HELP

[msburesh]

Hello everyone!

I am new to the forum but previously have found great help from the femoro-acetabular impingement forum through yahoo over the past year or so and now it has been recommended to me that I join here.

I am 36 years old with major hip problems right now.  Without boring you too much I'd like to give you some history.  I was a college wrestler and suffered an injury to my left hip (which have slight CHD from birth) and labrum.   I had a chiari osteotomy at Mayo Clinic in 1990 that was a complete failure do to the surgery performing the osteotomy far too high above the hip socket.   Five years later Dr. Jeff Mast magically performed a Peri Acetabular Osteotomy (PAO) with great success.  I had 11 great years of normal activity without any pain or restrictions.   

I noticed more pain with activity and decided to get things checked out.  The long and short of it is that I was told I needed FAI with open dislocation to eliminate the impingement and to repair the torn labrum.  This would then allow the hip to articulate properly and hopefully get me to my last 40's before need a THR.   Unfortunately, for the second time I receive another surgical error.  In Jan of 2007 the new surgeon removed far too much of the anterior aspect of the hip socket causing complete instability in the hip.

In the hospital post op the pain was only a 2 or 3.  Now it is about an 8 and the hip is so weak that I cannot even walk without severe gait issues.   It is not going to improve as the surgeon did admit the error and stated that I now need to see Dr. Matta in LA for an anterior total hip replacement as my only option.  At 36 I am not ready to concede this so I am turning to surfacehippy for help and advice.   Even though this surgeon is not on board with hip resurfacing I feel like I really would like to try it if I am a candidate.

My OA is bad now but really only in the joint.  The femoral head is still pretty healthy.  I am forwarding on all the data/rads/etc to Dr. Gross in SCarolina to see if in fact I am a candidate.

Any advice?  Is there someone else I should be seeing as a potential surgeon?  I live in Michigan but just want someone who is deemed to be top notch because my confidence in a surgeon is very rattled now since 2 of the 3 TOP NOTCH surgeons I have had prior produced terrible results.

Any input will be appreciated!
Matt   

[Vicky]

Dr Gross is one of the best. 
Dr. Gross is definitely one of the top resurfacing surgeons in the world IMO.  Also Dr. DeSmet in Belgium and Dr. Bose in India are top.  Here is their info, they offer free email consults.

Dr. Koen De Smet
ANCA-Clinic
Kalverbosstraat 31A
9070 Heusden
BELGIUM
Phone: +(1)32 9 2525903
Fax: +(1)32 9 2526457
+1 for USA & Canada:
E-mail: helpdesk@heup.be
ANCA Clinic Website

Dr. Vijay C. Bose
BHR Regional centre - India
Apollo Speciality Hospital, 320, Mount Road, Chennai - 600035. INDIA
E-Mail: bose5vijay@hotmail.com
Telephone: 0091-44-(0) 98400 - 32251
Hip Resurfacing India Website

Good luck,

Vicky

[Pat Walter]

Hi Matt

Welcome to the Hip Talk Discussion Group.  I am the webmaster and owner of the Surface Hippy Website and this discussion group.  The Yahoo Surface Hippy Group Vicky suggested you join is a great group of over 6000+ members and you will get over 100 emails a day. It is a great source of information and support. Much of the information on my website is from that group. I just try to categorize it better so you can find it more eaisly on my website.

I just wanted to tell you we understand the difficult position you are now in and the pain you are experiencing.  I had hip pain for 10 years and finally ended up that my only real activity was sitting in a chair and that even caused pain as well as just sleeping at night.  I did not have any unusual problems other than bone on bone osteoarthritis.  I was also 61 years old.

I am a true believer in hip resurfacing, especially for people that are young and active.  I guess I felt I was in that category too, even at 61.  I also know from the great deal of reading I have done and the information and studies I have on my website that experience is the most important thing to think about in choosing a surgeon.  My doctor, Dr. De Smet who has done over 2400 hip resurfacings, has explained to me that a person should not use a doctor with less than 100 hip resurfacings.  Hip resurfacing is almost as much an art as a learned skill.  The angle and placement of both the femur cap and acetabular cup are very, very important in having a long lasting hip resurfacing. The instrumentation for hip resurfacing is new and unlike innstrumentation for THR it does not help the doctor place everything as easily.

So you need a very experienced surgeon for hips with problems.  Vicky has given you very a good suggestion that you contact both Dr. De Smet and Dr. Bose to get their input. Both will give you a free email consultation if you send them your x-rays in a digital format or .jpg attached to the email.

Dr. Gross is also an excellent surgeon in the US.  One thing that you might not know is that sometimes, even the very great and experienced doctors will say that they don't think a hip resurfacing is correct for your situation.  In that case, it is always wise to try to talk to the other doctors.  There have been times when Dr. De Smet and Dr. Bose said no, and Dr. Gross has said yes to a hip resurfacing.  Also times when Gross said no and Bose or De Smet said yes.

The point is to try all the experienced surgeons before you have to accept a THR if you want a hip resurfacing.  Again, hip resurfacing is almost as much an art as a skill and each of the very experienced surgeons sometimes see every problem hip a little differently.

You are very young and really should try to get a hip resurfacing to save your femur bone in case you need surgery later in life.  THR revisions are tricky and if you start with a hip resurfacing - you keep your femur bone.  Then if you need a revision to a thr later in life, you have the whole femur bone left for them to saw off to give you a THR.

Dr. De Smet and Bose often answer your email by the next day.  Dr. Gross will normally take a little longer.  He might also ask for more test.  In my case he wanted a bone density test since I was an older woman.  Dr. De Smet and Dr. Bose say they can judge your bone density from the x-ray and I never got a bone density test.

Good luck and keep in touch.  We understand how you feel and will help in any way possible to give you information to point you in the right direction.

Pat