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Author Topic: BHR (hopefully) scheduled for 29/01/11...  (Read 3318 times)

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AlanN

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BHR (hopefully) scheduled for 29/01/11...
« on: January 04, 2011, 06:08:57 PM »
Hi all,
As the title says my surgery is scheduled for the above date.

My surgeon (Mr Graham Keene, Cambridge, UK) and I have always been discussing a BHR, over the last year.
I really should have bitten the bullet and had surgery at least 8 months ago but I have had a lot on my plate (a new business among others) so have been putting it of for as long as I could hold out, using Diclofenac to help.

I am now in so much pain the Diclofenac hardly touches it and I can't remember the last time I slept for more than an hour at a time (even after lots of wine lol)!

Anyway long story short, at my last consultation we set a date and he sent me for more X-rays, lots of, many from angles I hadn't had before.

When I returned to the consulting room he completely threw me a curveball by saying that he now wasn't so sure I was an ideal candidate for BHR as my femoral head is very large.
This coupled with the fact that I am large (6'4") and pretty fit with a lot of muscle mass he said he may prefer to do a THR with a large ball head with ceramic components.

I was totally stunned to be honest however after a further 30 minutes of discussion we have agreed that the surgery will go ahead and he will have both sets of components available, making the descision when he has opened me up.
He has promised to err on the side of BHR (he's happy doing them and has done quite a few I gather) but says that at the end of the day he wants the best result for me and if he feels this will be the ceramic THR then he will carry this out.

Now I trust him and guess I have to be guided by him ultimately, just wondered what you guys here thought?

By the way I'm 52 and very active up until 12 months ago.

Also any tips on gtrm work to prepare for the op over the next 3-4 weeks?

Great site, has taught me loads and without it I probably would've had a THR conventional small head a year or so ago as that's what my first surgeon wanted to do.
Found this site, read, found another surgeon ;)
Alan
Motor Racing nut now with LHBHR ;)

FlbrkMike

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Re: BHR (hopefully) scheduled for 29/01/11...
« Reply #1 on: January 04, 2011, 07:18:03 PM »
I've been under the impression that a large femoral head is an advantage in BHR, due to having good bone mass and less likelihood of dislocation after the surgery.  Maybe that's only true up to a point? 
Dr. Ball
56 years old
LBHR 2/11/11
RBHR 3/11/11

bothdone

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Re: BHR (hopefully) scheduled for 29/01/11...
« Reply #2 on: January 05, 2011, 04:57:51 AM »
Hi Alan

When I went for my first BHR in 2004 my surgeon said that he couldn't be certain about a BHR as my hip was so badly worn.    Like yours, he said he'd make the decision when he got in there.  You can guess what my first question was when I came to.... it was a BHR.

The second thing I wanted to find out was whether my legs were still the same length.  They were. (after both BHRs).

To quote your phrase, you've "bitten the bullet".   I really wish you all the best for your op and recovery.

I've no idea what "gtrm work" is so can't offer anything.  In terms of preparation, just have a good think about what you are going to need at home afterwards.  ( a raised loo seat would be good  ;D) and who is going to help you with your ted socks.

Best wishes

Ed

LBHR 25 May 2004
RBHR 19 March 2008

AlanN

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Re: BHR (hopefully) scheduled for 29/01/11...
« Reply #3 on: January 05, 2011, 05:40:04 AM »
Hi Mike/Ed,
Thanks for the replies.

Firstly, sorry for the typo, should read "gym work"  ;D

Mike, the issues with the large femoral head are apparently 1) the amount of bone potentially to be removed from pelvic area 2) as he will have to remove more than "normal" amount of bone from femoral head an increased risk of creating a "fracture line".

Thanks again.
Alan
Motor Racing nut now with LHBHR ;)

andybc

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  • Right BHR November 25 2010 Sarah Muirhead-Allwood
Re: BHR (hopefully) scheduled for 29/01/11...
« Reply #4 on: January 05, 2011, 08:28:23 AM »
Hi Alan,
No reason to suppose your surgeon is anything other than excellent, but why not get another opinion from one of the guys who you can email your xrays to as a jpeg.
It's always interested me that when patients go for a second opinion about a medical problem, they nearly always take the 2nd opinion as the correct one - seems to me the logical thing is to go for a third opinion if the first two are at variance.
I know this isn't quite the scenario in your case but it does seem that resurfacing is relatively difficult compared to thr and, just possibly, someone who has done thousands might view your case as relatively straightforward.
In terms of gym work - really working on your quads and glutes would be very good. I didn't do this enough and have a lot of muscle wasting. It'll bulk up eventually but I fancy my recovery might be a bit quicker if I had stronger quads.
You might like to take a look at a thread I started under post op issues - things I didn't expect in the post op period. Don't let it put you off, though! I'm just over 5 weeks post resurfacing and back at work; although it's still quite painful at times.
The best of luck whichever route you go down.
Andy

einreb

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Re: BHR (hopefully) scheduled for 29/01/11...
« Reply #5 on: January 05, 2011, 07:44:58 PM »
For what its worth... I canceled surgery with Dr Rogerson (Madison, Wisconsin resurfacing surgeon  in the US) because I found out from his assistant that he noted in my records that he thought I had a 20% chance of getting a THR once he opened me up.  I have no clue why he didn't tell me this to my face when we met.  :-\

I then scheduled with Dr Gross for this February after he assured me that I should end up with a resurface.  I had Perthes disease as a child and now have s squished/over-sized femoral head.  Turns out after 600+ resurfacings that Rogerson had never done a perthes hip.  Gross has done 60 or 70 perthes hips out of his 2000 plus.  Dr Bose was also very confident and had good Perthes hip experience.

Its a tough call, but I think one of the reasons for an 'oddball' like me to go to a surgeon with tons of experience is that they have seen other oddballs.

-b
40yo at the time of my 2/16/2011 left hip uncemented Biomet resurface with Tri Spike Acetabular cup by Gross

Mi Corazon

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Re: BHR (hopefully) scheduled for 29/01/11...
« Reply #6 on: January 06, 2011, 09:18:33 PM »
Not sure what the circumstances were around Dr. Rogerson, but, one would hope that a surgeon always allow the facts, as they appear in real time, to be the ultimate arbiter of events, rather than a pre-conceived notion of what would be best.

I mean, that's why you trust your doctor, right?  They should, after all, have your best interests in mind.

AlanN

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Re: BHR (hopefully) scheduled for 29/01/11...
« Reply #7 on: January 08, 2011, 10:34:16 PM »
Thanks again all.
Have emailed my xrays to Mr. McMinn who is going to give me his opinion.

Will let you all know the outcome.

Andy...read your thread with great interest and not the odd chuckle too :)
Good luck with your continued recovery and I'll let you and everyone else know how mine goes.
Alan
Motor Racing nut now with LHBHR ;)

AlanN

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Re: BHR (hopefully) scheduled for 29/01/11...
« Reply #8 on: January 09, 2011, 06:52:34 PM »
Quick update...have received today a copy of a letter Mr. Keene sent to my GP.

It appears that his concerns revolve around the possible size of the ace tabular component due to the size of the femoral head.
Makes a bit more sense now.
Alan
Motor Racing nut now with LHBHR ;)

AlanN

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Re: BHR (hopefully) scheduled for 29/01/11...
« Reply #9 on: January 15, 2011, 10:55:21 AM »
Update:

Received a response from Mr. McMinn and he almost to the word agrees with Mr Keen's comments.

Now a very happy and confident bunny and can' wait to get sorted one way or the other ;)
Alan
Motor Racing nut now with LHBHR ;)

andybc

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  • Right BHR November 25 2010 Sarah Muirhead-Allwood
Re: BHR (hopefully) scheduled for 29/01/11...
« Reply #10 on: January 17, 2011, 06:25:09 PM »
Sounds like Graham Keene is the real deal; Mr McMinn is the undisputed master, so if he agrees I think you can justifiably have total confidence.
Best of luck and a speedy recovery.
Andy

 

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