Considering Resurfacing, lots of questions!

[KarenZ]

Hi,
I am a 44 yo female cyclist, I live in the Phoenix, AZ area.  I have had hip pain for over 2 years now.  In August 2007 I had arthroscopic surgery to repair Femoral Acetabular Impingement Cam type.  Surgeon reshaped head and neck of my femur, cleaned up the labrum, microfractured my pelvis.  Recovery from this surgery was quite extensive,  6 weeks of crutches, months of PT - and did me absolutely no good.  I am not better, actually worst.  The arthritis in my R hip is just too advanced to have allowed any improvement with the arthroscopic surgery.  An MRI last week diagnosed progression from moderate degeneration in that hip (august 07) to severe - areas of bone on - cartilage loss - blah, blah, blah.
A PT of mine (I have had several) recommended I research Resurfacing as opposed to THR.  I have been pained about the thought of amputating bone - so I was thrilled to hear about this alternative.  This PT put me in touch with a surface hippy who gave me a lot of info about his procedure and turned me on to this site. (I am really grateful for this site, BTW!)
I have made an appointment with Dr Ball in San Diego for Sept 24.  Before I go to that appointment  I would love to hear from those of you who have experience with my situation.  Namely I am most interested in:
1. whether or not the arthroscopic surgery I had in any way diminishes my chances for a successful Resurfacing.
2. why isn't Resurfacing more popular?  For example, there aren't any physicains in AZ doing it.
3.  what is the "metal ionic issue" I have seen briefly mentioned in some postings?
4. I have bone on bone pain, but also quite a bit of muscular pain in response to the way my body accomodates to stay out of pain.  Will the bone pain be gone instantly?  how long for the muscles to go back to normal functioning?
5.  Any of Dr Ball's patients willing to tell me about him specifically?
6.  Another orthopedic surgeons nurse in town left me a voice message "saying Dr___ doesn't believe in Resurfacing".  No further explanation.  Any of you know what the surgeons who don't believe it in say about why they don't?
7. I have read that some of you had your resurfacing done as long as 10 years ago.  Is that same device still working for you?  have you had to have a THR? Is it prudent to believe that a single resurfacing could last me 40 years? (If I need a THR at 84 yo I would be OK with that I suppose ;)
8.  Will my limp eventually go away? Completely? 
I know you all are not physicians.  I am just looking to hear your experience.  I made the decision to have that last pointless surgery without doing much research.  I trusted in the one referral my PCP gave me.  This website offers so much wisdom, experience, and information - I want to take full advantage of the experiences you all have had.
The potential to be able to walk without pain, to be able to tie my shoe without performing acrobatics, to be able to ride my bike in the Time Trial position without hiking my right hip up and giving myself scoliosis would be a dream come true!  I am just hesitant to get my hopes up - after having such a discouraging surgery last year.
I am so grateful for your thoughts!

[sroberts]

Hi Karen.

Two of us from Tucson travelled out of state to get our resurfacing. Both of us are cyclists and you will be able to time trial again. Watch the Dr interviews that Vicky provides on this site. You can also email or call the top Docs in the country and the World and get free medical advice.

I plan on running again soon and compete in some more triathlons. Resurfacing isn't more popular because there is a steep learning curve for orthopaedists and in the past substandard materials were used.

If you want to discuss more, email me at Magoo451@msn.com


spencer roberts

[Pat Walter]

Hi Karen

Welcome to Hip Talk.

Many surgeons will bad mouth hip resurfacing for several reasons - either they don't know about the modern version of hip resurfacing and are still thinking it is the old hemi-resurfacing of years ago when the only capped the femur. That was not a sucessful surgery for many people.  

Or they are not skilled enough to do or learn hip resurfacing. There is a steep learning curve and some surgeons just don't want to learn. So they tend to say they don't believe in it.

You need to talk to experienced hip resurfacing surgeons that have done both THRs and resurfacing to get a good opinion.

There are probably doctors in AZ doing resurfacing, I just have no way of knowing about them all.  I post surgeons with experience on my list and most are there becuase they have a lot of happy patients.

Many people have had arthoscopy that did not work or did not last long and ended up with sucessful hip resurfacings.  THat is not an unusual case.

Here is information about the metal ion issue, most of us were not very worried about it and most doctors are not very worried about it.

http://www.surfacehippy.info/metalioninformation.php  Some women have become pregnant and had healthy babies after having hip resurfacing.

The oldest hip resurfacing patient's story on my website is now over 16 years post op.

http://www.surfacehippy.info/katieellis91.php

You can look at my Hip Stories page and see people with hip resurfacings that have had them quite a few years  http://www.surfacehippy.info/hipstories.php

You can return to normal if you body will allow you to.  If you have spent a great deal of your life with a short leg or severe problems, it will take a lot of work to get your body and muscles back where they belong.  Most people with just OA return to a completely normal life.  That is an important question to ask of your surgeon who is looking at your x-rays.  They will give you a much better idea about what you will be able to do after hip resurfacing.  

Resurfacing is normally choosen to allow a person to do anything they want.  

Here is an article I wrote as to why I chose a hip resurfacing, it is similar to many other people's thoughts  http://www.surfacehippy.info/pcbhrvsthr.php

I think the Hip Stories can give you a lot of insight into what you will be able to do after surgery.  Many people have written great stories as to why they choose hip resurfacing.

An evenings worth of reading on the website will give you a lot of insight.  Spending time in the Discussion Group will also give you a lot of support and information.

Good Luck.

Pat

[wayne-0]

Hey Karen,
I am waiting to get my surgery authorized and I had my consult with Dr. Ball. He was the third doctor I met with and he is the doctor I want to do my bilateral hip resurfacing surgery. He is a fantastic doctor from people I've spoke with and after meeting with him I knew almost instantly he is the doctor for me. He answered every question and spent considerable time with me and never rushed any answer. He is very thorough with any and all explanations. I believe you will be very  encouraged meeting with him. Good luck.
                                                    Wayne

[John C]

Hi Karen,
Just a couple of quick thoughts on some of your questions. I too had hip arthroscopy, and it had no affect on the resurfacing. In my case, the pain did not go away right away, but at six weeks out, it started improving daily, and at 11 weeks, everything continues to improve daily. Since my hip had been bad for a dozen years or more, it is taking a while to get range of motion back, but it is coming. Since you are a cyclist, I wanted to let you know that this is one place where I have seen the most improvement. My operated hip is absolutely pain free on a bike, and no longer jams out to the side like it has for years. Definitely a huge improvement there. Also on your question about limping; I have had a bad limp for years. It is still there for the first few steps, but after that, everyone comments that my old limp is gone :) At 11 weeks, I still have a long way to go, but am now happy with the way they are progressing.

John

[dgm]

Hi Karen,
As to the bone on bone pain - for me anyway it was gone immediately.  The limp took a longer to go away - I'm thinking about 6 weeks.  Once I was finished with the crutches and felt steady on my feet, it seemed to improve daily.  Had about 6 PT visits and daily exercises to do.

I'm 46 and was bone on bone, bone cysts, almost too far gone to have BHR.  I'm guessing part of it was from over 20 years of running. I'm over my six month mark and have been cleared to run again and ski this winter.  The only reminder of my surgery is the scar.  I only wish I'd done it sooner and not been so hard headed about waiting (guess I was expecting some spontaneous recovery. . .)

Good luck, you will be glad you went this route.
Denise

[TomBuell]

Hi Karen - I think you'll find a lot of people on this site (myself included) who found the bone/bone pain gone immediately (I noticed it the day after surgery in PT, and nearly wept) and resumption of a pretty-close-to-normal range of motion after a while. It takes some time to rebuild strength in the operated leg, and to retrain the body not to limp, but resurfacing changed my life.
There's a ton of information on this site, and of course the most important thing is to find the right doctor - one whom you're comfortable with and who has the proper experience.
Good luck!
- Tom
RBHR - 7/1/08

[obxpelican]

Karen,

I was bone on bone end stage and the pain was so bad that I could not walk more than a short distance without looking for a chair, I could not stand in one place for more than a minute before needing a place to sit.  The day of the operation when I stood up and put weight on I knew things were different, although I had a big monkey fist in my hip putting weight on my joint no longer hurt.  Remember they are taking the area out that used to hurt you and they replace it with metal that has no nerve endings.

I am off of crutches and have been for better than a week and a half and although I still have a limp it is for sure less than what I walked into the hospital with.  Before my muscles tighten up my gate is pretty good and you would be hard pressed to notice any limp.  As far as limping going away from what I've read is that most people walk normally after 6 months to a year... go to the stories section, it will make you feel better.

Many surgeons will tell you that hip resurfacing does not work, but that is mostly out of old information they have about the early hip resurfacings that were a failure.  Today the rates of failure is pretty low.  Some surgeons do not know how to do a resurfacings and want to do THRs because compared to a resurfacing it's pretty easy.

Chuck
RH/Biomet U/C Dr. Gross/Lee Webb
8-6-08

[DirkV]

Hi Karen,
Dirk here; I'm the surfacehippy you spoke with last weekend. Glad to see you've found this site, and welcome! The info I was able to provide is but a speck compared to what you can gather here (and related links). As a cyclist, you've probably read Lance ARmstrong's book, and one thing I got from that was the importance of being an active participant in your healthcare, researching medical alternatives and pushing to see that you get what's best.
Re item 3: the metal ionic issue, my take is that it is a legitimate concern, but most studies I've seen discount the health concern. To my mind it's a bit like the mobile phone health concern - there seems some valid reason for concern, but the weight of scientific studies says that it shouldn't be a problem. Ideally, I wouldn't have needed prosthetic hips, but given the position I was in, the metal ion concern was minimized by most studies and the benefits of the surgery.
Re 4: The bone on bone went away for me too. The muscle pain differs, but it is a long-term process to heal the muscles. I have very little muscle pain, but after 4+ months, I'm still working on ROM, which is already better than pre-surgery, but is still constricted compared to normal. People report regaining ROM through the 2nd year, so I continue to work at it (with the help of our favorite PT and her recommended PT) and continue to see significant improvements.
Re 5: I've already told you of my good experience with Dr. Ball, but of course I'm just one patient. I just thought of another anecdote. While getting preop xrays, I asked the xray techs if they see lots of hip patients. The answer was yes and they both offered good opinion of Dr. Ball. The one guy mentioned that he had put off a hip surgery himself but would schedule his surgery now that Dr. Ball was at the hospital. When I went back for my 4 mo follow-up that technician was one week post surgery.

Good luck and glad you're here,
Dirk (ASR Bilat 02/08 and 03/08)

[KarenZ]

Thank you so much to all of you who have replied to my message.  You are so very helpful.  I have spent hours combing this site and learning.  The support of your experience is invaluable.  I feel a great deal of hope that I can be back to my activities pain free.  I expect I will continue to stay close to this site and ask more questions. I'm anxious to meet Dr Ball on Sept 24.  I'll let you know how it goes!
Thanks again,
Karen