From: Gene Knouse
To: pwalter@surfacehippy.info
Sent: Tuesday, July 17, 2007 1:56 PM
Subject: Hip Resurfacing at Surface Hippy

Hello,

   I am facing replacement of both hips from Osteonecrosis, I have found a excellent Dr that does THR but not resurfacing, how do I find Dr’s in Oklahoma that do resurfacing.  I am very interested in it and from what I have read sounds like a great deal.

Please help.

Gene Knouse

Hi Gene

Thanks for writing to me.  If you are younger, under 70 or 75, and are active - you should have a hip resurfacing if possible, not a THR. Hip resurfacing is bone conserving and has no restrictions on your activities after you heal.  You can do whatever you want from tennis, karate, or an ironman triathalon.  http://www.surfacehippy.info/athletes.php

A THR requires that they cut the top of your femur bone off, drill it and pound the long stake of a THR ball into it.  So if you ever need a revision, it is much more difficult to remove the stake from your femur.  Here is what has to be done   http://www.surfacehippy.info/thrrevision.php    If you start with a hip resurfacing and ever need a revision, you have your whole femur bone left to revise to a THR.

Here is a list of many of the more experienced surgeons  http://www.surfacehippy.info/listofdoctors.php    and their statistics   http://www.surfacehippy.info/doctorstatistics.php

Hip resurfacing is a much more difficult surgery than a THR and you need an experienced surgeon doing your surgery.  The learning curve is steep for hip resurfacing according to the studies I have on my website and other doctors recommendaitons.  Usually it takes 50 - 100 to be experienced.   In my opinion, it takes many hundreds.  My doctor, Dr. De Smet has done over 2400 hip resurfacings and recommends a person always use a surgeon with over 100 hip resurfacings.

If you have a complicated case,you definitely need to use a very experienced surgeon. Don't worry about who is closest to you, decide who is best for you and your situation.  Many of us have travel accross country or to other countries to get experienced surgeons.  You only have 2 hips and if the surgeon does not do a good job, you could have a difficult time for the rest of your life or face revisions.

Many of the experienced overseas doctors will do both hips at one time.  The US surgeons are usually much more conservative.  That will be your choice as to how to face you hip replacment. I only had one hip done, but would have done both at one time if I needed to.  That way you only have one recovery and get it all over at the same time.  There have been bi-lats go to Belgium like I did by themselves and traveled home by themselves.  It is difficult, not not impossible.

Let me know how your progress is coming.  You can get free consultations from Dr. De Smet of Belgium and Dr. Bose of India if you send them emails with a digital copy of your x-rays attached in .jpg form.  The usually answer quickly and are very honest in evaluating your situation.  Hundreds of us older hippies have gone to both surgeons since we wanted experience and could not get a BHR in the US before May 2006.

I posted your email to me - without your email address on my Hip Talk - to see if anyone else has used any of the Oklahoma doctors. Check it out   http://surfacehippy.info/hiptalk/index.php?topic=52.0
Pat

Pat,
   do you know of any other person that has Osteonecrosis that has had the resurfacing?  I would be courious to find out at what stage they were at,  how long ago and the status of their recovery.

this is a awesome sight.......

Gene

Hi Gene

I don't know any people that I have talked with personally that have AVN, but I know a large number of people have had their hips resurfaced because of that problem.  Dr. Bose does a large number of AVN cases and you can read his input about it here
http://www.surfacehippy.info/avn.php

I will ask Vicky, a lady who had her hip resurfaced with Dr. Bose, if she knows anyone personally and have her post an answer to you. Probably some of the folks on my Hip Stories section had AVN, but I don't remember which ones.  It is a very common problem.

I have read about many AVN patients on the large Yahoo Surface Hippy Discussion Group and their recoveries are the same as anyone elses.  Your recovery time really depends on your own body.  Some people recover quickly while others seem to take much more time.  In the end, we all end up in the same place with new hip/s and no pain. That is the best part of hip resurfacing -no pain and no restrictions to your activities.

I made a quick check of my Hip Stories and here is one:

Ioannis Story, he had AVN
http://www.surfacehippy.info/ioannis.php

and here are some AVN Surgery Videos - beware, they are very real and vivid.
http://www.surfacehippy.info/surgeryvideos.php

I am glad my website is helpful to you. That is the purpose of it - to help people find out about hip resurfacing, get their hips resurfaced and then help other people learn about it.  Each person passes on their knowledge and experience to other people.

Pat

Pat, 
   I can't thank you enough,  your site has lifted a load off me tremendously.  I was getting depressed with the idea of THR and now have been excited about this with the resurfacing....I know it will all depend on the Dr if I am a canidate, but from the information that you have been giving me,  I am very excited.  I am at stage II of Osteonecrosis and I have 3 appointments next week with different Drs here in Oklahoma,  if I don't feel comforatable with their experiences then I have one in Fort Worth and Houston I will contact.  I have Dr Gross on my list (sadly he is not on my insurance) so I am hoping for the best with the Dr's here in Ok.

Thanks again.
Gene

Gene

You are welcome.  Many of us have had to search far and wide to get what we wanted, especially before the FDA approval of the BHR. 

Please keep in mind, that if you don't get the answers you want from the OK doctors, there are still other choices.  You can get the free consultations from both Dr. De Smet and Dr. Bose by sending them emails with your x-rays attached in .jpg format.

If your insurance won't cover your surgery, you can travel like I did and hundreds of others.  You can get your hip resurfaced in Belgium for about $17,000 total for travel and medical expenses.  I put it on my credit cards.  You can also do Dr. Bose in India for $10,000 to $12,000.  Just keep that info in the back of your mind.  Many have gone before you and many will still travel to get the experienced doctors.  Some people with insurance have gone to Dr. Bose and De Smet because they wanted experienced doctors.  They said with their deductibles, they were not paying much more to travel abroad to use some of the best surgeons in the world.

Keep me posted and I will help with any info that I can.

Good Luck!

Pat

Vicky,
   thanks for the input,  makes me feel better knowing I have options,  I am at stage II on my AVN, so very excitied after finding this site.  I have 3 Dr's appointments so will see what their experiences are with this and go from their.  I have never been to Asia or Blegum......LOL  might get to.....

Here is a list of questions to take with you

You’ve asked about questions that you might want to have for your doctor visit.  That question is often asked and here are some questions that various board members have suggested in the past. 


How many resurfacings have YOU done? (not observed or assisted with)
Where did you train?
How many complications have you had?
How many resurfacing failures with revision to THR have you had?
How many times during surgery have you had to change to a THR instead of a resurfacing and why was the change made?
What device (prosthesis) do you use, how long have you been using it and why do you prefer it?
Do you use cemented or uncemented?  Why?
Do you cement the stem?

What anesthetic do you use?
How long does the surgery take?
What surgical approach do you use?  Anterior or Posterior?
What is the incision length?
What is your post-op pain control plan?
What hospital do you use?
What is their infection rate?
Have any of your patients had infections that required IV antibiotics following resurfacing?
What drugs/methods do you use for anti-coagulation after surgery?
How long will I be in hospital?
How successful have you been obtaining insurance approvals for resurfacing?

What is the rehab protocol?
When will I be 100% weight bearing?
What assistive devices will I use for walking after surgery?
How long on 2 crutches, 1 crutch, cane?
What if any restrictions do you place on your patients after surgery
and how long do they last?
Will I be given any at home nurse or PT care?

How does my other hip look at this time?
If both hips are bad, how do you handle bilateral resurfacing?
Is there anything unusual about my hip that might present problems?
Do you have a resurfacing patient who you've done surgery on that I
could talk to about their experience?

What is your opinion of my returning to (whatever work or activities you do)
Have you done resurfacing for anyone who has returned to these activities?


Good luck and come back and let us know the outcome.

Vicky

Vicky,
   thanks for the questions I had started me a list of questions, but now one less thing I have to worry about.  I go in for first appt. Aug 1st in OKC and Aug 2nd in tulsa  and have another Dr to call in OKC. so will keep you posted.

Gene

Make sure you don't allow them to convince you that you are not a candidate for resurfacing until you get the opinion of at least one of the top resurfacing docs that offer free consults.

Vicky
LHBR Dr. Bose Dec 01 05

I will not allow them to talk me out of it,  I do have a question,  how do you get your x-rays onto a .jpg format?  thought about sending my to a few Dr's.

forget about my question on "how to get x-rays in .jpg format"  I was reading and found out......