Cement vs UnCemented?

[jackmac32]

Hi,
I am a 42 Year Old Male in Connecticut.  My left hip has severe Arthritis and my right hip isn't much better.  I have been having hip pain for the last 3 or 4 years and will probably pull the trigger on getting a hip resufacing in the coming Fall.  My question is whether people think getting the Cementless with Dr. Gross is worth the 12 hour Drive, vs getting the Cemented with Dr. Su by taking a 2 hour train ride.   Both are obviously VERY capable doctors, but I am struggling with going with the cementless because it MAY last a few years longer, but the trip to SC will be much longer.  Thoughts?
Thanks!
Jack.

[obxpelican]

Cemented vs. Uncemented.... that's been debated a lot.  To me the cemented allows a surgeon to do one less step, also IMHO it seems that bone on device is superior but it will take time to know for sure.  Dr. Gross's patients in the short term have done just as well either way but long term I think the uncemented femoral caps will outperform cememented, but that is just my opinion.  Keep in mind that acetabular cups are uncemented and so are most all total hip stems.  To me keeping it natural is the best way, why introduce something like cement?

It's always been my hope that all HR patients keep their implants until we're called back to that golf course in the sky.....speaking of which I just got back from playing 18 holes of golf.

Dr. Gross has probably performed twice the surgeries as any other doctor on the East coast minus Dr. Mont.  The hospital that Dr. Gross works under has a low infection rate, it's small sort of down home southern hospitality that makes it superior to any that I've ever been in.  Dr. Gross's pain management is fantastic, you're usually up and walking without much of any pain the first day, although you will have some incision discomfort.   Another thing that makes Dr. Gross superior to all others is his staff and their committment to the patients, Dr. Gross is able to control who works on the wing of the hospital for his patients too.  Anytime I needed anything I never waited more than 2 minutes and my buzzer was answered right away.

Read about Dr. Gross's patients on here, you'll be sold almost right away.   I drove 10+ hours to and from my surgery and I was able to drive 3+ hours (wife drove the rest) home the Saturday following my Wed AM surgery.

Good luck wherever you end up, I'm glad you're able to get a hip resurfacing.


Chuck

[Pat Walter]

Hi Jack

Both Dr. Gross and Dr. Su are great hip resurfacing surgeons with a lot of experience.

I met Dr. Gross and did a video with him about cementless resurfacing http://www.surfacehippy.info/doctorinterviews/grossinterview.php  I spent an evening and part of a day with he and Lee Webb.  I was very impressed with both of them and believe Dr. Gross feels that uncemented is the way most resurfacings will be in the future.  He does not, at this point however, have the long term statistics to support that belief.  He bases much of his belief on the fact that acetabular cups are generally uncemented and they have worked well for years.  They work well because of the special surface that allows bone growth into the cup.  That is his theory, discussed simply in layman's terms, of why uncemented femur caps will work - the special sprayed surface inside the cap.

The large majority of all resuracings to date have been cemented.  I know of one that is over 17 years old.  I have the story of one of McMinn's early patients under my hip stories.  I have been told by the very experienced hip resurfacing surgeons that they feel nothing is wrong with cement if it is done properly.  So that issue becomes to use a really experienced surgeon that has great technique.

I have not heard of any revision stories that I can remember that occured due to improper cementing of the femur cap.  Perhaps someone else remembers of some. If there are any, they certainly are in the minority.

All of us with our cemented resurfacings assume they will last us a lifetime.  So do many of the surgeons that place them.

So in the end, it all comes down to what you really think you want.  If you listen to that little inner voice inside of you, you will know what you want to do.  You can go with the majority of us and our cemented hip resurfacings or with the forward thinking folks that feel uncemented resurfacings are the best.

I don't think you could possibly go wrong with either doctor or the cemented or uncemented resurfacing.  They both have a lot of very happy patients.

Good Luck.

Pat

[mari]

My husband and I drove from southern MN for my surgery with Dr. Gross.  About 1400 miles.  Everything obxpelican says is true - I experienced it just like he says.   I had no pain to speak of at any time, only discomfort from the swelling after I got home, and that was because I didn't elevate or ice enough on the drive home.  I too went the uncemented route and am happy with my outcome.  Dr. Gross and Lee Webb and team are top-notch.

[sunny]

Hi, I had my HR done in Nov.  I am  "uncemeted".  I can't tell you the difference, because I would not know the difference.  I found this web site after my surgery (wish I would have found it before, I sure would have known alot more and what questions to ask).  I do not have cartilage between joints, the right side is next to be done.  I live in Florida, and had my surgery here, no traveling out of state etc.  I am NOT having troubles being uncemeted.  So, ask your Doc the options and make your decision on his preference.  I did not know I had a preference and am pleased.
Good luck
Sunny   

[JeanM]

Hi Jack,
Ditto what the others have said.  You need to look at all the information, then make the decision that you feel is right for you.  I traveled from Salt Lake City, Utah to have an uncemented resurfacing by Dr. Gross.  I don't regret it one bit.  I had a great experience, great recovery and at 7 months I'm able to snowboard in deep powder without a stitch of pain or discomfort.  

I felt that I had one shot to get this right.  Otherwise, I would potentially be going through another surgery.  Also, I was only 41.  So, I felt that if there was the possibility that the uncemented device would hold up better over time than the cemented, then I'd better go the uncemented route because I would like the best possible longterm outcome.  The whole concept behind the uncemented device made a lot of practical sense to me.  But, there is the risk associated with it being newer.

Dr. Su is also an excellent surgeon, very experienced and has many happy patients.  You're choosing between two outstanding surgeons, so you're already on the road to a positive outcome.

Good Luck!
Jean

[John C]

My only advice, is that you should not let the travel issue be a big part of your decision. I flew all the way from Hawaii to go to Dr. Gross, and then flew back to Idaho to recover. I am very happy with my decision. You must make your own choice based on the doctors and the the approaches, but I would not let something as minor as travel affect a lifelong decision.

[karenj_m]

Hi Jack...another Dr. Gross patient.

I'm from Northern NY and flew down to SC for my surgery with Dr. Gross...You can see my story (and nasty xrays) on Pat's site under "patient stories" / "Dr. Gross".

I was going to go to Dr. Su (since he is NY and HSS is an awesome facility)...but he didn't take my insurance and Dr. Gross was "in-network" ... weird!

At that time (I was 44)...Dr. Gross had performed a total of 1350 resurfacings compared to Dr. Su who was at 350 resurfacing...My case was pretty bad...the femur head and socket were almost fused together (20+ years of damage and awful pain).

To-date Dr. Gross has done over 600 resurfacings uncemented with no failure DUE TO THE UNCEMENTED procedure. He has done all together a total of over 1800+ resurfacings. The man has it down to a science and keeps perfected the procedure like putting a bio-something bandage on you before you leave that draws out the yuck in your incision and allows you to take a shower and NOT have to change the dressing until 10 days post-op. He puts a antiobiotic powder in the wound and a mixture of your blood in the femur cap (to enhance quicker bone growth)....he just keeps perfecting it.

These are the things you want from a surgeon. Let me state that Dr. Su is an awesome surgeon, and for the record has done a Biomet uncemented for a particular patient that was allergic to cement.

Either surgeon is a great choice....

For more information about uncemented and to see inside a femur cap showing both...go here:
http://www.grossortho.com/forms/Uncemented_femur_handout_9_2008.pdf

Note> Dr. Gross will give you a "cemented" if you request it.

PS: Now device manufacturers are starting to develop "uncemented" versions of their devices....

Take your time in choosing, read everything, and choose what YOU are comfortable...the main thing is choosing a great surgeon, and you've already picked two of the best.

[jackmac32]

Thanks Chuck,
Quick question.  You are about the same distance away from SC that I am...what do you do in the case of follow-up visits, or if some other issue should occur with the Device?   I see Dr Gross wants to see people after about a month and after a year.
Thanks,
Jack.

[obxpelican]

Jack,

Dr. Gross's 6 week out of town protocol is easy..... they will send you forms that any PT tech can fill out in regard to ROM and your gait, the x-rays are done at any x-ray lab and they will give you a script for that.

At one year they do try to get you back down there, I think if you push it you can do it as an out of town protocol too.

Unless you have problems, and with Dr. G it's VERY rare you don't have to see him until one year, although I think we're going to combine Myrtle Beach with my one year checkup.


Chuck

[John C]

Since we would need to travel from Idaho or Hawaii, Dr Gross and Lee have been very nice about doing our six week, one year, and all future check ups by using our local x-ray facilities and PTs. I know that they would like to see us in person to celebrate the success, but they are very understanding about the time and costs of traveling.