Dr Advises me against Hip Resurfacing

[ripit97223]

I am working with the only orthopedic Dr in the Kaiser system in Oregon that performs hip resurfacing and he strongly advises me to NOT pursue hip resurfacing. He believes the risks are too great and there are still to many unknowns with this type of surgery. If I insist he will perform the surgery, however believes I should wait. I am 48 year old active healthy male and have battled hip pain for over 2 years and not sure I want to wait any longer.
He has performed over 50 hip resurfacing surgeries and claims to have no problems. His biggest concern is metal on metal and the unknown possible side effects. I am now having second thoughts about having the surgery. Great website, appreciated any advise.

[Tin Soldier]

The surgeon that has done 50 HRs is advising against HR?

Talk to Boyd in Salem, he's got 700 or so HRs, and I think there might be a surgeon at OHSU, but I don't know their numbers.  See if Pritchett in Seattle does Kaiser.  I'd go with Pritchett.  Also, I heard recently that Dr. Sparling in Vancouver WA is not doing HRs any more, so maybe don't waste your time there.  I think what might happen is the inexperienced are very nervous about doing HR and so they don't do it, or if they do, they don't do it for very long. 

I'm 42, had classic standard OA, all the experienced surgeons would say I'd be an idiot to go with a THR.  Maybe you've got some other circumstances, but otherwise I don't see why an active 48 yr old shouldn't go with HR. 

Good Luck.

[Dannywayoflife]

With only 50 under his belt I wouldn't give much weight to his opinion! I'd find a more experienced surgeon! Even if it ment paying out of my own pocket!

[obxpelican]

As others have said, if he only has 50 surgeries you need to seek out a more experienced surgeon.

The statistics just do not match his opinion, that is unless he is refering to folks who got the ASR by Depuy.  I wonder which device he uses?


Chuck

I am working with the only orthopedic Dr in the Kaiser system in Oregon that performs hip resurfacing and he strongly advises me to NOT pursue hip resurfacing. He believes the risks are too great and there are still to many unknowns with this type of surgery. If I insist he will perform the surgery, however believes I should wait. I am 48 year old active healthy male and have battled hip pain for over 2 years and not sure I want to wait any longer.
He has performed over 50 hip resurfacing surgeries and claims to have no problems. His biggest concern is metal on metal and the unknown possible side effects. I am now having second thoughts about having the surgery. Great website, appreciated any advise.

[Pat Walter]

Hi

Most surgeons that don't do resurfacing or only do a few a year, will normally suggest a THR.  If you are in the Kaiser System, contact Dr. Klug in CA.  He does do resurfacing and is an excellent hip resurfacing surgeon.  Most people that want resurfacings have to travel becuase there are so few excellent hip resurfacing surgeons.  If you want a resurfacing and I think you should try to have one since you are young, you will have to travel a bit.  After all, you only have 2 hips and if one or both are not corrected properly, you could have pain and be inactive all your life.  Please take time and find a surgeon that does a lot of hip resurfacing and get some input.  If the top surgeons that does many hundreds and thousands say no - then you do know you are not a candidate.  Do not listen to a surgeon that does not specialize in resurfacing.   http://www.surfacehippy.info/listofdoctors.php#California_

Good Luck.

Pat

[Anniee]

Excellent advice from Pat, Chuck, and others to get opinions from experienced hip resurfacing surgeons!  And I think Pat meant to say do NOT listen to a surgeon who does not specialize in resurfacing.  Two years is a long time to be in pain!

[ScubaDuck]

I second everything said here.  This surgeon is being unreasonably cautious.  When the statistics show that 96% of HR are successful at 10 years, I don't believe this is a highly risky procedure.

Keep in mind the research shows the best outcomes come from experienced surgeons with proven devices.  Also the medical community, doctors and insurance companies, are trying to avoid costs.  This means avoiding lawsuits and denying procedures.

I am in Oregon but found Dr. Pritchett in Seattle that was in network for me.  I would follow Pat's advice and find an experienced doctor in the Kaiser network.

Best wishes.

Dan

[wayne-0]

Hey Ripit, 3 yrs ago before my surgery i met with several orthos who said that hip resurfacing is a horrible method and it fails misrerably and told me THR is the only safe way to go. Well i just would not take that answer as i was determined to have a life back that I was reading so many hippys on this website were describing they've recieved. Well i found a great doc who is pro resurfacing and had done a few hundred surgeries. Well i am doing great so far and hope it continues to go that way for many yrs to come. If you find a great doc you trust(and believe me you will know the right doc when you find him/her), and they say your a good canidate for HR, that is the surgery you should pursue. I may be biased but this surgery has been and given me a second lease on life. Good luck with your decisions in the future.

Wayne

[David]

Hey Ripit, don't you want to get out there and "ripit" once again?
Please schedule a consultation at least with an experienced HR surgeon.
You don't want to regret the failure to pursue all of your options.
Like you say battling hip pain for two years is no fun.
Not much in life is 100% fail safe, but so far 2 months in, I sure am glad to have had the opportunity at a second chance with my BHR...
Best in your direction and decision...
David

[Aerial]

I am from SC.  My first orthopeadic doctor did not recommended hip resurfacing.  I went literally down the road in Columbia, SC to see Dr. Gross and was very impressed with him.  He put my mind at ease about ions, excessive wear, metal on metal, etc.  I agree with others, surgeons are comfortable with the procedure if they do many of them.  This is totally understandable to me.  Find someone who has done many hip resurfacings and I think your reservations will be minimized.  Good luck to you!

[lori.36]

Same with me, the 1st two orthos that I saw, did not agree with me doing HR, but then again they do not do the procedure.  What was your impression of the doc, was he your doc?  I would say at 48, I would rather go with HR than a THR.  THR just seem designed for old people that break their hips, and you are not old.  Best of luck with your decisions.

[curt]

     I found it very interesting that in my area of Virginia, with several large Ortho practices, none of them even mentioned HR as an option.  This included two practices that support the Universities and three prefessional sports teams.  They talked about getting a THR, said I was a great candidate and would need one eventually, but at 50 recommended that I bite the bullet and gobs of Ibuprophens to wait until I was older.
      It was pure luck to stumble across someone who had undergone bilateral HRs in 2003, while the approval process was going on here, and he turned me onto this site and put me in contact with others who had received successful surgeries.  It led me to believe that while most people my age or younger who had received THRs had gotten relief, they had been ill-served by a lack of information about this newer option.  The doctors or practices do not perform them, so they don't promote them.  The "art" of placement, while being mitigated by better procedures and techniques, makes it harder to do and train for.  I feel for my friends that got THRs and were never given any information or direction about resurfacing.  I believe nearly all would have opted for the latter had they known what I did, and even if they did not, it sure would have been nice to have the choice.  Good luck with yours, Curt

[Anniee]

Curt, I had a very similar experience.  The first hip specialist that I saw in Augusta, GA, only mentioned THR, and said he would do it anytime I was ready.  I was not ready!  I just happened to mention this to one of my coworkers, who told me I should talk to another coworker, who had had some type of "less invasive" hip surgery a few years earlier.  This lady is the one who told me about Dr. Gross and this website.  This lady had the same hip doctor in Augusta that I had, and had received the same advice from him, and had actually scheduled a THR with this doctor.  She was only 37 and very, very active.  She found out about resurfacing from another coworker, who had a son with leukemia who had had his hip resurfaced by Dr. Gross while he was in his early 20's.  So she cancelled her THR, sent her information to Dr. Gross, and had her hip resurfaced.  Her story is on Dr. Gross's site if anyone is interested - she is "JL".

I think it's sad that more doctors do not even tell their patients about resurfacing - particularly, their young, active ones!  Or even old, active ones like myself! :)

[newdog]

The big name ortho that I went to here in my area never said a word about HR. At the time I myself never heard of it. He didn't say anything about it even though he was aware that another doc in this same town is performing it. He just told me that I would be back to see him or someone else in probably two years. I assumed he meant THR. "Just hang on until you can't stand the pain anymore."

About three months after my surgery I was talking to a woman from my hometown. She was in her late 40's when she had a THR done. She was very disappointed when the surgeon who performed her THR informed her that she was not a candidate for hip resurfacing and instead would do total hip on her. He was new at hip resurfacing and I would bet that if she went to an experienced HR doc she would have had it done. That's really sad. It is not an insurance issue with her because she works at the same university that I do and she has the same medical insurance.   

The only way I learned about HR was by searching on the internet for some kind of treatment for my bad hips. My primary care doc and two physical therapists that I went to before my surgery never mentioned HR to me. It's just not right.

[RJKELLY]

From what I read on this issue it's all about the alignment. 
Poor alignment=improper wear=excessive ion levels.  I was also very concerned about this issue and my surgeon at HSS in NYC told me that they use a laser alignment guidance system to ensure placement thereby minimizing the risk.  Also, BHR system has a significantly better placement outcome over other systems.  Hope this helps.

[imgetinold]

Broken record alert!  My first ortho - who has performed HRs, which is why I went to him - said he did both, and I could tell from his explanation that he thought THR was as good an option as a HR. 

Needless to say, I'm scheduled with Dr. Gross in January.  Good luck!

Andy

[Boomer]

I'll echo what RJKelly says and add a bit. The resurfacing heavyweights like Drs. Gross, Su, Pritchett, Rogerson, Bose, Treacy, McMinn,  De Smet and others keep doing resurfacing surgery because they have seen how it restores active lives. They have more experience and a larger active base of patients, and would be the first to know if there were problems. They are not seeing the problems that arose with the ASR or that arise from misplacement by inexperienced surgeons. There are a lot of inexperienced plastic surgeons who screw things up early on, but nobody is trying to disuade people from plastic surgery.

Pick the most experienced surgeon you can get to and let him/her do their magic.

[curt]

     Guess we should have asked if you are related in any way to the advice-giving ortho before the entire site came crashing down on his/her poor head!  The answers are from well-served patients of HR.  Find a great surgeon and you have a great chance for a great outcome!  Curt

[don flash]

Note by Patricia Walter:  They were not doing total hip resurfacing with the BHR Birmingham Hip Resurfacing Device in the 70's. The first BHRs were placed in the late 1990s.  There were hemi-resurfacings that were NOT called BHRs in the 70s.  They were not sucessful because only the femur ball was capped with a metal cap.  There was no metal acetabular component placed in the hip, so there was bone on metal.  Not a good situation.  Now with total hip resurfacing, they use a metal cup in the acetabulum and an metal cap on the femur ball - so there is metal on metal.  The problems experienced in the 70's were not associated with mis-placed acetabular cups today with full hip resurfaicngs.  Please note the retention rate for the BHR worldwide is now 96% with the first BHRs placed in 1997.  Just wanted new folks to understand the facts, not just the opinion of the poster.There are lots of Docs who still do breat implants, no?  Be very careful.  Us patients are NOT experts because we had it done and blog on this site.  The ist doc I went do would not do a BHR..says they tried it in the 70.s and there were problems.  He is one of the best in the country!  Of course, dumb me, went to a doc that was willing to do it and also had very little experience with it..I am (was)  too trusting..looking back after 2 years, I wish I had listened to the expert 1st doctor..thats my opinion...I am not sure if I would do it again or get a THR.

[Boomer]

Don,

I'm not clear on the point you are trying to make with your post. Are you saying we should not trust any doctor who recommends hip resurfacing or are you confirming that we should only trust those surgeons with significant resurfacing track records? I think virtually everyone posting on this website advises every patient to find the most experienced surgeon they can. It doesn't eliminate all the risks inherent in surgery, but it greatly increases the odds of a good outcome.

I am having trouble walking on a daily basis. Life is not good. I think most Hippys find themselves at a similar place and are forced to place their trust in someone. You have to believe. It works out well 97 per cent of the time.

Don, if your surgeon botched things, go see one of the top resurfacing guys and get some help. The technology has been proven over 13 years at least. There are some fabulous surgeons working with resurfacing.

I'm not a Hippy yet, but I'm enormously pleased that I have a chance to be free of all this pain in just a couple of weeks. My surgeon fully believes he is going to give me back prt of my life. Do you think he's lying so he can earn?

Sorry Don. We Hippys have to have trust to play it forward.

Boome