HR joint feel compared to normal joint

[HippyDogwood]

Who did the surgery Dr. Villar? Not many surgeons are using stem cells. Good luck with that, I would stay away from impact sports, ie running and jogging. I believe that's what made mine fail as I was ok for a couple of years after the surgeries.

Thanks,

Larry

Thanks Larry

It was at the Villar Bajwa practice in Cambridge but by Ali Bajwa who is very talented and Mr Villars protégé and business partner.

One of the reasons for having both done so close together is so that I can rehab properly. It would be too tempting to return too soon if doing one at a time so as to get a bit of normality ahead of starting the process again

[chuckm]

I'm under no illusions about the pioneering nature of this surgery and may end up no better off, but just wanted to flag to you that I wouldn't take one surgeons outlook on this as gospel in that another eminent surgeon will tell you that resurfacing is fundamentally flawed (I had one guy explain it to me as how any engineer will tell you that metal on metal is a bad thing and in an engine you have oil to lubricate and a magnet in the sump to collect metal filings!).

Hi HippyDogwood, I just read this and wanted to figure out why you are so opposed to resurfacing. You have been lurking on the site I see. But your impression of resurfacing is way incorrect. In my case I trust my surgeon - BUT - I trust and verify. My first surgeon did not like resurfacing and I was upset because before I went to see him I had done much research and knew of the successful track record of the BHR. He knew nothing but acted like he did. I think you should do more research and you will find how wrong that surgeon you spoke of is about resurfacing.

On the other hand I do think you are making a good choice to pursue stem cell therapy with microfracture. You must be a good candidate for that type of approach. The good thing is you will be no worse off if it doesn't work. But don't be upset by Dr. Gross's remarks. He is just like me - until there is lots of data to say it works well, then it has no value. Not that it doesn't work and not that it won't work for you.

My whole point here is that I didn't like your "fundamentally flawed" statement at first but then I wanted to help because you are avoiding resurfacing based on that conclusion. I'm on the other side like many here and I really doubt I am going to look at cortisone or stem cell/platelet ect. when resurfacing works so well. And the result isn't an improvement really, it's a fix.

Chuck

On the other hand

[Woodstock Hippy]

You've had a lot of replies.  I just want to add that I have bilaterals.  I run, bike and swim, two workouts a day and if it wasn't for the hassle at the airport, I wouldn't know that I ever had a problem or had it fixed.

[23109VC]

I'm almost 4 years post op.

I honestly think day in and day out - there is no real difference between my operated hip and my natural one.

My "natural" hip is starting to experience *some* problems but it's not nearly ready to be replaced...  and in that sense it is different from my operated hip.

I think my only limitation is that if I jog/run after about 3/4 of a mile or a mile - i start to notice some discomfort.  i have read about people doing marathons on their new hips... for whatever reason, that dind't happen for me.. but  the only real discomfort i get is after a run.

i ride my bike.. i've gone 10, 15, 25 miles..and never had any pain.  i play basekteball, racquetball.. no pain.   only running.

my range of motion is a bit less flexible with my operated hip vs my natural one.  but here is the weird part... say I run a mile or two... my operated hip might feel sore right after i run..but the next day it feels 100% normal.

but that next day my "normal" hip might flare up and throb for hours....

in all honestly, I think my oprated hip is better than my natural one..in that I do NOT get any of that nagging arthritic pain...  my "natural" hip is starting to get that arthritic pain here and ther and when it comes..it comes on for hours... and it reminds me of how bad my old hip was...

it's not bad enough to warrant surgery..but time will tell when it is..and when it is, you can be sure i'll be flyign back to see Dr. Gross.

i'm 100% glad I fixed my hip. it was the best thing I did.

I went from 24/7 pain to being pain free and enjoying life again.

[Dannywayoflife]

Yep my bhr side is so so much better than my other side. What we have to remember is that when we have a resurfacing done it is a foreign body and will never be as good as a fully functioning healthy hip. However I can only tell this when doing some fairly extreme stuff and I would say it's about 90-95% as good as my natural hip used to be prior to OA setting in.

[Ljpviper]

Thanks for the replies, the last two posts really help my decision on what to do to going forward.

I think I am going to  go with hip resurfacing. I had a cortisone shot on Thursday, it did not help.

I don’t think its wise to risk another arthroscopy if the first ones have failed. There is nothing that will be done different this time around, so I have
my doubts it will last.

The pain is 24/7 unless I am laying down. Also, I am not bending my hips properly to pick up objects, etc. My knees are starting to take a beating, and my back will be next.

Its silly to wait and risk more issues with other joints, no doctor has a solution for a grey area patient, so I will move forward with hip resurfacing. I don’t want to be another five years with these hip issues like the last five, I am over it.

I don’t see the point in waiting if there is no solution available.

Thanks,

Larry

[HippyDogwood]

I'm under no illusions about the pioneering nature of this surgery and may end up no better off, but just wanted to flag to you that I wouldn't take one surgeons outlook on this as gospel in that another eminent surgeon will tell you that resurfacing is fundamentally flawed (I had one guy explain it to me as how any engineer will tell you that metal on metal is a bad thing and in an engine you have oil to lubricate and a magnet in the sump to collect metal filings!).

Hi HippyDogwood, I just read this and wanted to figure out why you are so opposed to resurfacing. You have been lurking on the site I see. But your impression of resurfacing is way incorrect. In my case I trust my surgeon - BUT - I trust and verify. My first surgeon did not like resurfacing and I was upset because before I went to see him I had done much research and knew of the successful track record of the BHR. He knew nothing but acted like he did. I think you should do more research and you will find how wrong that surgeon you spoke of is about resurfacing.

On the other hand I do think you are making a good choice to pursue stem cell therapy with microfracture. You must be a good candidate for that type of approach. The good thing is you will be no worse off if it doesn't work. But don't be upset by Dr. Gross's remarks. He is just like me - until there is lots of data to say it works well, then it has no value. Not that it doesn't work and not that it won't work for you.

My whole point here is that I didn't like your "fundamentally flawed" statement at first but then I wanted to help because you are avoiding resurfacing based on that conclusion. I'm on the other side like many here and I really doubt I am going to look at cortisone or stem cell/platelet ect. when resurfacing works so well. And the result isn't an improvement really, it's a fix.

Chuck

On the other hand

Thanks Chuck but you need to read my post again as you are attributing statements to me that just aren't there. For instance the bit you highlighted and took issue with was a statement a surgeon made, NOT me!

The point I was making is that everyone has opinions and they can't all be right. Dr Gross' opinion on stem cell treatment is neither any more or less valuable than one of the UK's top hip experts (who I will not name here) who is totally opposed to resurfacing - the quote was HIS saying HR is fundamentally flawed.

Fortunately I have my own mind and can decant lots of information to make rational decisions that I feel are best for me. I would take resurfacing over THR all day long, and remember I already had my surgeon lined up for HR whenever that may be.

However, stem cell seems a root worth trying - you are right, I have lurked and will lurk here for a while and have probably done as much research as anybody as I like to make informed decisions; the reality is that whilst one can minimise the downside risk, we all know that HR (like most surgery) carries risks and this site is not only members who have had a great result through HR, some do everything right yet face revision because MOM is undeniably the weak link in the procedure. That is an area I think will improve through evolution of material choices but until then my preference is simply not to have ion levels as a life consideration until I have no option other than THR or HR (which is where I thought I was 6 months ago before offered stem cell treatment) Who knows, I may be back to looking at HR in the next 12 months, I just hope stem cell will give me some time

I think the strength of this site is sharing honest information so we all find a path that works for us - its a great resource and whilst Pat is clearly a huge advocate of HR, she doesn't want us all to be blind HR fanboys, but to share experiences for the greater good in the way that she has had a great result from HR.


I responded to this post as a fellow member was being left to feel he had no options which I didn't think was right, hence wanted to throw out there another avenue of thought. But don't take me as anti HR or misinformed, as that's some way off the mark but appreciate you taking the time to share your experiences and glad all has gone well for you
David

[chuckm]

That's a good reply HippyDogwood. But if you have done that much research then you must know what a poor analogy it is using metal parts in an engine to describe what happens when someone has a hip resurfacing. But it does highlight that even eminent surgeons can have a poor understanding of metallurgy and so they stay away from learning about it.

I am with you on the stem cell thing for sure. It will be useful for many people.

Chuckm

[hernanu]

The path we all take to our resurfacing(s) or THRs is individual and has waypoints that others may not.

Some of us have waited for a long while, canceling procedures and then doing them later. The best thing in my opinion is to wait until you are sure that this is the right way for you. Until then, since this is major surgery, I think you take your time and come to a decision.  This is important in my mind since recovery is work. If you have come to the right attitude and are all in, your recovery will go better.

So many of us have tried different treatments, changes in diet, exercise regimens, etc. to find an alternative to surgery. Many of us have taken or are in the process of taking the step to an HR or a THR. I preferred an HR for all of the positives that I see in this site.

Other treatments may work for a person, some are established but don't address the full problem if you have osteoarthritis, others are the future (I believe) but may not be ready for true effectiveness yet.

I think (my own opinion) that stem cells are an exciting possibility for true natural treatment, but is not yet developed to be a full treatment the way HR is. I may be wrong, but until it's clear that it works as reliably as HR, I am still enthusiastic about it, but awaiting its true birth.

I think you're still charting your own path, HippyDogwood, so lurk away as long as you need to and use all of the information here to support your decision. If you use the information here, and make sure that you are still a good candidate for HR, then that option, an excellent one for this point source of information, will still be open and available to you.

In the end it's a very personal decision which most of us have faced and come to. None of us would have had surgery without needing it. So the lack of options is there, since this disease is not reversible and must be dealt with at some point.

I think I would have been in a wheelchair if options were not available, so for me, while not minimizing the bad results that some of us have suffered (which we've seen here for people we value), the choice in my mind is one that had to be made, and made with current choices (HR, THR) not ones that will be realized in the future.

The happy thing in my mind is that both allow a return to normalcy. I went with HR because I wanted to be as active as possible and liked the minimized impact it offered.

I also went with full knowledge of the possible failures, which I think is important for a true decision to be made. Nothing is guaranteed, but I think I have great odds in my favor.

[MPH]

Well said. Each has their own pain or discomfort and therefore a decision to make. For me, experiencing real discomfort after 90 mins in the saddle on a proposed 4 hour ride ticked the box. I have woken up, got out of bed thinking 'feels ok today, should I be having surgery?' But then at least 5 times during the day I wince.  That can't be right.
Can't run, can't kick a ball with my kids = no brainer, even though at times it still feels ok. Although stiff and sore.
I like to deal with things, therefore its getting done. Time will tell if it was right but better making a decision than not making one at all.
This site has affirmed my reasoning and posts like those previous to mine give us real hope.
Thanks for the info and opinion, it really does help.

[HippyDogwood]

Thanks Hernanu much appreciated and will keep checking in, participating in debates and see where circumstances take me over the next few years.

I'm just one of those people who like to make fully researched decisions and reading good honest feedback (whether good or bad) on sites like this is a godsend.

And if anyone is wondering - two scopes with cartilage anchoring, fai removal microfracturing and stem cell treatment 8 weeks apart is pretty challenging rehab as you have to be more careful than HR over weightbearing!

Wishing all a Happy Xmas

[a sensation]

Hi Larry,

I believe we are in a very similar scenario.  I had two failed scopes, my joint space is good in the X-ray, but I have some severe pain.  I had microfracturing on both hips.  I had full chondral wear in weight bearing areas.  At the time of surgery, it said 2cm x 2cm.  And mentions of different grades of 3 to 4 on the Femoral head.  So, I'm not sure what it really means.  There is space on the x-ray, but the operating report talks about a lot of grade IV wear. 

De Smet, Treacy, and Bose all told me I have enough cartilage and resurfacing isn't optimal at this time. 

3 tops FAI surgeons told me there is a strong chance I won't get better from another scope, and 2 of them said there is a good chance it will get worse.  The scopes definitely worsened my situation the first and second time around.

There is a Dr. Fontana in Italy who I spoke with about the stem cells, but they still use MF on the femoral head with no scaffold of the stem scells; that makes me skeptical and I have little confidence in MF and the scope at this point.

I will see eithe Treacy or De Smet in person soon and see what they think of my situation in person.  I will let you know what they think.

[Dannywayoflife]

Mr Treacy has no problem operating on me right hip even though X-rays show joint space. He made me have an MRI though and this shows a total loss of cartilage on the femoral head and similar in the socket. X-rays do not always show the full story

[Ljpviper]

Wow, your case is just like mine, I also have roughly two centimeters found. How long did it take for your fai/microfracture surgeries to fail?

I was reviewing old MRIs from 2010, the one for my right hips states no arthritis. When I had surgery 4 months later he found that huge spot of grade 3 arhritis, just on that one spot.

No way you can get arhritis in four months. Imaging for hips is just so inaccurate, this can have a huge impact on saving your joints. I believe if caught early your hips can benefit from arthroscopy, but once arhritis sets in, entire different outcome.

While I would love to try another arthroscopy with stem cells to try to save my hips there is just not enough proof out there to risk it. I believe one day stems cells will be the saving grace for all joints. Also, the hip bears so much weight, that specific chrondal loss I have is the most weight bearing of the joint, so makes it even more difficult to correct.

I am sending my info to Dr Su next I am not staying like this. My knees are really starting to bother daily, 4 painful joints is a show stopper for me, time to do something about it.

Thanks all. Larry

[Ljpviper]

This is interesting, as the other poster mentioned providing a scaffold for the stem cells to adhere to is key.


http://www.healthline.com/health-news/stem-cell-treatment-to-repair-torn-meniscus-very-close-121214#2

[hernanu]

Very cool. I know several friends who've had meniscus tears, regrowing them would be a blessing.

I can see needing something to keep the stem cells around, since they are "pre" cells and can change to any cells needed, you want to catalyze them to become the cells you want in the area you want.

Very cool.

[a sensation]

I don't think the MFing did anything for me.  I never had any relief.    I'll let you know how my consultation goes in a couple of weeks.

[chuckm]

I had micro fracture done to the knee. Specifically behind the knee cap and in the trochlear groove. Fibrocartilage grew fully over the 10 mm patches and covered both lesions completely. I have pictures the surgeon took from a subsequent arthroscopic procedure to remove a large floater in the same knee a few years after the MF.

The knee became functional enough to return to competitive soccer. That was over ten years ago and I still play to this day.

The cartilage loss was due to a specific injury due to an accident years earlier that brought on osteoarthritis in front compartment of knee.

The MF did help provide relief to the cartilage surfaces but had no effect on all the other problems that come with OA, like enlarged joint, bony spurs, and a wider knee cap. These issue continue to get worse and the "new" cartilage is wearing out.

So, the end result from MF was a knee joint that was improved enough that I could go back to soccer - but it still hurt. Sometimes quite a bit as the tendons and ligaments had to deal with the bony problems when active.

At no point did the successful MF on my knee come even close to the level of pain relief and functional restoration that my resurfacing gave to my hip. 

Stem cell therapy with MF is very interesting. But just like with my MF, it will not be addressing all the bony issues that accompany OA. I suppose if you have specific cartilage loss in the absence of OA then this could be very successful over long term. But if you have some OA it's going to require shaving away some bone spurs and maybe some repairs to the labrum in addition to the MF. And then you will be where I was with my knee. It works much better. But it is sore.

In light of all the posts about stem cell I will certainly consider seeing if I am a good candidate as my other hip deteriorates but since I know I already have developing OA I will not be surprised if I choose resurfacing knowing the total relief it brings.

Chuckm

[Beth]

Larry,
When your OS did your hip scopes did he note any arthritic changes? I had bilateral hip scopes done in 2012 for labral tears/FAI. When he did the scopes he found bone on bone (femoral head grade 4 changes). My MULTIPLE hip xrays have continued to show "normal" spacing. I started having somewhat sudden pain 9 months after my right hip repair and my left hip started having issues just months after the repair.
I had hip resurfacing in the right hip 2/17/13 and wow, what a change. Dr Brooks brought up the normal hip spacing in my consultation. He said that some people don't get 100% relief from resurfacing that they hoped for but he would proceed with my hip resurfacing. Maybe ortho docs say this to everyone?
I have really struggled with the left hip-esp with sitting/riding in a car. I went for a 1 mile walk/shuffle as an experiment this week and my new hip did great-a little sore the next day but what concerned me was the terrible pain in the left hip afterwards.
I see my doc- Dr Brooks @ CCF later this month and I'm sure we will be discussing surgery #2.
I guess what I am saying is that I too, have put up with hip pain for years and although my recovering hasn't been a picnic, I'm just not in the pain that I was before for years and see good days ahead. I'm not looking forward to another surgery but the new hip sure does feel better than the one that doesn't!!
Beth

[lgbran]

14 months post op and my BHR joint and hip feels great. get the occasional clunk and my gait has changed completely. Pain free and able to do things I couldn't do years ago. The muscles and ligaments I guess can only get stronger as for the joint itself its better then my real hip. My operated leg isn't as straight as the other but I think this is due to muscle weakness and wearing orthotics for 20 plus years. Glad I did it and wish I had done so a few years earlier. Am envious of people who can run marathons post surgery. I miss my running but cycling is not a bad substitute.