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Author Topic: acetabular cup question  (Read 1440 times)

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jwtoto

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acetabular cup question
« on: December 21, 2009, 07:44:16 PM »
Hello all,

I am new here so please excuse me for asking a question that has already been asked.

But first here is a little about me. I have one bad hip that started giving me occasional problems one year ago when I was 59. I had a hip athroscopy done on it to correct the shape of the femoral head. This was called a femoral acetabulum impingement problem by the surgeon. In addition to removing the impingement and repairing the labrum, the surgeon debrided some of the cartilage in the joint which he determined to have arthritic changes. I now have about 1 mm. of joint space in the upper part of that hip, no new cartilage grew back. The surgery did not make my hip better. There is some continuous pain now and the surgeon who did the surgery said that I would definitely have to have a joint replacement in this hip. This, of course, was disappointing given that the surgeon, renowned in his field of hip arthroscopy,  had given me great hope of full recovery.  So, now I am researching all of my options. I am in very good physical shape, have good bone health and tolerate surgery very well. I am very light for my height (5'9"/ 145 pounds) I would like to stay as active as I possibly can for as long as I can. I don't have any delusions about being able to run or play contact sports, basketball, dance the jitterbug, or play gymnastics. I would love to be able to resume surfing as I have done for almost 50 years but if that is not possible I can learn to live without it. Walking, bicycling, swimming, playing golf, weight training, etc. are some things I hope I could continue to do after I have the resurfacing or THR surgery. I am sure that I will have a million questions to ask as I am very apprehensive about what the future holds in store for me, but let me start with only one.

 The question is this: I read today on a doctor's website that the cup used in resurfacing is much larger than that used in THR. Therefore, the doctor said, if a THR is required at some time in the future after resurfacing has been done, the extra bone removed in the acetabulum during resurfacing can cause problems for the surgeon doing subsequent THR. Here is a link to the website I referred to:

 http://www.hiphelp.com/pages/hottopics.html#Anchor-Resurfacing-35882

 Has anyone heard of this complication? Is the doctor's statement about the much greater bone excavation on the acetabulum during resurfacing correct?

                        Thanks for responding to my post,

                                    Jerry
Jerry RBHR Dr. Su 4/15/2010

Pat Walter

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Re: acetabular cup question
« Reply #1 on: December 21, 2009, 08:10:33 PM »
Hi
Welcome to hip talk.

Your doctor is not giving you correct information.  The acetabular cup used in hip resurfacing such as the BHR, Cormet or Wright C+ is the same exact cup used in a MOM metal on metal THR. That is what makes the resurfacing so attractive - it not only preserves your femur bone since it doesn't have to be cut off like in a THR, but can be revisied if ever needed without replacing the acetabular cup.

This surgeon obviously does not do hip resurfacing and doesn't know anytihing about it or MOM THRs.  No more bone is removed for a hip resurfacing acetabular cup than in a MOM THR.  They are the same.  Don't let a surgeon give you an old fashioned small ball plastic/metal THR if you are very active.  You will have a lot of restrictions.  The MOM THRs will allow you to be active, but they still cut off a large portion of your femur bone.

Here is a page with actual emails from hip resurfacing surgeons that answer the questions - does hip resurfacing remove more bone than a THR  http://www.surfacehippy.info/faqacetabularboneloss.php   This is a myth spread by doctors that don't believe in hip resurfacing and normally don't do them because it is a very diffiuclt surgery that they can't do.  Regular THRs can be very sloppily done and by less skilled surgeons.  People can also have a lot of problems with a poorly done THR - so be careful who you select for your surgery.

Here is my list of expeinced surgeons  http://www.surfacehippy.info/listofdoctors.php  If you choose the expeirnced surgeons, you won't hear such stories.  ONly an experinced hip resurfacing surgeon can look at your x-rays to determine if you are still a candidate.  They consider your x-ray, your bone density and activity level. 

Please take some time to learn about hip resurfacing from this site, the people here and reading and listening to the videos and interviews of experinced surgeons so you get a truthful picture of hip resurfacing. Here are some great videos by the top surgeons that will answer many of your questions  http://www.surfacehippy.info/shvideos/videosdoctor.php

Good Luck and stay in touch.

Pat
Webmaster/Owner of Surface Hippy
3/15/06 LBHR De Smet

medgerton

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Re: acetabular cup question
« Reply #2 on: December 21, 2009, 10:41:09 PM »
It looks like Pat answered your question. I have a couple of points. First, why would you think that cartiledge would grow back after your hip repair?  If this was possible everyone that had simple osteo arthritis would go through this procedure to grow new cartiledge and return their hip joint to "normal" spacing and function.

Second, I plan on playing basketball again after my resurfacing. My doctor said it would be about 6 months after surgery for basketball. So, do not give up on any athletics in your planning. Especially since you are light and physically active now.

jwtoto

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Re: acetabular cup question
« Reply #3 on: December 22, 2009, 07:55:58 PM »
Thanks, Pat and Medgerton for your replies. Hopefully, I will never have to have the resurfacing parts replaced and everything will go fine. Medgerton, thanks for giving me a shot of reality about my disappointment that my hip cartilage deteriorated. You are absolutely right. I am just in a sort of state of shock right now because the inevitability of having the prosthetic hip very soon has sort of overwhelmed me. I need to accept it and start making my plans.
Jerry RBHR Dr. Su 4/15/2010

 

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