Help about tape on the incision!

[shoraztri]

Attitude on the day is the WINNER, and thats where you EXCEL. :). Keep on moving forward [ no pun ]you are doing brilliant. Every day is a success and another day further up the Recovery ladder. Work on 1 rung at a time . Tick those boxes  ;) :D. Cheers .
Kiwi Boy Down Under.

[Meaghan]

Hi, I am new to this forum but am seeking advice about the Synovo Preserve Polyethylene hip replacement system.  I am a 54 year old women who is very active in skiing, power lifting and alpine hiking.  I have OA in both hips and a significantly torn and delaminated labrum in my right acetubular socket.  I have consulted two highly experienced surgeons in Melbourne Australia who want to do a ceramic THR on my right hip.  They will not do the MoM BHR due to the risk of metallosis.  After skiing daily in NZ for 6 weeks last september surviving on daily doses of 100 mg of Voltaren and Panadeine Forte, my nightly pain in my right hip became more prolonged and excrutiating than usual and unable to be relieved through my normal regimen of daily training / exercise.  I have gone from exercising for 2 - 2 1/2 hours a day to no activity in order to minimise the pain at night and still function as a manager at work.  I am absolutely miserable.  My issue with the THR is that the surgeon states that I will be unable to return to  power lifting and alpine hiking/climbing (due to the unacceptable mechanical stress loading of the ceramic implant leading to failure).  Does any one on this forum know of surgeons in Australia, New Zealand, Asia or India who do hip resurfacing using the polyethylene hybrid titanium system popularised by Dr Pritchett?  I am absolutely not ready to give up the activities I love but recognise that living on high dose NSAIDS and analgesics during my activities and after is not viable  solution either... Any advice is appreciated... thanks  :'(

[OtterDriver]

You're apparently willing to travel...why don't you send your x-rays to Dr. Pritchett?

[Meaghan]

Thanks for your response, I am willing to travel but don't have the financial means to fund a US operation unless it's only $5000 or less.  It's quite cheap to have operations done in Australia, NZ (due to the government medical care system in conjunction with my health insurance) and Asia and India.  My preference would be for a local surgeon but it appears that the Synovo Preserve hip replacement system is confined to the USA?  (It is really difficult to find information on it). 

[MPH]

Hi. I recently had my hip resurfaced in Melbourne, five weeks ago in fact. Today I did all my PT this morning followed by a good 45 minutes on the turbo trainer getting my heart rate up there. I will walk this evening too.  My recovery has been so good I already know I'll be fully active again. It's not a case of if, it's when. I am holding back rehab to ensure I end up with a hip that'll stand the test of time too. Which surgeons did you see? If it wasn't Andrew Shimmin from the Melbourne Orthopaedic Group or Stephen McMahon from a few doors down then my advice would be to see either of them. Mr Shimmin is highly regarded in hip resurfacing both internationally and here and Mr McMahon has a similar reputation but with less research on articles. You can search on this site for most of Mr Shimmin's research articles. I cannot speak highly enough of Mr Shimmin and a fellow Aussie on here speaks highly of Mr McMahon.

[MPH]

Sorry, forgot to add, neither use the Synovo device, they rely on the Birmingham given its track record.

[Meaghan]

Thanks MPH it's great to hear that you are recovering so well and that the resurfacing is working so well for you!  I didn't even make it past Andrew Shimmin's secretary as l was told that he no longer performs hip resurfacing on women.  Stephen McMahon told me the risk of revision was too high (considering l was a woman) and has slotted me in for a THR in less than 3 weeks time. I have a phone appointment with Stephen next week where I hope to change his mind or cancel the surgery.  I must say it has been a really disappointing experience, particularly hearing of the major changes to my activity l would have to make after a THR.  I hear there is a professor in Sydney who does MoM BHR so he will be my next consult l expect. Considering the response from two highly respected experts in articulating the risks to women from MoM BHR it does beg the question why the Hybrid polyethylene resurfacing system is apparently not offered in Australia?  l love my power lifting training which keeps me fit for skiing and hiking in NZ , maybe I will just have to continue on the really unhealthy maxed out NSAID and codeine dosages if I am unable to find an Australian surgeon prepared to do a resurfacing or until technology suitable for active women makes it downunder...

[MPH]

Hi Meaghan, ayah yes, there is the female part I'd forgotten about. It appears in one of the Melbourne Orthopaedic Group's research ipapers and their conclusion was the withdrawal of any resurfacing service for females due to the higher revision rates that seem to be for a number of reasons. Also, there have been posts on the forum that Smith and Nephew have recently given guidance to surgeons not to use femoral head implants of less than 48mm and that is a factor.
I'm sorry you're getting bad news, if seems the US surgeons still offer the procedure for females unless that recent guidance has yet to have an effect.
I wish you all the luck in the world, McMahon is good but if it's not what you want you may have go overseas. Good luck.

[nigel]

Hi Meaghan,

Don't know anything about Synovo Preserve Polyethylene, but perhaps its worth speaking to other surgeons regarding MoM HR. I had a Hip Resurfacing done by Prof. William Walter 9 months ago in Sydney. He seems a top rated surgeon  having performed 500+ i believe.

He does say on his website (http://billwalter.com.au/)  "Research done by Professor Walter and other surgeons around the world over the last 10 years has shown that this procedure is generally not suited to females, although Professor Walter will consider this procedure in to strong active women with good bone mineral density"



One other surgeon I saw in Sydney and would recommend  is Prof. Kohen http://www.jointreconstruction.com/

Hope this helps, best of luck

Nigel

[Comfortably Numb]

I'm scheduled for right hip resurfacing with Dr. Gross in late April.  To me, the most confusing part of the post-surgery requirements involves the ninety degree rule.  I've watched various videos that explain this and I'm left with the impression that for six weeks while resting or watching TV I'll either be confined to bed or a hard, straight back chair with arms.  My sofa sinks too deeply, and use of my recliner appears to be discouraged.

Can some of you shed a little light on this.  I believe I have read somewhere on this site that people have spent the first few nights in their recliners.  I guess it all comes down to whether or not you can get into and out of the recliner without violating the rule.  Maybe that's possible with the use of crutches to pull up with.  I also ran across a post about the Zero Gravity chair.  This probably deserves a closer look but it would still appear to compromise the rule much like a recliner.

I just can't see myself spending hours on end in a dining room chair.  Thanks.

[Comfortably Numb]

JHippy, my resufacing with Dr. Gross is scheduled for late April.  I started a new topic this morning concerning the ninety degree rule, and it looks like this recliner might be an answer to my concerns.    Did you consider other similar products or is the Lafuma top of the line?  An internet search shows many other brands available.  Thanks for your input.

[rburns]

Kevin,
Sorry for the delay in responding. I am seeing Dr. De Smet initially for a consult only, and have tentatively planned a consult on the same trip with McMinn in Birmingham (the pay-it yourself surgery fee is about 13,000 pounds). I'll see Dr. Pritchett before I leave and then make a choice. If you follow this link (http://www.hip-clinic.com/en/hip-info/publications/50-bhr-versus-conserve-plus) De Smet has a compelling argument for the Conserve + vs the BHR. Having said that, the BHR has the longest track record for active people like me. I also am a big fan of pool therapy asap after lower extremity surgery (2 knee scopes later) and this is, apparently, still possible in Ghent at the hotel. McMinn wants no pool for 6 weeks. As a former physio, I know the benefits are significant (swelling/ROM/etc..) if you can get in the water soon. We'll see who I feel more comfortable with and let them recommend the device (as per Pat's wisdom on this site). As far as Dr. Bose, I just don't see myself going to India for this, although I have heard good things as well. Hope that helps.....

[MattJersey]

Hi all. My background is a soccer injury in 1995 resulted in right OA diagnosed in 1996 and curtains to much of my sporting life aged 27. Depressing. I did a fair bit, golf, soccer, triathlon, running (4:20 mile, 33m 10k, 1:18 Half marathon). Managed to resurrect golf about 8 years ago, but in pain always, and noticing it a lot over past year. I'm 46 this year, 5'8" 156lb.

I play off 6 handicap even with my "handicap" and I believe I can play off scratch with a BHR. I reckon I could go on in pain and just get worse over next couple of years, with sleep disruption (sleep sooooo much better with a paracetamol tablet, which I discovered recently: last night had a full night's sleep without a "comfort break" for the first time, literally, in years. So refreshing!)

I have a young daughter too, 8 this year and I'm starting to say no too much. No, I don't want to race up the stairs. No I don't want to play tag. I don't like that, and feel my next ten years are the best 10 of the rest of my life. Time for carpe diem.

So. I am generally in pain. But I walk the dog twice a day 2x45 mins, with my modified gait, limping. This evening I was uncomfortable toward end of walk. Is that bad enough?

I played 18 holes Saturday, pushing my trolley, in pain or standing in a particular way so as to avoid pain. But I shot a gross 2 over. Then 9 holes Sunday, but I was beat up Sunday, really sore. Is that bad enough.

I will take a painkiller tonight at bedtime, as I know it helps sleep, and I've been tossing and turning for years.

Sorry for the long build up, but figure you need my history to help me ...

Writing all this down has me realising that, actually, I know the answer. So you could jump to question 2!

QUESTION 1: do you think it's too soon? I am thinking wait till end of summer, then do it. This would be convenient for work, and also means I scramble through summer and the rump of the recovery will be as the golf season finishes and winter comes. Or go for it mid-late-April after family holiday Easter. And be fit enough for summer family holiday at end of July?

QUESTION 2: Mr McMinn's website indicates gentle golf from 4 months. Of all the golfers out there, what do you think? What did your surgeon advise? If you could scrape through summer like I think I might, would you? Or might I actually get back to some golf by Sept if I get it done in April? How was your recovery, how much did you lose/how long before you got back to former level?

Sorry for asking so much!

And, thank you to everyone who posts on this site, and to Pat. It has been very helpful to me so far, understanding risks I am taking. I do feel ready, and my fear of what if it fails and I end up THR is now feelng like a so what, at least I won't be in pain anymore.

I saw a surgeon locally in Nov 2014, and he said keep going but if you want it done, just say so, you'll know when it is time. And I saw Mr McMinn last week, with similar conclusion. He emphasised don't get stuck in to painkillers ... My bone stock looks good, density wise, and I still have a little joint space, but obviously it is "patchy" coverage!

Thank you.

Matt

[oldsoccerplayer]

From what I remember, the 90 deg rule means don't bend your knees higher than your hip - i.e. no higher than your knee being at the same height as your hip. I got into trouble with Dr. Gross' staff when I told them I was trying to do a "Knees Up Mother Brown" dance (look it up on YouTube if you don't know what that is).
I was comfortable in a recliner, not sure why it would be discouraged. You do raise your legs but not by bending your knees.
I slept in my bed, lying on my back with pillows under my knees. I did need crutches to get out of bed and recliner for a few days. I was limited in how long I was comfortable in a regular straight-back chair, had to get up and walk around after a while. I found the best option was to alternate between chair, recliner and flat on my back, switching when it got uncomfortable.
Dr. Gross' staff is really good at answering any questions pre and post surgery, so don't hesitate to go to them with any concerns.

[Torontogirl]

Hi
Just thought I'd give you my 2 cents worth. I am from Toronto Canada and I had bi-lateral hip resurfacing with Dr. DeSmet about 2 1/2 yrs ago. Coinincidentally another female patient from Vancouver had bi-lateral surgery the same day! From my perspective-I have had nothing but positive comments to say about the  experience except for the hospital food!! Dr. DeSmet used the Conserve Plus- I believe because there were more size options for women, but he also had a coated metal option for men and I believe that option for women was coming. When I checked out the costs-it was a little less expensive than going to England and of course Dr. DeSmet was highly experienced and regarded. There is not a day goes by that I am not thankful that I made the choice to have both done together and that Dr. de Smet was my surgeon!

[JHippy]

Congrats on your upcoming surgery, you're in great hands!

Yea it's about getting in and out of the chair. At the hotel they had a low lazy boy and at home I had a zero gravity chair (I'll reply in your other thread as well). So you'd keep the operated leg straight at the knee as you lower yourself to the chair, using the crutch for support. If the chair is really low, put a pillow on the chair so that when you're sitting your knee is not above your hip. Then to get up it same thing -- your leg extended so you're only pushing yourself up with the non-operated leg and the crutch. You just don't want to get in a low position where you'd have to bend both legs to stand up -- not only you'd violate the 90-degree rule but your strength is not going be there yet in the beginning.

[JHippy]

The other one one I tried was an REI brand, they have a retail store here. It gave me a good idea that this type of recliner would work, but quality of the LaFuma seemed better. Price was pretty comparable if I recall correctly. Both felt very sturdy.

The larger size that I got has a slightly shallower seat angle when upright, and was a tad higher so I didn't have to lower myself as much. Either way is probably not a problem as long as you can scoot to the edge of the chair to get up (and sit down). But if comparing two brands you might want to take that into consideration.

[nigel]

Hi Matt,

Question 1 - In my opinion  you sound like you are defiantly, defiantly ready! If its stopping you doing the things you love and impacting your life then as you say carpe diem.
If i had known about having  this procedure 10 years ago (42 now) it would have given me 10 years of running, playing  football (soccer) and staying fit  not to mention the mental side of feeling old and having a worn out body which is tough.
Very scary to think of a big lump of metal  being put in you (for me anyway) but the operation and recovery weren't too bad at all. I'm 9 months out now and recently having a few twinges (I'm sure its just due to some scar tissue)  but I'm amazed all the time at how my hip feels no different to my other one even though its made of metal!
If your having Mr McMinn perform the op its  a no brainer i reckon!

Question 2 - Recovery wise, first 2 weeks I couldn't do much and for the first 6 weeks was extremely tired, needing day time naps, but after 1 week only took a single painkiller at night and that was only for a further week.  At 2 months i think i could probably have played golf, i did go to the driving  range and  play a round at about 3 months without any issue at all - Well not from the hip anyway  - as much a hacker as ever! As you'll hear on here everyone is different, just listen to your Surgeon and your body.

Hope this helps

Cheers

Nigel

[HowieF-16]

You found the right website to get the answers to your questions.

First, no it is not too early. You are dealing with the same issue I did. You can tolerate the pain, but you're sacrificing lifestyle. I was 50 when I had my hip done and I am good as new. Get your hip done now before it becomes so debilitating that you aren't in good enough shape to minimize recovery time.

Second, golf...no problem. I would only offer one piece of advice on that issue. Remember, your recovery is a marathon, not a sprint. Be careful not to overdo it early one, it will only slow things down in the long run(lived that mistake.)

Good luck on your decision.

[China Lady]

Dear Meaghan,
it depends on the female. her age, high and over all static. I am age 57, 1.82m, 100 kg. Dr. Brockwell, Hongkong, did my surgery January 2014; bilateral in one go. my friend Cory, similar age and all, will have her bilateral surgery March 13.
my recovery rules have been very strict for 6 month. women our age can have problems with the bone density, that's the reason for this new "restrictions".
I hope, you can do it!
if necessary contact Dr. Brockwell.