Resurfacing for older patients?

[shipnc]

Hello all....this is my first post since discovering this wonderful resource for info on hip resurfacing.  I have reached that point where I need a new hip and have to decide between replacement methods.  I am 65, a competitive tennis player, long distance biker, and (was) a regular hiker.  Returning to an active lifestyle is my goal, and my preliminary research has indicated that resurfacing might be the best option to achieve this goal.  However, I am finding that a doctor who does this procedure regularly on older patients is hard to find in my area, Charlotte, NC.  Through this web site, I have found doctors in Columbia, SC and Winston Salem, NC who might be candidates but this involves out of town travel with its concurrent problems.   At my age and with the improvement in technology, it seems unlikely that I would need a second procedure, so this negates one reason for resurfacing. I have heard that increased mobililty and fewer activity restrictions are another reason for resurfacing.  My question is this: is this true, and if so, how big a factor is this compared to traditional THR? Are the advantages great enough to risk using a less experienced surgeon or traveling away from home? Any opinions or throughs would be appreciated.  Thanks.

[Pat Walter]

Hi

Welcome to Hip Talk.

I was 61 when I had my hip resurfacing and would not have it any other way - as long as I was a candidate.  You don't know that you will not need another hip in your lifetime.  As you know, you keep your complete femur bone.  You gait with a resurfacing is more normal that with a THR http://www.surfacehippy.info/gaitstudy.php  There are also no restrictions on your activities normally after a resurfacing.

You did not say whether you are male or female.  If you are a 65 year old female, it is doubtful that any less expeirnced hip resurfacing surgeons will give you a resurfacing.  The really expeirnced ones like Dr. Gross of SC, Dr. Mont of MD, Dr. Su of NY and a few other will, the rest probably won't.  Also many of the top resurfacing surgeons will NOT accept medicare for resurfacing.  So that eliminates quite a few.  That is the first question to ask.

I you are like I was, an older female and 61 at the time, I choose to travel to Dr. De Smet in Belgium to get my resurfacing.  I felt I was too young for a THR.  The overseas surgeons often do older women when the US surgeons won't. You have to have good bone density and be a good candidate for a resurfacing.

Even a 65 year old male will have more resistance to resurfacing in the US.  So you may have to work hard at finding a surgeon who will resurface your hip.

If you can't get a resurfacing, just make sure that you at least get a MOM THR. You don't want an old fashioned small ball/metal plastic THR if you want to be really active with no restrictions.

You can see from people that send me their info that there are some older folks getting resurfacing  http://www.surfacehippy.info/agesurvey.php, but they are in the minority of the whole group of patients.

So it again comes down to what your individual case is and what you think you want.  Ask questions of this group and your surgeon.

Pat

[mari]

I had my hip resurfaced by Dr. Gross in Columbia, SC when I was 62, and I am very glad I had a resurfacing instead of THR.  I traveled all the way from Minnesota!  You are just a hop and a skip away from Columbia; I would highly recommend that you consult with Dr. Gross.

[Excapnal]

Hey, shipnc - I'm 66 years old and an avid racquetball player until my hip started really limiting me on the court.  I did all the same research and the first OS I consulted, who is very highly respected in the area, but does not do resurfacing, told me when I couldn't play anymore to come see him.  He said I might be able to play "racquetball lite", which for me is an oxymoron.  Anyway, did more research and found a guy 5 miles from my house who received his training in England and had done about 50 BHRs and was also highly regarded in the area (by doctors, not lay people).  He said I would be a perfectly good BHR candidate pending bone density testing, which I passed with flying colors.  Got my hip replaced 11/10/09.  I went home the third day, went to one crutch the following day and cane only on day nine.  Walked into his office 11/25 unaided for my follow up.  We reviewed my post-op x-ray and he said placement was spot-on.
  I still use the cane a fair amount to make sure my gait doesn't get out of whack but all else is pretty normal.

Bottom line is that age really is not a factor and there are plenty of OSs out there who would take you on as long as bone density is good.

[Pat Walter]

Hi Excapnal

Welcome to Hip Talk.  Thanks for your post.  Glad to hear you are doing well. I was 61 when I had my hip resurfacing.  You are right  - it is not age that determines if you are a candidate - it is your bone density and hip problems. 

Look forward to more of your posts, especially next year when you are back to playing racketball.  Give your body time to heal first and be patient.  You don't want to take any chances early on, there will be plenty of time to get back on the court after you are healed.

Pat

[Excapnal]

Thanks, Pat; just a note....this rehab road will not be my first rodeo; in 2007 I had massive rotator cup repair (three out four tendons were "shredded"  according to the OS).  I slept in my family room chair for the first two weeks and PT went on and on, but I won and my racquetball is none the worse at this point.
 BTW, my hip surgeon is from the same group.  Anyway, I am being careful and listening carefully to the ol' bod.

Alan