Posterior Approach & trochanteric flip

[Pat Walter]

I feel I need to respond to the many numbers of posts about the trochanteric flip or Gantz approach.  I recently watched a live BHR surgery with Dr. Kusuma in Columbus and he took time to show me how he is very careful to leave as much tissue around the femur neck as possible to keep the blood flow adequate.  Many surgeons using the posterior approach preserve the hip capsule and are very aware of how critical the blood flow to the femur neck tissue is. There have been a number of presentations at the courses I attend about the important of saving femur neck tissue. 

This is done in all posterior approaches to hip resurfacing.  There is no need for a trochanteric flip just save blood flow. This is just an mis-understanding with the trochanteric flip  people. I don't want perspective new patient to be afraid of the posterior approach due to the large amount of posting about how great the trochanteric flip appears to be.  This is an old fashioned type of surgery. The recovery takes a long time compared to a normal posterior approach.  Some people like myself and others had very quick recoveries.  I had a long incision with the posterior approach.  I took nothing but some Advil after leaving the hospital at 2 1/2 days.  I was on one crutch, doing stairs and walking the Holiday Inn in Belgium.  I walked to every meal down a long hall, then the elevator and another long hall to the dinning room.  I walked around the parking lot and then went sight seeing at 5 days post op.  I used one crutch for about 3 weeks.  I was doing deep knee bends showing off my new BHR at 6 weeks.  Many people had a similar recovery while others had longer recoveries. Normally, no one had to wait 8 weeks to start walking and being active. Usually at 6 weeks any restrictions like the 90 degree rule are lifted.  There is no need to stay in bed or sit around with the posterior approach.  You can be as active as you wish as soon as you can.  Many people end up doing too much becuse they feel so good.

The posterior approach is used by probably 99% of all surgeons doing the BHR.  There are only a small handful of surgeons using the anterior approach or the antereolateral approach.  All of the national registries show the results quite clearly.  The current retention rate of the BHR is 96%   It would be higher, but the new surgeons learning in 2006 brought the rate down to 96% when it had been 99% world wide before then.  Just study the nation registries and you can see the facts. The posterior approach for hip resurfacing is the most widely used with excellent outcomes.

I don't want this to become a large discission about what is best.  The trochanteric flip people are welcome to post, but I need to make sure that new people understand that there are only a very few people that had this approach. 99% of people usually have the posterior approach and it works quite well.  I have met most of the top surgeons in the world and they are always looking for new methods to improve hip resurfacing.  I can assure new people, that if the trochanteric flip was better than the current posterior approach, the surgeons would be using it. They are always looking for new methods and new tooling and new devices to make the surgery better and better.

Pat

[Pat Walter]

I tell everyone they are welcome on Hip Talk and welcome to discuss their stories.  My problem is that now we have 3 ? trochanteric flip patients vs over 3000+ other members and over 140,000 BHR patient worldwide that had the posterior approach.

I have attended hip resurfacing courses and listened to medical studies and presentations since 2009.  I know all of the top surgeons and have talked with them personally.  I have many video interviews listed.  I have a pretty good idea of what is used world wide for surgery approaches and know the outcomes based on courses I attended, medical studies and interviews from the surgeons.  So I do know the posterior approach is used in probably 99% of the cases and that the outcomes are good.  The outcomes have a 96% retention rate.  The retention rate for the top surgeons is about 99%

So because 3 or a few people had something different, I want to make sure new people don't think this is the up and coming type of surgery and it is the best surgery. The number of posts being made about the trochanteric flip are getting to be quite numberous because you feel you made the best choice and are recovering well.  I am glad you had that outcome.

The purpose of my site is to help new perspective patients learn about hip resurfacing and the top surgeons that have the best outcomes.  That will be the surgeons that use the posterior approach in almost all the cases.  So I don't want new people to think because of the amount of information you are placing on the site that it is what most surgeons would do or most doctors would recommend. If you feel this is the best surgical approach and want to talk a lot more about it, I would suggest you start a website dedicated to the approach for hip resurfacing.

I personally always recommend patients use the top surgeons which mean in 99% of the cases it will be a posterior approach.  This site is a place to place your story and opinion, but I don't want the opinions placed over and over for a very obscure type of surgical approach.  I want you to contniue to post about your recovery, but prefer you keep one thread going about your own story and not keep adding new threads about the trochanteric approach which is hardly ever used.  So you are very welcome, but please keep to using the current threads instead of making more and more about the trochanteric flip.  I don't want this to become a big debate.  It is my site and I pay for all the costs and I do all the work, it is my opinon based on medical studies and national registries that this is an obscure approach used by very, very few surgeons.

Thank You for your understanding and help.

Pat