You will often hear me and some of the other Surface Hippies recommend that you use the really experienced hip resurfacing surgeons. There have been published medical studies to indicate there is a steep learning curve for hip resurfacing surgeons. The really experienced hip resurfacing surgeons all had a few revisions in their early surgeries. Most of them were doing hip resurfacing before there was as much formal training like there is now. They had to do more experimenting to learn how to get the job done properly. There was less instrumentation to help surgeons place hip resurfacing devices than existed for THRs.
All doctors have to learn to do hip resurfacing. It is a much more difficult surgery than a THR. Some doctors can learn after doing 20 surgeries and other might take 200 surgeries. Some decide that hip resurfacing is just not for them and prefer to do THRs so the patient has a good outcome.
The survivorship rate of the BHR used to be 99.8% according to some McMinn studies. Some informal information now indicates that the survivorship rate might be 96% and I had one doctor tell me he thought the revision rate for the US was 7%. None of these numbers are from published medical studies. It does make common sense that it takes time to learn to do a complicated surgery consistently. I have heard the better know doctors say this. Some mention this in their videos interviews on Surface Hippy. http://surfacehippy.info/category/surface-hippy-videos/doctor-interview-videos/ (http://surfacehippy.info/category/surface-hippy-videos/doctor-interview-videos/)
In an effort to help people have good outcomes from their Hip Resurfacing Surgeries, we often tend to suggest the most experienced surgeons. There is little chance of serious post op problems. Many people can't, however, always go to these surgeons. Also if we only had a small handful of surgeons performing hip resurfacing, we would all wait years to get our surgeries done. Some people have to go to the doctors that are in their insurance plans which often include many of the newer surgeons. Some people just can't travel far distances or just don't want to travel to go to the more experienced surgeons. We are all different in our feelings and opinions.
Therefore, many people successfully use the newer surgeons. Most have successful surgeries and recoveries. Even if the odds say 4 out of 100 will have a revision, that is still pretty good odds. That means 96 people will have successful surgeries. Similar odds were given to my husband going into his triple bypass surgery. 5% chance of death or very serious complications. We felt that the odds were in his favor.
There are many discussions about doctors' surgical approaches, hip capsule preservation, best type of hip resurfacing devices and the cement/cementless issue. Many doctors have different post op protocols where some let you be 100% weight bearing immediately, others make you partial weight bearing for six weeks. Some keep you on walkers while others allow you to use one crutch or a cane post op. No one can say what is best for each individual person. No one can say what is the best approach for each surgeon to perform successful surgeries. Many of us had an experience with our doctor and we feel it was the best, so we want to share that with everyone. We want to see everyone have an easy surgery with a quick recovery.
Unfortunately, not everyone has the same experience. That may be due to our individual bodies, problems before surgery and our doctor’s techniques. It is difficult to separate the individual problems in such a complex situation and know why we all differ so much.
Therefore, we each have to read, talk to the doctor and make our own decisions. It is good to know others experiences, but each person has to feel good about their doctor. They need to have faith that they have chosen the best doctor which in turn makes all the important surgical decisions for them. Sometimes people choose the experienced surgeons and sometimes they choose the newer doctors. We all have to respect each others decisions. If no one ever used the newer surgeons, they would never become experienced. All the doctors started in the same place - doing their first, 10th or 50th hip resurfacing surgery. They all take the same path. People need to decide what is most important to them and choose the doctor feel will do the best for them.
PS. I wanted to comment on this because we somtimes get carried away with our own experiences and don't understand how other people feel. We should always support each other in our choice of doctors.
I have read of the importance of having an experienced doctor perform the hip resurfacing surgery. This is my dilemma. My insurance will pay to have the PA doctor who has done less than 100 hip resurfacings do my surgery, but it will not pay to have the MD doctor who has done over 2000 hip resurfacings do my surgery. I was hoping to have surgery last year around this time so I have postponed this long hoping to be able to have the MD doctor perform my surgery. Should I continue to wait or go ahead and have the surgery? My activity level is significantly hindered. I would like to have about 6 months under my belt before the summer as I work at camp in the summer.
That doesn't make sense to me. I would think it would be the other way and them wanting to pay for experienced only.
Is that something you can work out with your MD and have them talk to your insurance company?
As far as the timing of your surgery...it is time! Tomorrow will be 6 weeks post op and things are getting back to normal without that annoying pain that I felt before surgery. That's completely gone. Just getting the muscles back into shape and that's feeling pretty good. You deserve the same! Talk to your surgeon. By the way, what do you have for insurance?
i am about to get hip resurfacing and I also live in Riverside. I was seeing Dr. Tooma at Inland Vallley... he flat out told me that he thought I needed hip resurfacing, b/c of my age (38) but he told me doesn't do it and no one in his group did... i was eventually refered to a guy in Los Angeles named Dr. Bengs. I met with him, very n ice guy, but when I asked him how many hip resurfacings he had done, he said 30. I think he coudl tell that that wasn't what I wanted to hear... I never went back.. maybe he is a great surgeon..but I want someone who has more experience under their belt...
petition your insurance to see someone out of county if you can. another option is to change insurance. that's what I did. my HMO sent me to the guy in LA who only had 30 surgeries. I am paying more per month, but switched to a PPO plan and I can see whoever I want prettymuch. Ddr. Gross, Schmalzreid, and many of the other "top" guys are all "in network" ... but that's with a PPO...
can you switch plans? if you can't swtich, and you don't like who the HMO is giving you, you can petition them. ultimately all the HMO caresa bout is $. if you can find out what the out of county doc wants..and it's the same as the in county doc... why shoudl they care... if the costs are the same then they probably woudl be more inclined to approve it...
good luck.
I am a newbie on this site. In October, after an ex-ray revealed severe osteoarthritis, I started to explore the options of hip replacement. I didn't know anything about hip resurfacing and was spending a fair amount of time looking at the different surgical approaches and their pros and cons. After meeting with a highly regarded surgeon in the Minneapolis/ST. Paul area, he suggested that I might consider resurfacing. I then waited over two months to meet with a surgeon named Thomas Nelson. He looked at my ex-ray, and told me I was a candidate for either resurfacing or replacement--it was up to me. He has done 150 resurfacings, but only operates one day a week. We set a surgery date, and he told me to let his staff know three days before surgery what I wanted the BHR or THR. We spent a total of 15 minutes in his office. After doing serious research this week--I am really nervous about this particular doctor. I have tried to get into see a Dr. Palmer in Stillwater, but have to wait three months again! I can see a colleague of his Dr. Pancek in two months. Has anyone had experiece with Dr. Thomas Nelson? I am in a lot of pain every day and the waiting is difficult.
I live near Minneapolis and St. Paul and have researched doctors in this area extensively. I believe that Dr. Nelson is one of the better ones in the Cities, but I have no first hand info or research on him and suggest you keep digging. I've been to Mayo and Dr. Palmer, as well as St. Croix Orthopaedics. I have to say this: Do not pin your hopes on Dr. Palmer. He is 70 years old and I know a person who works in the unit where he performs surgeries. Lots of post-operative bleeding and problems. He is willing to operate at the drop of a hat and gets it done, but makes kind of a hash of it. That is the inside story. I don't know anything about Pancek. Really, your best bet and the one I am going to use is Dr. Rogerson in Madison. He is highly professional, has a great staff and knows what he is doing. Plus, he has thought about all aspects of the surgery, including using a warm-water pool during rehab to increase ROM. That's the best doctor I've found in this area. Mayo -- don't even think about them. I'll post the full story soon.
All the best,
Mi Corazon,
Thank you for your response! I just can't get a read on Nelson. I did go see Dr. Panek (Dr. Palmer's associate) and was very impressed. But everything I am reading kind of points to Rogerson. How long did it take you to get into Dr. Rogerson?
Kimberly
Dr. Rogerson has quite a waiting list. By the time I identified him as the number 1 doctor, it was around the middle of December. I didn't get a firm surgery date until December 21st, and by that time the surgery slipped all the way to March 21, so three months waiting list. Dr. Rogerson takes some time off in the winter, and who can blame him with the weather we've had. But, he doesn't operate the week before his vacation, in case there are problems post-surgery, which, shows some good sense. Anyway, I think his operations are down for 6 weeks this winter, which explains why surgeries are so far out. But, with people flying in from out of state, truth is, you'd rather have the doctor in demand than the guy with a lot of holes in his schedule.
Help!! I am baffled trying to make decisions about my surgery. 6 months ago I had unsuccessful hip scope surgery that left me in worse pain then prior to the surgery. I am clear at this point that resurfacing is the way to go for me. I am a 46 year old woman living in the Albany NY area. Dr. Su is one option for me and I've scheduled a consultation with him for the end of April (soonest I can get to see him).
I've seen the only 2 docs in my area that I am aware of who do resurfacing. One does BHR the other CHR. I am leaning toward BHR just because I've been able to read more about it but not sure if that's a good reason to choose. The other reason is I really did not like the doc who does CHR and he is in the same practice as the doc who did my unsuccessful surgery. (also not necessarily the right reasons).
The doc I do like up here says he's done about 400 or more in the past 4 years but is not listed on this web site and does not have any statistics for resurfacing on his own website (Dr. Fletcher, Northeast Ortho, any input).
Part of my concern is that because there is an "experienced" doctor in my area my insurance company is less likely to approve Dr. Su in NYC, so I'm not sure what the out of pocket expense might be (even if they do approve I'll be in position of paying the difference between what they are willing to pay and what the actual cost is. I have not been able to get any clear information about what that will be yet.).
I'm leaning toward the doctor up here because of cost and timing. He can do the surgery before I can even get into see Dr. Su. One of my concerns about Dr. Fletcher has been that he appears to underestimate the surgery so its hard to know what his success has been. He said things like I could be back to work in 2 - 3 weeks, which seems contradictory to everything I've read and didn't seem to have a lot to say about any negative experiences he's had during surgery - that always worries me because I wonder what he's not telling me. I always prefer people to be upfront and direct about both good and bad.
My previous bad experience with hip scope is making me extremely cautious and I would appreciate any and all feedback that will help me sort this out.
thanks for all of your help.
What is CHR?
Several quick thoughts here. When looking at medical expenses, don't forget that while your insurance may not cover the doctor's fee completely, it may completely cover the hospital, etc. So a little research is in order.
A second thought concerning your comment about being uncomfortable with some of the responses, or lack of responses, from Dr. Fletcher. I experienced some of the same problems when doing my own research. I strongly suggest you find a doc you are comfortable with. Have you take a look at Dr. Clarke in Syracuse? He has done over 1000 HR and uses the BHR. Would he be covered by your insurance?
I chose Dr. Gross for mine, even though I have to wait three months to get it done. I think I preferred to wait for the most experience surgeon who was busy, as opposed to a local surgeon who had done quite a few less and who was readily available.
A last thought. Why call you insurance company and explain your concerns and see what they say your options are?
Good luck,
Mac
Cormet Hip Resurfacing - still resurfacing but different product? different technique (I think)
Quote from: dinabm on February 13, 2011, 10:47:34 AM
Help!! I am baffled trying to make decisions about my surgery... and I would appreciate any and all feedback that will help me sort this out.
As I mentioned earlier in this thread, find a surgeon who accepts you as a human being.
D.
thanks - Syracuse is just as far (and out of my insurance as NYC) - the hospital coverage part is a good thought though I didn't ask about that part, which is probably the biggest expense I would think. I did talk to my insurance company but didn't get any great information. It was late Friday though so I'm hoping I might get a bit more when I call again on Monday. My Primary care md has been great and she is trying to help me navigate through the insurance nightmare. I'd hate for the decision to be financial but I'm guessing the cost could be in the tens of thousands.
Does anyone have any info or experience with Dr Fletcher?
CHR - Cormet hip resurfacing
Two words....Dr Gross...excellent. I wish I would have gone to him the first time.
I have just had a left BHR last week and am happy so far. My brother, who lives in Austin, TX will have to have a replacement soon and I wanted to be helpful. Can anyone recommend a Dr. who does resurfacing there?
Quote from: Denver_wrench on June 19, 2011, 08:30:41 PM
I have just had a left BHR last week and am happy so far. My brother, who lives in Austin, TX will have to have a replacement soon and I wanted to be helpful. Can anyone recommend a Dr. who does resurfacing there?
The superstar here is Dr Shelby Carter. All the doctors go to Carter. Prepare for a long wait for surgery though. It took me over six months once I got in to see him also a month wait for my first appointment. Just had mine done on May 31. I hardly know it's there now and have range of motion increases every day. Totally pain free the first time in nearly 3 years. Tell him to accept no on else.
Thanks, Jimdg...I'll pass this along.
I am in the Twin Cities of Minnesota. Before tripping over this website, I'd booked an appointment with Dr. Patrick Morgan. Does anyone have experience with him?
Also, I looked over the list of questions for surgeons on the Surface Hippy website but I'm not sure what sort of answers I should be looking for. Any advice would be greatly appreciated. I haven't been in a hospital since I had my tonsils out 55 years ago.
Pat
Have you ever heard anything about Dr. Riyaz Jinnah frpm Winston-Salem, NC ? He came pretty highly recommened and is in my Blue Cross network. I had a consultation and he confirmed an earlier diagnosis.
The board has answered most of my questions and concerns. I'm looking to getting it done right after the 2012 cycling season. The only time it doesn't hurt is when I'm on the bike.
What is considered to be the best device to install. There are a few different ones.
Thanks to everyone for your help and sharing expeiences.
Hi
I met Dr. Jinnah at several hip resurfacing courses. I never got time to interview him. I have stories posted here http://www.surfacehippy.info/hipstories.php#Dr._Jinnah_Hip_ (http://www.surfacehippy.info/hipstories.php#Dr._Jinnah_Hip_) I think there are some Dr. Jinnah patients that post on here, too.
The BHR is the most used device worldwide and has the best record. The Wright C+ is also good and Dr. Gross uses the Biomet. I would choose the most experienced surgeon and let them decide what is best for you. That is why you want a very experienced surgeon. He has placed hundreds and hundreds of resurfacings and know what will work best for you. Same advice for surgical approaches, etc. Choose the surgeon and let them decide what will work best for you. Like flying on a jet plane. Once you are on the plane, you are in the hands of the pilot.
Pat
I am new to the hippy site, but am grateful that it exists. I recently found out that I need bilateral HR surgery and have been going through the process of deciding who and where. My son is an OT and he suggested Union Memorial Hospital in Baltimore, MD, a Dr. Henry Boucher. Does anyone out there have any experience with this surgeon? Or any advice for a good surgeon in the Baltimore area.
Dr. Mont is the most experienced hip resurfacing surgeon in Baltimore. There are a number of Mont patients on HIP Talk.
Pat
@Dinabm
I would go with Dr Su if it were me. I flew from Indiana and from the time I have been out of OR I have been in zero pain. He is one, if not the best surgeon.
I did 4 miles today on eliptical and have been able to swim, walk pain free etc.....m I credit all to Dr Su and his skills.
Good luck to you.
I am sure most of us would prefer using the most experienced person available in most aspects of our life. I had planned to use my cousin for a THR because of him being family and his hundreds of surgeries. Due to another family illness and his being 1000 miles away, I had to change plans. I selected a local practice where both my wife and I had had good experience with the staff and doctors. One of the hip surgeons is very well known on this forum.
I had planned on having the anterior THR procedure done. Because of this I was placed with another surgeon in the practice. After talking with him I decided on the HR. He has certainly not done the numbers the "old pro" has done, but he is the type of doctor I have been fortunate to know most of my life. He always explained, never hurried, and was totally confident in which procedure I needed and that he could do the job.
I never had a doubt about my doctor and was more relaxed limping into the hospital the morning of the surgery than I had been in months. My advice is to "visit" with the staff and the doctor and don't worry so much about how many notches the surgeon has on his belt. The "best" mentioned on this forum had a first.
I am a 66 year old very active senior who plays basketball 3 to 4 times a week. I have been diagnosed with osteoarthritis in my left hip and want to know if I would be a candidate for hip resurfacing. Does medicare pay for it. My doctor only does hip replacement and seem to feel negative about hip resurfacing. I am leaning toward hip resurfacing and looking into orthokine therapy. Please send me your opinion. Thank You
Dr Su did my hip resurfacing on March 23 of this year. I am a 45 year old triathlete , aerobics/spin instructor, skier and mother of two active young boys. I can't even begin to tell you how wonderful I feel. NO PAIN. I got on the bike yesterday without resistance and it felt great but a bit boring. I have been walking up to three miles a day. I am from Maine so I had to travel a bit to see Dr Su. The hospital staff made my stay so comfortable and I can't say enough about Dr. Su. He has a great bedside manner and my recovery has been better than I thought! I have been able to work out my upper body from a seated position successfully as well as doing some abs. I can't wait for next ski season! Needless to say I am a big Dr Su fan.
drpain,
most surgeons will be very negative about a procedure when they don't have a good understanding or grasp of that procedure. A very large percentage of orthopedic surgeons have gotten stale and stuck into doing the same procedures, and using the same devices, over and over again; without progressing and becoming familiar with newer technology. That's why it's so important for you to do your own research on what's available to you. I never trust solely on some doctors opinions. The technology for hip resurfacing is very, very good. Especially when you use the right device, like a Birmingham system, and find a very experienced surgeon. The chance of your outcomes being successful, and the likleyhood of you returning to basketball, will be very, very high.
I have been refused by my medicare insurance (advantage) HMO for Hip resurfacing because of my age 66. What I found out that my HMO does not have a doctor that does resurfacing. Next month I am switching over to new HMO with to Doctors that perform hip resurfacing. In January I will switch to Medicare Supplementary so I can go o any doctor. Does anyone know of an experienced Doctor in San Diego California that does hip resurfacing. Thanks
Quote from: drpain on May 11, 2012, 12:43:35 AM
I have been refused by my medicare insurance (advantage) HMO for Hip resurfacing because of my age 66. What I found out that my HMO does not have a doctor that does resurfacing. Next month I am switching over to new HMO with to Doctors that perform hip resurfacing. In January I will switch to Medicare Supplementary so I can go o any doctor. Does anyone know of an experienced Doctor in San Diego California that does hip resurfacing. Thanks
Check out Dr. Scott Ball. I know Wayne-O was really happy with him.
http://ortho.ucsd.edu/faculty/Clinical%20Profiles/BallClinicalProfile.shtml
Hi,
I just read your post for choosing the right doctor. When I asked my doctor how many BHR you do per year he said 1 or 2 per week, so that means around 80 BHR per year. Now that makes me wonder if he should do mine or not. He is a very experienced dr not young though, maybe 60 years old. Anyway, for now I'm trying to get my records from him and hopefully get a third opinion from anothr dr. My other side is hurting today as I'm sitting in the chair typing.
Thanks!
Momy,
80 per year doesnt seem very many to me. How many has he done so far? Where and when was he trained and by who? What are his success rates? How many failures has he had and what were they? Personally i wouldnt go to a surgeon who has done less than 1000 and with a good success rates. Most of the top surgeons say that the learning curve levels out around 1000. Also id ask other patients about there surgeons. Use the forum and also Vicky Marlows Yahoo group is a useful site to ask about surgeons.
Hope this helps and best of luck.
Danny
I'd second Danny's advice. This procedure, as good as it is in experienced and/or talented hands, requires practice and skill. Skill is a hard thing to evaluate for us at the non-professional end, so practice is the one thing we can ask about.
I was operated by my surgeon twice. At my first surgery, he had done over 800 procedures, by the time of my second he had gotten to about 950 (three months later). On the day he did my first, he did two or three others. So on the week, he usually has above 10.
The hospital has an area dedicated to recovering hip surgeries (there may be knees also), so the staff there is very experienced with both the surgery and recuperation. I felt that there was real commitment, not just from the surgeon, but his whole staff. That has continued with support afterwards.
I think for this procedure you deserve that level of commitment. There are many talented surgeons out there, but talent is not enough. You need experience in the procedure and an ongoing maintenance of excellence that only repetition can give you. A study that I read noted that the percentage of errors went down drastically at above 200 procedures; I would add that you also need to demand frequency of performance to be served the way you need.
I have great confidence in this procedure (had it done twice and feel great), but only by those who are committed to it.
Hi dinabm,
I just read your post and you live in Albany, NY also. I would really like to talk to you since my ortho dr is the same as yours. I would give you my email address
Thanks!
Hi all,
I replied to dinabm but no response so far. She lives in the same area as I do but maybe she doesn't post at this site anymore. I called Dr. Su office and my ins does not cover the consultation and the procedure itself. I have to pay $450 just for one consultation and the surgery will cost $18,000. With my son going to college next year there is no way I can pay for that. My primary dr. said that she would send me to Boston for another opinion before I decide to do anything. Does anybody knows any experienced dr that performs BHR in Boston?
Thank You!
There are other doctors in the New York area that have been successful. Woodstock in particular had very good luck with his, if you're looking in that area.
I used Dr. Su and it is out of network for me too, so there are bills that you may be able to avoid by using another local doctor. I had a friend that said I just had to use Dr. Su so I did. I am not sorry that I did by any means but with many of the other local NYC doctors with great experience I would not have hesitated to have tried someone that many other "surface hippies" have recommended and had good luck with. Hope you are able to benefit from resurfacing ASAP.
Joe
If you are in San Diego (not sure if it's the OP or fork off of the original message), I second the recommendation for Dr. Scott Ball. I traveled from Phx to have my surgeries done by him. Feel free to PM me if you'd like. I think Pat also has some hip stories listed by surgeon elsewhere on the site.
Good luck,
Dirk
Yes it is hard dealing with the financial considerations. However, there are options as well. Many times providers will allow you to make payments over a long length of time, some being interest free for a while. I had this consideration. I am a Dr. Su patient. Luckily the hospital and anesthesia costs were covered very well. I looked at the other fees and did a payment over a period of time. Had the hospital and other fees not been covered the cost would have been over the top. I had also looked into for the first time surgery--either in England with Dr. McMinn or considered Dr. De Smet. I ended up staying with Dr. Su. I was amazed at how much was covered overseas and with such good surgeons as these. I just knew in the end I needed someone with alot of experience with females as well as hip resurfacing.
Good point brightside! I didn't think of that option, but if HSS and Dr. Su allow interest free payments for a bit of time I would put a lot more thought into using him. Think of it like buying a house except its your body. Great post!
Hi, definately check more, my surgeon did 8 every Tuesday! I agree with everone elses posts on this. Good Luck
hey everyone,
does anyone of you can recommend me a good surgeon in australia? preferably sydney or melbourne but if i have to fly to other state to see the surgeon i would.
im 28 yrs old with left hip oa grade II-III and my sports physician here in sydney australia said my last resort if the cortisone doesnt work then i need to get total hip replacement.
from physio therapist point of view, they seem to be against any surgery, let alone a major ones like this. my physio said, "we dont wana go there yet" so will see how you go with cortisone.
im in the military but i've been doing research lately on top surgeon in the world in regards to hip resurfacing. if i get to choose to travel overseas to get it done if I'm a "good candidate" then i would but the fact that i dont want to break the contract at work.
any thoughts everyone? please be honest and straight forward on suggestion. i dont want to go to the stage where the hip go bone on bone which is stage IV i think.
if anyone here could let me know it would be much appreciated.
jc
JC,
grade 3 is mid spectrum but how has that been diagnosed? Xray? I had grade 4 which was bone on bone in areas larger than 1'' so i did have some cartlage left but not much. If more conservative options are available id say take those. No matter how good a device it will never be as good as a natural hip.
I dont know any Aussie HR docs but if you were to go international then you could come here to the UK and see Mr Treacy or Mr McMinn the 2 developers of the BHR Treacy has the biggest single experience in the world and is reguarded as really on of the best. As is McMinn. You could also use Dr Bose in india hes one of the best too.
Pm me if you need any help or info mate
Danny
Hi JC, I'm just going to jump in to say that the X-rays are just a tool, nothing can compare to the surgeon actually seeing inside your joint. My hips (on both sides) were much worse inside than X-rays and MRI suggested. You need a surgeon who treats you, the patient, and your pain and your disability. don't just accept the diagnostic grade. If you are in severe pain and disabled then be your own advocate and seek treatment. There are no medals for putting up with pain. I wish you luck. I think I've read quite a few stories on here where the OA was hidden, not visible but present. It is serious surgery, but you only get one life and only you know where the tipping point in that equation is. Keep us posted. Sal
Hi JC,
I'm in Launceston, Tasmania. I hope the more conservative approaches can offer you a solution. If it does come to resurfacing, Pat (site owner) recommended two surgeons in Australia to me prior to my surgery. Lawrence Kohan in Sydney and Andrew Shimmin in Melbourne. Both have completed over 1000 resurfacings. I ended up going with a local surgeon who has performed far fewer but has an excellent reputation for being a meticulous surgeon. I knew I was taking a risk but he inspired confidence in me and almost 5 months post op, I'm really pleased with my results. Hopefully that will be the case long term. Obviously all of the advice on this forum would steer you toward a high volume surgeon with an excellent record and reputation.
Good luck, keen to know how you get on,
Mike
Mike i knew i'd find a tasmanian brother here! i originally came from tassie but i live in sydney now. yes i have heard of lawrence kohan and andrew shim min. i've been doing lots of research around sydney and inter state. did you ended up seeing those 2 surgeons in person? i checked dr kohan's website and i actually need a referral from the doctors. but according to the specialist area at work they dont use dr kohan's as one of the provider. but i'll double check with the doctor when i see him.
hows the new hip goin mike? how old were you when you had it done? can i PM you?
let me know!
thanks,
jc
Hi JC,
What part of Tassie are you from? I'm 45, a fair bit older that you. but the OA was still a shock. I thought I had some soft tissue injury that wouldn't heal. I didnt consult Kohan or Shimmin. Peter Van Winden did my surgery in Launceston. I had done all the research, just like you and knew that I was acting against some very good advice but his reputation is excellent and and I took a chance on surgery at home. I'm 5 months post op on the 2nd of September and im progressing really well. I swim heaps, walk lots and have had a lot of massage for scar tissue. As people on here will tell you recovery has its ups and downs, My IT band gave trouble when I got off crutches and caused me knee pain. Massage and swimming fixed that. The hip itself feels great, getting flexibility back is the slowest thing but im making steady progress.
I have been really cautious in my recovery, I can jog without pain but I am not stupid enough to do it and risk fracture, Walking, swimming and cycling are my staple. Its too early for me to tell you what capacity I will get back.
The thing I do know is that my sporting life was over, I couldn't even hit the tennis ball with my daughter in the end. If things get too bad for you, its great to know that resurfacing is there as an option. I hated my diagnosis but I stopped thinking of myself as unlucky to have OA and started thinking about how lucky I was tio have such a good option available.
What kind of shape is your hip in as far as day to day functionality? Feel free to PM
Cheers
Mike
SAL,
thanks so much for the advise. i hope you did get my long and boring complaint on my topic? im not in severe pain as yet but i do know and feel that its slowly limiting my activity on a normal day to day activities. i just dont know how long i can put up with it. all my plans travelling wise this year has been on hold coz im afraid if i go on a tour that i might not be able to enjoy it because of this condition.
Hey JC, no one says you have to be crawling in pain, I had problems getting them to recognise that I needed the surgery ( refer back to my X-rays comment!) there have been guys with bad OA but not much pain who have had it done, there are some good threads you can read about whether or not it's too soon for surgery. It really is the question for you. When is it the right time in your life. Do be honest with your pals, the only way they can help is if they know. Arthritis is less embarrassing than mad cleaning urges ;D Sal
dan, sal and mike! thanks for the reply. theres so many things i have to know about this hip resurfacing but a big big thank you for everyone. i will PM each of youse!
hope all is well with everyone and living happy active lifestyle!
cheers
jc
I think you have some good names there with the several that have been mentioned. I'm not sure if Kiwi posted but he went to Hugh Blackly in NZ. That might be a bit more travel than you were thinking, but it sounds like Blackly has been doing HR since 2003 and studied with McMinn/Treacy and is well recognized. Good luck
Sal - good point about the medals, I actually used be that way, before I knew I had full-blown OA. I would hobble around in pain, grunting and groaning, thinking I was just getting old and damn it I should be able to fight it,... after I knew the demise was going to be a slow and arduous death by OA, and that I didn't want to ruin what was left (something to think about when deciding on surgery), I finally gave in. I did get a few proverbial medals for chasing down fancy-footed forwards while playing soccer, with a labral tear in both hips ;)
Ouch Tin, sounds very sore! I take it that you have fully functioning play hips now, are you back to soccer?
Hi JC,
Keep in mind the Hip Arthroscopy option too. As was mentioned earlier, diagnostic xrays etc are good, but looking inside the joint via key hole surgery is gold standard.
It's amazing what they can do these days & there are some excellent surgeons performing this in Australia by searching on Internet.
I've had 3 arthroscopies over the years (1 x look & see, 1 x cartilage trim, 1 x bony growth removal.. FAI / clean up) & my next step could well be HR, but the scopes have kept me relatively pain free.
Regards
Steven.
steve,
the sports physician said i wont benefit from another arthroscopy because of OA grade II-III. the only surgery option he gave me was THR. i had arthroscopy left hip labral debridement and i didnt get good result from the surgeon.. it took me 10-11 months to rehab. so no way im going back to that surgeon again. looking back now, i remember i didnt have to wait for months to book to that surgeon. it only took me 2 weeks to wait! lessons learned!
anyone on here know any "top 3 surgeons in regards to hip resurfacing in sydney australia" or had their hip resurfaced in sydney?? .. im seeing the military doctor first week next month. if i could get a name that would be great. from what ive seen on this website, it has dr lawrence kohan, dr craig waller. on vicky marlow's website, its dr michael solomon and dr william walter. i will also ask my doctor to refer me to get an xray and get a copy of a cd and get an opinion from the top surgeon by emailing them. im hoping my hip hasnt change dramatically since october 2011.
many many thanks for all the people for telling me their experience and giving me so much info!
i will get back from everyone privately!
thanks,
jc
Hi Jc, as Sal says a good surgeon takes far more into consideration. Just make sure the one you eventually choose has vast experience as Danny mentioned. Don`t wait til you could be crawling in agony either. You`re bound to find all the info on here:)
does anyone know of a kaiser doctor with alot of bhr's under his belt? my friend needs a lbhr and he lives in los angeles. unfortunately he's stuck with kaiser. thank you
Dr. Klug is an excellent hip resurfacing surgeons and has a lot of very happy patients.
Raphael Klug, MD
400 Hip Resurfacings to date
The Permanente Medical Group
1600 Eureka Road
Roseville, CA 95661
(916) 784-5051
Website for Dr. Klug http://mydoctor.kaiserpermanente.org/ncal/provider/raphaelklug (http://mydoctor.kaiserpermanente.org/ncal/provider/raphaelklug)
Greetings All,
I'm new to this forum and I'm hoping it can help me make a decision.
I'm a 50 year old active male who was diagnosed with OA in my left hip about 4 years ago by Dr Emil Schemitch at St. Mikes in Toronto. At the time he did do BHR but I couldn't find out anything about his record in this area, although my doctor said he was the best. I decided to wait on the surgery until it was bad enough that I had no choice, and I think it's getting to that point now (climbing ladders to put up the Christmas lights and walking the dogs in the uneven snowy ground were far more painful for me this year than last). I have had to give up racquetball and Martial arts because of my hip, and now, with the birth of my daughter, I've decided I want to be able to move and play and do all the things I used to do. This brings me to me current dilemma; which doctor? I live within driving distance of Dr. Young in Scarborough, Dr. Schemitsch in Toronto and Dr. MacCalden in London. My doctor is happy to provide me with a referral to whichever one I want to use, but so far the only one who seems to be on anyone's radar is Dr. young. Her office informs me there is almost a 2 year waiting list to get the surgery done, and I would have to believe the others have similar wait times. Can anyone provide me with some first-hand experiences with any of these 3?
Any and all advice/information is greatly appreciated.
Cheers
John
No advice on docs as I am an American, I just wanted to weigh in on the two year waiting list. That's atrocious! I don't want to politicize this website, but I fear that is our future here in the U.S as well.
Good luck and I hope it doesn't wind up being that long. I guess I would add that you should find out what's up with the other hip (via x-ray), and get it in the queue if you can (I have no idea how that process works so forgive my ignorance). Anecdotally, a lot of people (perhaps especially males with FAI, though that is just speculation on my part) experience rapid deterioration of the second hip after having the first fixed. My unfixed hip felt great for 6 or 8 months after first hip fixed and now I have the second surgery scheduled for just shy of the two year mark due to rapid deterioration in function and increasing pain.
Regards,
Mike
My first post here.
I'm also from Toronto, Canada like two posts above - Johnston. I'm on the waiting list to do right hip BHR with Dr. Emil Schemitsch.
During my last visit I was told that due to the latest research like Australia registry, they do NOT do it on women or small men anymore!
That scares me because it means even though I requested BHR I could still wake up with THR. They make final desicion during surgery from the size. I'm average male, hight 5'9", athletic build. Would this size be still in the small risk category???
Please advise, I'm confused and scared here.
Quote from: labusas on January 18, 2014, 10:37:36 PM
My first post here.
I'm also from Toronto, Canada like two posts above - Johnston. I'm on the waiting list to do right hip BHR with Dr. Emil Schemitsch.
During my last visit I was told that due to the latest research like Australia registry, they do NOT do it on women or small men anymore!
That scares me because it means even though I requested BHR I could still wake up with THR. They make final desicion during surgery from the size. I'm average male, hight 5'9", athletic build. Would this size be still in the small risk category???
Please advise, I'm confused and scared here.
I would think that would be in the small risk category. Too bad that they are going in that direction.
Hi labusas,
If you want to get some clarity on what they might decide, I would ask ahead of time what size of prosthesis they consider to be the risk cutoff. This varies from one "authority" to another, so it would be useful to know exactly what cutoff they are using. Also, if they have your x-rays, they should be able to template what size they expect to use (though with some surgeons it is possible that they may change the size choice during surgery). This templating is often done just prior to surgery, so it may take some coaxing to get them to template at this point. However, if they are going to decide what kind of replacement to give you based on size, it is very reasonable for you to ask for this ahead of time so that you know what to expect.
With these two pieces of information, what size prosthesis you would need and what size they consider to be the cutoff for high risk, you should be able to get a clearer picture of what to expect, and therefore whether you want to go ahead with them.
Quote from: Tkdbob on February 05, 2014, 09:58:54 PM
I am seven weeks post op BHR performed by a surgeon with a little over 100 procedures. He is highly respected as a hip surgeon and has been performing total hip replacements for 27 years. He is also chief of surgeons at a nationally recognized hospital. I know being an expert at THR does not make him an expert at BHR. However, I do believe that all the talk about a surgeon needing to perform 1000 BHR's is not serving the guests of this website in a positive way.
I would be interested in hearing success stories from hippies who took the leap of faith and went with a surgeon with 50-100 procedures under their belt.
By the way, so far I'm very pleased with the results. I am a 4'th Dan taekwondo master and expect to be performing at a high level after I reach the six month mark.
BHR 12/16/2013
I'm glad that your HR is going well. All of the surgeons, even the most experienced and capable ones passed through the 50-100 procedures period.
The advice given here is to pick the best and most capable surgeon. There are many subjective metrics you can use in picking that surgeon:
- Years of experience doing surgery.
- Reputation among his or her peers.
- Reputation among his or her patients.
- Years of experience doing hip replacement of either type
- The reputation of the hospital where the surgery is being done.
I consider these subjective because although they are very positive influences, they are not objective in that I can't tie the possible outcome of my HR directly to them. They are (in my opinion) very good indications, but I need more information.
To me, the things that I prefer to consider are:
- The number of HRs that have been done directly by that surgeon. This is important to me, because the number of HRs speak directly to his or her facility with the procedure. In the Australian national registries, the number of revisions per surgeon went down above 200 procedures. That means that for all surgeons, good or bad, the average number of revisions went down after the 200 HR threshold.
- The frequency of HRs done. If someone does five+ per week, they are apt to be more practiced than someone who does one every month. They are also more likely to be up on the latest technologies, since they are more committed to the procedure.
- The success rate for their patients. You should be able to talk to them and find out their failure rate, and why it happened. No one is perfect and I'm sure even the most successful have their failures. Their ability to talk candidly and to be able to see where the problem was is a quality that I value.
- Their regimen for recuperation. Some failures or scares in HRs happen because the patient did something incorrectly or too early. If the surgeon can list not just a good regimen of limitations and exercise (even if it's just walking), but talk well to you about it, that is important in my view.
Again, this is just my view of things. The results in the registries are very supportive of the success rates with more experienced surgeons, in a gross manner. Surgeons with greater than 200 HRs have fewer revisions. That's as measured over twelve years now.
Obviously, in the end it comes down to your own choice and opinion. I'm sure there are outstanding surgeons who have fewer than two hundred who do an excellent job of it and more power to them, we need them doing these.
But the overall results point to more repetitions giving better results, so I think (and again, my opinion) that finding a surgeon who has more experience is an important metric. As I listed above, though it's not the only one.
I don't think anyone here says that you need to have someone with thousands of HRs. My doctor had 800+ when I did mine and I had no problem with that, but he was doing several per day and I felt comfortable with him.
As for the TKD, good for you, I have my first degree and have gotten back fully to it. It took me about fifteen months until I could do full contact, and really until about a year before I started doing kicks at speed.
Re below remply, Thanks for the tips,
I did requested the information about risk cutoff and templating. They told me to book another appointment and discuss it. So I'll do.
What is the other questions to ask the doc?
This is for Dr Schemitch in Toronto. Not sure how many BHR's he's done and how experienced he's in it.
Hi labusas,
If you want to get some clarity on what they might decide, I would ask ahead of time what size of prosthesis they consider to be the risk cutoff. This varies from one "authority" to another, so it would be useful to know exactly what cutoff they are using. Also, if they have your x-rays, they should be able to template what size they expect to use (though with some surgeons it is possible that they may change the size choice during surgery). This templating is often done just prior to surgery, so it may take some coaxing to get them to template at this point. However, if they are going to decide what kind of replacement to give you based on size, it is very reasonable for you to ask for this ahead of time so that you know what to expect.
With these two pieces of information, what size prosthesis you would need and what size they consider to be the cutoff for high risk, you should be able to get a clearer picture of what to expect, and therefore whether you want to go ahead with them.
Tkdbob, glad to hear your surgery went well. There is a reason that you are not seeing why this forum gravitates to top surgeons (gurus). Unlike total hip replacement, with hip resurfacing, you only get ONE chance. If your surgeon doesn't get this very difficult surgery right, you don't get a second chance. It can't be repaired or replaced - except in rare circumstances.
Especially the young who are planning to return to impact occupations or sports, it is critical that they know the statistical correlation between a surgeon's experience and patient outcomes.
Pat Walter has done a great job setting up this forum and her website "surface hippy" to inform the masses about hip resurfacing. Thanks again Pat.
As bad as a total hip surgery gone bad would be, the surgeon could revise it to another total hip replacement.
And the comment about the those of less means or those who can't travel far - do you mean hide facts or change the way this forum feels so their feelings aren't hurt.
Chuckm
Tkdbob
I choose to feature surgeons that have excellent outcomes over a period of time and a large number of hip resurfacings. Using a surgeon that does not do hip resurfacing on a regular basis every day or every week does not mean you will have a poor outcome - but the national registries, medical studies and personal records of the top surgeons do show experience is important. The overall retention rate of the BHR at 11 years is 94% That means some patients, 6 out of 100, are going to have revisions and serious problems. If you look at the retention rates of the top experienced surgeons they are 98 to 99% at 10 and 11 years.
It is simple math. The way to keep from being a statistic is to choose the most experienced surgeons. I doubt the professional football teams would use a quarterback only once a month and expect him to be on top of his game. Hip resurfacing surgery is very difficult and a surgeon normally does better surgery when doing them on a daily basis.
This is not my opinion, this is based on National Registry Data and surgeon's personal series data. I attend most of the hip resurfacing courses and listened to surgeon after surgeon state the same theory. They are very concerned about hip resurfacings gone wrong and there is a great deal of discussion about it. Methods presented to do better component placement, etc. In the end - one thing all the surgeons agree on is to use a surgeon that is very experienced and doing them on a daily or weekly basis. They suggest if there is a group of surgeons, the group chooses only surgeon to do the hip resurfacing so he remains their specialists doing them often.
Many people have used less experienced surgeons and had good outcomes - but many have had problems. There are many stories posted where the patient states "If only I had listened to the group and choose one of the top experienced surgeons" There is no going back when a resurfacing is not done properly.
I have read personal stories on this website since 2005 and just by reading those stories, understand the very experienced surgeons have better outcomes.
I had no health insurance and no money, but I was not going to get an old fashioned THR at 61. I put the $18,000 for the travel, hotel and all medical costs on my credit cards to go to Belgium. I wanted a hip resurfacing and wanted a surgeon that had done several thousand.
The moral of the story is - it is your health and your body - you only get one chance to have it done right. Most people can travel a reasonable distance to get their hip resurfacing. I flew about 10 hours each way to get mine. It took me a long time to pay the credit cards - but my hip is perfect. I was not going to face a revision of my hip resurfacing because I could choose one of the new surgeons in the US to do the BHR. Many of those surgeons no longer do hip resurfacing. They had bad outcomes or it was just too difficult for them.
I am going to lock this discussion since it is so many pages long and I am going to have the last word in this discussion. My opinion based on hundreds of personal stories, national registries, medical studies and surgeon series outcomes is - USE THE MOST EXPERIENCED SURGEON AVAILABLE, ONE THAT HAS DONE THOUSANDS, NOT A FEW HUNDRED.
Pat
Most of the problems that we've had on this forum with people with less than positive outcomes come from surgeons with small numbers of HR surgeries.
Being perfect at doing THRs does not make that surgeon necessarily someone who might be good at doing HRs, you are correct.
Locations or standing in a surgical community has nothing to do with what outcome you should expect. My surgeon performs his surgery in the middle of South Carolina in a very small hospital but yet he yields excellent results.
You may or may not have a good result, I am sure I can speak for others that we hope, wish and pray that you have a great outcome, however by choosing someone with limited procedures under his belt you have increased the risk of a negative outcome.
It is all about the numbers, I wish I had $10 for every patient we've seen on this site end up needing revisions because they picked an inexperienced surgeon, I could buy a new car probably.
I think Pat should post in 4 inch font on her home page "Pick an experienced surgeon if you want good results".
Chuck
Quote from: Tkdbob on February 05, 2014, 09:58:54 PM
I am seven weeks post op BHR performed by a surgeon with a little over 100 procedures. He is highly respected as a hip surgeon and has been performing total hip replacements for 27 years. He is also chief of surgeons at a nationally recognized hospital. I know being an expert at THR does not make him an expert at BHR. However, I do believe that all the talk about a surgeon needing to perform 1000 BHR's is not serving the guests of this website in a positive way.
I would be interested in hearing success stories from hippies who took the leap of faith and went with a surgeon with 50-100 procedures under their belt.
By the way, so far I'm very pleased with the results. I am a 4'th Dan taekwondo master and expect to be performing at a high level after I reach the six month mark.
BHR 12/16/2013