Hello surfacehippies,  I am new to this site.  I already have a THR but am interesting in resurfacing for my other hip when it needs to be fixed.  I don't want to miss the window of opportunity for the second one!  I have heard that one of the advantages of resurfacing with its anatomically sized implant, you will have a more natural gait.  I was wondering if someone could elaborate on this point.  Thanks, and I've enjoyed browsing through your forum.  Very helpful.
Gail       

Hi Gail W

Welcome to Hip Talk.

Glad you are interested in hip resurfacing. I know of several people that have both a THR and a resurfacing.  Several decided like you, that after their THR, they wanted their other hip done as a resurfacing since it is bone conserving.

Hopefully, your THR is also a MOM or metal on metal THR which is actually the same size cup and thr cap as a resurfacing.  The acetabuar cups and size of the femur devices are the same size.  It is just that the resurfacing femur cap does not require the bone be cut off and a long rod be pounded into the femur bone.

I have heard several surgeons including Dr. Mont discuss the fact that a resurfacing gives a person a more natural gait since it is much more like your orignal hip than a THR.  I have one gait study here  http://www.surfacehippy.info/gaitstudy.php

It makes sense to me as a non medical person that very little of the femur bone is removed and it is only capped almost like a crown on a tooth.  So the surgeon is not changing the structural design of the hip.  It does take a very experinced surgeon to place the acetabular cup in the proper position with the proper angle. That is one of the differences in Resurfacing.  It is critical that the components are placed properly.  The resurfacing surgery is much more techincal and difficult than a THR.  So I always suggest using the most expeirenced surgeons available.

I hope that helps some.  I look forward to learning what decision you make and how your new hip is when you decide what to do.  Good Luck.

Pat

Hi Pat,  Thanks for the quick reply and the pointer to the article.  I had a ceramic-on-metal THR 3 months ago and am doing great and have no apparent gait problems at all.  This is why I asked the question.  I think I have a pretty good understanding of all the other advantages of resurfacing (and the need for a top surgeon), but wondered about this one.  I suspect the gait issue is highly individual, depending in part on the orthopedic status and conditioning of the person prior to surgery.  I expect broader studies will be done in the future.  I'm hoping my unoperated hip holds out for a loooong time but I plan on keeping my finger on the pulse of the technology in the meantime.   I'm just so happy to be back hiking and bicycling!  The one thing we should all be pushing for is a U.S. hip registry.  We should be collecting data now to help those in the future make the best decisions for themselves.  Thanks again for the site.
Gail   

Hi Gail,

The lower incidence of dislocation for hip resurfacing vs hip replacement was most important for me since I am an avid downhill skiier and I hunt in mountainous terrain.  I also heard from another skiier than he experienced thigh pain after skiing with a conventional total hip replacement (small metal head w/ poly liner for socket).  The metal stem flexes differently than bone and tranfers load into the thigh bone.  A hip resurfacing matches the natural anatomy and is seemingly unnoticeable during sporting activities for many people (at least for me).  A full size metal on metal hip replacement may match the lower dislocation rate of a hip resurfacing, but then the load transfer to the thigh bone is still an issue.

Hi Steve,  Thanks for the comments.  I see you're from Alaska -- good hunting up there.  I wish you could come down to upstate New York and pick off some of the white tails that are overbrowsing the understory here, not to mention devastating the Victory gardens.  I have read about the femoral loading concerns and know that could be an issue for me down the road but so far I have no problems with thigh pain.  I have resumed hiking on rugged trails and plan to resume skiing next winter, although I was always a strong intermediate skier, not double black diamond!  As long as I can walk and hike long distances, I am happy!  I just want to stay more on top of any problems with my unoperated hip so I can keep my options open.
Gail