Hi everyone,
I'm going into surgery on Monday morning, and something keeps coming up when I meet with nurses and therapist. They keep saying "I'm going in for either hip resurfacing OR hip replacement" Its bothering me, because it keeps coming up and the last nurse I spoke to said some times the doctor sees some when they open you up which they didn't see in the xrays or MRI s. Is this true? I really don't think I'm ready for a full hip replacement. I'm only 39. The hospital said I signed off for it.
Any ideas?
I had a friend who was an active Marathoner. He was scheduled for Hr but the SUrgeon said he could not properly place the device and he had to have THR. It happens. You just want to make sure you have an experienced and skilled surgeon. However, this happened with one of the most skilled HR surgeons in the East coast. It depends on what the Surgeon sees when they go in. There are many factors that come into play.
I would make sure to have ac onversation with your Surgeon about the alternative THR device. You want something that will give you more range of motion and provide for a more active lifestyle. In the case of my colleague, the suregoen said he will still be able to run on his THR. Good Luck dude.
Quote from: hipnhop on March 01, 2012, 07:22:04 PM
I had a friend who was an active Marathoner. He was scheduled for Hr but the SUrgeon said he could not properly place the device and he had to have THR. It happens. You just want to make sure you have an experienced and skilled surgeon. However, this happened with one of the most skilled HR surgeons in the East coast. It depends on what the Surgeon sees when they go in. There are many factors that come into play.
I would make sure to have ac onversation with your Surgeon about the alternative THR device. You want something that will give you more range of motion and provide for a more active lifestyle. In the case of my colleague, the suregoen said he will still be able to run on his THR. Good Luck dude.
OMG!!! With all the research I've done I can't believe I missed this. I only have a day or 2 to think about it.
I'm not a surgeon, but the way it was explained to me is if there are any significant bone cysts in the femoral neck that were missed on x-ray, it could be possible. Did you have a CT scan? This is usually a mitigating factor that can give you and your surgeon more confidence. Worse case, you need to really know from your surgeon what the THR device would be.. quite possibly large-ball MOM THR, which would be similar performance characteristics as HR.. sounds like you need a phone call with your surgeon to alleviate any fears, my friend! Force the issue and get some answers before you go in!
Let us know what's up!
Jake in MN
I think that for your piece of mind, the key question to ask the surgeon is how often this has happened with him. With the surgeons that are most experienced and committed to resurfacing, the number of times this happens is extremely rare, almost never. For other surgeons, it might happen more often. If you are worried about the possibility, this might be a key question to ask. There should not be any problem in quoting you exact numbers.
I do not think any surgeon can give you a 100% guarantee, but a review of their history should give you a good insight into the risk.
That's interesting. I asked my surgeon, Dr. Pritchett before surgery if he wanted to reserve the right to change to a THR if he got in there and couldn't do a hip resurfacing. He smiled and said "no - I'm going to do what I tell you I'm going to do". He'd been seeing me for 3 years so he had a lot of info about my hip.
On the other hand, he told a woman who is flying up here this coming weekend for an HR that she may end up with either an HR or a THR depending on what he finds during surgery. Same doctor two different responses to two different patients.
If I were you, I'd want to get as much information as possible so that you go into surgery feeling confident with whatever happens.
Luanna
My surgeon also advised there is a chance, if something is amiss, a THR would be performed instead of the BHR. They can't leave you with nothing.
Quote from: mslendzion on March 01, 2012, 08:47:49 PM
My surgeon also advised there is a chance, if something is amiss, a THR would be performed instead of the BHR. They can't leave you with nothing.
Touche' Ms!
I was told the same thing - Strive for BHR but could be THR. When I woke up and the surgeon visited the first thing she said was "You got the BHR" I started crying - just couldn't help it. So relieved, but would have been disappointed but glad to be rid of the O/A even if I'd gotten a THR.
It may depend partly on how carefully your surgeon chooses his patients.
Going in my surgeon, who has performed many hundreds and probably more than a thousand HRs, admitted that there was a possibility that I could come out with a THR. He then qualified that by saying that he had never had to switch.
Quote from: jakemn on March 01, 2012, 07:43:40 PM
I'm not a surgeon, but the way it was explained to me is if there are any significant bone cysts in the femoral neck that were missed on x-ray, it could be possible. Did you have a CT scan? This is usually a mitigating factor that can give you and your surgeon more confidence. Worse case, you need to really know from your surgeon what the THR device would be.. quite possibly large-ball MOM THR, which would be similar performance characteristics as HR.. sounds like you need a phone call with your surgeon to alleviate any fears, my friend! Force the issue and get some answers before you go in!
Let us know what's up!
Jake in MN
Yes I had the CT scan and bone scan. I did every scan possible. Everything was good. Hopefully I can get some answers tomorrow. For some reason I feel they shouldn't even tell us before surgery. Tell us after. Something went wrong and this is what they needed to do. Its like taking my car into the garage to replace a fuel pump and the mechanic tells you " I have to remove the gas tank, if it explodes, you have to get a new car. Sign here" In your mind, you're thinking, It will never blow up, but then later on, nurses are saying "oh , you're getting a new fuel pump or a new car" :)
Zap. I agree. In my case it was one of the many questions I had at my last pre op office visit. I was able to generate a pretty good set of questions from the info on this site. Collected and stored them on my notes iPhone app.
I had a fellow cyclist who went in for a BHR and came out with a THR. All because the surgeon wasn't that skilled or experienced. That's why it's so, so important to get a surgeon who is very skilled at this and has done a number of procedures. Everytime they go in they will see something different. But, an unskilled, lesser experience surgeon may not know how to handle that one case of "something being different", or "something they've not ever experience" before. All surgeons will have you sign a release saying there could be a possibility of getting a THR when they go in for a resurfacing. But, if you ask the good ones how many times has this happened the occurance rate is either none existant, or so small it's almost not even worth mentioning.
Quote from: johnd_emd on March 01, 2012, 10:59:33 PM
I had a fellow cyclist who went in for a BHR and came out with a THR. All because the surgeon wasn't that skilled or experienced. That's why it's so, so important to get a surgeon who is very skilled at this and has done a number of procedures. Everytime they go in they will see something different. But, an unskilled, lesser experience surgeon may not know how to handle that one case of "something being different", or "something they've not ever experience" before. All surgeons will have you sign a release saying there could be a possibility of getting a THR when they go in for a resurfacing. But, if you ask the good ones how many times has this happened the occurance rate is either none existant, or so small it's almost not even worth mentioning.
This ^^^ sums it all up. Dr. Su told me I have a duty to advice you and then said with a smile, "I know what I am doing."
On both of my resurfacing's I got the same warning. On the left one the doc told me it was in way worse shape than indicated on the x-rays, but during the surgery he never considered changing course.
Ask your doctor if he has ever had this happen. I asked Dr Marwin and he said that he has never had to to a THR when he went in for a HR. I got jsut what I asked for; two nice shiney BHR's, and right now I'm feeling great.
Like everyone said, it depends on the experience of the surgeon.
At my pre-op appt., I asked Dr. Gross what device he'd use if they had to go to a THR, and the response was "We're not. You'll have a resurfacing. I was very lucky to have that kind of confidence going in.
So, yes, ask the surgeon what his statistics are.
Oh geez didn't even think of this. However I am borderline to get in implanted. If i wake up with a total hip my Dr. better run! :o
but i will have the "talk" with him.
I have a similar concern. I'm having a BMHR done, but given that it is almost like the 'last chance saloon' alternative to a THR, I worry that I'll end up with a THR.
I think the best thing to do is to talk to the surgeon, ask straight questions, demand straight answers. That way everything is on the table and the doctor doesn't have to run for his / her life (eventually, it takes us a bit to catch up with that walker).
Well it looks like my doctors office is closed on Fridays and my surgery time is Monday morning. This forum has calmed my nerves a little. It seems like this is standard for the surgeon to have the patient sign off for THR. I WILL NOT LET THEM PUT ME UNDER UNTIL I TALK TO MY SURGEON ON MONDAY MORNING. :)
i think all surgeons will say "there is a chance" but (as others have mentioned, with a good surgeon/patient selection the chance is very small). cysts are an issue. for me, one suregoon would not do resurfacing on me because the xray showed a cycst (he doesn't do many hip resurfacings). dr su said my cycts were not big enough to be a concern. my actual suregon (dr craig della valle) ... noted my cysts on the xray, performed a CT scan, and concluded my cysts were small and "in a good spot" so hip resurfacing was okay (i can't remember where exactly they should be as i was just so happy that he said hip resurfacing was for me, i really didn't listen to the explanation).
ZAP,
I was told pre-surgery that there was always the possibility that it could become a THR once my surgeon went in there. When I asked him how many times this had happened to him, he said zero! It is a standard precaution. I had several cysts, including one large one, and still ended up with a BHR.
June
About the "being happy to hear BHR was a go" factor... I hear you there Maxx! I had some bone cyst concerns indicated on x-ray, and Dr. Rogerson had ordered a CT scan, which I had sent over a couple of days before. It was a Friday afternoon after work, and I happened to be in a deer-hunting tree stand for about an hour, and there wasn't much action, so I decided to check my cel phone messages. Dr. Rogerson had left a message for me in the time it took me to walk into my hunting stand while my phone was shut off. He informed me that the CT scan indicated NO problem after all, and that I was fully qualified for resurfacing. I almost fell out of my tree-stand with happiness! LOL!
Jake in MN
This seems to be a pretty common concern. I agree with everyone's posts. Pritchett responded to me like Su did to Woody. My assumption is that there is a legal need for the hospital/surgeon to allow them to put in a THR while there, thus the constant affirmation from the staff that "you might have a THR", when really the doc will probably know just from the x-ray, what the plan is and how confident they are to achieve the plan. Pritchett said he's never had to change plans midstream. I think there a probabaly few cases, like Luanna pointed out, where the doc will and should be very upfront about the likelihood of having to change plans midstream.
Zap - You should be meeting with the surgeon in the pre-op room or waiting room before surgery. I'm assuming they only mentioned the THR because they have to. Good luck on Monday, I'll be thinking about you.
Well, the first home visit from the nurse just finished explaining to me it is a standard for doctors to do this. He said its a 1% chance of this happening. He said if for some reason the surgeon causes a fracture because the bone was to weak, they can't just leave you on the table. He said, he had one guy that it happened to, but the guy was a vegan and not as athletic as my self so his bones couldn't handle it.
Most experienced surgeons will tell you whether or not you will get an HR or total hip.
Dr. Gross did not say that to me, he said "you will wake up with a hip resurface.
It maybe one of those just in case things with that staff, or (don't take this badly) your surgeon has some problems when things are really tight when he opens up and dislocates.
Some surgeons end up doing an alarming number of switches to mini hips or total hips during the surgery, that bothers me, it's almost like a bait and switch. I had some good sized holes on the top of my femur and Dr. Gross did some bone grafts and I was good to go with full weight post op.
I would ask your surgeon how many he's had to switch to a total hip during surgery, if he is unsure of the number or the number is more than say 1% of his hip resurfaces then I would question him further about your case.
Chuck
Quote from: ZAP on March 01, 2012, 07:02:25 PM
Hi everyone,
I'm going into surgery on Monday morning, and something keeps coming up when I meet with nurses and therapist. They keep saying "I'm going in for either hip resurfacing OR hip replacement" Its bothering me, because it keeps coming up and the last nurse I spoke to said some times the doctor sees some when they open you up which they didn't see in the xrays or MRI s. Is this true? I really don't think I'm ready for a full hip replacement. I'm only 39. The hospital said I signed off for it.
Any ideas?
Best of luck to you. Dr. Gross's staff said the same thing but if I remember correctly there was only 2 or 3 times they actually had to revert to a THR, very unlikely odds in the hands of a skilled surgeon!
As of Aug 2008 when I had mine done Dr. Gross told me he only ever had to revise one (at that time of course), I believe the head was just shot with too much damage.
Chuck
Quote from: Aerial on March 02, 2012, 07:19:25 PM
Best of luck to you. Dr. Gross's staff said the same thing but if I remember correctly there was only 2 or 3 times they actually had to revert to a THR, very unlikely odds in the hands of a skilled surgeon!