Going in for Hip-resurfacing waking up with Hip-Replacement?

[ZAP]

Hi everyone,

I'm going into surgery on Monday morning, and something keeps coming up when I meet with nurses and therapist.   They keep saying "I'm going in for either hip resurfacing OR hip replacement"  Its bothering me, because it keeps coming up and the last nurse I spoke to said some times the doctor sees some when they open you up which they didn't see in the xrays or MRI s.    Is this true?    I really don't think I'm ready for a full hip replacement. I'm only 39.  The hospital said I signed off for it. 

Any ideas? 

[hipnhop]

I had a friend who was an active Marathoner. He was scheduled for Hr but the SUrgeon said he could not properly place the device and he had to have THR. It happens. You just want to make sure you have an experienced and skilled surgeon. However, this happened with one of the most skilled HR surgeons in the East coast. It depends on what the Surgeon sees when they go in. There are many factors that come into play.

I would make sure to have ac onversation with your Surgeon about the alternative THR device. You want something that will give you more range of motion and provide for a more active lifestyle.  In the case of my colleague, the suregoen said he will still be able to run on his THR. Good Luck dude.

[ZAP]

I had a friend who was an active Marathoner. He was scheduled for Hr but the SUrgeon said he could not properly place the device and he had to have THR. It happens. You just want to make sure you have an experienced and skilled surgeon. However, this happened with one of the most skilled HR surgeons in the East coast. It depends on what the Surgeon sees when they go in. There are many factors that come into play.

I would make sure to have ac onversation with your Surgeon about the alternative THR device. You want something that will give you more range of motion and provide for a more active lifestyle.  In the case of my colleague, the suregoen said he will still be able to run on his THR. Good Luck dude.

OMG!!!         With all the research I've done I can't believe I missed this.  I only have a day or 2 to think about it. 

[jakemn]

I'm not a surgeon, but the way it was explained to me is if there are any significant bone cysts in the femoral neck that were missed on x-ray, it could be possible.  Did you have a CT scan?  This is usually a mitigating factor that can give you and your surgeon more confidence.   Worse case, you need to really know from your surgeon what the THR device would be.. quite possibly large-ball MOM THR, which would be similar performance characteristics as HR.. sounds like you need a phone call with your surgeon to alleviate any fears, my friend!    Force the issue and get some answers before you go in!

Let us know what's up!

Jake in MN

[John C]

I think that for your piece of mind, the key question to ask the surgeon is how often this has happened with him. With the surgeons that are most experienced and committed to resurfacing, the number of times this happens is extremely rare, almost never. For other surgeons, it might happen more often. If you are worried about the possibility, this might be a key question to ask. There should not be any problem in quoting you exact numbers.
I do not think any surgeon can give you a 100% guarantee, but a review of their history should give you a good insight into the risk.

[Luanna]

That's interesting. I asked my surgeon, Dr. Pritchett before surgery if he wanted to reserve the right to change to a THR if he got in there and couldn't do a hip resurfacing. He smiled and said "no - I'm going to do what I tell you I'm going to do".  He'd been seeing me for 3 years so he had a lot of info about my hip.

On the other hand, he told a woman who is flying up here this coming weekend for an HR that she may end up with either an HR or a THR depending on what he finds during surgery. Same doctor two different responses to two different patients.

If I were you, I'd want to get as much information as possible so that you go into surgery feeling confident with whatever happens.   

Luanna

[mslendzion]

My surgeon also advised there is a chance, if something is amiss, a THR would be performed instead of the BHR. They can't leave you with nothing.

[WTW15]

My surgeon also advised there is a chance, if something is amiss, a THR would be performed instead of the BHR. They can't leave you with nothing.

Touche'  Ms! 

I was told the same thing - Strive for BHR but could be THR.  When I woke up and the surgeon visited the first thing she said was "You got the BHR"  I started crying - just couldn't help it.  So relieved, but would have been disappointed but glad to be rid of the O/A even if I'd gotten a THR. 

[FlbrkMike]

It may depend partly on how carefully your surgeon chooses his patients.

Going in my surgeon, who has performed many hundreds and probably more than a thousand HRs, admitted that there was a possibility that I could come out with a THR.  He then qualified that by saying that he had never had to switch. 

[ZAP]

I'm not a surgeon, but the way it was explained to me is if there are any significant bone cysts in the femoral neck that were missed on x-ray, it could be possible.  Did you have a CT scan?  This is usually a mitigating factor that can give you and your surgeon more confidence.   Worse case, you need to really know from your surgeon what the THR device would be.. quite possibly large-ball MOM THR, which would be similar performance characteristics as HR.. sounds like you need a phone call with your surgeon to alleviate any fears, my friend!    Force the issue and get some answers before you go in!

Let us know what's up!

Jake in MN

Yes I had the CT scan and bone scan. I did every scan possible.  Everything was good. Hopefully I can get some answers tomorrow.  For some reason I feel they shouldn't even tell us before surgery.  Tell us after. Something went wrong and this is what they needed to do.   Its like taking my car into the garage to replace a fuel pump and the mechanic tells you " I  have to remove the gas tank, if it explodes, you have to get a new car.  Sign here"   In your mind, you're thinking, It will never blow up, but then later on, nurses are saying "oh , you're getting a new fuel pump or a new car"  :)

[mslendzion]

Zap. I agree. In my case it was one of the many questions I had at my last pre op office visit. I was able to generate a pretty good set of questions from the info on this site. Collected and stored them on my notes iPhone app. 

[johnd_emd]

I had a fellow cyclist who went in for a BHR and came out with a THR.  All because the surgeon wasn't that skilled or experienced.  That's why it's so, so important to get a surgeon who is very skilled at this and has done a number of procedures.  Everytime they go in they will see something different.  But, an unskilled, lesser experience surgeon may not know how to handle that one case of "something being different", or "something they've not ever experience" before.  All surgeons will have you sign a release saying there could be a possibility of getting a THR when they go in for a resurfacing.  But, if you ask the good ones how many times has this happened the occurance rate is either none existant, or so small it's almost not even worth mentioning. 

[Nemesis]

I had a fellow cyclist who went in for a BHR and came out with a THR.  All because the surgeon wasn't that skilled or experienced.  That's why it's so, so important to get a surgeon who is very skilled at this and has done a number of procedures.  Everytime they go in they will see something different.  But, an unskilled, lesser experience surgeon may not know how to handle that one case of "something being different", or "something they've not ever experience" before.  All surgeons will have you sign a release saying there could be a possibility of getting a THR when they go in for a resurfacing.  But, if you ask the good ones how many times has this happened the occurance rate is either none existant, or so small it's almost not even worth mentioning.

This ^^^ sums it all up.  Dr. Su told me I have a duty to advice you and then said with a smile, "I know what I am doing."

[Neild5]

On both of my resurfacing's I got the same warning.  On the left one the doc told me it was in way worse shape than indicated on the x-rays, but during the surgery he never considered changing course.

[Woodstock Hippy]

Ask your doctor if he has ever had this happen.  I asked Dr Marwin and he said that he has never had to to a THR when he went in for a HR.  I got jsut what I asked for; two nice shiney BHR's, and right now I'm feeling great.

[imgetinold]

Like everyone said, it depends on the experience of the surgeon.

At my pre-op appt., I asked Dr. Gross what device he'd use if they had to go to a THR, and the response was "We're not.  You'll have a resurfacing.  I was very lucky to have that kind of confidence going in. 

So, yes, ask the surgeon what his statistics are.

[triathlete98]

Oh geez didn't even think of this.  However I am borderline to get in implanted.  If i wake up with a total hip my Dr. better run!   :o
but i will have the "talk" with him.

[SeanD]

I have a similar concern. I'm having a BMHR done, but given that it is almost like the 'last chance saloon' alternative to a THR, I worry that I'll end up with a THR.

[hernanu]

I think the best thing to do is to talk to the surgeon, ask straight questions, demand straight answers. That way everything is on the table and the doctor doesn't have to run for his / her life (eventually, it takes us a bit to catch up with that walker).

[ZAP]

Well it looks like my doctors office is closed on Fridays and my surgery time is Monday morning.  This forum has calmed my nerves  a little. It seems like this is standard for the surgeon to  have the patient sign off for THR.  I WILL NOT LET THEM PUT ME UNDER UNTIL I TALK TO MY SURGEON ON MONDAY MORNING.  :)