Not enough hip mobility for a resurfacing ??

[pmonko1]

I went to the surgeon yesterday and had a few questions about the procedure and whether or not I was eligible for a hip resurfacing.  He told me that I have very little mobility in the hip and that a resurfacing may not be possible because he may not be able to move the hip enough to expose the femur head enough.  Has anyone else been through this?  Should I get a second opinion from an out of state surgeon? 


For the record, the surgeon (Dr. Della Valle) has done over 400 resurfacings and 4000 hip replacements since 2008. 

[LMS]

That sounds odd... had I had retained good bone quality, it would've been a go for HR & I had no mobility (bone on bone). So.... yeah, won't hurt to get another opinion.  Maybe this one doctor doesn't feel confident enough in a case like yours.

[Joe_CA]

Hi pmonko.

Welcome to the group. There is no doubt that you should get a second opinion. Hopefully from a hip-resurfacing surgeon who has done a high number of resurfacing procedures. I'm relatively new here (and about a month out from my own surgery), but I believe most here, including me, would believe some surgeon's skills are better than others with some of the more difficult cases, like yours *may* be. Besides factors like age, one of the few disqualifying factors to hip resurfacing is the condition of your femur, and whether it's in good enough condition to cap. Assuming that isn't the case, a second opinion from a surgeon who handles more complex cases would definitely be warranted.

Good luck!

[Dannywayoflife]

my range of movement on both my hips was terrible. my right side from memory had 0 degrees internal rotation, about 5 degrees external and 70 degrees hip flexion. i know the surgery was very very difficult and even Mr Treacy came ans told me after the op that he struggled and it was a very tough surgery for him...... it took him i think 90 mins he usually finishes in about 25 mins. I would personally find another experienced surgeon for a second opinion.....

[Saf57]

That sounds odd and counter-intuitive. Most patients that have hip resurfacing have terrible range of motion(I know I did), since they are bone on bone, or very close to it. That's precisely why they need the procedure! I would get a second opinion.

[Ljpviper]

That does sound odd, they dislocate the hip anyways what difference would it make. I know if you leave bone on bone too long it can be a problem.

[chuckm]

Dr. Della Valle is at the Hospital for Special Surgery. Why don't you go back there and see Dr. Su?


Chuckm

[Dannywayoflife]

The lack or ROM can be due to other issues as well as bone on bone such as the whole capsule sizing up. I spoke to a consultant who Mr Treacy had done a 4th THR re do on thanks to other poor surgeons. He explained that especially in someone of my stature with my rather ridiculous quads and glutes a super tight hip capsule can really make the surgery hard to perform...... Still its not impossible and my case was pretty bad!

[pmonko1]

Thanks for the input everyone.  I do have reasonably big quads since I've done nothing but cycling since being diagnosed with arthritis about 3 years ago.  Maybe with the tight neck capsule as well as some impingement and a small pelvis, a resurfacing may not be technically feasible. 
Dr. Della Valle has had to covert just over 1% of his cases to THR so the odds may be in my favor.

[einreb]

Dr. Della Valle is at the Hospital for Special Surgery. Why don't you go back there and see Dr. Su?


Chuckm

He's at Rush in Chicago, no?  I'm near Chicago.  I visited with five surgeons before selecting Dr Gross and traveling for the surgery.

I don't want to suggest that Della Valle is not a talented surgeon, but I suspect it could be argued that he is not a resurfacing 'specialist'.  Unique cases or difficult surgeries (mine was very unique and not easy) are most definitely the time to discuss your options with someone that has 4000 rather than 400.

-Bernie

[chuckm]

There are two doctors named Dr. Della Valle. One at HSS and the other at Midwest. Both do hip resurfacing. Craig at Midwest and Alejandro at HSS.


Chuckm