HR, THR, PAO help a brother out!!

[slade]

Hey everyone- great site and forum!! So glad I ran across it!

Quick background-
Almost 39- male, General Building Contractor. Used to be an incredible athlete- surfing, swimming, soccer, football, water polo- anything and everything. 5'11 200 lbs.

Started getting groin pain about 5 years ago- thought it was an old injury (dislocated my hip surfing years ago). Now both hips hurt- not constant- impingement. Certain movements result in stabbing/ tearing pain. Good times. My back is also in constant pain- my MRI there looks decent, nothing major.

So I have seen 4 OS- essentially I have hip dysplasia. All have agreed that I should have a PAO. I have researched it a lot. Not sold.

I started researching THR- not totally sold, but sounded better than a PAO. All the surgeons are talking me out of THR because of my age and profession- telling me that if I don't have a PAO in the next six months I should just tough it out for as long as possible and then consider THR- told me I would probably only get ten years out of a THR, be back in late 40s, harder to revise etc. Damn...

Months back I remember reading about HR but scared off by the metal ion stuff. I now find myself thinking about it again and feeling encouraged about it. Couple of specific questions-

1- Am I a good candidate? I don't think my dysplasia is extreme, but I'm not sure.
2- I'm in Northern California (Santa Cruz). I'm honestly willing to travel to SOuth Carolina if need be to see someone fantastic, insurance depending. Anyone have suggestions to the best OS in the Bay Area or California for that matter??
3- Anyone else have a similar story to mine that opted out of PAO and went with HR?

I'm just diving into the site but can say I'm really glad I stumbled in here. Wealth of info-

Thanks in advance, and I hope you're all doing well and living relatively pain free!!

Slade

[hernanu]

Hey Slade, good to have you here. Most of us have had or are having an HR. I have had two done. Some of us had dysplasia, and some either contemplated or had PAO, so you are at a good place for information.

There are several good surgeons in your (general) area who are very good options; Dr. Gross in South Carolina is definitely a good choice, but Pritchett in Seattle, Rector in Boulder have very good reputations.

Look at the surgeons listed here,

http://www.surfacehippy.info/listofdoctors.php

this lets you know surgeons and their statistics - the more they have done, the better the result is what we've found here. The turning point seems to be above 200 procedures and the number of successful HRs go up significantly. If you can afford it, or your insurance covers it, go for the best.

As a personal note, I was also talked at by the surgeons I initially went to about not doing HR and going with THR over the metal ions issue. They described the limitations and possibilities of revision with the THR.

I decided to take my chances to go for as fully a functional result as possible. The more I found out about it, the more I realized the metallosis issue, while bad for those of us who get it, was not significant enough to dissuade me, given the benefits possible, and that I found to be true over the last two years. This was a personal choice, but I would do it again in a flash in the same situation.

[Tin Soldier]

Slade - welcome.

You might PM Vicky Marlow from the other site or do a search for her.  She's in SF and puts together an annual hippy gathering in Oakland in Feb around the time of the AAOS Conference.  Each year she invites one of the well-known surgeons to attend the gathering and to do some ad-hoc appointments of sorts with folks interested in HR.  Last year she had McMinn go, I was almost tempted to drive down from Eugene just to meet the guy and maybe get an autograph.     This year, I believe she is having Dr. Su from NY come.  It would be cool to see him too.  Anyway, enough about all this glossy-eyed idolizing of surgeons.  Wierd.  Anyway, I thought there was a fairly experienced surgeon in the SF area, but don't recall.  You can also check on Schmalzried in the LA area, or his mentor Amstutz (not sure if he's still practicing, but I thought he was in LA.

Good Luck

[Dan L]

Welcome Slade

Not certain about the dysplasia aspect, but you being, young, active, athletic are all the attributes of a typical HR patient for which HR can offer help, without the restrictions that THR patients often face.  Many here who are athletes get back to doing everything they love. 

In my case 15 months and 11 months out, I am very happy with the results and will have no restrictions at all in about 30 days.  The results for me are like magic, hard to describe how much better I am, also seems to have helped with lower back stiffness and pain.  Like the hippys above mentioned a very experienced doc is the key to a great outcome, I was fortunate to have one of them in my city, Dr Brooks, who explained the process in great detail before I decided to do it, and showed me the devices used for BHR, THR and a revised THR (bigger spike) which made the choice easy for me.

Good luck as you consider all the options.

Dan

[Spanielsal]

Hi Slade, try the Adult Hip Dysplasia page, a guy called Julian has just had a PAO, he might be good to bounce ideas off.

I had dysplasia diagnosed at 26, felt as you do about PAO, had a resurfacing at 31 after a lot of difficult painful time, then a thr at 40.  With hindsight I wish I had considered PAO more. It could have corrected my misshapen joint and I might have had a sporting chance of never needing a thr. If they are offering you a PAO thn chances are your arthritis isn't too far along. It is a bitch of an operation but, it might save you many more. I'm now on a treadmill that I won't ever get off. The hip joints need to last (actually it s more that your body keeps hold of them, loosening is my worry).  You will find the right solution for you but speak to those at the top of their game, good resurfacing surgeons will be suggested here, and try to find a PAO SPECiALIST you do not want a botch job there. Not all hip surgeons can do all procedures or all implants.  That is something that it took me time to learn.  Good luck and ask lots of questions. Whichever surgery is right for you you will find out, but you want to be secure in your choice in those last few seconds before you are unconscious on the operation table. Panic at that stage is not good! 

Hope you figure it out!

Best wishes

Sal

[Dannywayoflife]

The key for you is to see the BEST surgeons you can. See the best PAO surgeon you can find and then see the best HR surgeon you can and decide what you feel is best for you