Deciding when to have Hip Resurfacing done

[Steve]

I have consulted with a Doctor who has done over 200 Resurfacings.  He said that with what he sees on X-Rays, he would have been willing to do the surgury 2 years ago.  That being said, he also mentioned that it was up to my pain tolerance as to when I have it done.  Currently, I am not able to run.  My 5 year old can get away from me quite easily.  Other than that, I am still refereeing HS Wrestling with a very noticeable limp and a heavy pre-dose of Ibuprofin.  I do not want to 'pull the trigger' on having the surgery to early, but I have also heard that my limp and atrophy of muscles will both make other things worse and make post surgery PT more difficult.  I am looking for some opinions from people who have struggled with this issue.

[Pat Walter]

Hi Steve

Welcome to Hip Talk.

How old are you? 

One thing about hip resurfacing is that if you wait too long, you can lose your window of opportunity. If a hip becomes too degenerated, a hip resurfacing can't be done.  You do want to watch how long you wait.  If you have put your life on hold along with activities you love to do, it is time to get your hip resurfaced. Also the longer you use NSAIDS, the more chance you have of causing more damage to your hip.

It really depends on what you can stand as far as pain. There are many stronger pain killers than Ibuprofin that can be taken. 

I waited almost 10 years  to get my hip done because I did not want a THR and did not know about hip resurfacing. I was 61 when I had my hip done.  I could not do any activities or even walk from the parking lot of Walmart into the store without great pain. I could not sleep at night even with Vicoden.

What is wrong with your hip?  Is it just osteoarthritis or some other problem?

Life slowly comes to a halt with a bad hip/s.  You don't realize how much you stop doing and how slow you walk.

What doctor are you working with?

Pat in Ohio
3/15/06 LBHR De Smet

[jjiam]

I agree with pat, I put it off put it off like you, I would work, but in constant pain, I even tried 2 hip arthroscopys that did absolutely nothing.  You have degraded your life like I did, and since I got it done one week ago on Sept 11th, immediately the "pain" was gone in my join(groin)area that would cripple me if I did too much.  I could bicycle, but I would pay for it in pain at work, there is no relief.  So that being said, GET IT DONE.. I am so disappointed I waited so long......... but oh well don't do the same. You don't realize how you compensate on the good side for your bad hip.  It's just brutal, and life is too short.

[takilasunrise]

I have recently consulted with an Ortho. Surgeon who has done over 2,500 hip replacements (I don't know how many resurfacing procedures he has done, but I didn't ask, either, but he was referred to me by my regular Ortho. Surgeon).  I have been going to my doctor and my regular Ortho. Surgeon for over 2 years now trying to deal with my right hip pain.  The newest Ortho. Surgeon stated I have a lot of osteoarthritis in my hip and whenever I'm ready, he'll do the surgery on my hip.  He said it's up to me which one I want to go with, a THR or resurfacing.  He said, since you're still active and "young" as they keep telling me (I am 44 years old and my husband and I ride motorcycles and I do a lot of gardening and sell in craft shows), that the resurfacing would be the better choice for me because there is less chance of dislocation.  I, too, am still teetering back and forth on when to get the surgery.  I will more than likely do it, but I'm just nervous, as I'm sure most people are.  This website and forum has helped me in making my decision, but I still want to keep hearing from others who have had it done and what to expect, etc.

My doctors gave me prescription NSAIDS, but they didn't help at all!  I am now taking arthritis strength Tylenol and prescribed Tramadol.  It helps me get by, but there are still days when it's unbearable!  I've had the "shot" in my hip twice, and it did help me alot but it didn't last 2 months.  And it really sucks when you can't sleep at night because of the pain (I'm surprised my husband hasn't kicked me out of bed because of my tossing and turning and moaning)!  I know it's time! I'm just scared.  I've had 2 surgeries before, but it was just to remove "organs gone bad"!  Being "rebuilt" scares me for some reason, but I am ready to be pain free again!  I do have a limp all the time now.  I don't even know I do it anymore.  My 65 year old mom jokes with me and says "you walk like an 80 year old woman"!  And I've noticed my right knee aches now and my left hip is sore some days because I'm sure it's from me walking funny or when I stand, I put all my weight on my left hip.  I've never been injured, so I don't know where it came from. 

Anyway, I guess we all need to encourage each other to get it done.  Thanks for this website!  I know I'll be back here often!

[Pat Walter]

He Welcome to Hip Talk

You are way too young to have a THR. You should be glad your orth suggested hip resurfacing. I would ask how many he/she has done.  You do want to use an experienced hip resurfacing surgeon if possible.  It is a much more difficult surgery than a THR and it take 50-100 resurfacings to get experienced according to quite a few studies. 

My doctor, De Smet, has done over 2400 hip resurfacings and over 3000 thrs and he will tell people they should always choose a surgeon with at least 100 resurfs under his/her belt.

I was 61 when I had my hip resurfacing and I did not want a THR.  I wanted to save my femur bone so I could have an easy revision later in life if required.  When you get a THR they saw off a good section of your femur bone. Then later if you need a revision, they have to break apart the femur bone to get to the long stem of the thr device. Then they wire it back closed. Revisions are more difficult surgeries than the original THRs.  So if you start with a hip resurfacing, you have a whole femur bone left to work with later in life.

If you are at the point that you can't sleep at night even with Vicoden and other strong meds, it is time.  Why go thru life miserable.  You whole life comes to a halt with your hip becomes bone on bone with OA.

I learned a lot before my surgery and could not wait to fly to Belgium and have my BHR by Dr. De Smet.  I looked forward to getting my life back without pain.

Pain from a bone on bone hip just keeps creeping into your life and finally it owns you - you do nothing because it controls your life.  You will be amazed how well you will feel after surgery.  You can look forward to living again.

Don't wait too long or you could miss your window of opportunity for a resurf.  It depends on how bad your hip is. If you do a lot of gardening and craft shows, you need to get down on your knees and be able to lift and move.  Hip Resurfacing is the surgery that lets you do anything after you heal. You just don't have to worry about your activities at all.  You will have to be careful about lwhat THR they would give you.  Make sure you would at least get a MOM metal on metal or ceramic on ceramic that matches the size of the ball of your original femur bone.

Again, you are lucky to have a surgeon give you an option for hip resurfacing.  Normaly the experienced hip resurfacing surgeons will always give a person a resurf if possible. They understand how difficult revisions are.

I had my hip resurfacing at 61 and should have had one at 51, but I did not know about it.  Listen to your Mom- don't walk like an 80 year old woman - get a hip resurfacing and start living again.

Did you read the many personal hip stories on the website?  If you want to interact with 6000+ surface hippies, join the large Yahoo Surface Hippy Discussion Group http://health.groups.yahoo.com/group/surfacehippy/. You will read hundreds of emails about people just like yourself. This is a pretty small group since I just started it a few months ago.

I hope you will still visit and let us know how you are doing.  If and when you decide, I hope you will send me a story to post about your experience. That really helps others and helps you to remember all about your hip replacment. It quickly becomes a distant memory when life gets back to normal.

Let me know if I can give you any more info.

Pat in Ohio
3/15/06 LBHR De Smet

[hippy_bob]

I started having pain in my hip around age 45 and finally had the resurfacing done (three weeks ago today) at age 51. During those six years I quit playing soccer, but continued to referee at the youth and high school level, up until this spring. Since the spring, my activity level diminished considerably, mostly because of the pain (osteoarthritis). I finally made the decision to have the surgery. I've got my fingers crossed that I've made the right decision.

During that period - from the time the pain started to July of this year - I went through just about every possible "remedy" available, including: injections of SynVisc or cortisone, NSAIDS, PT, Vioxx, Bextra, Mobic, etc., etc. I hope I never have to take any of them again!

Bob

[Pat Walter]

Hi Bob

Welcome to Hip Talk.

I hope your recovery is quick and easy.  Who did your surgery?

I am sure you will feel you made the right decision in a few months when you start to be really active again.  It is great to be without pain and no needing all those meds.

Let us know how you are doing as time goes on.

Are you doing any PT yet? Are you still on crutches?

Pat in Ohio
3/15/06 LBHR De Smet

[Pat Walter]

Hi Bob

Sounds like your are doing very well.  Most people want a quick recovery like you are having.

I was very stiff after sitting around 6 weeks post op also.  I started doing some water walking and exercises in the pool. That cured my stiff muscles and I did not have that problem occur again.

If you find out how many hip resurfacings your doctor has had, I might want to post him on my list.  I always post their stats with their listings now.  So I need more information about him.

Thanks for letting us know how well you are doing.

Pat

[mr.hips]

This sounds familar to me I'm an old jock just turned 61 and have been injured many many times but the thought of hip surgery leaves me cold. i also have trouble sleeping and anti inflams do not do much. the hip pain in my groin increases with each step it seems then radiates down my thigh to my knee. ironically I'm playing the best golf of my life shooting in the 70 ies  i just can't run walk or jump lol.
My ortho doc does not want me to get resurfacing saying THr is proven and will last 20 yearsso I may only have one operation .
i went to the rothman institute   where I meet with a big league ortho doc Dr. hozack he said either one would be good he does ceramic on cross link total hips.
i had a surgery date scheduled but canciled it at my ortho docs suggestion that i try synvisc shots in my hip he says try to delay surgery and by time so i won't outlive my THR and need revision. Well i say NUTS i'm rescheduling my resurfacing and let the ions fall where they may LOL !! the ion issue does scare me however  because I will need both hips done and both knees.knees are holding up with help of synvics shots. So in the next 5 to 10 years I'm gonna cary lots of metal inside me!! Oh and I got two rotator cuff tears as well. Just years and years of baseball pitching,singles tennis, basketball, soccer,& football did I say I was a jock?

regards
Scott

[Liz]

Hi everyone

I really indentify with everyone who is carrying on despite the pain putting the surgery off. Nobody really wants surgery! I did this for 2 years, and finally had my resurface 3 months ago.

Everyone needs to make their own decision, but I can't believe how fantastic I feel now. I had no idea I was feeling so rough, tired, down and in pain. I thought how I felt was normal it had crept up on me. Now I am bouncing around with loads of enthusiasm for life, walking and sleeping with no pain and have more enegry than I remember for years. I continued to work though the years of pain, and am just about to return to work post op , in fact I visited this week to catch up with everyone. I can't tell you the number of people who told me I looked younger and amazingly well. I guess I didn't look too hot before!

I think of my surgeon as the man who gave me back my life and if I was ever in ythe position where I needed the other hip doing I would not wait a moment longer than I had to. The day post op my pain was nothing like as bad as it had been in the previous months. It was different pain and yes it was sore and it took a few weeks to be walking, but still better than before..

Hope my experience helps you to decide

Liz

[momzer2]

Run, just kidding, and have the BHR done.  Don't go ceramic.  Have the Birmingham done and NOW.  You may live another 30 years.  Only God nows your plan.  Having a THR now is silly, you won't be able to be as active--you did say you were a jock, right?  lol    I had pain for almost 2 years, had to give up running,hiking, skiing.....  The last straw was when I couldn't even jog without pain this past May.  I had had enough.  Just walking slowly caused pain.  I had my LBHR 9-18.  It's been one month and I can already see that I'm gonna be super in another month or two.  I'm only 48 and I'm not ready to 'sit on the bench' the rest of my life.  Having major surgery, especially ortho kind, was daunting to me as well (I'm an RN), but I'm so glad I did it.  For me it was a little extra scary cuz the doc in my area (which I HAD to use, cuz I couldn't go to Belgium) has only been doing this procedure for a year.  My x-ray looks perfect since my procedure.   I say don't hesitate, life is too short.!!

Karen

[Lisa]

I agree 100% with the last post! There shouldn't be any deciding, other than how many more minutes before you pick up the phone and schedule the BHR. I had pain for 10 years and wish I hadn't had to wait for so long to get this done. I had L-BHR with John Rogerson in Madison, WI on May 14. I am about 85% back to what I could do before. I had major atrpohy of muscles and the limpa was a challenge to rectify after so long. but this does not generally complicate rehab, because the body works to normalize itself.

I understand your fear, but the fear of having a diminished life for any longer should be greater! I hate to broach this subject, but it seems to me that men have greater fear of this procedure than women, and therefore take longer in the decision-making process, meanwhile life goes on with pain. I know a couple of other men in your position who are still limping around, not sleeping, not having a good quality of life, but still "deciding." I agree that no one really wants surgery, and we call have our concerns about the process. But I have never heard anyone say that they wished they'd waited longer! I hope you will find the strength to have this procedure - then you'll be posting like the rest of us and encouraging others to do so as well...

[Pat Walter]

Hi Scott

I was 61 when I had my hip resurfacing last year with Dr. De Smet in Belgium.  I waited 10 years because I did not want a THR and did not know about hip resurfacing. 

I could have received a free or almost free THR due to our financial situation.  We lost our health insurance and could not get any due to preexisting conditions.  But I did not want a THR.  I had 16 dogs and I need to get on the floor to brush and cut nails.  I did not want to worry about a dislocation or problems.  I went to 4 orths who all wanted to give me THRs.  3 of the orths were suggesting the old fashioned small ball plastic/metal.  CRAZY FOOLS - no one wants those unless they are 90 years old.  They told me I could not even mow my grass if the ground was uneven. 

I had a THR scheduled and found out about hip resurfacing. Boy did I cancel fast. I could not do anything but sit in a chair.  I could not walk from the Wal Mart parking lot into the store. I could not sleep at night even with the good pain meds.  My life was miserable and so was I.

I found enough money on our credit cards to go to Belgium and get my new BHR.  Immediately after surgery my hip pain was gone.  I was on one crutch at 4 days and none at 4 weeks.  I had a quick and easy recovery.  No swelling or bruising.  I was with 8 other De Smet hippies and we all had the same experience.

Get your self a good experienced hip resurfacing surgeon and get your hip resurfaced.  I expect my hip to last just as long as any THR.  I have a story about a lady who has had her BHR for 15 1/2 years on my Hip Stories.  The keys to having your hip remain sound are
1. use a really experienced doctor if you are older.  There is a steep learning curve to hip resurfacing and the technique they use in setting the hip and the amount of cement needs to be just right.
2. your own bones.  If you have a loss of bone density, you need to continue to walk.  Dr. De Smet and Dr. Bose both say your bone density will increase after your hip resurfacing if you walk, walk and walk.  There are studies that show weight bearing activities help increase bone density.

Please think about having your hip resurfacing.  You life slowly diminishes to nothing and you don't realize it.  You feel bad mentally and physically.  You don't even know how bad you feel because it happens slowly.  Wait until you get a new hip - you will be amazed how much more energy you feel and peopel will tell you how great you look.

The overseas doctors do a lot of older men.  De Smet has done men in the 70's because they have young wives and because they are very active.  Age is not the determing factor for hip resurfacing - you activity level and your bone density determines if you can have it done.

Keep in touch.

Pat