Right on curt (takes me back!) but I think you should change the legend on your avatar -- don't have cruddy cartilage no mo'

There are no guarantees in life.  Without the hip resurfacing what would any of us be doing?  It is our choice of activities that brought us here in the first place.  This is no surprise to me.  I guess somewhere in my reading and discussions with my surgeon it was clear to me that I had to respect my device and know that I could wear it out faster or slower depending on my activities.  Unfortunately for me my hobby is bellydancing. What most people don't know is that bellydancing is so much hipwork, well at least the style I was doing: hip twists, circles and shimmies, which are a pistoning of the hips, oftentimes at doubletime speed.  Our Saturday drill work for two hours at a time would beat the hell out of our hips. I will have to tone down my dancing and drop the drills.  And not being a part of those drill classes leaves me ineligible for the dance troupe I had hoped to join. Those days are gone. But there is still so much of it I can do and with a THR that would not have been the case.

Having gone over the whole wear thing several times I really don't think that you could ever actuly wear one of these out. Use floyd landis for example when he had his HR done he was doing 30million + cycles a year if wear were a problem he Would have worn his out pretty sharpish! Also guys like Corey fulks the same aplys. If you listen to the northern lights debate Derrick Mcminn talks about a thr (a freeman device I think) that was revised after 26 years and it showed like only 20microns of wear! It was revised because the actabular cup loosened.
I think this study is more aimed at the impact side of things and my guess would be revisions due to loosened components .

Having posted the study that started this thread, I wanted to add to the positive attitude, and hopefully take some of the load off of Danny and others.
1. Forgive me for rounding the numbers, but 88.8% is pretty darn close to 90%, which is not that bad a number considering the options. It is a far higher success rate than studies would show could be expected with a THR subjected to high intensity sports (probably more like 68%). Even for people with all their original parts, participating in many of our sports carries with it some percentage of risk for debilitating injuries anyway; comes with the territory. Every year we lose a few skiers to life altering (or ending) injuries; don't plan to stop skiing.
2. Danny is correct, I have read other studies out of Europe which I believe were larger, that showed no correlation between activity and survival rates. There are studies, and studies, etc.
3. If we look at the other risk factors listed in this study, someone like Danny is going to be well back up into the 90+% range; he does not have a small component size, I think that he is probably not a skinny little thing, I am sure that Mr Treacy's technique is well past "1st generation", the study does not separate men from women (sorry ladies), and though the study does not list the brand of prosthesis, we know that Danny has the BHR on his side. With all of these other factors taken into account, it is clear that someone like Danny is not going to be anywhere close to the 88.8% number, since he does not share any of the other risk factors noted in the study.
Like so many others have said on this thread, I do not see this study changing the active lifestyle that my resurfacing has given me. However I do feel that it is important to share studies like this, so that each person can make their own decisions based on cumulative risk factors, and how much risk they are willing to accept in balancing the activities that we love.

Thanks for putting it like that John. When I first read the post I was having a bit of a bad day!
Although you are unfortunately wrong about one thing I'm far from skinny! I wish I was! Even when I'm in top shape I'm around 180-190 at 5'9". I am cursed by the stocky gene:-)

What do they mean when they say the Device fails? is it:
1. Loosening
2. High Metal Ion count
3. Bone Fracturing
4. Intense pain


I held on of those bad boys in my hand. If I threw it at a brick wall, ran over it with my car or dropped it from a 6 story building I dont think there will be a mark on it. I think it is less on the device than on it's placement and our willingness to give it time to fuse with out bodies.

Fair points hipnhop. I've read the thing again and the thing that sticks out to me is the "first generation surgery" bit.

Honestly, if I didn't try hip resurfacing with Dr. Gross in my hometown, I truly believe that would have been a mistake.  I pray my hip lasts a lifetime but if not, I sure am glad I tried HR!

Do you think they would have recorded data such as:
-Prosthesis type
-Experience of Surgeon
-Reason for revision

445 is not a huge number to study. If it can be further quantified that would be good. Still a worth while study - just want more detail now. Sometimes I wish I didn't read so much!

Interesting how 7% drop has got us all talking though.

You would have thought so but it ain't in the write up I've read.

QuoteSurgeons should advise patients to limit their physical activity to levels that the device can sustain.

No one has commented on this little beauty at the end.  Haven't many of our surgeons been advising us that it is okay to return to specific impact activities including running?  I suspect that there is more to this story than this limited statement makes.  For example, what role does bone density play.  In other words, the device doesn't fail but the bone can't sustain the stresses.

It definitely gives me pause.  But as several of you have said, there is limited information.  Even in the case of other factors there is still over 88% HR survival.

I will stay up on the latest research and certainly not go crazy in the meantime.

Dan

I think that long term bone health is probably the big thing that will decide how long devices will last. And I for one make sure I get my calcium vit d&k and magnesium. I supplement calcium with the coral calcium capsules. Hopefully this will keep my bones health and my device in place.

 I wish we knew what the some of the top HR doctors thought of this study. I was bummed out by the  findings, but you have to do what you have to do. I still think its worth taking a chance, although I will admit I wish I needed a larger component. Oh well..lyn 

3 days to go and this is what i get to think about now. hell should i just eat the pain or what? i thought this was the best for people that do physical labor for a living with many years to go @45. brad.

Brad count yourself lucky your original kit got you to 45 mine got me to 28!
Many times it's been said on here the most important factor is surgeon selection. Who's your surgeon what's there record like? What device are you getting?

Short of stem cell repair (which they have not perfected yet) hip resurfacing is the best possible outcome, for now.

When my left hip goes I am hoping they will at least use me as a test, we have a well known vet around here who has many dogs with good working hips via stem cell transplant.



Chuck

Quote from: midiowa on February 09, 2012, 08:38:11 PM
3 days to go and this is what i get to think about now. hell should i just eat the pain or what? i thought this was the best for people that do physical labor for a living with many years to go @45. brad.

Chuck it was my understanding that the stem cell thing was a fair way off. Is this not the case?

my surgeon is DR Devon goetz in Des moines ,Iowa.   his credentials and surgery record looks great.  he came recommended from university of Iowa doctor, was told hes very good and has done hundreds. but how many makes you good 100 500 1000?. what do ya do?

I've contacted several researchers involved in stem cell technologies as well as a couple BHR surgeons and there is quite a range of opinions on when the first true cartilage repair technologies are likely to become widely available. Anywhere from 5 to 20+ years depending on who is asked.

It seems to me no one knows when, but successful repair strategies of the kind that will help people with OA are likely at some point.

Interestingly, a lead researcher at one of Canada's leading hospitals in Toronto stated that the goal it to produce a "toolkit" of options for people with various problems. "Maybe" these will include biological replacements for people who already have a resurfacing. I wouldn't hold my breath, but she did say this may be possible. 

A major turning point will be when researchers graduate from animal to human models, she told me. It seems this is all about proving safety, funding, and politics.   

Quote from: midiowa on February 09, 2012, 09:01:53 PM
my surgeon is DR Devon goetz in Des moines ,Iowa.   his credentials and surgery record looks great.  he came recommended from university of Iowa doctor, was told hes very good and has done hundreds. but how many makes you good 100 500 1000?. what do ya do?

Personally I don't just think the number of resurfacings is important but there record. The world average retention rate is 96% so to me that means if they average 96% there average and if it's over then there good if there under personally I wouldn't use them.
On the numbers thing most interviews I've seen with the top surgeons say they felt the learning curve levelled out at around 1000 but they always continue to get better with experience.