Concerns again.

[IRONMAN]

Removed per members request.

[Philbrd]

Hello Fitness85,
its been a while since I've been on this forum.  I had both hips done with Dr. Gross when I was 54.   It's been 4 years and I could not be more happy.  Playing hockey, cat skiiing, hiking, etc.  I was pretty much in the situation you described.   Just did hikers high route in Switzerland.   Its really an individual choice on when the time is right but I have no regrets on choosing resurfacing.   What I can say is that rehab is really important.  In fact, I continue to work on strength / flexibility.   Anyway, just passing along some comments from someone who is happy with results!  best regards, Dan

[nafisher]

If it makes you feel any better I have my left hip scheduled for January and I am 28yo...I have had almost identical symptoms as you and have also had a lot of anxiety. I think the thing that gives me the most peace is the thought of being able to run and play hockey again and the fact that Dr. Brooks will be doing the surgery. I am probably going to need to get both done so should have both by mid year next year. I have set a goal for myself to run a 5K or 10K by the end of 2025 which will allow me one year of healing after my second side is done, as is recommended by Dr. Brooks. I would suggest you find a surgeon who has done a lot of these and to set a goal for yourself to accomplish when you are healed. That way you at least have a light at the end of the tunnel.

[gccornwe]

Hi Fitness85,

I am 38, so I can empathize with the feelings you are having. In my case I found that though I was able to manage symptoms pretty well with activity restriction and ibuprofen/tylenol, over time I had to restrict my activities further and further in order to manage the pain, and my ROM continued to get worse. I tried to hold off as long (roughly two years) as I could because I was worried about the longevity of the implant and conversion to THR. By the time I decided to get the surgery, it was a struggle to tie my shoes and I was in constant pain, even with light activity. Getting my hip resurfaced (Dr. Pritchett, late April) was absolutely the right decision. I didn't fully realize how much I had circumscribed my life due to my hip until after the surgery. While I am not fully recovered, I have no pain and have been able to return to most of my activities and I am much, much happier. Do you have any idea on when the NHS might start offering alternative implants? I assume that most of your concerns are regarding the metal ions?

Good luck!

[gccornwe]

It is a personal decision. I was at the point where 15 years of a functional hip sounded great, even if there was a chance that I might have to convert to THR after that.

My surgeon was very bullish on the prospect of implants that have a highly cross-linked polyethylene liner, in terms of long term durability. They have low wear rates and a much reduced risk of osteolysis compared to implants with polyethylene. I know Mr. McMinn was trialing a similar implant at some point (https://www.mcminncentre.co.uk/custom-polyethylene-hip-resurfacing.html), but I don't know if he still uses it.

[karlos.bell]

Hi look up polymotion hip resurfacing, On trial in the USA at present. MOM and COC resurfacing still have lots of tiny particles entering the blood stream, If the COC fails man that is one surgeon you need to then fix that up! Poly on metal has small amount of large particles that don’t enter the blood stream. Dr Pritchett USA is the best hip resurfacing for biocompatibility. I know as I had mine removed due to the worlds best installing them 5 degrees out! That almost killed me. 50mm hips you are most likely around 5,10.   Thr’s can cause massive issues as well so don’t think they know it all! stems go from 125 degree to 140 degree and they can insert them Varus or Vulgar how do I know? as they installed mine varus and 125 degree stems this causes issue on the trunnions and heads. So don’t go to a THR unless you do your home work. I am going to write a check list / information do you know? As I have had this done and now need my hips redone! So all reading this and this forum they still don’t know enough about corrosion, biocompatibility, metalosis of different metals in the body what it does to the body! Ceramic poisoning is another, But they do know about the new poly that is ok and Some biocompatibility material being TiN or titanium nitride coating!   So love it or hate it do you home work!. You can email me of message me through this forum as I have been through the ropes on this and if I helps 1 person out of not getting sick that would be cool. As I pointed out I have had poor THR work done so that as well is an eye opener.
I have named no surgeons except Dr Pritchett here, but resurfacing as well has some drawbacks of taking away good bone stock from the acetabular so all surgery has flaws. Nothing is as good as your natural hips were. Good luck. Hope this makes sense. Karlos

[ahausheer]

So like many on this forum I have great anxiety to have this operation. I am 38 and have osteoarthritis in both hips but the left is causing me issues.

I had a BHR (50mm head) implanted in both hips at age 37 by Dr. Peter Brooks and am glad I didn't wait a day longer. You will read many many stories of people saying they wish they didn't wait as long to do it. He said they will probably outlive me and his data strongly supports that. I this his revision rate at 20 years is in the low single digit % and that's all causes such as car accidents, falls etc.

I would not worry about metal ions, unless you are allergic, which can be tested for, it is a non issue. I also do not recommend anything other than metal on metal because even though the initial data looks promising for other material, they do not have the 20+ years of proven data in a resurfacing implant and proven long term durability, safety, patient satisfaction etc.  it is not just materials either, it is manufacturing/design as well. I also talked to Pritchett first about the COC he is doing and I am glad he turned me down (on imagining he said I had too much cartilage spacing left). I was thinking, oh, its newer, it seems fancier, it's this, it's that, it must be better. Glad Dr. Brooks took me as a patient and got my head straight that you don't need to change an already 20 year+ winning team. 

I would hesitate to do this surgery under the hands of an unskilled surgeon though but it has come a long way.

Don't let it turn into back pain, knee pain, etc etc, the hips affect everything and as you compensate for the bad side, other parts of your body start to go. If/when that happens, you waited to long.

It is scary, and there are risks, and it is mentally difficult knowing once its done there is no goin back, the bone is gone, but it is worth the risk to be pain free and not wreck the rest of your body.

If I can say one thing - do not push the recovery. I over did something by pushing physical therapy and 3 years later I still feel it and its uncomfortable at times, but, I can surf aggressively and hike up mountains. Before, I could not walk around a supermarket without needing opiate pain meds later in the day.

DM me if you have any questions. I could go on all day about the weird symptoms (knee pain/back pain etc) I had pre surgery that cleared up too. 

[ahausheer]

If it makes you feel any better I have my left hip scheduled for January and I am 28yo...I have had almost identical symptoms as you and have also had a lot of anxiety. I think the thing that gives me the most peace is the thought of being able to run and play hockey again and the fact that Dr. Brooks will be doing the surgery. I am probably going to need to get both done so should have both by mid year next year. I have set a goal for myself to run a 5K or 10K by the end of 2025 which will allow me one year of healing after my second side is done, as is recommended by Dr. Brooks. I would suggest you find a surgeon who has done a lot of these and to set a goal for yourself to accomplish when you are healed. That way you at least have a light at the end of the tunnel.

He did both my hips at 38, you will be in good hands. I was back surfing at less than a year (before he actually cleared me) and I stopped noticeable recovery improvements at about 3 years (walking still feels harder than it should though but it could be scar tissue from 4 previous hip surgeries).  The first 2-4 months progressed way slower than most on here but it worked out so don't rush it.  At 3 years I am surfing pretty aggressively now.

I did mine 6 months apart and would recommend that just to get them done.

Do not push the recovery process early on, you can screw things up.

He is also a little short on words, but he is a very talented surgeon. If you get both done, if he sees your x ray - say something about those two beautiful balls because that's literally his only joke that he tells the nurses.

[stevel]

This photo shows what happens to your muscles when you wait too long for surgery.
The photo was taken the day before surgery for my LBHR over 15 years ago.
The left leg had atrophied to about 1/2 the size of the right leg.
I walked with a severe limp (antalgic gait) to compensate for arthritic pain in my left hip which also affects the back as my pelvis was tilted.
Rehab after surgery took nearly six months to restore muscular function in the left leg and back and I skied at 6 months post-op.
I didn't wait as long for my RBHR.
When X-Rays showed I had severe osteoarthritis and I walked with a limp after mowing the lawn and two orthopaedic surgeons said I was eligible for hip resurfacing (insurance will cover), I did not delay and booked the surgery on 11/01/2019, just before Covid hit the US.  Lucky me, had I delayed surgery until the following Spring and complete the ski season, my surgery date would have been cancelled until July at the earliest.
Rehab was much faster.  I skied at 3 months post-op.  My muscles were restored and Dr Su relaxed the time period for bone healing from 6 months to 3 months to return to skiing.

[Desert Tortoise]

I'm 57, but I had hip problems for 35 years before I had bilateral surgery by Dr. DeSmet in July '22.  My suggestion is:  if you qualify for it now, don't put it off.  Just be sure to go to a really good surgeon.  Unlike traditional hip replacement, you don't have to worry about the stem loosening over time, nor do you have to deal with the dislocation risks and increased wear rate that are associated with the smaller articular surface that you get with traditional replacements.  Why keep yourself in pain?  I tell you, getting rid of that pain made my whole outlook on life a lot brighter!  I hadn't realized how depressing chronic pain can be until I got out from under it.

All that being said, you have to trust your gut.  Surgical techniques and materials keep improving, so it's not like you're missing the boat if you don't do it now.  When you meet the right surgeon, I think you'll be more comfortable making the decision.

Good luck to you!

[ahausheer]

Don't be sorry, it is a big decision. Sounds like you are due for the surgery. Document your thoughts, your pain levels, how you are physically compensating, everything, it will be easy to forget and any setbacks in recovery will have you doubting yourself even more. I don't know your condition, but usually that kind of think only gets worse. No point in waiting until you are suffering everyday. Just be aware there are risks, but you have to weigh them against being in pain or not enjoying life to the fullest. In the hands of a good surgeon the complication rate is very very low and the implant should outlive you.

[jimbone]

Your concerns and fears are normal and nearly universal- it's a big surgery.  Those emotions can make rational decisions more difficult.  What you do know is that your condition has progressed to the point where you have taken steps to schedule the surgery, you have a limp that is a direct result of the OA, your pain is not completely debilitating but is bad enough some days to impact your quality of life, you know the pain and OA will not improve and will get worse, the really bad hip is needing the better hip to maintain a degrading condition and in doing so could accelerate its failure sooner rather than later, there is a risk that delaying surgery could lead to complications that could rule out HR and require THR.

Most importantly remember OA is progressive and will not fix itself- it will get worse.  From my own experience and many others on the forum, often times that decline can be surprisingly fast- literally a matter of months.  In my own case it was merely a matter of weeks after my first left hip surgery that, relieved of its duty to support my bad hip, the good hip went down fast and I had the right hip done 8 weeks later. I was 63, that was 5 years ago and I have not regretted the decision for a single minute since- in fact on the rare occasions I think about it my experience is one of gratitude it was such a success.  With the top surgeons it is so often a success that failures are nearly non-existent and poor outcomes statistically nearly irrelevant- these guys have this down and know what they're doing so well it's almost impossible to fault them.

Believe you said you were 38?  Worse case scenario, say the prosthesis only lasts 20 years- now your 58 and need a revision.  Maybe you'll need a THR but there are surgeons that do revisions with HR as well.  You'd be 58, healthy and fit because you had your HR in your 30s and have been able to stay active and maintain your health so the outcomes of any revision- if it were ever necessary- would be enhanced by improved physical condition and while 58 can sound really old, if you've stayed healthy it's not as old as it sounds and you'd be getting not just a second but a third chance to live an active, healthy and satisfying life.

My surgeon said a interesting thing when I was presenting my concerns, fears and questions, he told me, "People think of it as an amputation, it's not, it's a reconstruction" I found that perspective reassuring and the results have borne that out.  I had a lot of resistance to the idea of surgery and prosthetics but in the end it was one of the best decisions I ever made as I think you'll find most people who went forward with HR would agree.  Best wishes.