Study on reduced fexion and notching risk

[Holger]

Hi there,

I just read a new study that found out that in contrast to wide belief, surfaced hips seem to have a lower flexion rate:

Kluess, D., Zietz, C., Lindner, T., Mittelmeier, W., Schmitz, K. P., & Bader, R. (2008). Limited range of motion of hip resurfacing arthroplasty due to unfavorable ratio of prosthetic head size and femoral neck diameter. Acta orthopaedica, 79(6), 748-754.

This is quite a shock to me because this would mean that squatting increases the risk of "notching" with the danger of a neck fracture. Does anybody know anything?

Best,
Holger

[Pat Walter]

This is not a new study.  It was done in 2008, just 2 years after the FDA approved the BHR in the US.  So it is not clear what devices they were looking at or who the surgeons were that placed the devices in the study.
If you look at the thousands of athletes that had hip resurfacing, few have limited range problems.  I would look for studies that included the experienced hip resurfacing surgeons that have been doing hip resurfacing more than 2 years.  McMinn placed the first BHR in 1997.  So this was very early during the development of surgery approaches and tools.
I wish I could give you a current similar study, but I can't.  Best thing to do is ask your surgeon about your future range of flexibility.  There have been almost no neck notchings that I have heard of with the experienced surgeons.  There are tons of negative studies just trying to show hip resurfacing is not a good procedure. Ask current surgeons and look for new studies.

Mr. McMinn shares a large amount of information in his videos I feature on this page:  https://surfacehippy.info/mr-mcminn-interview/
Pat

[tobyskier]

Hi pat, just a N of 1 - I have notching on my neck on most recent xray, and by surgeon was very experienced.

[Pat Walter]

I am sorry to hear that.  I hope you are able to keep your hip resurfacing.  This doesn't happen very often, but it is terrible for the few people that have it happen.  Again, I am sorry.  I hope there is a solution.  I wish you the best.    Pat

[tobyskier]

No worries, Unfortunately I have to convert to a thr. It's rare, but it does happen with high volume, reputable surgeons.

[Pat Walter]

I wish you the best. I am happy you shared your story.  It is important that people understand hip resurfacing is not always 100% successful, but has very few have problems.  I have always shared that information.
Any surgery has possibilities of failures, revisions or death.  My open heart surgery had a 1% chance of death. The radiation therapy I had for Breast Cancer had a 30% chance of fatigue and other problems forever after treatment. Even a year out, the fatigue is still holding me down.  So people must understand there is always a chance of problems, but fortunately hip resurfacing has very few.
I have a section on the website for Revision Stories  https://surfacehippy.info/category/hip-resurfacing-stories/thr-and-revision-stories/    There is also a section on this forum for Revisions and THRs  https://surfacehippy.info/hiptalk/index.php?board=49.0
Thanks again for sharing.  I hope you will get your revision and be pain free soon.  Pat

[Holger]

Hi Pat and Toby,

yes you're right. The study is quite old and it is (only) a simulation. But I found the claim that the femor neck can touch the cup quite reasonable (especially with deep squats under high load). I wrote an emal to my doctor (Raimund Voelker in Germany). Will see what he will say.

Best,
Holger

[MattFL]

Hi pat, just a N of 1 - I have notching on my neck on most recent xray, and by surgeon was very experienced.

Did you have any symptoms, or did it just show up during a checkup x-ray?  Also were you doing anything such as deep squats? 

[tobyskier]

Yes,
I have impingement and clunking 100's of times a day, likely converting to thr with de smet this year.