My time has come!

[Knighterrant]

Hello all!

First, thank you all for this wonderful website; it has helped me greatly to read your (mostly positive!) stories and think that having both of my hips resurfaced will be a good thing.

Like most of you, I ignored and put off the thought of surgery, even as my functioning declined.  I started seeing an orthopedic a few years ago, and managed the pain with medication and ignored the increasing limp and reduction in motion.  Last December was it; I crossed that point were I was no longer as good as my job as I once was, and that I had given up too many of the activities I enjoyed.  My old doctor recommended a full hip replacement on both hips.

I did my homework, attended a seminar, talked to some people, and saw a second surgeon who is well respected in this region for this work, and he said I was a fine candidate for the BMR resurfacing (I am a 44 year old male). 

I really like this idea, but I tell you the thought of those metal ions in my body is the only thing that gives me pause.  I would have double the ions (like most of you here) because you have it on both hips.

Does this bother any of you?  I have looked up all the studies on the ions and the long term effects of these ions are not known, however they do not appear to be an issue at this time, with most reports not showing an increase in rates of cancer or mortality.

You all have had to make this decision; are you still comfortable with it? 

I am scheduled to get my BMR done on June 5th. 

Thanks again for this site, and I look forward to talking to you all.

Knighterrant

[hernanu]

Hi and welcome!

Is that a BHMR or a BHR that you are having inserted? I

'm still happy with both of my resurfacings. As to the metal ions issue, it is a real issue. You have to give it consideration, some of our hippies have had it and needed revisions from the resurfacing due to it.

There are other issues that can also come up with this surgery, as with any surgery.

Much more prevalent issues than metal ions problems are loosening of the device, femoral neck fractures during the first six months... statistically these are more likely than metal ion issues.

Like with any surgery there is no guarantee, but this does have a high chance of success. By high it means over 90%. So to me, (not being a medical person) it is a very good way to deal with an intractable problem - the loss of cartilage due to arthritis.

The best ways to up your chances of success are to choose an experienced and committed surgeon, who has done at least 200 procedures, preferably more. Who does these frequently and can provide a record of success and discuss the failures.

The success of the procedure goes up with the skill and experience of the surgeon. Metal ions problems in particular seem to be tied to the ability of the surgeon to place the device properly, and with the device chosen.

There is a lot of information on the site, I'd look around - also ask your surgeon about his or her experience, frequency of procedures done, recovery protocols, etc.  Pat has a checklist of questions to ask your surgeon, I'd take one of those along next time you talk.

[Miguelito]

Hello! Obviously this surgery entails risks of failure, but responding specifically to your concern about metal ions: Two years post-HR on my right hip my levels of cobalt and chromium were equal to or less than that on the general population. We'll see what happens with the one I just had put in in my left, but I expect (and hope!) it to be similar. I know that my surgeon believes that the problem of metal ions has been largely addressed by the elimination of less good devices, and the relatively recent understanding of the need for one angle (forget which one) to be less than 50 degrees. I suspect he shoots for much less, as mine are at 31 and 29. He cannot prove this empirically yet so this is just informed conjecture, but it smells right.

My only significant concern for my hip is late failure, which I consider inevitable (looking at aging relatives, and understanding how my own body has declined over the years, I believe that the bone that attaches to my cementless device will deteriorate over time and ultimately give). But I hope that isn't until I'm 65 or 70 and I can get a THR (or whatever they are doing 25 years from now) popped in there. Of course, these devices just fail in a small percentage of people right off the bat (for a number of reasons) and I cross my fingers that that doesn't happen to me.

Good luck with everything.

Mike

[Pat Walter]

Welcome to Hip Talk

Are you having a BMHR or BHR?  Just wondering.  Who is your surgeon?

The overall retention rate for the BHR worldwide at 11 years is 94%   That means very few people have problems which includes high metal ions.  When the components, especially the acetabular cup, are placed at the proper angles, the metal ion level is small.  High metal ions occur when there is edge wear from the components not being placed properly.  Use a very experienced surgeon who places the components at the proper angles and you should not worry about high metal ions.  Very, Very few people are actually allergic to chromium and cobalt.  There have been a few, but very few. 

I have a list of revision stories here   http://www.surfacehippy.info/hipresurfacingproblems.php   Although it looks like a long list, you have to remember that about 98 to 99% of the experienced surgeons patients had no problems.  Their retention rates are much higher than the over all BHR retention rate including all surgeons.

There are a lot of bilateral patients here who are doing great with no problems.  I am sure you will hear from them.

Good Luck.

Pat

[China Lady]

dear Knighterrant, welcome!
I am sure you made the right decision to go on and get your life back!
the last weeks I followed some threads with this metal poisoning topics and I am more and more annoyed.
we all are with the best surgeons in the world for this surgery. they will give the best implants to you money can buy. I am sure they consider the plus and minus between technique and up to date knowledge. this kind of surgery and treatment is younger than 15 years. (to my knowledge).
nobody on earth can give you 100% guaranty.
our bones had vanished, pain was my daily companion. I was an old women before my age; now I ride my bikes again and soon I will dancing again.
there is no cure for anything without the pay off.
I don't know for sure what my "pay off" will be in the future but I am willing to pay the prize. when I was a young child I got Amalgam in some of my teeth and it is still there. do I need to worry now? maybe this will kill me when I am 90 years old. maybe it will be my smoking, overweight, chocolate love, air pollution in China, white wine, motorbike riding ................. fill in what ever you love

[Knighterrant]

Hi and welcome!

Is that a BHMR or a BHR that you are having inserted? I

'm still happy with both of my resurfacings. As to the metal ions issue, it is a real issue. You have to give it consideration, some of our hippies have had it and needed revisions from the resurfacing due to it.

There are other issues that can also come up with this surgery, as with any surgery.

Much more prevalent issues than metal ions problems are loosening of the device, femoral neck fractures during the first six months... statistically these are more likely than metal ion issues.

Like with any surgery there is no guarantee, but this does have a high chance of success. By high it means over 90%. So to me, (not being a medical person) it is a very good way to deal with an intractable problem - the loss of cartilage due to arthritis.

The best ways to up your chances of success are to choose an experienced and committed surgeon, who has done at least 200 procedures, preferably more. Who does these frequently and can provide a record of success and discuss the failures.

The success of the procedure goes up with the skill and experience of the surgeon. Metal ions problems in particular seem to be tied to the ability of the surgeon to place the device properly, and with the device chosen.

There is a lot of information on the site, I'd look around - also ask your surgeon about his or her experience, frequency of procedures done, recovery protocols, etc.  Pat has a checklist of questions to ask your surgeon, I'd take one of those along next time you talk.

Hi Hernanu, and thanks for the welcome!

Its the BMR on both sides for me; I live in Virginia (USA) so no BHMR for me.

After I was offered the two choices I have done very little but read up on the pros and cons between the total hip replacement and the hip resurfacing, and I must admit I have gone back and forth many times before deciding on the resurfacing.  After all of my reading over late last week and this weekend I emailed off a long list of more informed questions to the doctor's office; so far they have been great in getting back to me promptly and making me feel good about my choices.

I'm still reading all of your stories, so I know I will continue to become more informed as the weeks go by towards the surgery date.

[Knighterrant]

Hello! Obviously this surgery entails risks of failure, but responding specifically to your concern about metal ions: Two years post-HR on my right hip my levels of cobalt and chromium were equal to or less than that on the general population. We'll see what happens with the one I just had put in in my left, but I expect (and hope!) it to be similar. I know that my surgeon believes that the problem of metal ions has been largely addressed by the elimination of less good devices, and the relatively recent understanding of the need for one angle (forget which one) to be less than 50 degrees. I suspect he shoots for much less, as mine are at 31 and 29. He cannot prove this empirically yet so this is just informed conjecture, but it smells right.

My only significant concern for my hip is late failure, which I consider inevitable (looking at aging relatives, and understanding how my own body has declined over the years, I believe that the bone that attaches to my cementless device will deteriorate over time and ultimately give). But I hope that isn't until I'm 65 or 70 and I can get a THR (or whatever they are doing 25 years from now) popped in there. Of course, these devices just fail in a small percentage of people right off the bat (for a number of reasons) and I cross my fingers that that doesn't happen to me.

Good luck with everything.

Mike

Hello Miguelito, and thank you for replying!

I did come across a few studies that mention how important the angle was for the cup; I was also glad to see of the high success rate with the BMR vs. some other marketed devices. 

I guess it comes down to the trade off of the potential risk of ions vs. bone that may not be in the best shape for a second THR later in life.  All of us here...heck, all of you here....have already made that choice and it seems like it has changed your life for the better.

Good luck to you, and I hope you don't have that failure!

Knighterrant

[Knighterrant]

Welcome to Hip Talk

Are you having a BMHR or BHR?  Just wondering.  Who is your surgeon?

The overall retention rate for the BHR worldwide at 11 years is 94%   That means very few people have problems which includes high metal ions.  When the components, especially the acetabular cup, are placed at the proper angles, the metal ion level is small.  High metal ions occur when there is edge wear from the components not being placed properly.  Use a very experienced surgeon who places the components at the proper angles and you should not worry about high metal ions.  Very, Very few people are actually allergic to chromium and cobalt.  There have been a few, but very few. 

I have a list of revision stories here   http://www.surfacehippy.info/hipresurfacingproblems.php   Although it looks like a long list, you have to remember that about 98 to 99% of the experienced surgeons patients had no problems.  Their retention rates are much higher than the over all BHR retention rate including all surgeons.

There are a lot of bilateral patients here who are doing great with no problems.  I am sure you will hear from them.

Good Luck.

Pat

Hi Pat; I saw your introductory video and I thank you for hosting and building this online community.

As a Virginian I'm staying here in the states and getting the BHR; although I am sure we are all interested in following the development and use of the BHMR. 

I chose Dr. Anthony Carter of Newport News, Virginia, when I thought I was just getting a THR.  He is one of the top docs in this region for the procedure, and he is the one who spoke to me of the possibility of resurfacing (incidentally, my previous local doc never mentioned this procedure to me).  I sent off some questions this morning to him and his staff (including how many BMRs he had done and his revision rate for them), but online I have discovered that he has been doing anterior resurfacing since 2008.  I am hoping he reports back that he has performed a high number of the resurfacings.  He is reported to be the the go to guy around here; I hope to be able to speak to some of his resurfacing patients too and not just to his THR patients (which I have...this guy came recommended from multiple sources, so hoping for the best)

Thanks again!

Knighterrant

[Knighterrant]

dear Knighterrant, welcome!
I am sure you made the right decision to go on and get your life back!
the last weeks I followed some threads with this metal poisoning topics and I am more and more annoyed.
we all are with the best surgeons in the world for this surgery. they will give the best implants to you money can buy. I am sure they consider the plus and minus between technique and up to date knowledge. this kind of surgery and treatment is younger than 15 years. (to my knowledge).
nobody on earth can give you 100% guaranty.
our bones had vanished, pain was my daily companion. I was an old women before my age; now I ride my bikes again and soon I will dancing again.
there is no cure for anything without the pay off.
I don't know for sure what my "pay off" will be in the future but I am willing to pay the prize. when I was a young child I got Amalgam in some of my teeth and it is still there. do I need to worry now? maybe this will kill me when I am 90 years old. maybe it will be my smoking, overweight, chocolate love, air pollution in China, white wine, motorbike riding ................. fill in what ever you love

Hello China Lady, and thank you for saying hi!

You are right.  The studies only seem to go out to about 15 years, but I was able to pull up studies about metal in the blood that went back to 1980.  In many of these cases, the metal in the blood was quite high, however the older era devices were in use for many decades and they did not seem to have suggest an increase in cancer or mortality for the users. 

But, as you say, yes life is risk.  I had given up on many activities I had once enjoyed, and after one of the few remaining ones went (hiking) I became determined that I needed to take action and stop putting it off, stop overrating the "good hip days" and realized that I had to have something done or I too would be in an aging body that did not fit who I was.

Enjoy your chocolate China Lady; sounds like you deserve it!

Knighterrant