Pritchett was at 2600 in Feb, 2011. At about 6 per week or so, I estimated he'd be at about 2800 or so about now. He doesn't seem to be too interested in his numbers, though. He's a little quiet, but once you start talking about the FDA or a particular device, or details of metallosis or most other technical details about HR, he gets into it. I saw him last week for my 8-weeker, he almost left the room without me asking questions. We got into a healthy Q/A about various issues, from femoral neck thinning, ASR problems, a proposed joint registry in the US, and we even talked about Barry (NY Times Journalist). I didn't drive 5 hours and pay $400 for just an x-ray (insurance is paying for that). Being a bit of an HR vet, I didn't feel the need to ask questions specific to my recovery, so I prefered to talk about the latest study or latest topic of interest in the HR community.
BTW - I know I'm a Pritchett groupie, but I do want to emphasize that he is extremely experienced, well-authored, and does keep current with HR.
Hi Tin,
I'm going to get his stats on Wed. when I go in for my 8 week check up. We are going to see if he will respond to a request for his views on the Gantz approach but if he isn't passionate about it - he may not have a lot to say.
Yep, Pritchett groupie here too. I think we all love our surgeon especially when things go well. He loves to talk research and about his studies and ideas for future improvements for HR. Otherwise he is very quiet and can almost seem aloof. He's been doing this for so long - he's seen it all.
Luanna
Tin,
I feel the same way about the questions I will be asking at my next visit. I have a few about myself but I want to discuss HR with my doc and see what he has to say. Yeah, I don't want to travel a far distance and only see him and an x-ray for about 5 or 10 minutes then leave. Those are impressive numbers for Dr. Pritchett.
Here are the stats as of 10/25/2011 per Susan, his patient-care coordinator plus.
"Luann â€"
Dr. Pritchett & I are familiar with the Surface Hippy website and I understand it has provided a lot of information for many patients. I would estimate that 2700 would be an accurate approximation for the number of resurfacings Dr. Pritchett has done to date. His weekly surgery schedule isn’t 100% hip resurfacings. In addition to the resurfacing procedure, Dr. Pritchett also performs total hip replacements, total knee replacements and shoulder surgeries.....
Sincerely,
Susan"
I was close.
You'd think after more than 2700 procedures, we could get a few more people to chime in here :)
I'm scheduled with Dr. Pritchett in the New Year. I would love to hear more stories, thoughts and/or opinions on people's experience with him.
If you're not comfortable posting here... please email me at the address below.
Thanks everyone!
BB-
There is not really a question to respond to so I was just lurking.
Like Tin, I am a very satisfied Pritchett groupie. He is quiet but confident. He appears to be exactly the type of man that would write the medical study articles he has written. I have nothing but good things to say about Dr. Pritchett and the staff at Swedish Hospital Orthopedic.
Best wishes. Send me an e-mail if you wish. Also check out my blog that is in my signature line.
Dan
A Dr Pritchett patient (not quite ready to be identified as a groupie). I am 58 years young and am 3+ years with my BHR. I hike and backpack (started that 8 months post op) and can honestly say that I never even think about the hip, never any pain, tightness, etc. Pritchett certainly deserves to mentioned with the best hip replacement surgeons in the world.
Okay, so I will have another opinion, and have chosen Dr Pritchett based on his proximity to Vancouver. AND your experiences written here.
This will be mid December once a second round of blood results come back, and the ultrasound, which has been delayed until November 30
My cup placement is at 40, which I'm told is perfect.
And if there is no fluid around the joint (ultrasound) then its just the very high levels that are a concern. And a warning ?
Am trying to remain patient.
Hi cwg,
Good to get his opinion. Be sure you ask lots of questions and get him talking. He firmly believes that cup placement is only one issue and that other factors are as or more important. Be sure you ask him to share his views with you on this. I think you will be quite surprised and relieved to hear his thinking on it. I don't think that it is a controversial issue but I'd rather not push ideas that are not in sync with this site's philosophy and point of view. So - be sure and ask him about it.
There is a big conference coming up in Feb. and I believe there will be new data and a lot of debate about it. Some of the surgeons who have proposed the cup placement theory as the primary cause of metalosis may be backing off of that stance a bit. We'll see.
One of my friends with a recalled ASR device will be consulting with him in Dec as well. Her original surgeon is in Colorado and she is living here now. He said that unless she is having problems he would leave it be but he is very happy to work with her and do his best for her. Her cup placement is also excellent. But she is having high metal ion count but feels great.
Best to you.
Luanna
For the benefit of Baby Barista,
I am one of the 2700 who got a resurfacing from Dr. Pritchett. Mine was back in July 2008, which may not have been his best year. At least 4 of his patients that year, including me, wound up with acetabuar cups with angles greater than 55 degrees (mine was 65 degrees). More information about these cases, and at least one other Pritchett patient, are buried in the long list of posts to this website. My details were described in a post in May 2010 under the group entitled "Has anyone had acetabular cup reset to fix the angle?". All except me ended up with quite high metal levels in the blood. Two of them had revisions to THR, and one was revised by Pritchett to a BHR. Since my metal levels are less than 7 micrograms per liter so far (10 or more seems to the level of action), and I can still do quite a bit without major pain, I have been dragging my feet on the revision that is probably inevitable. I want to be able to run more than the steps and the occasional 1 or 2 miles I have to limit mysef to at present. I like Dr Pritchett, who emails me from time to time to check on my status. My non-professional opinion is that the reason for his steep angle cup situations is the fact that in 2008 he did not perform inter-operative x-rays to confirm an appropriate angle had been achieved before closing. He assured me that precaution is now being done. I will probably have him do my revision because he also appears to be far ahead of most resurfacing surgeons in experience with BHR revisions.
Best of luck.
Mccabe66
Hi mccabe66,
Good information. I know that there is at least one other person using this site, Barbara, who has had an experience that would be worth mentioning here. If I recall, after her bilateral HRs with Dr. Pritchett her bone would not grow and adhere to the acetabular cup implant and I believe that she is in the process of having Dr. Pritchett revise to THRs. I think she said that he put in titanium and her bone is taking to it nicely. Barbara, if you read this please correct me if I've got it wrong.
cwg, my friend's metal level is in the 8 range right now 2 years post surgery.
Luanna
Hi Mccabe66,
Another steep cup angle installed by Dr. Pritchett in May 2008 was for Jim Turk aka Jim Tork.
You have to read his story on Vicky's website for more details about the revision about a year ago.
I stumbled across his story by monitoring the two surface hippy websites and hearing anecdotal reports from other Alaska racquetball players, since Jim is an Anchorage racquetball player who resided in Juneau many years ago when I met him at the local racquetball club.
Quote from: cwg on November 21, 2011, 12:24:40 AM
What is Vicky's website- Thanks
http://www.hipresurfacingsite.com/
Stevel - I was going to mention that story on Vicky's site. That certainly gave me a little concern as well as your comment about continuing through Seattle on your way to NY, when I was searching out surgeons. Interesting discussion.
Maccabe - Interesting detail about the inter-op x-rays. So what happened before 2008? Pritchett has being doing HR for more than 4 years. Was inter-op x-rays generally not done by all surgeons until then, or was he a late in utilizing inter-op x-rays, if so would we expect to see problems from 2007 or earlier?
cwg - I was a believer in the steep angle issue before I chatted with Pritchett, but I am also a believer in his perspective. He's a no nonsense scientist and I find it hard to not have faith in his opinion on the whole thing. On the other hand, common sense seems to suggest that the best angle for good distribution of weight and connection of surfaces, would not be a steep cup angle. Some of the discussion about edge-loading coupled with some of the x-rays of a steep cup really seems to support the idea of higher wear. Anyway, I think you'll get a lot from him. Like Luanna says, ask lots of questions.
Also check out Keith Brewster's surface hippy website on Yahoo for posts about Dr. Pritchett.
Posts on this website extend back to 2000, when the website was started.
Tin Soldier & others,
I first heard about the inter-operative xray from Dr Snyder in Boston, whom I visited in early 2010 for a second opinion on my steep cup situation. He said Mass General and Newton Wellesly hospitals will not let you do a BHR without it. The earliest I can find mention of use of the inter-operative xray was from Dr. Gross, who said he had been using it since 2007. Dr. Schmalzreid mentioned its use in 2010. I don't think Dr. Pritchett was particularly late in picking up that approach, because it seems most surgeons were not using it before about 2009 or 2010. Dr. Pritchett probably felt he did not need it because of his experience. I am sure he would admit that during his years of doing BHRs he produced a number of steep cups, - - he said he was never sure about the angle until the xrays after the operation. Today it would be very short-sighted not to use an xray during the operation to check that extremely important angle.
Thanks for the mention of Jim Tork, - - I considered him as one the steep angled cases from Pritchett in 2008.
An upcoming decision for me is whether to go back to metal-on-metal, or switch to polyethylene.
I read with envy the post by JimK who said he doesn't even think about his Pritchett BHR because it feels so natural. In contrast, my hip reminds me every day that something is not quite right. If you are getting a BHR, make sure your surgeon takes all available precautions to avoid a steep cup angle.
Cheers
Mccabe 66
I must have dodged a bullet by bypassing Seattle and going to New York for surgery by Dr. Su in Sept 2008.
I have never heard of any steep cups installed by Dr. Su, even before it became common knowledge to hip resurfacing Drs.
I used frequent flyer mileage to travel anywhere Alaska Airlines flies, so I flew to the Newark, NJ airport for surgery at the HSS, which was rated no. 1 for orthopedics in 2007, 2008 & 2010 by US News and World report. And this includes diagnostics, nursing, aftercare, infection, casualties, etc.
Good to see a robust discussion going on about Dr. Pritchett and his protocols now. However, I think it is unfair to characterize bypassing him as, "dodging a bullet".
I have spent the better part of six months reading all of the hip resurfacing sites front to back. Look long enough and you'll find horror stories about *every* HR surgeon. I've also reviewed state medical board records from New York to Washington, and again, if you look long enough -- you'll find trouble.
I think in general, these findings speak less about the doctors and more about the complexity of the procedure. And if we're being completely honest here -- we won't know who *really* are the best surgeons until 15 or 20 years from now.
Hi Baby Barista,
I agree that having honest discussions is great. I'm totally thrilled with Dr. Pritchett and especially like how honest he is about problems that crop up from time to time. He doesn't try to hide them or minimize them. His main focus is on his patients and doing the best he can for them. If you ask him a difficult question he will answer it fully. He is not concerned with fascades or marketing, and when his opinion differs from other top surgeons he sticks to his guns rather than agreeing just to get along. He doesn't care to be popular if it means compromising his integrity. He is very skilled, continues to learn, is honest, and has great integrity.
He told me that when a patient has a problem (and it happens with every surgeon from time to time) he loses sleep over it. He is very diligent about following up with his patients and tracking outcomes over time. His research is impeccable as well. I admire him greatly.
Bottom line - his failure rate is extremely low.
Luanna
Chuckle- I think Steve L's comment about 'dodging the bullet" is fine.. I also don't think it ruins Dr Pritchett's reputation and huge experience.
That being said, my surgeon did take xrays and worried about angles, in 2007.
Whatever..
My reason for not going to Pritchett just yet is I can start, with no drive and for free, with Dr Su.
Both Doctors are in my second and third opinion choices.
I think ALL the doctors names who are mentioned here should be very grateful. No doubt they know about this site.
Baby Barista:
I meant "dodging a bullet" because several steep cups were installed by Dr. Pritchett during this period, whereas Dr. Su has recently published results for 925 resurfacings from 2004 to 2009 and of the 12 revisions (1.3 %), there is no mention of steep cups. See the results on the new information page on this website. Dr. Gross also recently posted results for 2000 plus resurfacings with similarly low revisions and/or complications.
Ask Dr. Pritchett for his results and examine revisions and complications.
I have to admit, I did not ask Dr. Su for results before I went for surgery.
During the Summer 2008, I also found on Keith Brewster's yahoo surface hippy website, message no. 104629 (nerve damage, foot drop) for a patient from Juneau, message no. 131434 comparing first hip resurfacing by Dr. Pritchett and second hip resurfacing by Dr. Gross for another patient from Juneau and several other negative messages about Dr. Pritchett. Check it out.
I've seen the self reported studies by Dr. Su and Dr. Gross. I've also seen a preliminary numbers from Dr. Pritchett. But more importantly, I have FOIA'd records from state medical boards for a number of different doctors across the country. While the stories shared on this website and others are invaluable, I would not take anonymous posts as gospel. You might be surprised what you find when you start digging through official records.
Some of these stories are corroborated by local physical therapists.
When one of the PT recommends going to the East Coast for hip resurfacing surgery, what does that imply?
After all the PT's, see the end results of hip resurfacing surgeries, good or bad.
Here is a self report by sixstring about how his physician, Dr. Gross and others did not have access to the machines they use now to ensure cup angles. They do now and are able to measure angle before closing up.
Sixstring:
"I got a right hip resurfacing using the Biomet Magnum Recap by Dr. Gross in SC in June 2006. The hip functions well other than frequent clunking/shifting when the hip is extended (standing/walking); the clunking causes no pain. I am a very active 59 year old male, 5'-8", 163 lbs....
In February 2011, I had blood levels of chromium and cobalt measured on my own - Dr. Gross did not suggest it. Cr was 38 mcg/l ("normal" <1.4mcg/l) and Co was 81 mcg/l ("normal" <0.5 mcg/l), both extremely high. I reported this to Dr. Gross who asked me to have them rechecked with a lab he uses - results there were virtually identical. (Note: mcg/l means micrograms/liter; one lab measured serum metal levels and one measured plasma levels with very little difference between the two.)
I talked to Dr. Gross after the elevated blood metal levels were confirmed. He said my cup inclination angle is ~ 60 degrees (optimum is closer to 40 degrees) which is associated with excessive wear, probably due to edge loading of the cup. He said steep inclination angles weren't known to be a problem in 2006 when I had the resurfacing, and that he didn't have a way then to set the angle during the operation. He now uses an intra-operative x-ray to measure the angle at which the cup is placed and now never has cup angles > 50 degrees. I recommend reading Dr. Gross's article on Acetabular Component Inclination Angle on his website ( newbielink:http://www.grossortho.com/ [nonactive]). Given that my hip is functioning well, he didn't feel my blood metal levels were a serious health issue, and said the options were to continue to track metal levels, get an MRI to check surrounding tissues for signs of metallosis, or to revise the cup."
Luanna
CWG,
One local PT has recommended the East Coast for hip resurfacing surgery.
He apparently has worked with patient(s) of Dr. Gross.
He did not work with me (another PT at the same practice did) but he knows that I went to Dr. Su in New York.
I don't know if he has worked with patients of other East Coast Drs. (such as Dr. Mont in Baltimore).
He has worked with several patients of Dr. Pritchett, who had complications.
He said Dr. Amstutz, Los Angeles, CA retired recently, and he does not know any other West Coast Drs. that he would recommend.
Okay- You have my attention. However, one or two PT persons at the same clinic, does not alarm all my bells.
PTs from all over your area, would ring the bell.
Also, is this current stuff?
You obviously? feel strong/ly about all of this, or why would you bother writing?
To be frank, I find 2700 BHRs very impressive, but at the same time I find that a huge number. That does worry me a bit.
In my case, I believe I had an unnecessary BHR, year 2007.
From reading about other person's stories here, and their much worse problems pre- op, I realize mine was premature.. Ridiculous as this may sound, my back may have been the bigger issue.
And the BHR was a new "trendy" option.
Never mind.. I had the BHR, and things got worse all around, and now I am facing other things due to high ion levels
Hence my checking on a second opinion in December.. some where.
You are quite committed with your thread, which keeps my attention.
At the same time, I think one learns from his/her mistakes
Do you CURRENTLY hear about "stuff"
Thank you
CWG,
The only recent item I heard from the local PT, was that one hip resurfacing patient of Dr. Pritchett continues to have pain.
I suppose you could call Patrick Ripp at Juneau Physical Therapy (907) 586-5951 and ask him for more details about why he recommends going to the East Coast for hip resurfacing surgery.
I also corresponded via email with a prospective patient from Juneau who has done her research and has scheduled surgery with Dr. Pritchett in a couple of weeks.
I question the reported 2700 hip resurfacings when his own website (FAQ) states that he has completed 1200 (both BHR's and Conserve Plus) since being trained for the BHR in 2006.
He did complete hip resurfacings extending back to the 1980's before beginning BHRs in 2006, but how does this total 2700?
Hi Steve,
His website is not up to date. I was the one who got the 2700 number from him and his staff directly just a couple of weeks ago. The numbers on Pat's site here are accurate.
I'm glad that you are happy with your choice of surgeon. I've heard very good things about Dr. Su.
Best regards,
Luanna
Hi Luanna- Quick note in this doc thread- Just to let you know I was to see him yesterday but cancelled the appointment (with an outrageously wonderful secretary/nurse) for various reasons.
Am also not seeking second/third opinions, just yet .
Reason being, all my tests show perfect cup placement no pseudotumours etc. And the two pros I saw here in Vancouver have nothing invested in protecting themselves. Things really are ok ... so far
I believe you are quite right in that Dr Pritchett agrees that high metal levels can happen even without "obvious" things like cup angle etc. I will be curious to read what he says regarding high levels
I have my own thoughts about this, mostly that I had not strengthened enough, and little particles can slip out- whatever- am working 5 days a week on this and feeling better, stronger.
Yes 5 years after my BHR there is still room for improvement.
Luanna, Dr Pritchett will be the one I speak with about this, at some point. He is a pro, with heaps of experience. All of you "Pritchett groupies" have good reason to be- In my opinion
Hi cwg,
Good to hear from you. The outrageously wonderful nurse is most likely Susan. She's great.
I'm hoping that some new substantial research findings will be presented at the Feb. conference in San Francisco. From what Dr. Pritchett mentioned at my last checkup most of the serious and candid talk between surgeons goes on after conference hours at dinners etc. That sounds right to me. I attended lots of conferences when I was an academic and it was true that we'd talk more openly about our research, hot topics in our field, and our thinking with colleagues after conference hours.
So glad to hear that you are feeling stronger and better. Those are both excellent things to be feeling. Keep up the good work and please share your progress.
I'm very, very, very pleased with my surgery and the results and I feel blessed that I just happened on to Dr. Pritchett by chance. I sure got lucky!!
Luanna
It was "Helen"- smile
ALL of us , no matter our work, speak more thruthfully "after hours". Of course-
Anyway, I'm certain Pritchett Su and everyone mentioned here are good value. Mistakes and all are great opportunities to learn and improve, if not perfect things.
Have to say though, when put on hold and listening to the 'muzak' as I wait for a person to get back on, the muzak is now one big promo for the clinic and orthopedic procedures etc. Kinda turned my stomache.
Okay, I will end my part of this thread here. Looking forward to Feb conference thoughts ideas or results.
Cheers
Just wanted to note that I have confirmed with both Swedish Medical Center and Dr. Pritchett himself, that since 2009 he has used intraoperative x-rays with image enhancement, to ensure proper cup placement before surgical closure.
Yes. It showed up on my bill and I paid for it - so I'm assuming it was done. :) Good for you for checking. I didn't even know the right questions to ask at my surgery date. Now I do.
Baby Barista - your date is getting closer. Do you know what brand(s) of implants you will be getting? Just curious.
Luanna
It shows in his work, from what I've seen here, baby barista - sounds like he's going to do a good job with you.
I will be getting the BHR. My understanding, is that except in unique cases (like Luanna's ;-) or per the patient's request, resurfacings conducted at Swedish Orthopedic are now uniformly BHR's. It has to do with their proven performance and what I'm told is an agreement with Smith and Nephew.
Good for you. They do have a great performance record. I just heard from one other person (happens to be a small boned female) who just had HR with Dr. P and she received the same implants that I received. So excited to hear that there is more than one female visiting this site with the same implants as mine.
Not the odd duck out any longer! ;)
Luanna
Hi Luanna- I had to post after being mentioned :) I saw Dr. P today. He told me that he has been using our implants (cross-linked polyethylene) on women for about 8 years with very few failures. I was pleased that there are women out there doing well after 8 years!
Davina
Greetings Davina,
8 years. That's reassuring!!! Thanks so much for posting that fact. And congrats on your excellent 2 weeks post-op check up.
Also, remember that if you have any questions in between appointments that you can easily email or call Susan and she will get back to you on the same day.
Best wishes for a GREAT recovery.
Luanna
I didn't see Dr. Prittchett as topic I was too busy out enjoying the new hip he gave me...So I guess I am somewhere about 2750 with 5 months post op tomorrow.
Everything I saw posted before was correct he is quiet person and my 8 week check up would have been 2 mins had I not asked a lot of questions. His opening line was You are healing great, no restrictions the placement looks perfect and go do anything you like and see me in 2 years.
I asked him why my scar was so long 10" and he told me, "Would you rather I got the hip in the right place or saved your bikini line." lol
He just cranks out successful BHRs....I couldn't be more happy!
Matt
Matt - I found that you have to ask some questions. I really enjoyed asking him questions, you can learn a lot from him about the history and development of HR. The last section in McMinn's book (Modern Hip Resurfacing) was written by Pritchett. It sort of concludes that HR will be around for a long time.
Some people are put off by his quiet demeanor and short bedside manner. But as I was wheeled into the OR this morning and saw him studying my X-rays on his computer, I could not have been more confident in my decision.
Some leaders are vocal and speak for their work, others are quiet and let their work speak for them. That is Dr. Jim Pritchett. He's extremely frank and doesn't sugar coat. I appreciate that. When he came out to talk to my wife when I was in post-op, she too was impressed by his candor. He said everything went as planned, my arthritis was more more advanced than it appeared on film and that time will tell the surgery's success. He believes if I hit the 4 month, 1 year and 4 year benchmarks... I could retain my BHR for life. No flowery words, no promises... just facts.
Excellent report! Welcome to the Dr. P Hippy Club!
Best wishes as you recover.
Dan
I'm with you Barista. Just tell me the truth and don't waste my time. Some people prefer a more indirect approach but I'd rather have the info straight up with a twist of lime.
Luanna
Good news Barista.
Yeah, no sugercoating for me either, not even a lime, maybe some salt in the wound just so I won't forget the experience.
I guess I should put some stuff on this site. I had a right hip done by Dr. Pritchett July 2011 and I'm very happy with the results. I was 57 years old at the time and active. My main problem after the surgery was a very tight and painful iliotibial band (sp?) but it finally stretched out fine and I've had no problems with it since. I returned to running and did the 5K Turkey Trot on Bainbridge Island in November 2011, just four months after the surgery. It is now March 2012 and I now run about 3 times a week for 35 to 40 minutes each time - I completely changed my running style to minimize the impact by running exclusively on my toes and mid-foot (no heel striking at all) with a shorter stride (tiny steps on my toes going down steep hills), but I still have a pretty decent gate and speed and I very happy with my progress. I'm using my old shoes but plan to go to the newer minimal impact style like New Balance Minimus or 5 Fingers something like that - the "barefoot" theory makes a lot of sense to me and seems to be working.
As for Dr. Pritchett, I did a lot of research ahead of time and know he is perhaps the most knowledgeable resurfacing doctor around. His bedside manner isn't great in that he can seem abrupt and distant and disinterested, but he will respond if you are up front and direct with him, particularly on technical issues. I strongly suggest that you read his many technical articles on resurfacing, particularly on the metal-on-metal issue. I realize there is a relatively small likelihood that I will have problems with metal in the future but decided that the rewards of resurfacing are well worth that small risk, and I have no regrets at all about doing it - best thing I ever did. My older brother had both his hips fully replaced and he is very jealous.
Thanks for the post, JE - your experience with this is good for fresh hippies or prospective hippies to see. The more realistic happy folks we see here, the better.
Thanks for the running tip too - I'm not a runner, but probably need the tip more since the running I do is on the treadmill or for small distances and I'm not clued into what would work best for us.
Thanks for sharing your experience JE. I had surgery in August 2011 and had a similar experience with Dr. Pritchett. My new hip at 7 months is doing very well.
Luanna
Thanks for posting JE, I did the same with the research and Pritchett has so much experience and he was relatively close, and my insurance worked. I'll put you on the list for NW hippy gathering, if I ever get around to making something happen.