Hip Talk Forum About Hip Resurfacing

I fly from Denver to Atlanta two weeks from tomorrow, where my mom will pick me up and drive me to Columbia to have Dr. Gross perform my hip resurfacing on Wed Apr 8th.  I am getting really excited, having gone through a gamut of emotions in the last few weeks.  First, being told I am not a candidate, then being told I am, but that It would be June or July, to then finding out due to a cancellation, I can have surgery in less than three weeks. 

Due to the Master's taking place just down the road in Augusta, and with such short notice, the Marriotts near Providence are all booked up, but I did find a room not too far away.  I contacted my airline and have wheelchair service and bulkhead seating arranged for Friday evening Apr 10th. 

Feel free to give me any advice that any of you can think of.

Good luck!  My advice is to get your upper body in shape. 2 1/2 weeks is not a lot of time, but push-ups, pull-ups, and crunches will help. You will be using only upper body for the first few days getting in and out of bed.

Quote from: Arrojo on March 22, 2015, 03:54:26 PM
Good luck!  My advice is to get your upper body in shape. 2 1/2 weeks is not a lot of time, but push-ups, pull-ups, and crunches will help. You will be using only upper body for the first few days getting in and out of bed.

Got that one covered.  I am an avid rock climber and bench only powerlifter, so upper body is my strength.  Also, picked up a zero gravity chair today. 

"Due to the Master's taking place just down the road in Augusta, and with such short notice, the Marriotts near Providence are all booked up, but I did find a room not too far away."

Either of these two motels would be just as good as the "Mariott near Providence," and you will be in a much quieter, less congested environment.  You'll only be about 3 or 4 miles up I-77 from Providence.  Well worth considering if you haven't already found these:

http://www.ihg.com/holidayinnexpress/hotels/us/en/blythewood/blwsc/hoteldetail

http://www.comfortinnblythewoodsc.com/

I agree on the upper body advice -- the better shape you're in, the better. Don't overlook abductor and adductor exercises if your pain allows; it will help in recovery.

Also, buy those little things you'll need around the house in advance (Amazon helped me out): grabber, sock assist device, raised toilet seat, crutches, etc.

And, video games and long extension cords for the hospital; depending on post-op meds, you may not be too interested in reading or watching TV, but a good iPhone game or two can help.

Additionally, I brought ear plugs and eye shades to help sleep in the noisy hospital environment.

Above all... just relax.

I agree with all the advice. Get your core strong, plus quads, gluteus and hamstrings as much as the pain will help. I'm almost 10 weeks post op and swam 1km this morning, followed by 45mins hard graft on the elliptical (keeping HR at 80%) then came home and walked the dog along a coastal path for 3.5 miles.. No reaction with pain or stiffness. I'm sure its because of pre op conditioning. Hydrotherapy has been a huge accelerator in recovery.

You can do a fair bit in 2.5 weeks, take the pain meds to get in as good condition as you can. so my advice is do as much as you can!! Good luck and I'm sure you'll be fine

Thanks for all the advice.  I was still doing a lot of leg strengthening and conditioning up until about 2 months ago, and just started back Thursday after setting the surgery date.  I will make sure to hit it hard and just deal with the pain, knowing that it will help on the back side of this. 

Hello everyone ,  I am 3 weeks post surgery and it went very well with no complications.  However, after 2 weeks my bandage was changed by my surgeon and he said I was having an allergic reaction probably to one of the medications.  My symptoms were bumps/rashes on various parts of the body and the worst was my lips, tongue, and gums were very sensitive especially in the morning .  I woke a couple mornings and my lips were actually numb feeling and my tongue and gums were so sensitive that it was painful to eat or drink.  Things are getting better now but I would love to hear any feedback ?????   Has anyone experienced these symptoms ?   Thanks ! 

Three years ago I had the BHR done by Dr. Gross. This website was instrumental in choosing to have this procedure done and to select Dr. Gross as the surgeon. I contacted a member of surface hippy and he provided very specific details on the surgery, recovery process, and results. I feel I need to give back as well to tell people my story.

I am 50 years old male who could not tie his shoe before I had BHR done on my left hip. 9 months and 1 day after I was back to playing hockey. Today I play as hard and fast (with mostly 20 year old kids) as before the arthritis set in. This winter I went skiing out west and skied most of the double black diamonds trails on Lone Peak at Big sky and spent more time on moguls than groomed trails. I cant be happier with my decision to have the procedure done and to select Dr. Gross as my surgeon. (Yes the 6 hour post surgery drive home was miserable but well worth it!). My only regret is waiting as long as I did. I hope my story is as helpful to others as the input I received from this website  when I was making my decision on which path to take.

Great to hear, royash! Love when people check in after many years, good to see how everyone is doing longer term.

Thanks- In my haste to post I realize two mistakes I made in the post:
1: It was Biomet not BHR that Dr Gross used. At this point I couldn't tell you the difference but I could 3 years ago.
2: It was 6 months + 1 day that I was back to playing hockey. (6 months was my restriction- felt like I could have played 3 months post op).

Great to hear. I'm 5 weeks away from the start line. I hope I get a similar outcome (not sure about hockey though  ;) ) and can tell a positive story down the line.

Not had a reaction like that my allergic reaction was more seizure and cardiac arrest based. Hope you get well soon

Danny

Glad to hear your story.  I am 15 days from my resurfacing with Dr. Gross and also hope to be able to tell of success down the road. 

Thanks Danny,  I believe I am coming off the allergic reaction.  Stopped taking all meds and things are getting better.  Have a great week !

Sounds like you may be allergic to one of the meds then buddy. Hope you get well soon buddy :)

Good luck, only one piece of advice - there's no rush.

Take your time to do exercises right, ice to get your swelling down when it comes, hydrate as much as you can (I had a water bottle continually next to me), do your exercise religiously and relax religiously. Use your crutches for as long as needed - you don't want to have a bad gait because you dropped them early.

There's several things going on simultaneously here:

- the most important is healing the bone / device connection. This can't be rushed but can be helped with walking, nutrition, rest.

- Less in importance until your bone / device is set is muscular healing. It is important once you get the Ok from the doctor to expand your activities.

- Emotional - keep positive and get as many support people around you to talk to, text, etc. Treat yourself well and don't stint on games / movies / books while recouping.

Most of all listen to your body. If something feels painful, it's your body telling you not to do it. You can't power through this.

JT, you probably don't need the pain meds at this point but check with your Dr on any others if you haven't already. Blood thinners are important to avoid clots, and anti-inflammatory is not only for inflammation but also helps prevent Heterotopic Ossification. Not sure what your Dr prescribes but I was on a small cocktail of meds for a while, not all related to pain. Glad to hear you're doing better!

I might have said this before, but if you have  one of those electric icing machines connect it to an extension cord with an on / off switch that is within easy reach from where you'll be sitting or laying down for the first few days post-op. The one I had did not have its own switch and bending down every 20 mins to plug / unplug it was not possible. I plugged it into an extension cord on a table next to my recliner so I just had to reach over to turn it on or off.
Best of luck ...

Congrats royash! I'm closing in on five years with great results so far. Enjoy the days.

Approaching 1.5 years  post BHR and life is grand. Able to do so much

My advice-- Listen to Hernnu's advice, he's a trooper and has been there for hundreds of us, and he knows the deal, extremely well.

Dan

Hi All-

My name is Matt and I have been following this site on and off now for about a year and this is my first time posting.  I've gained a lot of inspiration and information from you all on this site from reading about all the success stories, which has helped me to finally make a decision to go forward with surgery. 

A little background on me and my condition.  I am a 28 year old very active guy who was enjoying playing hockey, training in mixed martial arts, running, lifting weights, and staying busy outside with yard work on my house.  My career and passion in life is that of a Police Officer, whose primary job at the moment is regular patrol, so that also requires a good amount of physical activity (i.e carrying all the weight of my equipment on my waist, getting in and out of a low car all day)

Most of my life I have been bothered by tight hips, pulled muscles, and poor flexibility.  When I was younger, the doctors just told me I needed to stretch more.  After completing a years worth of police academy training at the age of 25, I was in a lot of pain.  Some nights I would wake up and my legs would be frozen so much that I had to lift them with my arms to change positions in bed.  Long story short I was finally diagnosed was bilateral FAI and Dysplasia.  The dysplasia was classified as mild.  Most orthos around me told me that there was nothing I could do and that I would need a hip replacement later in life.  I ended up traveling to Hospital for Special Surgery in NYC where I found Dr. Struan Coleman and he performed a bilateral hip arthroscopy in July of 2012 in an attempt to clean out all the damage in the joints and hopefully buy me some time until later in life.   I completed my rehab and felt a lot better from surgery and returned to all of my previous high impact activities (probably a big mistake for someone looking to preserve their problematic hip joints, but what other choice is there for someone so young?)

Fast forward to a year and half later post arthroscopic surgery, Spring 2014, and I found myself with a severe left limp after heavy activity, especially running and hockey.  Returned to Dr. Coleman, who diagnosed me with osteophytes and a patch of bone on bone arthritis in my left hip.  He stated at this point arthroscopy would not really be an option and that unfortunately I was looking at joint replacement.  He referred me to two doctors at HSS who perform hip resurfacing, Dr. David Mayman and Dr. Edwin Su, the latter seeming to be the rock star of the hip resurfacing world. I visited with both doctors, and both agreed that hip resurfacing was my best option and that I could do it at any time now if I no longer wanted to deal with the pain.   Both doctors were excellent and I ended up choosing Dr. Su (even though he is an out of network doctor for me) primarily due to his higher level of experience in this procedure, as well as seeing that he had performed this surgery on several professional athletes including NHL player Ed Jovanoski, MLB pitcher Colby Lewis, and even the WWE's The Undertaker.

I continued to put off the surgery, for all kinds of reasons you can think of (some of them ludicrous at best), primarily because I felt I was too young to be dealing with all this, along with fear of the surgery and its outcome long term, as well as not wanting to be out of work.  However, after a year of struggling everyday to put socks on, tie my shoes, and bend over without getting into weird positions, I've decided to go ahead with it.  I also could no longer stand the fact that I have been very inactive physically, having stopped all impact activities for the last 5 months.  The decision also weighed heavily on my ability to perform my job without suffering through pain throughout my 12 hour shifts. 

Anyway, I have finally chosen to go ahead with it and I am set to have the procedure 5 days from now on Tuesday March 31 with Dr. Su at HSS.  As you can imagine, I'm pretty nervous for the operation, but I'm excited at the idea of getting my active life back....as well as being able to tie my shoes again. 

I've combed through a lot of the posts here and I haven't been able to find any other police officers who have gone through this.  I've only seen one story posted on another site about a firefighter who successfully returned to her duties like 5 weeks after surgery?  Dr. Su says that there would be no reason I couldn't return to work without any problems once rehab is complete, but never the less, I still worry. 

If there are any other police officers out there I would love to hear about your story and how the new hip is holding up to the job.  I also welcome anyone else's advice and support as I embark on my journey. 

This site is an awesome collection of support and information and I'm thankful to have found it 

Hi Matt,

Not a police officer, but welcome to the site and you are right to be excited at the prospect of a much better life ahead. So sorry you are having to deal with this at such a young age, but with a top surgeon (which you have), you should be confident.

Given the levels of sport that people achieve after this surgery I cannot imagine anything the police want would not be within your range.

Very best for five days time!

Hi Matt and welcome. I personally am not a police officer however my oldest buddy is and I know several others also.

I was also 28 at the time of my first bhr and was very very active prior to that op. I wouldn't worry about returning to policing it will happen once you are healed but make sure you allow yourself to heal!

If you ever fancy a chat with another young bilat hippy feel free to PM me buddy :)

Greetings Matt -

I didn't need my first resurfacing until after retiring from a 27 year stint with a Southern California Law Enforcement Agency.  I'm just now three weeks out of having my other hip done, but can assure you that continuing my patrol duties after recovering from the first one would not have been an issue...Sam Browne and all!

To use our west coast radio parlance...you'll be 10-8 before you know it!

Best of luck to you, Bruce

Hi Matt. I'm a police officer in Australia. I came he after spending 20 years as a UK cop in specialist firearms roles that required fitness, strength stamina etc etc. I still have a few years to do here before laying up my boots, I return to work in April after surgery in January. I now have zero pain, already have a better range of movement and know I'll be able to hold my own with any drunk idiot if the taser fails😉
My advice, get it done, stop living with pain, get back to previous fitness levels or better and see the doors open to the many career paths available to you. I chose one of the best surgeons in this part of the world and from my research, Dr Su is awesome. Good luck, and the grass is greener on the other side of this fence.

Dr. Su is a great surgeon. Sorry you're dealing with this so young.

And to echo what Danny said, the recovery is very important. You're going to be anxious to getting back to doing things and getting back to work, and the hard part is you will feel like you're able to. But you can screw it up if you push it too soon. Follow the restrictions and rehab protocols to the letter. It's not that long in the grand scheme of things. You need this to last a long time so get it off to a good start. It's more about healing than conditioning in the beginning.

Good luck, keep us posted.

Hi all.

I wanted to see if anyone else had been told that a BHR may not been used due to cysts?
A little back ground on me, I’m a, 6’1, 95kg, 37 year old former mixed martial artist with advanced arthritis in my let hip due to excessive overuse.

I have tried everything in opposition to any surgery which culminated in stem cell injections last year, as it has been around 20-30% less pain but it’s not really improving my quality of life.

Everyone that I have contacted both overseas and locally have recommended that Dr. Andrew shimmin.

I saw him last week and I really liked him, he was direct and no-nonsense but he said that he may not be able to use a BHR and wont know until he actually performs the surgery, I felt that he may not be willing to use the BHR and wouldn’t give me a percentage either way.

As I have my heart set on the BHR  or Birmingham Mid Head Resection I wanted any advice on how I approach confirming that I get a BHR is a second opinion worth it?

Thanks in advance.

Hi and welcome large cysts can be a contraindication for resurfacing but I would think they would use of have to be very extensive.  The bmhr was designed specifically for avn and similar conditions however I thought that Smith and nephew discontinued it last year. If I were in your shoes I would seek an opinion from some other top surgeons like McMinn, Vijay Bose, and Koen De Smet.

for what its worth... I had a large cyst (>1cm) and was resurfaced by dr gross.  with the bhr, they have the option of filling the cyst with cement.  with an uncemented (what I had), it was a mix of plasma and bone paste that apparently would 'regrow' bone to fill the cyst.  i suspect it depends on the cyst size and the experience of the surgeon.

good luck,

Bernie

You are in great hands with Dr. Gross. The trip will be a good experience (certainly pre-surgery :-)).

Stay ahead of the pain, take the medicine. Don't be a hero. Dr. Gross will send you home with an ice machine, he is a big proponent. Was $250 three years ago, not covered by my insurance. Well worth it. I love that thing.

The first two weeks were hard for me, but particularly the first five days to one week. But it gets better steadily. Recliners are awesome if you have one. Binge watching hour long tv series on demand or DVD is the way to mindlessly pass the time (as I did) until you are out of the woods. Post-surgery I was surprised how well I felt that day and the next, but it really hit me on D-day+2. I think that is common, be prepared if it does. That first week was tough, but you'll get through it.

For me, getting in and out of bed on the side was the hardest thing about recovery. What ultimately was a lifesaver was the inchworm method from the bottom. Sit as far back on foot of bed as you can, lay back, and then worm your way up using arms and good leg.

Gotta go, three kids, wife out of town.

Best wishes,

Mike

I was resurfaced by Dr. Raterman and had issues with cysts, too. I was told pre-op that if necessary, the cysts would be filled with a bone graft. In the end, most of my cysts were "milled" out during the resurfacing process. I have had a good recovery with no problems.

I read here repeatedly that finding an experienced surgeon is critical for this operation. However I also worry that outside of McMinn, Treacy, DeSmet, Gross, Su, Bose (and some others that I have missed) there are not enough surgeons frequently performing HR to sustain this surgery as a valid ongoing option for most candidates. With all the negative press and the poor statistics published (For other than the S&N BHR) are there still new surgeons developing their skills for this operation? In ~10 years when the current crop of successful HR surgeons start to retire will there be others or will this operation disappear? It seems to me to make HR successful for the majority of candidates more surgeons are needed - which also means people going with less experienced surgeons (Which is contradictory to the perceived wisdom here.)

and Pritchett in Seattle

I had my BHR with Andrew Shimmin in January this year. At the end of 2014 I was posting about his warnings to me that he may have to do a THR if, for any reason, he couldn't do a BHR when he opened me up. It worried me for weeks. At my second appointment with him, he was happy that I had researched and considered what might happen if he couldn't do a BHR. He is a fantastic surgeon, his belief is that the patient must be aware of what could happen and be at ease with that. He willl then affirm that he will go for a BHR and he does a superb job. My results 11 weeks post op are nothing short of miraculous, zero pain, huge ROM improvement and 90% strength back in all planes of movement. I do as I'm told but just do a lot of it.
In my opinion, if you live down here, Shimmin is THE man. He knows what he's on about, wants patients to buy into his philosophies re HR and get back to active living. It is why he is respected worldwide and a member of AAOS as well as the Australian version.
Plus he's a top bloke! Just my opinion!!!

Hello all my name is Elliot and a police officer for the royal Canadian mounted police. I am 43 years old and ten weeks bhr right hip. Well what a ride it has been so far doc had complication due to muscle size 14 inch incision hard time getting cup on no femoral neck. Had bad recovery had bad medication Withdrawels what ever has been talked about had happened.  Going for check up in calgary used Dr Jim Mckenzie. All I can say Matt is it all is worth it still limping a little but way better then before. Have hard time deciding what I can do what I cant. Doc said have at er just stay away from impact stuff for ah wile. The hardest part for me is the emotional part. We are trained to help the public give our lives without hesitation and now we are the helpless ones. Not a good feeling. Got help for depression and right now I am starting to believe fellow hipsters.  It does get better. Matt all I can tell you is it is better anytime you want to talk feel free good people out there.  One thing I will say is don't listen to much to the people that are running twenty miles 4 weeks post op. Not encouraging at all!!!  Lol fellow police officers remember we act and are trained to think we are impenetrable but remember we are human. Glad to finally be on the site.

Hello all 43 year old police officer had rbhr ten weeks ago. Had some issues but all is good. Have a question doc said I can do everything my body will allow me to just stay away from impact running for at least six months.  My question to all is can I go hiking and yes I have ,probably four miles up down hills using poles. Feel sore next day but day after feel great. Any suggestions. I know I should have asked doc but forgot. Next visit with him is couple of weeks. Thanks for imput.

Thanks for all the advice.  Down to the last week and a half.   Got all my required presurgery  bloodwork done last week, and my numbers are excellent in everything.  My primary care says I should heal quickly.  Crossing my fingers for that. 

I was hiking with a pole up & down small hills, 4 miles, in snow & frost conditions at eight weeks with no problem, and 20+ miles around proper hills at 4 months, still with a trekking pole for extra security. Most of my walking has been done on the road, though, up to ten miles and up to 4 mph. The physio I saw said walking was as good as any of the exercises she showed me and I think I agree. 320 miles so far...

Hi Gazza, I share the sentiments and concerns you express in your post. When I was doing my research some 6/7 years ago there were many questions aimed at the HR surgeons and much research re- learning curve for HR and most conclusions indicated around 100. I feel that I conducted my extensive research diligently and had the good fortune of being helped by a close friend who is a world renowned ENT surgeon operating in top London hospitals, who was able to gain some additional information from staff working in the operating theatres. Living in the UK I had the opportunity of going with McMinn or Treacy but opted for a highly respected surgeon who had performed around 250 HRs, who had written extensively, was a huge advocate of HR and in his post of Head of Orthopaedics at Imperial College Hospital (leading/cutting edge UK teaching Hospital) trained surgeons in Hip Resurfacing. Also, he was working on 3D Scanning and using robotic technology to achieve placement precision, which appealed to me as I was a pretty complex case having had a major femoral fracture in my early twenties. So I guess in answer to your question, yes I feel that although they don't get the coverage there are many talented lower profile surgeons performing and developing Hip Resurfacing. Gazza, I also feel that we have a responsibility to those new to the site to encourage them to do their research wisely and opt for a surgeon who has appropriate HR training/up to date knowledge/experience/patient reviews/supporting data etc but of course it doesn't mean that they have to completed thousands to be sufficiently talented. Indeed, if several hundred/thousands were needed then everyone would have come over to the UK/Belgium for Mcminn, Treacy and DeSmet and HR would have missed out on the talents of Gross, Su, Bose, Brooks, Antonio, Kim, Pritchett, Rogerson et al Plus, these top surgeons were able to achieve incredible results inside the learning curve well before we had the current understanding of deal prosthetic placement and advanced operative technique which newer surgeons now have.
So yes Gazza if we really want HR to remain an option we also have a responsibility  to support and encourage those up and coming talented surgeons who like us advocate and know the advantages of HR to pick up the baton and develop Hip Resurfacing into the future.
Regards
Toby

oops line should have read and HR would have missed out on the talents of Gross, Su, Bose, Brooks, Antonio, Kim, Pritchett, Rogerson, and even further afield..Shiminn, Blackley, MacMahon et al cos there are numerous others

You really have nothing to worry about with Dr. Gross and company steering your ship.  They leave nothing to chance as I'm sure you've discovered.  They tell you and/or put everything on paper that you need to know for your prep and recovery.  With no worries on the administrative and prep front you can just focus on your comfort and getting well.  Take it slow, if in doubt - don't do it, and don't be a hero.  You want this to last your lifetime so let things heal and in due time you're back to as normal as you could hope.  This is coming from a guy who is 13 weeks out and loving every day for being pain free and my decision to finally do something about it.  You did all your homework, now let it be!!!
Stay ahead of pain with meds, ice is your friend, let family and friends help you, and GOOD LUCK.

Quote from: Tundra911 on March 29, 2015, 09:49:25 AM
Hello all my name is Elliot and a police officer for the royal Canadian mounted police. I am 43 years old and ten weeks bhr right hip. Well what a ride it has been so far doc had complication due to muscle size 14 inch incision hard time getting cup on no femoral neck. Had bad recovery had bad medication Withdrawels what ever has been talked about had happened.  Going for check up in calgary used Dr Jim Mckenzie. All I can say Matt is it all is worth it still limping a little but way better then before. Have hard time deciding what I can do what I cant. Doc said have at er just stay away from impact stuff for ah wile. The hardest part for me is the emotional part. We are trained to help the public give our lives without hesitation and now we are the helpless ones. Not a good feeling. Got help for depression and right now I am starting to believe fellow hipsters.  It does get better. Matt all I can tell you is it is better anytime you want to talk feel free good people out there.  One thing I will say is don't listen to much to the people that are running twenty miles 4 weeks post op. Not encouraging at all!!!  Lol fellow police officers remember we act and are trained to think we are impenetrable but remember we are human. Glad to finally be on the site.

Congrats and welcome ... I had depression fro a few weeks both times, the second even while knowing it would come. It just seems to be the case for some hippies. It was truly gone, and then you enjoy the improvements.

Everyone is different in their recovery; you want to be well healed before you try to put stress on it, which is why my surgeon had me wait six months to bear more than 50 lbs of weight, and a full year before I returned to heavy duty martial arts.

It seems awfully long, and some folks can do more earlier, but for me that seemed best.

Here's my take: if it doesn't cause pain (I'm not talking about short term muscular soreness that goes away) and you enjoy doing it, then hiking up and down four miles with poles at ten weeks is good for what ails you. Be careful not to take a spill and go for it. If it causes pain, then step back, take it easier and try for less. But keep walking. 

From what I can tell, most of the top resurfacing surgeons seem to think that walking is the best rehabilitation you can do. For someone who is in reasonably good shape and not having difficulties with their recovery, four miles up and down with poles at ten weeks does not sound at all excessive to me.   
Cheers
Tim

First let me say that I have absolute confidence in Dr. Gross and his selection of hip resurfacing devices.  If this question involved anything more than semantics, I would direct it to him or Lee.  That being said, as I read this website with particular attention directed towards those of you who have used Dr. Gross, I get very confused concerning system terminology. 

For example, my surgical order specifies Biomet, and the FAQs indicate that I will have a Biomet uncemented metal on metal hip.  When I look at what some of you say you have, I generally see one of the following:  Biomet; Biomet Uncemented; and Uncemented Biomet Recap/Magnum. 

In looking at one of Dr. Gross' more recent abstracts, I see this terminology used:
"Hip resurfacing with the Biomet Hybrid ReCap-Magnum system: 7-year results."
http://www.ncbi.nlm.nih.gov/pubmed/22595183
And then when I look on the internet, I see all types of legal issues with the Biomet M2a Magnum.
http://www.drugwatch.com/hip-replacement/biomet/

Can anyone shed some light on what this thing(s) I'm getting is called? I know that it's Biomet and I know it will be uncemented (I assume this refers to the FDA approved femoral component).  I also know that the acetabular component will be uncemented, but I don't know what it is called.  And where does the "Recap Magnum" come into play?

It could be that my confusion arises from his "off-label" use of the acetabular component (if I'm correct about that), and maybe that's why he uses the term "hybrid."  Any clarification would be appreciated.

Not a Gross hippy or anything but it's my understanding that Dr Gross has to use both components off label. I think this is because both are FDA approved however it's not approved as a system to work together. That may be where the "hybrid" part comes from? Your best bet would be to email him. He was very responsive when I have my first HR done and I was seriously considering Flying to the states to use him at one point.

Hi Gazza.
Hopefully yes.  I will ask De Smet when I see him in end of April and get back to you.
See what he says. Cheers

Thank you all!!

Great responses! This has given me some level of comfort and a few thing to consider.

I did have that feeling that Dr. Shimmin was giving me the worst case scenario and will build from there.

Much appreciated.

Hey thanks everyone for taking the time to read my long post, and to reply back with well wishes and advice. 

Well- tomorrow is it...D-Day...scheduled to be at the hospital for 7:30AM with a scheduled surgery time of 10:30AM.  Hope everything goes according to plan and schedule, and hopefully this time tomorrow I will have good news to report.  Still extremely nervous for the surgery and have all kinds of crazy thoughts running through my mind like will it work, will I end up with a THR, will I regret surgery, but I imagine that this is all common. 

The Biomet Recap femoral component, was approved by the FDA for use as a Hemi resurfacing where only the femoral head is resurfaced and capped but the acetabulum is left intact.  Problem was and is that there is much accelerated wear on the acetabular cartilage and there are poor outcomes in general.  It is not used in that application much if at all anymore.  The FDA approved Magnum metal acetabular cup was used with a total hip replacement system that was discontinued by Biomet because of the MoM controversy and our litigious society.  Dr. Gross has "married" the two approved components to create a complete resurfacing system, Recap/Magnum.  This system is not FDA approved as a unit and so must be used "off label" or for use other than it's approved status.  It is completely legal for the physician to do this.  It is kind of like not having a UL listing for a product but it is nonetheless reliable.  Dr. Gross's registry speaks volumes as to the worthiness of the Biomet System of which he had a hand in designing.  If you are a believer in HRA, MoM, and uncemented components,  Dr. Gross is your man.  I hope this helps and please chime in fellow hippies if I've overlooked something.

Quote from: DeviceGuy on March 30, 2015, 04:58:23 PM
The Biomet Recap femoral component, was approved by the FDA for use as a Hemi resurfacing where only the femoral head is resurfaced and capped but the acetabulum is left intact.  Problem was and is that there is much accelerated wear on the acetabular cartilage and there are poor outcomes in general.  It is not used in that application much if at all anymore.  The FDA approved Magnum metal acetabular cup was used with a total hip replacement system that was discontinued by Biomet because of the MoM controversy and our litigious society.  Dr. Gross has "married" the two approved components to create a complete resurfacing system, Recap/Magnum.  This system is not FDA approved as a unit and so must be used "off label" or for use other than it's approved status.  It is completely legal for the physician to do this.  It is kind of like not having a UL listing for a product but it is nonetheless reliable.  Dr. Gross's registry speaks volumes as to the worthiness of the Biomet System of which he had a hand in designing.  If you are a believer in HRA, MoM, and uncemented components,  Dr. Gross is your man.  I hope this helps and please chime in fellow hippies if I've overlooked something.

This helps more than you'll ever know.  I've had bits and pieces of this explained to me before but I've never really been concerned about any of it because of my confidence in Dr. Gross and the fact that I could care less about the FDA (I'm paying Dr. Gross/Lee out of pocket because I'm on Medicare).  I think the term "Magnum" has peaked my curiosity lately because of the M2a Magnum controversy.  Are you saying that the Magnum cup that was discontinued by Biomet because of MOM issues (maybe it's the M2a??) is not the same as the Magnum cup that is part of Dr. Gross' marriage?  Must not be, otherwise there would not be two approved components.  Thanks

Good luck with surgery and keep us updated. 

If I'm not mistaken the Magnum 2a is synonymous with Magnum.  The 2a was a THA system of femoral and acetabular components.  Dr. Gross may have had modifications made to the cup in some fashion but I don't know that for a fact.  The Magnum 2a was not recalled but removed as a sellable product system.  Now the Recap/Magnum are sold individually and used as a system off label.

Quote from: DeviceGuy on March 31, 2015, 07:01:27 PM
If I'm not mistaken the Magnum 2a is synonymous with Magnum.  The 2a was a THA system of femoral and acetabular components.  Dr. Gross may have had modifications made to the cup in some fashion but I don't know that for a fact.  The Magnum 2a was not recalled but removed as a sellable product system.  Now the Recap/Magnum are sold individually and used as a system off label.

Thanks again for your help with this.  I think you are exactly right.  This is a fairly recent bio of Dr. Gross, and it also clarifies the issue:
http://www.grossortho.com/doctor.htm

Yes he combines two different components (I never asked why). Looking at my operative report it says I got the Biomet Magnum acetabular component and the recap HA femoral component.

Keep your thoughts positive and good luck!

I just celebrated my 7 yr anniversary with resurfaced hips. I was a "staged" bilateral, with the 2 sides done 5 weeks apart, the 2nd one on March 31, 7 yrs ago. I long ago reached the point where I don't think about my hips when considering any physical undertaking.

With the negative press about resurfacing in general and ASR in specific, I want to give the good report on my 7 yr anniversary. I just reread my hip story from 7 yrs ago that Pat has hosted to remind myself of the early days (http://surfacehippy.info/hipresurfacing/stories/dr-ball/212-dirk-van-dyke-bilateral-hr-dr-ball-2008)
The summary for me is that the surgery has been very successful. It's almost a cliche to say "it gave me back my lifestyle," but that is the case.

Before surgery: Daily movement was painful. I recall getting irritated doing house chores such as mowing the lawn, just because of the pain.
Now: On the eve of my 7 yr anniversary (for my 1st resurf), I took a 4-day weekend to participate in building a home in MX - kind of a Habit for Humanity lite. I was sore in lots of places, but no problems in hips. Had a great time. In fact, I've done this every yr since the resurfacing.

Before surgery: Quit hockey. Hung up the skates approx a yr before surgery, due to pain and diminished level of play.
Now: Playing hockey again. I didn't start again until a good yr after surgery. I get up to 2-3x per week, until my body starts telling me that's too much for somebody over 50, and then cut back to once or twice per week. (If you are a goalie, and show up, you can play as frequently as you want.)

Before surgery: I recall going on a hike with family friends, a month or so before surgery, knowing that I'd turn around after 1/4 mile and go back to the trailhead and read a book.
Now: I've hiked the Grand Canyon a couple times post surgery. In a couple weeks, I'm taking a short 4-day vacation to hike remote canyons in Utah. It's great to get this back.

The only thing that's a bit of a cloud is the ASR. I geeked out on research, and I feel that J&J put profits ahead of patients in withholding or minimizing known problems. If those concerns had come to light, I would have requested a different device. It seems that the ASR design is intolerant of sub-optimal placement. So perhaps my research on selecting a surgeon trumped the device selection. Or maybe I'm just lucky. Knowing what I know from following the legal proceedings, even though my resurfacing is fine so far, my gratitude is mixed with ill feelings towards J&J. It's kind of like they played ~85% odds russian roulette with me, twice.

But I'm going to enjoy my blessings and get out from under that cloud. Thanks to Pat for hosting the site, and Vicki (wow, time flies, the community certainly misses her) for all she did for resurfacing, and Chuck for his concern and advocacy.

On this forum, I'm kind of in that camp of people who have had a successful surgery and gradually fade away, as hip functionality and lack of pain becomes normal.
It's been a great 7 yrs with fake hips (well the first couple months were a bit of struggle, but mostly forgotten now).

Congrats Dirk. :) I hope you have many years ahead of you with your shiny fake hips :)

Congrats, Dirk! 7 years! We don't hear too often from the long-timers, loved reading your story. Glad you didn't have problems with the ASR.

Congratulations on your anniversary!  I remember your name.  You were one of the persons I followed on this site when I was considering a hip resurfacing.  I just celebrated my 6th anniversary in February, all because of Pat hosting this site and people like you who posted their experiences.  Thank you all!

Good to hear Dirk all is well. I too remember reading your posts as I was just 6 months behind you with my  bi-lat surgery. I am in similar circumstances as you being that I had the same doctor (Dr. Ball) who I believe to be an amazing doc, and that I have the ASR implants as well. Just wanted to check in and tell you, and everyone else, that I am doing great still with no problems whatsoever, and no limitations at all. Dr. Ball placed our implants at the correct angles and I believe that makes this surgery successful for us. Here's to many more great years ahead.
BTW I might come down to SD and try to put one in the back of the net against you. Ha Ha Ha
Go Ducks Go

Wayne

Hi Dirk

Congratulations.  Thanks for stopping by to give us an update.  Great to hear back from folks with those older hip resurfacings.

Just a note to new people that not all ASRs have gone bad or needed a revision.  Most devices did well when they were placed very carefully at the proper angles. 

I hope you have another 7 years with your ASRs.  Enjoy.  The reason we all get our hips fixed is to be able to get back to an active, pain free life.  That includes moving on and not dwelling on our repaired hips because once they are healed, we seldom think about them.

Good Luck.

Pat

Congrats and good luck Dirk!

This is an interesting conversation, I selected a surgeon with a little over one hundred resurfacings under his belt and have had excellent results. However, he has been performing total hips for decades which may have some bearing on his skill level. The stats support finding a surgeon with hundreds of BHR's performed but looking at the difference in failure rate between one hundred and one thousand appears to be low risk for selecting the less experienced surgeon - that's just my opinion as I am a bit of a risk taker anyway. Some people have very few options and need to evaluate the cost benefit.

I've always felt that this site is a good community. It was a great help to me, and I'm glad if I can help pay some of that back.
Mari, congrats on your successful 6 yrs. And Wayne, great to hear another good performing ASR from Dr. Ball. I followed your story back in the day, and it seemed to be a straightforward good outcome. I live in AZ, so don't look for me in a hockey game in San Diego. I know a couple groups that go to that Snoopy Old Timers Tournament up your way. Maybe some year.
Pat, thanks for the good wishes, and congrats to you on 9 yrs!

I have been having left hip pain for over a year...got the diagnosis of osteoarthritis and am scheduled for surgery with Dr. Brooks for June 19.  In the 6 months since, my right leg is now more painful than the left.  I was wondering is this because I am favoring my left leg?  Should I have Dr. Books look at it as see if I should have the right hip done first? Has this happened to anyone else?  How do you deal with the pain in your supposedly good leg when you are recovering from the surgery on your bad leg? Any advise is greatly appreciated.  Thanks in advance.
Lisa

You should definitely have it looked at well before surgery, just in case you need to do bilateral. 

Unfortunately, Dr. Brooks does not do bilateral HR's. It is one at a time with him.

Hi Lisa, I had both diagnosed as needing to be done.

My left was worse, so that went first. My surgeon doesn't do simultaneous bilateral, so the right went three months later.

It was not a happy time for the right, especially since the left felt so good that at the end of three months, the right was being pushed heavily.

It worked for me, since I was able to rehab the left so that the left supported the right. It seems like forever to wait for the second, but now seems like a blip.

It was actually good for me mentally to have both scheduled and set.

Good luck.

royash, thanks for the update and for the encouragement.  I'm three months post-op with Dr Gross and currently suffering through as bad a case of cabin fever that I've ever had.  It's encouraging to hear about someone else that's back out there 'doing it' after a successful resurfacing.  Three months down and three to go!

Hi-
I am 10 months out from my second replacement.  The recovery has been outstanding so far, much faster than first one.  A big difference this time is numbness at the incision site and about 1/2 outside of leg that was noticeable right after surgery and about half of numb area has resolved but numbness remains around the gluteal area.  I have exercised very consistently and with high intensity including biking, elliptical, and jogging once a week for 40 minutes now. 
Over the last few weeks, I have noticed significant atrophy of my rump on the surgery side where the numbness remains.  There is no loss in apparent strength but I am worried about this.  I have read that high metal ions could cause an inflammatory response that might damage muscle but WTF?
My metal ion levels were measured a few months ago and I did not get a call back indicating no abnormal levels??
I have a call in to see my surgeon but any info from the group here would be very welcome. 
Thanks
Tim

Tim if I were you I would speak to your surgeon. It sounds possibly like you have some nerve damage?

Dr. Gross did my resurfacing 4 days ago, and in the process lengthened my leg 1.6 cm.  Now when I try to stand up straight, it feels extremely tight on my quad and hip flexors.  I suspect it is from the leg lengthening.  Even laying down, I can't lay flat on my back with my operated leg flat due to tightness. 

Did anyone else experience this post surgery, especially if your leg was lengthened?  How long did it last?

Dr. Brooks did my LBR just under 7 years ago.  When I went in for my X-rays just before surgery he said "that Right hip does look bad"  which I thought was strange because it was the Left one that hurt.  After checking his notes he commented that I would be back for the Right hip at some point. I was able to make it 4-1/2 years before it was time to have the Right hip done. 

You should definitely contact him or Phil and let him know the situation.  They may need to schedule a second if you will need both done. It seems that whenever we favor one leg due to pain, it puts a lot on unnatural wear and tear on the other legs hip and knee.   
Good luck!

Hello everyone! I just wanted to share my experience. I had outpatient surgery with Dr Gross on April 6Th. First of all, I was very nervous as I am 53 years old and having this done, but after 8 years of some intense pain, I was ready. After reading a good bit of posts, I realize there are a lot of people younger than me having this done. After meeting Dr Gross and his team sent my worries running away. My surgery went well, and everyone was great. I was out before they even wheeled me back to the or. I woke up in post op, it seemed like just minutes after I went in, although it was hours later. I started to get an appetite, we were served a light lunch, and they were bringing out the gatoraide to get me hydrated. My surgery was at 10 am, and I was able to relieve myself and was leaving around 5:30 pm. When Dr gross came to the hotel the next morning, I saw him in the hallway, as I was taking my first walk. He was happy to see me up and about and following his instructions. He checked me out, released me, and we drove back to Florida. Pretty amazing for the procedure involved. My first 2 days back home were a bit rough, but expected. I took my long term narcotics for 5 days and nights, but was able to ween myself off the oxycodone by day 4. I hate feeling drugged up, and although I had to deal with a bit more pain, overall, I felt better. Sleep has been the hardest thing to accomplish, but It's coming along. Each day I am amazed at how much better I am doing. Day 7, the bandages were taken off, and things looked good with no drainage, and almost completely healed up.  Day 8, I transferred to a cane. Went down to the beach and walked a bit. Luckily I have a great oceanfront park, that allows a lot of walking options. Last night was a little rough as I felt pretty sore from the transition to the cane. My walks have been good, and I'm progressing nicely. I have now driven 3 times. A couple down to the beach, and 1 to drop off my taxes, do some grocery shopping, and to shop for a cane. The only pain meds are the Tylenol. Other than surgery pain, I'm experiencing a little muscle pain up front at the attachment point. This subsides overnight, and feels good in the morning. I realize I have a long road ahead of me, But am pleased with the progress I have achieved. Reading posts has given me a realistic view and timeline for my expectations.

Congrats on the surgery.  I had my surgery (inpatient) Apr 8th so I am 2 days behind you.  You were given oxycodone instead of Nucynta? 

Thanks for your update.  I'm glad that things are going well for you.  I think this is the first report I've read from someone who had outpatient resurfacing by Dr. Gross.  I had my pre-surgery exam yesterday and will have surgery on 4/29.  They said I have the bones of a 25 year old although I just turned 67.  I don't think Dr. Gross has an age limit as long as bone density is good.  I also had a question about oxycodone since he gives Nucynta to just about everyone these days--not than there's a whole lot of difference.  Drop by more often and keep us informed.

Good stuff, surf hippy. Hopefully progress will continue as smooth ahead.

I'm due 28/04, will be 45 and recently have wished I was older!, in patient with Mr McMinn. Scared but your story, like so many, is encouraging and also realistic. I expect pain, and I hope it is minimal but it's an investment is how I see it. Pay dividends a few weeks later ...

Driving at day 9, wow. What hip, what car, presumably an automatic gear shift ...

Keep up the good progress. Best wishes.

Matt

I was prescribed Nucynta for long term and oxycodone for short term pain. I actually drove 5 days post op, just for a few miles. I have a big suv and it an automatic. It is my right hip, and I just brake with the left leg. I also have great bone density, so recovery should be easier since I've been full weight on the leg post surgery. I'm still targeting 6 months post op for anything crazy like surfing or mountain biking. Staying on top of the rehab! Advil works best for me but it seems I read where it wasn't a good mix for hip recovery. Maybe I just dreamed it. If I could take a couple of Advil PMs, I could get a good nights rest.

Quote from: surfhippy on April 15, 2015, 04:15:04 PM
I was prescribed Nucynta for long term and oxycodone for short term pain. I actually drove 5 days post op, just for a few miles. I have a big suv and it an automatic. It is my right hip, and I just brake with the left leg. I also have great bone density, so recovery should be easier since I've been full weight on the leg post surgery. I'm still targeting 6 months post op for anything crazy like surfing or mountain biking. Staying on top of the rehab! Advil works best for me but it seems I read where it wasn't a good mix for hip recovery. Maybe I just dreamed it. If I could take a couple of Advil PMs, I could get a good nights rest.

My understand is you can't do advil because of the mobic prescription.  Don't want you having multiple anti-inflammatory sources.  I was full weight bearing immediately after surgery as well, but due to severe deformities, and Dr. Gross cleaning up an old surgery scar, I am sure to be a little slower early on.  Good luck and keep us informed.

Congrats, surfhippy! Sounds like you are doing great.

I was pretty sore last night with my first full day on the cane. This morning, most the soreness had diminished. I was contemplating going back to the crutches for a day or 2, but the night's rest helped tremendously, although for obvious reasons I'm not sleeping the best. I'm already back from a short beach walk, and I've noticed when I walk with good posture and really let my leg relax and do the work, I have better results with full weight on leg. The first couple of steps when I get up are a little tough, but when I get into motion, I'm basically using my cane as a back up, although I will still be using it until I feel confident to walk without it. Thanks for the kind comments and encouragement!

I am a 53 year old man-14 months post operation. I went under the knife for a hip resurfacing (BHR) and was informed after surgery that there was a problem with my femur and as a result was given a total hip replacement. Now here's the rub (in every sense of the word). I have developed a nasty clunking and loud squeak in my hip with no pain. Blood test and MRI show elevated cobalt 9.5-and Chromium 8.5 as well as pseudotumor. Research of my surgery shows that the BHR 62mm acetabular cup was left in place and I was "fitted" with a S&N 54mm modular head and stem.
Does anyone know if this sounds right? Are these parts compatible? My surgeon wants me to come right back for a revision surgery but I am uncertain. Am I just the unlucky one who got defective parts or was thus an "off label" use of BHR and modular parts?
Any help or imput would be greatly appreciated. 

Hi Dave sorry to hear your having issues. It sounds like the surgeon didn't place the components correctly. The BHR cup can indeed be used with S&N large head THR components. The fact your having high metal levels likely means that the surgeon put the cup in at a steep angle and it's causing edge loading.

Danny

Thanks for the beta Danny! I have been struggling to get this simple answer to my question. The next question tough question will be who can I trust to do the job correctly this time. Obviously leaving things as is is not an option. I'm guessing I'm married to S&N to avoid having to revise the stem as well.

It will depend what stem has been used. Some of the best stems like the corail stem can be used with several heads.

As far as who to do your revision well that has to be the most experienced surgeon you can find!

It says I have a "size 17 Synergy" stem # 71306117

Hi Caverdave, sorry for what you are going through.
Do you mind telling us who the surgeon was?
I ask because your situation is unusual. The standard BHR procedure has the surgeon first confirm the femoral component size that will be used. That determines the rest of the sizing. The matching cup is then put in FIRST and then they return to put on the femoral component.
A 54MM head size (which you have) usually indicates the surgeon should use a 60mm cup size. But you have a 62mm cup. That could mean you started with a 60mm cup and had to change to a 62mm when he had problems. But then he says it was the femur that was the problem. The report and component sizes you ended up with are compatible but you probably wouldn't end up with a 62 unless there were problems at the cup too.
Not sure you should return to that surgeon because it sounds like he had trouble all around.

Chuckm

Caverdave, to answer your question about surgeons there a great list here: http://www.surfacehippy.info/listofdoctors.php. If it were me I'd definitely consult with at least Dr. Gross and Dr. DeSmet before you do anything. They both do phone consultations (after you send them xrays) and they both have lots of experience with tough cases and fixing problems.

Chuck you get a 62mm dysplasia cup which works with a 54mm head

Caver the best advice any of us can give you is to go to a TOP surgeon. Where about's are you in the world so members can reccomend some?

I am in New Jersey (USA) Danny and suggestions would be great. If I understand correctly the dysplasia cup is the one that uses screws. I do not have any screws. The 62mm BHR acetabular cup is catalog # 74120162 and the 54mm femoral head # 74122554

I'd go see Dr Su then mate he's in New York.

Hi  I am sorry to hear about your hip problems.  This obviously is not a BHR problem.  This is a problem of device components placed incorrectory and/or incompatible components.  None of us are medically trained or surgeons, so we reallly have no idea of what should have been done.

The very best advice I have is to get several opinions from top, experienced surgeons as others have said.  Dr. Su, Dr. Gross, Dr. De Smet - surgeons that have done thousands.  Sometimes even they do have a few very unusual problems, but I would definite not go for another surgery without some more input.

You can't keep having surgeries.  You need to choose the right surgeon and get it done right. 

I know that sounds mean, but it is the truth.  Even if you used one of the top surgeons that have done thousands and are having this problem, it is time you get input from several others.  Even the top surgeons will sometimes disagree on what to do.

You do need something done if you have such high metal ions and a pseudotumor.

Who is your surgeon?

Note: I changed the title of your post since there is no such thing as a hybrid BHR, you received a THR which obviously was not done correctly.  There use to be simmilar BHR cups that were used for THRs, but I thought I read that they are no longer used since metal on metal THRs are no longer used.

I wish I could tell you more, but I can't since I am not or any of us are not technically trained. We can give you support as you go thru this terrible experience.

Good Luck.

Pat

Caverdave, that part # is the standard 62mm cup. The shell thickness is 6mm.
The 60mm cup is only 4mm thick. So a surgeon might start with the 60 and then if something goes wrong he can ream a little more and try to get the 62 to work because they both have the same inside diameter. You wouldn't want to start with the 62 because once the reaming is done you can't go back smaller.

But if that 62m cup is in properly one of the hip gurus should be able to match it with something.
Danny is right, go see Dr. Su at the Hospital for Special Surgery.

Chuckm

Quote from: chuckm on April 18, 2015, 12:10:58 PM
Caverdave, that part # is the standard 62mm cup. The shell thickness is 6mm.
The 60mm cup is only 4mm thick. So a surgeon might start with the 60 and then if something goes wrong he can ream a little more and try to get the 62 to work because they both have the same inside diameter. You wouldn't want to start with the 62 because once the reaming is done you can't go back smaller.

But if that 62m cup is in properly one of the hip gurus should be able to match it with something.
Danny is right, go see Dr. Su at the Hospital for Special Surgery.

Chuckm

If it has a shell thickness of 6mm, then the THR side should be 56mm, not 54mm.

Hi Surfhippy, I'm an 'older' surfer too and had a BHR in India with Dr Bose last November. My recovery has gone really well but haven't been able to get back into surfing yet. Tried a few times but I'm a natural foot and my operated leg was my left and I can't get this through quickly enough on take-off. Quite frustrating. I'm very active and quite fit so I thought my recovery would be quicker than it has which was a bit of a good reality check. I'm going hard out with lots of rehab and getting my range of motion back but probably a bit further down the track to get back into the water and catching waves. Ski season starts in a couple of months and I'm feeling very confident now that I could ski quite fine.
Anyway I'm looking forward to following your recovery and especially getting back into the surf. Keep posting regular updates.

I think the 54mm femoral "ball" is correct. If the outside diameter of the acetabular cup is 62mm, with a thickness of 3mm, then the interior diameter of the cup would be 56mm (62 - 6 = 56). Typically, the femoral ball is 2mm smaller than the interior diameter of the cup, to allow 1mm of clearance on each side. So, a 54mm ball would be typical for a cup with an interior diameter of 56mm.

Quote from: bluedevilsadvocate on April 19, 2015, 02:28:47 PM
I think the 54mm femoral "ball" is correct. If the outside diameter of the acetabular cup is 62mm, with a thickness of 3mm, then the interior diameter of the cup would be 56mm (62 - 6 = 56). Typically, the femoral ball is 2mm smaller than the interior diameter of the cup, to allow 1mm of clearance on each side. So, a 54mm ball would be typical for a cup with an interior diameter of 56mm.

1mm sounds a lot of clearance. I think the clearance is somewhat less than that, my understanding is it changes from size to size but the studies ive seen by McMinn and Treacy showed the best clearance was in the 150-200 micron range.

Quote from: Dannywayoflife on April 19, 2015, 03:37:14 PM

Quote from: bluedevilsadvocate on April 19, 2015, 02:28:47 PM
I think the 54mm femoral "ball" is correct. If the outside diameter of the acetabular cup is 62mm, with a thickness of 3mm, then the interior diameter of the cup would be 56mm (62 - 6 = 56). Typically, the femoral ball is 2mm smaller than the interior diameter of the cup, to allow 1mm of clearance on each side. So, a 54mm ball would be typical for a cup with an interior diameter of 56mm.

1mm sounds a lot of clearance. I think the clearance is somewhat less than that, my understanding is it changes from size to size but the studies ive seen by McMinn and Treacy showed the best clearance was in the 150-200 micron range.

That is my understanding as well.  1mm clearance is FAR too much.

My mistake on the cup thickness. It is about 3mm for the 60mm cup and about 4mm for the 62.
Both cups match up with the 54mm femoral component. While the femoral component is 54mm and round, the cup is a fraction larger than the matching head to allow for the fluid film space. And the cup is not perfectly round like the femoral component, it flares out so there is some space for movement but as Danny says that space is very small.

Chuckm

Hi Dumpf, Glad to see other surfers on here. The guy next to me in pre-op was also a surfer. Where do you live where it's almost ski season? I'm now 2 weeks post op today, and have been doing pretty good. I started with a cane after 1 week and feel as if I could lose it soon. I'm getting around with it, but don't need it all the time. It's painful the first few steps but eases after a few strides. There are some good surf specific exercises that may help you along with getting up. Just search on youtube or google surf fitness. I'm in pretty good shape with good bone density, and hoping it helps with my rehab. Surfing and mountain biking are my life as far as fitness goes, and can't wait to get back to them. When I'm able, I'm targeting a very fit future with a lot of rehab, then strengthening exercises with an emphasis on flexibility. Keep posting and let me know how the surfing is going.

I was cleared by my Dr at 2 months and I was back in the water on a longboard the day after being cleared. I was a little tentative and mindful when up and riding trying to avoid critical sections, keep maneuvering to a minimum. Was just glad to be back out in the water. I originally thought I would have been out for at least 6 months.

I am at almost 5 months, still on my high performance longboard, although I did ride my 5'10" a couple times, it went ok, not ready for my shortboards yet.

Cleared after 2 months is amazing! I'm 2 weeks post op and started getting around without the cane for the first time today. My Dr. is firm on not releasing me for 6 months for surfing and mountain biking, and I'm 53, fit with great bone density. I believe it has to do with the Biomet uncemented device, and waiting until the bone grows into the pores of the device. Will be going out on my longboard to start off for sure.

Hi Shabbis, interested to see you get back into the water and catching waves so quickly. Are you goofy or natural and which leg did you have the surgery? I think if I had my back leg operated on I would be surfing by now. I'm living in Dunedin, NZ which is actually one of the surf capitals of the world  :)
Been doing lots of yoga, having massage, acupuncture, walking, cycling, swimming plenty. Also started Pilates which has been quite amazing and I'm using this instead of going to physio which I lost faith in. The physio didn't really understand the surgery, the recovery prognosis and had lower expectations than I hold.
Yoga works on the large muscle groups but Pilates focuses on the smaller, inner core muscle groups that are harder to access but fairly critical for full recovery.

I am regular foot and had my left hip resurfaced. Not sure I would have went out so soon if it was the right hip, I think. We'll see, I have to get the right done at some point as well.

I'm now 3 week post op and easily walking a mile in the mornings. I've been taking Advil Pm to help me sleep, and it lets me get a decent nights' sleep and allows my leg to relax without a lot of tossing and turning to get comfy. I dumped the cane after 1 week of use (1 week on crutches, 1 week on cane), and don't even take it with me anymore. Other than surgery pain, which is now minimal, I'm experiencing muscle pain at the attachment point up front, which feels like a nerve pinch. I'm sure this can be worked out with proper stretching, and therapy. I will have to wait for my 6 week follow up to see what I can do about this. My follow up was actually scheduled 5 weeks post op, so I'm really looking forward to seeing the doctor and team to see what I can do. Not looking forward to the 10-11 hours on the road that day, especially since South Carolina has the worse roads in the US highway system, with two lanes on I-95, and I-26. lol. It's been difficult to watch the surf and know I can't be out in it until October. Counting down the days...

Keep up the good progress Surfhippy. I think simply walking lots is probably the best rehab you can do. Hope you're in the surf before you know it. Have you thought about going out on a bodyboard or bodysurfing a few waves in the meantime?

IF you are taking the meloxicam that Dr. Gross prescribes, you are not supposed to be taking advil. 

Just wanted to point out that going back for the six week follow-up is not really a requirement for out of state patients. I did not either time. I am sure they would love to see you, of course.

Mike

Thanks for the replys and encouragement! Ecchastang, I have been off the meds for over a week. The antii inflammatory meds took a toll on my stomach so I quit them a few days early. Dumph, I have thought of bodysurfing, bodyboarding, and if the doc allows, I'll be out there in a heartbeat. I also thought about getting an SUP to get me on the water for some exercise. Mike, I just may have to forgo the trip if I can. I will contact them and see if we can work something out for my next phase of rehab.

Mark

After my first surgery I was all gung-ho to return for six weeks and show off how good I was doing. But I delayed booking a flight until a week or two before and the cost was outrageous so I called Dr. Gross's office to apologize and say I couldn't make it and I was a little surprised (shouldn't have been, though) that they didn't seem at all put-out, and it was pretty clear that many (most?) out of state patients do not return for the six-week, or one year, two year, etc. They are going to want you to do three things for six weeks, though; see a Physical Therapist for an evaluation, get an x-ray, and fill out a questionnaire; Dr. Gross is very serious about tracking his results.

They know almost every surgery (knock on wood) goes without any real complications, so they understand if out of state patients do not return.

You weren't bilateral, right? If you had FAI (anecdotally, generally bilateral) you are gonna be back for the other hip in a few years anyway, like I was.

Take care,

Mike

I'm now 4 weeks post op and feel pretty good. Easily logging a mile on my walks when I walk in the morning. was back at work on week 3, but I'm a picture framer/photographic artist, and have to stand a good bit of my day. Was able to work 31 hours last week and hope to get close to 40 this week.  Usually sore at the end of the day, with tightness at attachment point of the upper quad. With advil, this calms down over night. I opted not to travel for my 6 week post op, and am waiting on my new workout directions in the mail. I will travel 6 month post op, because I will be released, and there is a great mountain bike trail system just a little over an hour away from the doc's office. Will camp for a few days and get some riding in. It's killing me not to surf, as we had real good waves over the weekend, and have surf all week long. I just go down to the beach, walk, stand in the water, watch my friends, and lounge in my beach chair. As soon as the swell drops, I'm going in the ocean!

Please check with Dr Gross before planning your visit to the mountain bike trails. He is usually very adamant about no biking outdoors for the first six months. Indoor stationary bikes are fine. Obviously you can choose the risks that you are comfortable with, but it might be wise to get his input as to the severity and consequences of those risks before committing to the biking plans.
Glad to hear that you are doing so well, but remember that your bones around the joint are "remodeling" right now, and will continue to get weaker out to around three months, before starting to get stronger again. It is my understanding that your bones, particularly at the femoral neck, are actually weaker right now than they were the day after surgery, since they are in the process of breaking down as they "remodel" along new stress lines. The great news after a resurfacing, as opposed to a total hip, is that studies show that eventually the bones around your new hip are often 110% the strength of a normal hip; great stuff. But not yet.
Please check with Dr Gross on this since he is the expert, and I am just trying to pass on my limited understanding of the process as he explained it to me when I wanted to include more activities between 6 weeks and 6 months. He was extremely strict with me on this sort of thing, and it worked.

I second what John C said. I think the restriction on not riding a real bike until the 6 month mark is to avoid the risk of falling off and damaging the bone around the implant which is still rebuilding. Definitely check with Dr. Gross' staff.

My surgeon warned about stress fractures from those of us who are lucky to have the accelerated healing. He was adamant that stress fractures occur from overuse of weakened or damaged muscles when the bone takes more stress. Until that 6 month mark he advised huge caution with time limits on repetitive motion exercise and impact i.e. running. I am taking his advice even though I feel perfectly normal after 15 weeks. Just sharing...... :)

Quote from: oldsoccerplayer on May 08, 2015, 08:13:56 AM
I second what John C said. I think the restriction on not riding a real bike until the 6 month mark is to avoid the risk of falling off and damaging the bone around the implant which is still rebuilding. Definitely check with Dr. Gross' staff.

Yep.  Bone is apparently weakest at around the 3 month mark.

I held off until about 5 months before doing some easy road riding.  At  6 months I cut loose.

Its really just an actuarial gamble.  i.e. what are the odds that you are going to take a fall?  Well, the odds will be a bit higher than normal.  All sorts of little stabilizer muscles coming back online, etc.

Thanks guys. That was a typo. I'm traveling for my 6 month, not week, and won't be riding before then. I'm feeling good but not that good. I did go for a mellow dip in the ocean for the first time today, which felt nice. We have had good surf for the last couple of days, and I was just waiting for the swell to drop.

Funny that it was just a typo. Well, at least you now know that there are lots of people on this forum paying attention and looking out for everyone's best interest.
Enjoy your mountain bike trip.
Isn't it great to get back in the ocean. I was in the pool everyday for the first five months. I stayed out of the surf for six months, except for the one time at about three months when our 18 year old nephew was visiting us here in Hawaii, and got pulled out to sea by a 35 mph offshore wind while surfing. I had to borrow a longboard and paddle a quarter of a mile offshore to catch him and drag him back in on the end of my leash. Felt good to have a paddling workout, but I had to waste a perfectly good wave on the way back in by just proning out so as not to break doctors orders.http://surfacehippy.info/hiptalk/Smileys/default/cry.gif

Thanks John! I had no idea the timeline of the breakdown/rebuilding of the femoral head. Great info! It was nice to get in the water and float around with the dolphins present the other morning. It was as if they were welcoming me back. I thought about paddling my longboard when the time comes, just to get out and get some paddling exercise. My friend is giving me access to an sup to paddle on flat days which will help my leg muscles, and my balance. Summer in Florida... we will be having plenty of flat days. Where in Hawaii do you live? I thought about doing Hawaii around January next year to work on my wave/ocean art. Haven't been since 1989. I'm now doing a beach walk 2 miles in the morning with no limp. Work throughout the day and take it easy in the evenings, and topping off with my exercises. Phase 2 exercises starts this weekend. Excited!

Hi surfhippy. My wife and I live on Maui for six months every year. I teach high level windsurfing (high wind, wavesailing, etc), and we are here for the summer half of the year which is trade wind season. Winters I switch to teaching skiing.
Its great that you are doing lots of beach walking. Walking in soft sand is great exercise. You are doing amazingly well to be walking in sand with no limp. The slant of the beach gave me trouble for a couple of months before it no longer affected me.
Say hello to the dolphins for me. Thirty years ago I used to surf an out of the way spot near San Diego that had dolphins come by almost every morning and catch a couple of waves with me. What a treat that was.

John, Sounds like a nice gig you have going. My friend John Holzol (not sure of spelling of his last name) moved from here to Maui years ago to teach windsurfing. I'm so ready to get out of here and do things on my own terms. Just treading water paying bills it feels like. Get a little out of debt, and I'm out of here. I need a low tide as the beach slant at high tide messes with me. Starting phase 2 exercises tomorrow. Stoked!

LeeLa I have the same circumstance.  I have had hip resurfacing and am 2.5 months out.  I was confused as to which hip I should have surgery on b/c on xray the least painful indicated the least cartledge.  Its too soon to tell if I have made the right decision but interestingly my nonoperative (L) hip still doesnt hurt that much unless I push myself or in the case of depending on it while I was in the early stages of recovery.  ROM is terrible though.  I too thought my R hip may be more troublesome B/C I was twisting as I walked.