Question about statement by our illustrious Administrator

[avid]

Hello,

This is my first post here at Hip Talk. I am a 55 year old guy whose hip finally balked last week. I have managed to keep going for the last five years while I waited for improvements in the state of the art. The waiting is over and not by my choice. I am slowly reading all the information here and am grateful for its availability. I live in Oregon and that gives me the choice of several good surgeons. I am still considering going to South Carolina, Los Angeles or possibly Belgium for the best.

In my ramblings through the message board I found this quote by Patricia.

"But patients seem to recover much faster with the overseas doctors since they have much fewer restrictions than the US doctors."

The quote is in this thread:
http://surfacehippy.info/hiptalk/index.php?topic=9.msg16#msg16

I would like to know about these restrictions. I have seen the references to very fast recovery by Dr. Bose patients. What are overseas doctors permitted to do, that are not permitted in the US?

Thanks!

David

[Pat Walter]

Hi

I can't tell you specifically what each new resurfacing doctor does unless you ask them.  I belong to the large Yahoo Surface Hippy Discussion Group of over 6000+ members.  Have belonged for several years.  I can only tell you what I read from people using the newer doctors that have just learned the BHR surgery.  They are very inexperienced and don't want to take any chances of having problems. There have been problems in the last few years.  I have just read about 2 slipped cups, 2 dislocations and a couple revisions.  There is  a steep learning curve for hip resurfacing surgery.  The studies show the doctors need 50 - 100 surgeries to become exprienced.  I actually think it is much more.

I went to Belgium with DR. De Smet and I was on one crutch at 4 days and no crutch at 4 weeks.  I was walking 3/4 mile a day when I got home from Belgium on day 11.  Then I was walking over a mile a day after that.  I had no bruising or swelling. The other 8 people that I met there did not have that either except for one lady that walked too much on day 5 when we went sight seeing.

Dr. Bose's patients also have quick and easy recoveries usually.  The over seas doctors have done hundreds and thousands of hip resurfacings and know what to expect.  The us doctors are new at it and are very conservative.  They don't want problems and don't want to be sued. So many have restrictions on weight bearing and staying on crutches longer.

Dr. Gross in SC is one of the best in the US and his patients recoveries are usually fairly quick.  BUT - your recovery does depend somewhat on your own body.  If the surgeon does a great job - then it is up to your body.  If the surgeon takes a long time to do the surgery and pushes and cuts stuff that should not be touched - then your have brusiing and swelling and problems.  That's the reason for using Experienced surgeons.  Hip resurfacing is a much more technical surgery than a THR. There isn't as much instrumentation to help with the surgery.  Now you need a doctor that is almost an artist as well as a surgeon.  All the angles have to be just right or there are problems.  I just posted an article about how navigation tools help new surgeons doing hip resurfacing. http://www.hipresurfacingnews.com/archives/128-Navigation-Reduces-the-Learning-Curve-in-Resurfacing-Total-Hip-Arthroplasty.html  REading that will help you understand that hip resrufacing is not an easy surgery.

I don't know much about Dr. Boyd, but he has done 550 hip resurfacings.  You might want to talk with him too.
Harold S. Boyd, M.D.
550 Hip Resurfacings to date
1280 Center Street N. E.
Salem, OR  97301
(503) 581-4402 Phone
(503) 581-8817 Fax

You might want to check my list  http://www.surfacehippy.info/listofdoctors.php to see who might also be somewhat closer to you and experienced.

I was 61 when I had my hip resurfacing.  My reasonings was that I wanted one of the best surgeons (De Smet having done over 2700 hip resurfacings)  because if something went wrong, I would never have to keep telling myself - if only I had choosen one of the better surgeons.  I had a loss of bone density and did not want to take a chance.  Many of the newer BHR surgeons won't do older women.

Let me know if I can send any more info your way.

Pat in Ohio
3/15/06 LBHR De Smet

[avid]

Pat,

Thank you so very much for your detailed reply. I understand your sentiment about using the best, so there is no regret. I certainly feel that way as well. In addition to Dr. Boyd there is also Dr. Ure very close by as well. Someone who has posted here had their hip resurfaced by Dr. Ure on Monday. His wife emailed me back and said the surgery went well. I am hoping to hear how his recovery goes. I have been thinking about how many times it took me to feel proficient when learning a new complicated manual task. I would suppose there is another end of the learning curve were one could become complacent.

I have read a couple of reports of Dr. Gross's patients walking without the aid of even a cane the next day. I have seen the article here in which Dr. Bose says when the surgery is over a resurfacing should be solid, if done correctly.

There was an research project done by Harvard Medical School and commission by NIH on minimally invasive THRs. Their conclusion was that it took a minimum of 80 surgeries to become proficient. The bottom line was that patients shouldn't want to be part of the learning curve.

The only drawback to going out-of-state or the country is the complications that involves. Having had three surgeries in my life I still find them very frightening. Not being close to home or especially in a different culture sounds over-the-top. But I know that if that is what I decide is the best option; I will be boarding a plane bound for where ever.

Thanks for your expert advice.

David

[Pat Walter]

Hi

Dr. De Smet also says you should be 100% weight bearing right after surgery.  If you can't be, the surgery was not done properly.  Of course, you really can't put all your weight on your leg that quickly, but it doesn't take long.

I am glad you understand the learning curve.  Many new people don't get it.  I know someone has to be first, but if you have another choice, it is prudent to not be first, 10th or even 100th.

Dr. Ure is very well thought of on the large Yahoo Surface Hippy Group. There are are many of his patients that have posted there.  Martha is one of the most recent patients  http://www.surfacehippy.info/marthakennedy.php

You might want to join the large group to get some more input from other surface hippies.  http://health.groups.yahoo.com/group/surfacehippy/

Many of us have traveled to India and Belgium.  I will tell you there has never been one person regreting their decision and all of us vow we would go back for our other hip if need be.  In Belgium, the common language is English. So you don't have any problem talking with people.  In India, they have plenty of people at the hospital and resort that speak English too.  In India, they assign you your own private aid/nurse to be in your room at all times.

I loved the Belgium experience.  I have never traveled outside the US before and would go back in a minute.  I would stay much longer the next time if I had the money.

Keep in Touch.

Pat