group participate in leisure-time sporting activity.

The extremely low rate of failure in spite of the resumption of high level occupational and leisure activities provides early evidence of the suitability of this procedure for young and active patients with arthritis."

No matter what THR's ARE definitely different than resurfacing, just no two ways around that.

Plus a top UK surgeon wrote this about THR's vs. Resurfacing and made a point, even though this was written a while ago, it is starting to show up in some of the recent ortho conferences I have attended.

The main point is the fat that is released when the bone marrow is invaded, you do NOT get that with resurfacing.

I apologize to those of you that opted for a THR or mini hip (same difference) but these are very important facts that newbies looking into surgery need to know.  It is not meant to argue, put you down, make you feel bad, make us feel better, etc.  It is strictly pointing out the cold hard facts.  The majority of the top hip resurfacing surgeons have done more THR's than they have done resurfacings, just FYI, so they are truly the world experts.  The majority of THR surgeons do NOT do resurfacings, too complicated, they don't have the skills to, they tried it and failed, they went to a training and said, this is way too difficult, I think I will just stick with THR's.  It is NOT what is in YOUR best interest it is in THEIR best interest.  If you think metal ions are an issue, then watch these six world renowned surgeons talk about the FACTS, what the negative press, the negative docs conveniently leave out.  Like Paul Harvey used to say......heres' the REST of the story.

This should not be a battle, those that ended up with a THR, well all I can say is just because you made that decision, give the newbies a chance to listen to the cold hard facts.  Pick a SKILLED surgeon, numbers do NOT tell the whole story, go by RESULTS.  Anyone that wants opinions from some of the worlds top surgeons are welcome to contact me, I usually get responses within 24 to 48 hours, not several months like if you went through the normal routs on your own and tried to contact them yourself.  I do NOT get kick backs, blah blah blah.  I am a patient advocate that is here to educate the patient community.  A THR is not the end of the world, but if you qualify for a resurfacing, my question to you is WHY in the world would you go with a THR? 

And thanks again Chuck.

Vicky

Vicky,

I see you are still a fiery little pistol   ;) .... I totally agree with you Vicky, I've read far too many things about Snyder.

Guys, Vicky is spot on IMHO.  Look up Snyder on Surface Hippy, then comeback here and tell me that all is well at Newton.


@Vicky I am glad to hear you're surgery went well.

Hi Chuck,

Yes, I think it is in my nature to ALWAYS be a fiery pistol!  Always have been and always will be.  LOL.  Thanks for the kind words about my new hip.  This recovery has been nothing short of amazing.  I agree with many of your points, but why is it that I can no longer respond to this thread?

Hope you are doing well.

[B.I.L.L.]

This thread delivers, thats all I'm saying. Tons of information and entertaing as well. ;D