Scheduled bilateral with Dr. De Smet

[sergioms]

So finally I have pulled the trigger. Given that if I am not too active I do not have pain, I could adapt the surgery date to my familiar needs. So I am booked for surgery in October '24.

For background: 38 yo, male, 174cm, Spanish (just to justify potential English mistakes ;)).

I do not know yet the measure of the device but Dr. De Smet believed it should be 50 or 52mm (MoM). He told me that due to long follow up he'd rather not recommend CoC on me.

The trigger point: Given that since diagnosed with bilateral OA (back in 2018) i gave up impact sports (mostly football and tennis), I was not fully sure about the right timing of the surgery. Maybe I could still postpone it a few more years? So I decided to play a very amateur football game with some work colleagues. Result: even after 6 years no playing, I was very proud of my level, no physical discomfort and felt really good while playing. Negative side: limping after 2 hours for around 2 weeks. The weird thing is that the limping leg is the one with the "good" hip. 

I am just looking forward to hearing bilateral stories from Dr. De Smet ;) Also, advice on i.e exercises ahead of surgery, things to be aware of, and any sort of advice is more than welcome.

Thanks to you all.
Sergio

[sergioms]

Hi Fitness85,

I quote here results from study in 2020 (apparently biggest study up to date) taking into account head sizes:  Head sizes < 48 mm had a significantly worse survival at 22 years: 81.1% (95% CI: 79.9â€"82.3%) compared to head sizes ⩾ 48 mm: 93.8% (95% CI: 93.2â€"94.4%) (p < 0.001). In both genders, survival of head sizes ⩾ 48mm was significantly better than <48mm: 94.3% (95% CI: 93.7â€" 94.9%) versus 82.5% (95% CI: 80.4â€"84.6%) in males (p<0.001); 85.6% (95% CI: 82.8â€"88.4%) versus 80.8% (95% CI: 79.4â€"82.2%) in females (p=0.005) (Figure 4(C)).

You are a male, more than 48mm, with OA (also leads to better results when segmenting according to study), I think there is a lot of positive data for us. Of course there is always a risk, general risk for surgery and specifics to HRA.

I tell myself that sooner or later I will have to take the risk so why not take the risk now? What would be the difference that something goes wrong now or in 3 years? It would feel exactly the same (we would still be young enough to enjoy life at 41 or 45). Going through it sooner makes sense. And probabilities play in favor. So let's take the risk. 

By the way, why wouldn't you be able to squat? I see many stories where people go back to all activities they performed before. Can you squat now?

Hugs,
Sergio

[BilateralRecerf]

He told me that due to long follow up he'd rather not recommend CoC on me.

What is meant by "long follow up": is it that metal has longer history (+20years) while CoC has now +5 years of success? 

Personally I chose CoC (recerf) because it is better for running (not heating up as much as metal, as DeSmet says). So it depends what you prefer and what risks you are willing to take. Also former european marathon champion has Recerf and he runs almost every day.  ;)

So I had bilateral surgery this winter with DeSmet. Have recovered quite ok, first week was tough. However It needs a lot of work, i have done excercises/walking/cycling approx 2h / day. was 5  weeks on sick leave from office work.

Now have tried also running from less than 3 months after surgery but still holding it little bit as other side needs strengthening while other leg is slightly better.

I started squatting 7 days after surgery with body weights (no full squats, just sitting on bed and getting back up) and now have progressed safely squatting with 60kg (back squat) and 30kg (bulgarian squat). Before surgery I squatted with 100kg/50kg so still some catching up to do.

Let me know if anything you would like to know about bilateral..

[sergioms]

Hi BilateralRecerf ;)

Thanks for commenting and giving the possibility to get in touch for advice!

I did just have a zoom meeting with him that lasted around 15min. Dr. De Smet said that given I am male, femoral head of 50mm or more and long follow up (25 years of follow up) of that type of prosthesis he advices me MoM. I did not challenge him any further. What is your case? Is it smaller? that might be the reason?

I am going through the surgery in October and plan to have another meeting with him well in advance to get more details and reassuring.

I would be interested to know more about how to rehab after you come back home. I will be getting surgery in Knokke. His assistant said 4 days in Hospital post op and 5 days in a hotel where I would be picked up everyday and transported to hotel for PT and Hydrotherapy. No many more details though.

What was your experience?

Thanks again and much luck going forward!!
Sergio

[BilateralRecerf]

I had 56 and 54mm prosthesis. Reason was running, as i wrote, metal heats up 5 degrees when repetitive movement in running and that can be painful. So personal choice. Also i was offered first mom but its the patient who makes the choice. If running is not something you do, then go with the metal. Some people can run with mom, some not. With coc i have not heard running related problems.

Also did not want metal ions in body as that might cause issues. Metal ions are mostly the reason why hip resurfacing is not possible to get in many countries. DeSmet does good job with any prosthesis. Mostly things go wrong on this kind of surgery because doctors are not skillfull enough. He places the cup right position so less ions are released in body.

Knokke is good. Food at the hospital not the best but people (nurses and physio) are great. You get home&gym program from physio which you do at home. After six week can add more movements and add weights in gym. I added weights after 7 weeks.  work starts in knokke from the 0 day post operation in bed and then you continue it. Very basic stuff first. Then comes glute bridges, squats, split squats etc. Lots of walking, with crutches and without them. I had crutches 5 and 6 weeks for each leg. Also stationary bike exercises is started already in knokke.

Before surgery i would advice to strenghten glutes and piriformis as that will be cut. If you are in good shape then recovery is faster. If you skip exercises or are in bad shape before surgery then it also takes longer to recover.

[sergioms]

Many thanks for your response! I am not too fond of just running. I like football and tennis mostly.

Very interesting your stay at Knokke. Surprised that even with bilat you started working from day 1. I am generally in good shape but will definitely train my glutes if you say is better.

Is there anything you would recommend for me to buy and use on my return home? Were you in Knokke also 10 days and then released?

Thanks again and best of recoveries!!