I saw a surgeon yesterday who has done 300+ revisions. I require surgery on both hips. He said that I am a candidate for resurfacing but is not sure if he could perform it on my right hip, the left hip looks good. He will make a final determination on the surgery table and either go with a BHR or THR depending on his analysis.
He said I should be prepared for either outcome when I wake from surgery.
Has anyone else faced the same situation? Is this common?
Frank,
You need to ask some questions in order to be better informed. There may be issues with your right hip that cause concern, osteoporosis, cysts, necrosis, etc., but you need to get that explained to you. If and when you get your surgeon's further reasons for his uncertainty on whether you'll get a THR or a HRA, GET ANOTHER OPINION OR TWO. There are many physicians referenced on this site. Ask questions and then ask more questions. Make an informed decision so you will hopefully have no regrets.
I find it very interesting and at the same time disturbing.
Good luck and let us know how this all plays out.
My only hip condition is Osteoarthritis. It seems that I need to see a resurfacing specialist to get another opinion.
Is the surgeon's inability to make a determination based on the X-ray a red flag?
Hi Frank,
I faced the same situation almost 3 years ago. My surgeon was Ronan Treacey who has done thousands of resurfacing and THR's.
From my X - rays, he told me I was 70/30 against being able to have resurfacing but he took the kit into theatre because if it was possible when he "got in there", he would do it.
It turned out that it couldn't be done and I received an Oxinium X Poly THR.
It wasn't just down to osteoarthritis, the top of my femur was slightly twisted due to childhood surgery when my hips were pinned due to a slipped femoral epiphysis.
I had no disappointment though because I knew that if Ronan Treacey could not resurface my hip,it couldn't be done.
If this is how it works out for you, don't be too down about it- it's an excellent alternative to resurfacing.
The only two drawbacks I see are the lack of bone conservation and being limited on heavy impact sports.
I think the main thing for most people who have THR is accepting it. Get over that and you can get on with a pain free life for a long time.
Go to see someone with lots of experience and give yourself the best chance possible of getting the best outcome.
Cheers Mike.
I hear what Mike D is saying, but a guy who's done 300 surgeries is not Ronan Treacy. As others have said, see one of the high volume surgeons and see what they say. Don't accept this surgeon's opinion as gospel. Personally I recommend Dr. Gross. I have been here long enough to have seen a number of people saying the same things you are, they consulted with Dr. Gross and it's HR.
And if he does determine you are a candidate for resurfacing, you will be waking up with HR. Don't quote me, but my recollection is that he used to mention that one time (maybe two) he had to a THR when he had planned an HR, and that might have been a while back. When I asked him that question, any chance I'll wake up with THR he just said no. Perhaps my situation was more run of the mill than yours, but I think he is comfortable doing HR on patients some others aren't. My recommendation is unreserved.
Mike
There is only 1 high volume surgeon who accepts my insurance in the NY Tri-State Region, Dr. Marwin. I left a voicemail with his office yesterday in order to setup an appointment and have not heard back yet. Does anyone know how backlogged he is and have any idea of how long the wait would be to see him?
Are there any other high volume resurface surgeons in my area that are not on the list?
I just setup an appointment with Dr. Marwin. Will let everyone know the outcome. Thanks for everyone's replies.
Frank--I am scheduled for left hip resurfacing with Dr. Marwin on August 28th. My right was done more than 12 years ago with Dr. Gross. Both are fantastic surgeons. I saw Dr. Marwin just two weeks ago, and I believe his office is scheduling about two months out. With regard to the possibility of a thr, I don't know, obviously, what your xrays show, but I know Dr. Marwin has taken on many difficult cases, with successful outcomes. Good luck to you.
After doing some research and educating myself, I'm feeling good about Marwin. Thanks for the info about his availability. It's good to hear. Good luck on the 28th, I'll be following your progress.
Frank, I can't say enough good things about Dr Marwin. And I know five other runners and triathletes who owe it to Dr Marwin's skills that they are back racing again. Because of Dr Marwin's ''direct lateral technique'' we all had a much easier recovery than someone who had their glutes cut and re-attached. I'm at 3.5 years same day bilateral and I have to look a my scars to tell that I ever had the surgery. His number is much higher than 300
Have you seen him at his office. When I met him, he explained the surgery so well that I felt like I could perform it. I remember him telling me that if it was necessary, I could end up with TLR's. I'm pretty sure that I asked him how many times this happened and he said never but he had to tell me. He's a great doc, and a good guy.
Here's the link to my posts from my stay at Hospital for Joint Disease:
http://surfacehippy.info/hiptalk/index.php?topic=2982.60
Dr. Marwin told me that he has now surpassed 3,000 resurfacings(as of two weeks ago). I did ask him about the number of instances he had to go to a thr, and he told me five. So, five out of three thousand plus procedures.
I've gone from despair to elation after discovering the procedure of hip resurfacing. The first surgeon I spoke to made no mention of it. He said that I needed THR and would never run again, that was a little over a year ago.
Seeing no real advantage for getting the procedure because I was already unable to run and the pain was bearable I put it off. Unfortunately the pain increased so I saw another surgeon who performs BHR but not in high volume. I have to thank him for enlightening me to the procedure. This led to researching an option that I did not even know existed.
I wonder how many people have received THR without ever knowing there were other options.
After discovering this site and reading the replies to my post, I am elated. I am actually looking forward to speaking to a surgeon and will likely be booking the surgery on the spot, to be done ASAP.
If only I had learned about it sooner I might have done it 4 or 5 years ago when I thought I was merely suffering from muscle soreness.
My appointment with Marwin is on the 5th. Can't wait!!
I hope it works out for you Frank. A lot of people travel for this procedure, due to finding a reputable surgeon. I used Dr. Gross, and can't praise him enough. Worth a check if you don't hear what you want.
Will keep that in mind. I have already sent him my X-rays. Hope to hear back from him soon.
Frank-I had my right hip resurfaced in January 2003, during the original FDA clinical trial. I was 45, an athlete all of my life, and searching for an alternative to thr. I stumbled onto resurfacing doing my own research, and to make a long story short, flew to Columbia, sc(of all places!) to have the surgery performed by Dr. Gross. I think I was maybe his 200th case, and that was a lot at the time. I saw several of the top orthos in NYC at the time I was contemplating this, all of whom told me I was crazy. The traditional, entrenched orthopedic community has, to put it kindly, never embraced resurfacing, and never will. There are many, many thousands of people who should have had resurfacings, but were never even informed of the procedure as an option. So, you are fortunate that you took the initiative. Good luck to you on the 5th. Perhaps Marwin can squeeze you in on 8/28, and I'll see you at NYU.
I wish I could go in on the 28th, if I'm not there, good luck and keep us updated.
Does anyone know if a sufferer of Sleep Apnea could be a candidate for bilateral resurfacing? I would love to get this over with in one stay. That is my only health condition.
Saw Dr. Marwin yesterday. My first impression upon his entrance to the examining room was that he was a rockstar in his field. He was wearing a striped seersucker suit and bow tie. His look and demeanor exuded an abundance of confidence which I was delighted to see.
He is very personable and a straight shooter. He said that I am a candidate for bilateral resurfacing and would like to do them together but my sleep apnea condition could preclude that from happening. Since I have no other health concerns such as diabetes, heart condition, obesity, etc.. he would go forward doing both at the same time. My only hurdle will be getting clearance during pre-op assessments with the anesthesiologists.
Upon examination of my X-rays his assistant was amazed that I am getting by with my only therapy being 15MG of Mobic daily.
She said that that opening for surgery is in the 6-8 week time frame and I should be hearing from the office to schedule the surgery within 24 hours.
Now my dilemmas are being able to do both hips at the same time and breaking the news to my management that I will be missing time from work.
Does anyone know how temporary disability works in New Jersey and if I will be receiving official letters concerning how long I must be out of work to show management?
Frank--glad that you're a go with Dr. Marwin. Yes, he is very confident, but most importantly, backs it up with surgical skill and results. I can't help with the new jersey issues, as I'm a New Yorker. Hope that you get it ironed out, and can proceed shortly. Good Luck.
Yes, definitely going with Marwin, scheduled the date today. They offered me to go on the 28th with you and I was tempted to accept but considering I'm on vacation this week I don't want to shock management at my company too much.
I'm going in on 9/22 and need to take care of the preliminaries. As far as disability goes I'm a NY'er in exile, originally from Brooklyn but I wouldn't know how to deal with disability in the city anyway. I'll figure it out.
It feels good being back in my old stomping grounds to get this procedure. I got good vibes.
Woodstock, he said that he can do the bilateral and I would be out in around 3 or 4 days. I asked him about doing rehab for some time at the hospital but he said I would be alright. Do you remember how your conversation went in these regards? I'm considering pushing for some days in rehab.
Frank, I spent 9 days total at NYU Langone. The first 3 days were on the surgical floor with PT twice a day. Then I was moved to the Rusk Rehab part of the building. Rusk is the number 2 rehab facility in the country, the only better is Kessler in NJ. I now had serious PT twice a day and occupational therapy once a day. Occupational is like PT but they also teach you how to do things like getting into the bathtub and the car. Staying at Rusk was one of the main reasons that I chose to go bilateral. I would not have wanted to go home on the third day. I had all of this help and my pain was managed so well that I don't remember being in pain, just stiff. I forget Dr Marwin's secretary's name, but talk to her about staying at Rusk for your rehab. On the 9th day after my surgery, I was able to walk with just one cane, from my room, down the elevator, out the door and got into the car like a pro.
My conversation with Dr Marwin was something like this;
''Do you want to have it done bilateral''
''Are you nuts, I won't have a leg to stand on''
Then he explained about staying at Rusk for my rehab and it sounded much better. After I thought about it, I called the office and agreed to go bilateral.
I was in the old hospital that the nursed called ''the joint''. The nurses couldn't have been better. We got plenty of food, 3 meals and 2 snacks a day. When I left, I was confident that I could handle it with ease. And they handled my pain like the professionals that the are.
Try to stay at Rusk. It worked out great for me and I'm sure it will work for you also.
Good Luck
Woodstock, contacted the surgical coordinator yesterday. She said I am a candidate for post rehab at Rusk and will be contacted 2 week prior to surgery. If by any chance they are full I could go to Kessler being that I live nearby to a couple of their facilities but I would like to stay put at NYU. My journey seems identical to yours. Hopefully it will be as successful.
Frank--I believe that you will be having your surgery with Dr. Marwin next week, so just wanted to wish you the best. I am now 19 days out, and doing well. Dr. Marwin and staff at NYU were great, spent two days there, left the hospital with only a cane, and recovery is progressing nicely. You're in good hands.
Saf, that is good to hear. I'm still scheduled for Tuesday but I doubt I'll be in such good shape as you after a bilateral but I'm hoping for the best and confident with Marwin's and NYU's expertise. Good Luck!
Congratultions Saf. It's like a miracle, isn't it. If not for my fake hips I'd probably be in a wheelchair by now. Instead I ran 5 miles this morning and I'll go swim 2000 meters later. I'm going to San Diego tomorrow, racing an Olympic distance triathlon on Sunday in San Diego harbor Sunday, then a 5K running race the following saturday in Coranodo and a 1.2 mile ocean swim race in Oceanside sunday.
Frank, best of luck on Tuesday. Once the stiffness goes away, it just keeps getting better.
Woodstock, thanks for the well wishes! Check your inbox, I PM'd you about Rusk.
Best of luck, Frank - the best is yet to come.
Woodstock--I love what you're doing with those hips! The whole point of getting resurfacing, from my perspective, is to be able to resume those athletic activities that we did before. I'm now bilateral, having had my other hip done 12.5 years ago. I played basketball, ran, and did many other things on that first resurfaced hip for at least ten years until the other side gave out. I fully intend to resume those activities at the six month mark. Frank--again, best of luck to you. Be patient those first few days after surgery, and you'll be golden.
4 weeks Post-op
Surgery went as planned, both hips were resurfaced. Spent two days in the hospital, NYU Hospital for Joint Diseases. Started doing PT within 24 hours of surgery which consisted merely of forcing myself out of bed with help and using a walker to drag myself 15 feet out of the room and back. Did the same routine the second day traveling a little further and then was transferred to Rusk Acute Rehab two floors down.
At Rusk, rehab PT consisted of a full 3 hours daily. 1.5 of basic PT and 1.5 of Occupational. It was grueling and sometimes painful but I am glad it was made available to me.
By the 5th day after surgery I was using 2 crutches to get around. Before being discharged after 7 days in Rusk I was able to climb 2 flights of steps with 2 crutches and comfortable in my ability to take a shower, dress myself, and get into and out of a car.
I made steady progress that I could measure almost daily since. I'm currently going to outpatient PT at Kessler in NJ, walking without crutches, driving, and started going back to work yesterday.
I have to say everything has went as well as can be expected except I am still experiencing slight drainage from the incision wound on my right hip.
At my post-op appointment last week with Dr. Marwin, he inspected the wound and does not believe it is infected. He prescribed an antibiotic for 14 days until I see him again.
Any thoughts about drainage at 4 weeks??
Frank--I'm glad to hear that all went well, and that you are progressing nicely. I can't sat that I can offer any advice on the incision drainage issue, since I did not experience that, except a bit the first week or so. But, I would trust Dr. Marwin, and what sounds like just a precautionary use of antibiotics.
I specifically asked him if the antibiotics were just a precaution and he said yes. I'm not stressing it, yet...
It seems as though the drainage is ending with only minimal drainage in the last 24 hours.
Now I'm concerned about my limping. Everyone says that it is normal. Dr. Marwin said to discard the crutches when I felt I was ready, and I do feel ready, able to get around including up and down stairs without them.
Has anyone else had the experience of walking with limps on both sides after a bilateral and if so, did it go away or how long did it take until you got back to normal walking?
Quote from: frankx99x on October 22, 2015, 09:08:26 AM
It seems as though the drainage is ending with only minimal drainage in the last 24 hours.
Now I'm concerned about my limping. Everyone says that it is normal. Dr. Marwin said to discard the crutches when I felt I was ready, and I do feel ready, able to get around including up and down stairs without them.
Has anyone else had the experience of walking with limps on both sides after a bilateral and if so, did it go away or how long did it take until you got back to normal walking?
The advice I was given is to use walking aids until you do not limp without them as you really want to focus on regaining a normal gait. Do you have two canes you can use? Particularly since it's bilateral, using two crutches isn't exactly conducive to normal gait. I would try two canes, then maybe one. Focus on walking without a limp and you should notice that over time you naturally place less weight on the cane(s). It'll be obvious when you're essentially not weighting them and that's the time to ditch them. I'd say this is particularly important for going on your daily walks and if you're just walking across the room then maybe a single cane or sometimes none is fine.
But, if you ignore the above and simply focus on trying to walk without a limp it'll probably get better too. Is your PT taking it seriously?
MY PT said to use a crutch if I felt tired or in pain. She said that the limping was normal.
In the meantime I will focus on walking normally, even if it means walking slowly.
Quote from: frankx99x on October 22, 2015, 12:39:13 PM
MY PT said to use a crutch if I felt tired or in pain. She said that the limping was normal.
In the meantime I will focus on walking normally, even if it means walking slowly.
Absolutely. It's far better to take your time walking but walk well than to rush about limping. Good luck!
Having said that, it likely *is* normal to be limping still, just something to work on from here.
:) 8) Hey Frankx99x !!! your quote........
"Has anyone else had the experience of walking with limps on both sides after a bilateral and if so, did it go away or how long did it take until you got back to normal walking?"
Yep I could not get out of bed for 5 days........ crutches for a long time. Left leg still weak and issue with but can run on it!!! wow that is run on it. So don't worry too much about your stuff at this stage. Do what your body tells you as I do not know your age..... Ok 6 months time look back and see where you have come from.... you may have no issues! Cheers K
I'm 51. I also was practically immobile for days after the surgery. Urinating in a plastic container can get you down. At that point I thought I would be on crutches for a long time. As the days went on I was somewhat amazed at my progress. From walker to crutches to 1 crutch, and then to none within 25 days.
I'm glad to hear that you can run. I'm looking forward to playing basketball, lifting weights, running,hiking and coaching my son's pitching from behind the plate.
It just seems there is a long way to go but if things go according to plan it will be happening in 5 months time, which is really not a long time at all.
:) 8) Hey Frank... Don't get to down about stuff and or others that read this post. Hell man I was on crutches for 7 years. I was hooting around behind my mate on my Trance Giant bike yesterday then before that a 20 min run thinking this is a big change from what happened. I am going to have to throw all those things over my shoulder the years of chronic pain and being down about it. Try and get the most out of life and what I want to still do and keep trucking on.... You may have some small issues in life but they may never cause you as much problems as not being able to walk.
Be honest my goal is to wear these things out cause if I make it that far I will be a real old man.
Yep put those things up on the notice board as they may come around then you can tick them off. Wow now that would be cool and a great achievement.
Cheers K
Congratulations Frank. You are on your way.
Now my advise: DON'T LIMP!
If you start to limp, you'll have to unlearn the limp. When I first started using the walker in the hospital they told me to focus on a spot at the end of the hall and not let it rock side to side. You can do this at the supermarket or better yet Target or Walmart. Use the shopping cart and practice walking without the limp. Look down the isle and don't let it rock. Keep working on your recovery, it's all great once you are recovered.
I've been on a roll. Went to California an did a Olympic Tri, a 5k running race and a 1.2 mile ocean swim race. Got age group 1st, 1st, 2nd. It was great!
Ran 5k races the past 2 weekends; age group 1st and 1st. No issues at all with my hardware!
During the last session with my PT, I was given instructions on how to stop limping. If I concentrate and take the time, I can walk practically normally with some difficulty. I'm making progress. It seems that once the swelling goes down further and I build up my muscles it will be OK.
Woodstock, If I can get close to what you're doing I will be satisfied.
That's great news Frank. Yup, it's hard work to retrain and rebuild some of these muscles, but you'll get there, and it'll be worth it!
:) Good Frank it is hard work, it is the opposite to what you think I have found that out. To rebuild the muscle and tendons up again one has to use them in order to get back to normal. Exercise, rest, eat, takes some time my physio said. 9 to 12 months from the time your can start to walk a little normal. keep at it. Cheers K
After 4 months the progress continues. I have no trouble sleeping on either side. I can get dressed normally. I walk without a limp and pain free. I am going to the gym, doing full body workouts including squat and hamstring machines.
My question now is that I feel some stiffness around both incisions from scar tissue. Is this normal on my timeline? If so, when can I expect it to be completely healed?
Not sure there is such a thing as normal, but from what you're describing you might want to look at getting a foam roller to work on the incision areas. Of course consult your surgeon / PT before you start using it.
Do you feel that the roller is necessary, as the scar tissue will not break down on its own?
Yes Frank, the foam roller works well. I also saw a chiropractor for the Graston Technique to bread up any scar tissue. This was at the advice of another MD who I used to ride with. You are doing great, keep working at the gym. Build back strength and everything else will follow
Good Luck!!!