Recent results in Oxford,England reports failures in women under 45

[kmminer4]

Hello,
I have a question. I am soon to be having surgery on my left hip due to osteoarthritis and my dr. said I was prime candidate for the BHR but I recently received a email from a well known surgeon from Johns Hopkins telling me that in Europe they are doing away with the BHR in women under 45 due to the high failure rate of 25% in women under 45.Can someone tell me if they have heard any of this and how long has everyone that has had the BHR had success with it and how long.I am only 42 and I have 4 young children to take care of with my active lifestyle and I'm wondering if I should have the total hip replacement done instead.I know I'm sounding a little panicky but this is a huge decision (4 years of pain) for me to finally bite the bullet and do something about it. I just want to make sure that I am making the right decision.

Note from Pat Walter - owner of Surface Hippy. Please note - I changed the title of your post because I don't want new visitors to get the wrong information or be alarmed.  Sorry to do that, but I feel it is very important to not spread incorrect information.  I know you have no way of knowing what is correct, but I prefer the title I choose.  I hope you don't get upset.  Pat

[Pat Walter]

Hi

Welcome to hip talk.  I don't know where this surgeon found his information, but it is not consistent with any other published information I have seen in 4 years.

It is true that women under 50 can have more problems than men, but it is not a 25% failure rate.  It is also true that women that are large boned that use the larger sized BHR and hip resurfacing devices have the same outcome as men.  I have the Australian National Registry posted here with that info  http://www.surfacehippy.info/aoanationalreg08.php   and here   http://www.surfacehippy.info/pdf/NJRRAnnRep08.pdf

Goodness, not even the worst surgeons in the US have that failure rate.  The failure rate worldwide was less than 1% with a survivorship of 99.8%, then when the US surgeons started in 2006, it brought that down to a worldwide suvivorship of 96%.  That included men and women.   http://www.surfacehippy.info/bhrhistory.php

Surgeons that are against resurfacing tend to find some very strange information which is not normally public and OFTEN incorrect.  I can only tell you that I have many hundreds of personal sucess stories on my website.  My own BHR is now almost 4 years old and I had mine at 61.  I know a handful of older women with sucessful hip resurfacing.

What surgeon are you considering using? You should ask your own surgeon what the survival rate is.  Trust me, US surgeons in our sue crazy country would never do procedures that had a 25% failure rate!  This information is just not correct.  Maybe is it from some obscure surgeon that only did 4 resurfacings and had 1 failure - then quit resurfacing.  I know of no surgeon with that kind of failure rate in the US or overseas.  Remember, the BHR and resurfacings has been done overseas since 1997.  My own surgeon, De Smet of Belgium, has now done way over 3000 resurfacings and some surgeons have done way over 4000 overseas.

Please take some time to read more information, talk to the folks here and ask your own surgeon for information.  If he is one of the really experienced surgeons I have on my list, he/she will definitely set the record straight.

Pat

[kmminer4]

Thank You very much for your input. I am in no way offended and I look forward to any input that is out there.I am still having the BHR even with the recent study and have to consider that each case is different and may not refer to me. I was wondering if weight  would be an issue for the failure rate. I am 5'9" and 145 pds. ,so I know right now this is not an issue but if I was to become  not as active and gain weight,do you feel this would play a role in the failure rate?What is your take on this ? I know that in the future I will have to have THR (I'm 42) but I know that going in and I am comfortable with that. So Thank You again and Thank You for having this forum,it has helped me tremendously to get all of the info that I need.
Kelly Miner

[Tekka]

Hi Kelly,

Your post really interests me, I was 42 when I received my LBHR seven months ago this week, you are correct in being realistic in what you can expect long term....will a BHR last a lifetime!!!  Well the answer is none of us Know, the BHR has only been around for ten or so years but all of the early signs look really promising. Mr McMinn has one of his early patients approaching close to 20 years I think, I am a realist and I appreciate variables play a part in life and we do have a chunk of metal in our hips.

I sit here completely pain free and feel the best I have done for years, so as long as I am able to remain healthy and keep active, then I hope I keep my BHR for a lifetime...well thats the plan.

I hope this helps.

Regards

Terry

[kmminer4]

Terry,
Thank You helping me relieve my fears about what is the best type of surgery for me. I hear different reports from very reputable surgeons and then I get nervous that I may be making the wrong decision.I have too much at stake (4 young kids) to be a drs. guinea pig.So I want to make sure that people like yourself feels confident in their results with the BHR.I know that weight and activity level does play a role and I've always been active and weight conscience,so I am going into this for the long haul and I'm sure that my results will be positive and then I will be writing to others here telling them the same thing you have told me...positive results.Thank You again for your input and 18 days and counting til surgery.
Kelly

[John C]

Here are some more positive thoughts for you. At 5'9" and 145, you would seem to be the ideal female candidate, since it is the tiny women that seem to have the most problems, and larger boned women seem to have the same success rate as the men. Also, do not assume that you will need a THR someday. After my surgery, Dr. Gross was very clear in his expectations that my resurfacing could last a lifetime. Many people do not know that there are studies going back well over thirty years that show almost 100% success rates with MOM resurfacing done in this country back in the seventies. Most of the resurfacings from that era failed because of the use of plastic cups, which is why many Doctors are still concerned. However of the few that were done using Metal on Metal, recent studies show that almost all of these are still going. I believe that this study is on this web-site. Good luck with your procedure.

[fedup]

There is an article out of Oxford in Archives of Physical Medicine and rehabilitation , Vol 89, April 2008 that reviewed 120 patients that had 1 year follow up after Conserve MOM resurfacing (retrospective study). The patients were questioned regarding fnctional outcome 1 year after MOM resurfacing. 25% of patients were considered to have a poor outcome with persistent pain, reduced hip flexion, decreased leg strength, walking and other functional limitations. 5 patients had been revised to THR by one year due to 4 femoral fractures and 1 AVN. Those with ongoing pain at 3 months seem to still have pain and reduced function at 1 year. There is not a lot of information on the characteristics of the implant in the patients. It did not study the causes of the pain in this article. There was concern about inadequate physiotherapy in the perioperative period. There may be another study of these patients related to outcome by sex. It was not noted in this paper The experience of the hospital or surgeons was not noted and is of utmost importance I would think. Mean age was 56 +/- 9 years , 71 men, 49 women.