Unsure About Having a Hip Resurfacing

[OneHipDude]

I am 46 years old, 6'1", semi-athletic, also unilateral severe hip arthritis.  A year ago I spoke with an orthopedist and discussed options; either THR or resurfacing.  We had a frank discussion about success factors, and weight came up.  I took the discussion to heart and since then I lost 105 pounds, with the goal being to make myself a better candidate for resurfacing.

In the interim I changed employers, and insurance (I live in the Portland Oregon, USA), which put my original doctor out of network.  This week I met with a surgeon at a different place (in network) who does both THR and resurfacing, but he told me that "resurfacing has fallen out of favor" and that all they do now is THR. 

I'm pretty disappointed because the advantages to the resurfacing are significant in terms of available activities, recovery time, and range of motion. 

I'm considering going back to the original, out-of-network doctor and seeing what they say.  (Either location would put me at my out of pocket maximum for insurance, so it is a wash from my perspective unless some unexpected costs arise.) 

Has anyone else heard of practices backing off on resurfacing? 

[Pat Walter]

Hi

Welcome to Hip Talk.  I hope you don't mind, but I started your post as a new topic so it won't be lost with many other posts..

You are the second member to recently post about being unsure about hip resurfacing due to input from surgeons and the orthopedic community. I posted a long reply for the other person and I think you would be interested in reading it.  One of the members here, John C, also commented.
I welcome others to post answers, but I want to reference mine for your to read.

https://surfacehippy.info/i-want-a-hip-resurfacing-but-am-concerned-about-the-negative-response-in-the-medical-community/

There is a large amount of positive information and personal stories here on the website.  I hope you get time to review it and hopefully, learn more positive information.

I wish you the best.

Pat

[blinky]

Hey Pat, I stumbled across a speech by Dr Su you posted maybe a year ago that summarized the history of the BHR. I can't find it now to set a link.


In the talk, Dr Su goes thru the history of resurfacing, from when it was this hot, new idea and everybody loved it, to when there were issues and everyone fled from it, to the present in which there is a more balanced view of the pros and cons. I think it would be helpful for new hippies to view the talk, only about fifteen minutes long, to get some perspective.

[Saf57]

MyHipFuIsWeak--yes, resurfacing has unfortunately fallen out of favor. Ignore that. Have your hip resurfaced. Nothing against the second surgeon, but don't use him, as he doesn't want to do them, and probably has done very few. Have the surgery performed by an experienced resurfacing surgeon. Pritchett may be the closest to you, but all of the names/information can be found on this site. Good luck!

[Pat Walter]

Dr. Su Video about history of BHR
https://surfacehippy.info/hip-resurfacing-bhr-past-present-and-future-by-dr-edwin-su-2017/

[OneHipDude]

Thanks for the replies.

I'm going back to my original physician on Tuesday to see if they are still on-board with resurfacing.  I'll deal with the added out-of-network costs if need be.

If they, too, have moved on from resurfacing then I'll have to locate another physician.  Dr. Su seems to be an extremely popular choice.  Though the additional costs for traveling to, and staying in, New York may delay my options while I save up.

[Saddlepal3]

Hi there,
You should contact Dr. Pritchett in Seattle. He’s one of the most experienced resurfacing surgeons in the USA. It’s a good idea to consult with several highly experienced surgeons to see which one you relate best to. Good luck!

[OneHipDude]

Good news. 
I spoke with my original physician and they are enthusiastically on board with going ahead with resurfacing.  I'm a prime candidate due to my age, bone size, and (now) weight.  They're also very positive about my prospects for returning to activities after healing up from the procedure. 

[PaulBridgwater]

Hello, I am new to the group but have similar concerns. I am a M59 and until 2018 was a sub 3 marathoner and 35 - 38 min 10K. In fall of 2018 I was diagnosed with severe OA after experiencing hip pain and loss of motion. I am looking at a THA (ceramic on poly) or Smith and Nephew Birmingham resurface. I want to get back to running, at least social if not marathons. Pros and cons seem to be; a) THA tried and trusted but poly wear will mean revision, less range of motion, lower probability of return to running, but lower complications due to more leeway in the surgical procedure b) resurface: "natural feel", more compatible with running but metal issues and more difficult procedure with less tolerance for error. Any thoughts? I just joined the facebook support group "Runners with hip injuries" and posted the same question so apologies if this is repeated for soem of you. I saw the original post was posted in 2018 and wondered if there had been any more data. My pubmed search for outcome from experienced surgeons looks promising for resurface. Thanks, Paul.

[jimbone]

Paul,

Depending on your location there a alternatives to metal on metal resurfacing devices.  Look into Dr. Pritchett's use of the Synovo cross linked poly device.  There are ceramic prosthesis as well.  The Birmingham MoM has been around successfully for a long time but some people do develop issues with metal ions.  This site is a great place for research and education in making your decision.  Best of luck.

[petemeads]

Hi Paul - don't write off the THR option, see hiprunner.com for runner's experiences with ceramic/plastic and all-ceramic hips. My THR leg has better range of movement and feels more natural than my BHR, despite being mechanically inferior and having a smaller bearing surface. The upside of the BHR is you get an extra bite of the cherry, revision to THR is straightforward if necessary at some later date.
DeSmet is trialling an all-ceramic resurfacing, that might be worth checking out.
I race 5k every Saturday, train from 6 to 13 miles, have long days in the hills and rock-climb with no problems (at the moment!) that are not related to being 69, that is...