It's good to rant, this is the place to do it. I think if you look back at all of our posts, you'll find rants by everyone here.
I think you are doing the right thing by doing as much research as possible. This is major surgery and you want to do the right thing for you. All of us have put off treatment for as long as it took to reach a solid decision.
I know I tried everything possible and did research until it was clear that I could not go on without resolution. So this process is good, and we will back your research and decision in whatever way possible.
Like with any other treatment of disease, nothing is guaranteed. There were, are and will continue to be those of us whose treatment does not work out, and need revision of some sort. You'll also find their stories here.
Thankfully, if it does not work out, even with those of us who get metallosis, there is a good alternative in a revision to a THR. It is yet another surgery, but all of us have to contemplate the possibility. I'm glad that there is that if I need it, since it offers a continued way to be painless and functional. I'd rather not, but unlike with other diseases, it is a very good option.
The landscape of advice out there is confusing. I went to three separate doctors, all talking against HR, telling me to have two total hip replacements because of the different issues that were and are being talked about.
I looked at the results and the possibilities. To me, the most reliable results come from long study and many patients monitored over years. Unluckily, that does not exist in the US, because we have not kept a patient registry with statistics of successful outcome versus having to be redone.
Thankfully, there are other countries that have amassed those statistics, with (to me) Australia being the leader in these kinds of statistics. They did a massive study over ten years for both total hip replacements (THR) and hip resurfacing (HR) to see how successful they were, with the measure of success being not having to be redone surgically.
The success rate for hip resurfacing was 91.5 percent over 11 years. This is for all devices (including the recalled ones) and all surgeons (including the less experienced ones). That includes all patients, those who are more and less suited. The most successful device, the BHR had a 93 percent success rate over 11 years.
The charts over time show that the failures go down as time goes on, so the hope is, based on this data that the devices remain in good shape.
Total hip replacement had similar results. To me, that is a great success rate and bodes well for the type of treatment.
That still leaves 9.5 percent of us who do not succeed over that time, needing a revision to a THR at some point. It sucks. It is very sad when some need to go through it again, but the hope and the expectation is that the revised hip will give them long and good function for that much longer.
In the Australian results, the largest percentage of those who did not succeed wasn't because of metallosis. More than half failed because the cup on the hip side or the femur device came loose.
Of the 9.5 percent, only 16.6 percent failed because of metallosis.
So overall, according to the statistics there (and it may be slightly off, since I'm doing this from memory), 16.6 percent of the 9.5 percent failures were caused by metallosis. So if I've got the math right, one and a half percent of all hip resurfacings end in metallosis. I believe this is the same with THRs.
That is for all surgeons and all devices. There are two resurfacing devices that were recalled, because their failure rates were much higher than others. Their failure rates were about 10 - 18 percent. This was high enough to cause action, but to me it still meant a high success rate. Just not as high as the others.
I think it's a good, strong thing to do as much research as is possible, and I value hard evidence being an engineer and at one time a biochemist. Take a look at the Australian registry results, and use that to give some structure to all of the opinions that you're hearing. It helps to have their solidity, I know it did me.
Here is the summary of the latest Australian registry results, as put together by Pat:
http://www.surfacehippy.info/2012-aoanjr-hip-resurfacing-information.phpHere is the entire report, so you can see the raw data. I think it's important to read this, as helpful as the summary is, so you can feel confident that you've seen the actual results. It also breaks things down by age, gender, body size, devices and many other things. It is worthwhile, and will support your questions.
http://www.surfacehippy.info/pdf/australian-nat-reg-2011.pdfIf I were you (and I was) I also would want to be as knowledgeable and sure in what I'm doing. The one thing I can tell you, having traveled this path: if you have osteoarthritis, living with it is a temporary option only. It will not improve and it does get worse. Sometimes slowly and sometimes more quickly.
You will need treatment and the options are HR or THR. HR is an option but waiting too long can take you past the time when it can be applied.
So there is no guarantee. But the odds are good. Again it is major surgery and you shouldn't rush into this. I just wanted to make sure you have good information to help with it.
Good luck.
Topic: Biomet VS BHR (Read 12132 times)
Recent Posts
