Confused

[frankx99x]

I saw a surgeon yesterday who has done 300+ revisions. I require surgery on both hips. He said that I am a candidate for resurfacing but is not sure if he could perform it on my right hip, the left hip looks good. He will make a final determination on the surgery table and either go with a BHR or THR depending on his analysis.


He said I should be prepared for either outcome when I wake from surgery.



Has anyone else faced the same situation? Is this common?

[DeviceGuy]

Frank,
You need to ask some questions in order to be better informed.  There may be issues with your right hip that cause concern, osteoporosis, cysts, necrosis, etc., but you need to get that explained to you.  If and when you get your surgeon's further reasons for his uncertainty on whether you'll get a THR or a HRA, GET ANOTHER OPINION OR TWO. There are many physicians referenced on this site.  Ask questions and then ask more questions.  Make an informed decision so you will hopefully have no regrets.
I find it very interesting and at the same time disturbing.
Good luck and let us know how this all plays out.

[frankx99x]

My only hip condition is Osteoarthritis. It seems that I need to see a resurfacing specialist to get another opinion.


Is the surgeon's inability to make a determination based on the X-ray a red flag?

[Mike D]

Hi Frank,
I faced the same situation almost  3 years ago.  My surgeon was Ronan  Treacey who has done thousands of resurfacing and THR's.
From my X - rays,  he told me I was 70/30 against being able to have resurfacing but he took the kit into theatre because if it was  possible when he "got in there", he would do it.
It turned out  that it  couldn't  be done and I received an Oxinium  X Poly THR.
It wasn't  just down to osteoarthritis,  the top of my femur was slightly  twisted due to childhood  surgery  when my hips were pinned due to a slipped femoral epiphysis.
I had no disappointment  though because I knew that if Ronan Treacey  could not resurface  my hip,it couldn't  be done.
If this is how it works out for you, don't  be too down about it- it's  an excellent alternative to resurfacing.
The only two drawbacks I see are the lack of bone conservation and being limited on heavy impact sports.
I think the main thing for most people  who have THR is accepting it. Get over that and you can get on with a pain free life for a long time.
Go to see someone with lots of experience  and give yourself the best chance possible  of getting the best outcome.
Cheers  Mike.

[Miguelito]

I hear what Mike D is saying, but a guy who's done 300 surgeries is not Ronan Treacy. As others have said, see one of the high volume surgeons and see what they say. Don't accept this surgeon's opinion as gospel. Personally I recommend Dr. Gross. I have been here long enough to have seen a number of people saying the same things you are, they consulted with Dr. Gross and it's HR.

And if he does determine you are a candidate for resurfacing, you will be waking up with HR. Don't quote me, but my recollection is that he used to mention that one time (maybe two) he had to a THR when he had planned an HR, and that might have been a while back. When I asked him that question, any chance I'll wake up with THR he just said no. Perhaps my situation was more run of the mill than yours, but I think he is comfortable doing HR on patients some others aren't. My recommendation is unreserved.

Mike

[frankx99x]

There is only 1 high volume surgeon who accepts my insurance in the NY Tri-State Region, Dr. Marwin. I left a voicemail with his office yesterday in order to setup an appointment and have not heard back yet. Does anyone know how backlogged he is and have any idea of how long the wait would be to see him?

[frankx99x]

Are there any other high volume resurface surgeons in my area that are not on the list?

[frankx99x]

I just setup an appointment with Dr. Marwin. Will let everyone know the outcome. Thanks for everyone's replies.

[Saf57]

Frank--I am scheduled for left hip resurfacing with Dr. Marwin on August 28th. My right was done more than 12 years ago with Dr. Gross. Both are fantastic surgeons. I saw Dr. Marwin just two weeks ago, and I believe his office is scheduling about two months out. With regard to the possibility of a thr, I don't know, obviously, what your xrays show, but I know Dr. Marwin has taken on many difficult cases, with successful outcomes. Good luck to you.

[frankx99x]

After doing some research and educating myself, I'm feeling good about Marwin. Thanks for the info about his availability. It's good to hear. Good luck on the 28th, I'll be following your progress.

[Woodstock Hippy]

Frank, I can't say enough good things about Dr Marwin.  And I know five other runners and triathletes who owe it to Dr Marwin's skills that they are back racing again.  Because of Dr Marwin's ''direct lateral technique'' we all had a much easier recovery than someone who had their glutes cut and re-attached. I'm at 3.5 years same day bilateral and I have to look a my scars to tell that I ever had the surgery.  His number is much higher than 300

Have you seen him at his office.  When I met him, he explained the surgery so well that I felt like I could perform it.  I remember him telling me that if it was necessary, I could end up with TLR's.  I'm pretty sure that I asked him how many times this happened and he said never but he had to tell me.  He's a great doc, and a good guy. 

Here's the link to my posts from my stay at Hospital for Joint Disease:

http://surfacehippy.info/hiptalk/index.php?topic=2982.60

[Saf57]

Dr. Marwin told me that he has now surpassed 3,000 resurfacings(as of two weeks ago). I did ask him about the number of instances he had to go to a thr, and he told me five. So, five out of three thousand plus procedures.

[frankx99x]

I've gone from despair to elation after discovering the procedure of hip resurfacing. The first surgeon I spoke to made no mention of it. He said that I needed THR and would never run again, that was a little over a year ago.

Seeing no real advantage for getting the procedure because I was already unable to run and the pain was bearable I put it off. Unfortunately the pain increased so I saw another surgeon who performs BHR but not in high volume. I have to thank him for enlightening me to the procedure. This led to researching an option that I did not even know existed.

I wonder how many people have received THR without ever knowing there were other options.

After discovering this site and reading the replies to my post, I am elated. I am actually looking forward to speaking to a surgeon and will likely be booking the surgery on the spot, to be done ASAP.

If only I had learned about it sooner I might have done it 4 or 5 years ago when I thought I was merely suffering from muscle soreness.

My appointment with Marwin is on the 5th. Can't wait!!

[surfhippy]

I hope it works out for you Frank. A lot of people travel for this procedure, due to finding a reputable surgeon. I used Dr. Gross, and can't praise him enough. Worth a check if you don't hear what you want.

[frankx99x]

Will keep that in mind. I have already sent him my X-rays. Hope to hear back from him soon.

[Saf57]

Frank-I had my right hip resurfaced in January 2003, during the original FDA clinical trial. I was 45, an athlete all of my life, and searching for an alternative to thr. I stumbled onto resurfacing doing my own research, and to make a long story short, flew to Columbia, sc(of all places!) to have the surgery performed by Dr. Gross. I think I was maybe his 200th case, and that was a lot at the time. I saw several of the top orthos in NYC at the time I was contemplating this, all of whom told me I was crazy. The traditional, entrenched orthopedic community has, to put it kindly, never embraced resurfacing, and never will. There are many, many thousands of people who should have had resurfacings, but were never even informed of the procedure as an option. So, you are fortunate that you took the initiative. Good luck to you on the 5th. Perhaps Marwin can squeeze you in on 8/28, and I'll see you at NYU.

[frankx99x]

I wish I could go in on the 28th, if I'm not there, good luck and keep us updated.


Does anyone know if a sufferer of Sleep Apnea could be a candidate for bilateral resurfacing? I would love to get this over with in one stay. That is my only health condition.

[frankx99x]

Saw Dr. Marwin yesterday. My first impression upon his entrance to the examining room was that he was a rockstar in his field. He was wearing a striped seersucker suit and bow tie. His look and demeanor exuded an abundance of confidence which I was delighted to see.


He is very personable and a straight shooter. He said that I am a candidate for bilateral resurfacing and would like to do them together but my sleep apnea condition could preclude that from happening. Since I have no other health concerns such as diabetes, heart condition, obesity, etc.. he would go forward doing both at the same time. My only hurdle will be getting clearance during pre-op assessments with the anesthesiologists.


Upon examination of my X-rays his assistant was amazed that I am getting by with my only therapy being 15MG of Mobic daily.


She said that that opening for surgery is in the 6-8 week time frame and I should be hearing from the office to schedule the surgery within 24 hours.


Now my dilemmas are being able to do both hips at the same time and breaking the news to my management that I will be missing time from work.


Does anyone know how temporary disability works in New Jersey and if I will be receiving official letters concerning how long I must be out of work to show management?

[Saf57]

Frank--glad that you're a go with Dr. Marwin. Yes, he is very confident, but most importantly, backs it up with surgical skill and results. I can't help with the new jersey issues, as I'm a New Yorker. Hope that you get it ironed out, and can proceed shortly. Good Luck.

[frankx99x]

Yes, definitely going with Marwin, scheduled the date today. They offered me to go on the 28th with you and I was tempted to accept but considering I'm on vacation this week I don't want to shock management at my company too much.


I'm going in on 9/22 and need to take care of the preliminaries. As far as disability goes I'm a NY'er in exile, originally from Brooklyn but I wouldn't know how to deal with disability in the city anyway. I'll figure it out.


It feels good being back in my old stomping grounds to get this procedure. I got good vibes.


Woodstock, he said that he can do the bilateral and I would be out  in around 3 or 4 days. I asked him about doing rehab for some time at the hospital but he said I would be alright. Do you remember how your conversation went in these regards? I'm considering pushing for some days in rehab.