Recall & Ions

[Shannon]

I was all about being resurfaced instead of replaced until I spoke with a doctor who used to do the surgery but has since quit due to the recall and the ion issues. Now I'm scared to go this route since an actual surgeon (actually 2) have warned me against it. I am/was an avid marathoner and if I have a total hip replacement they tell me I won't be able to run at all. I'm confused and would love any advice/info anyone has.

[moe]

Shannon, talk to a surgeon who uses the Birmingham. Many people have returned to running and all kinds of sports, mountain biking in my case. I have no doubt I could run again if I wanted to. Good luck, moe

[stevel]

Send your x-rays to Dr. Bose and read Cory Foulk's story as he pushes the envelope for his BHR installed by Dr. Bose in 2005 by doing marathons, ultra-marathons and triathalons with no evidence of excess metal wear.  Other senior experienced hip resurfacing surgeons such as Mr. McMinn, Dr. Desmet, Dr. Gross and Dr. Su will say OK for running.

[Lopsided]

Shannon,

...and if I have a total hip replacement they tell me I won't be able to run at all.

Well, it is quite obvious that you won't be satisfied with a total replacement.

...and the ion issues.

If he is worried about ion issues, does that rule out metal on metal replacements too?

Please don't get an old fashioned small ball metal on plastic replacement. If your doctor is not skillful enough, then look for a new fashioned doctor.

D.

[John C]

Hi Shannon,
I think that what you have been told really reinforces two things; you must really do your homework in choosing the type of prosthesis, and you must really do your homework in choosing a top resurfacing surgeon, even if his location is not convenient for you.
You can find brands of prosthesis out there that have been around long enough to avoid concerns about recall issues, and you can find surgeons that consistently do a good enough job of placing a well designed prosthesis so that the ion problem becomes very remote. I had my ions level tested after two years of intense athletics on a resurfaced hip, and they were within the normal range for people without a prosthesis. I credit this to the design of the prothesis and the skill of the surgeon.
It is true that there is no such thing as a joint replacement without some compromises and risks. If you want to return to running, and a top resurfacing surgeon confirms that you are a good candidate, my own belief, and experience, is that resurfacing holds the best balance of risks in order to get you back out there.
Do your research, and choose the option that provides the balance of risks and benefits that fits your priorities. In my case the compromise is that I still have some occasional minor soft tissue discomfort due to the extent of soft tissue resection involved in a resurfacing, but the benefit is that I am able to return to all of my sports.

[Pat Walter]

Shannon

Welcome to Hip Talk.

There is a small increase in the metal ions in your blood during the break in period after a hip resurfacing.  That settles down to normal sometime during the first year.  The high metal ions your surgeon is refering to are those that occur when a surgeon does not do the hip resurfacing correctly.  When an inexpeirnced surgeon places the acetabular cup at the wrong angle, the two bearing surfaces of the femur cap and acetabular cup don't rub properly.  The is excessive edge wear creating high metal ions.  This does not occur when the components are placed properly.  If you want to learn more you can read this  http://www.surfacehippy.info/bhrpressconference2010.php  and you can watch the videos interviewing Mr. McMinn explaining how surgeons and the press are not properly reporting the results of hip resurfacing. They are making decisions upon the poorly placed hip resurfacings by inexpeirnced surgeons.  http://www.surfacehippy.info/mcminnnegativepr.php

There are many people that have had their resurfacings 10 - 12 years. There is an excellent track record.  YOu can see the national registries to view that  http://www.surfacehippy.info/nationalregistries.php

There have been two poorly designed resurfacing devices including the ASR which have been recalled.  If you surgeon used those and did not place the absolutely correctly, there could be problems.   Please understand that even a MOM  metal on metal THR has the same metallic components as a resurfacing. The femur cap portion and acetabulur cup is the same as a resurfacing.  So if you want to stay really active - the MOM resurfacing or THR are really the best solutions.  The ceramic on ceramic used in the US does not have as large of ball sizes as those used overseas. So I would be careful going that route.  Also if you are going the MOM THR - why not resurfacing?  Same metal and same components.

You surgeon is not one of the really experinced surgeons.  Resuracing is a VERY difficult surgery and most regular THR surgeons aren't skilled to do them.  There are only a handful of really skilled resurfacing surgeons.  It takes a great deal of time and doing several thousand to get experinced.  Those surgeons that have done a few here and there like a 100 even, just are not as skilled as the top surgeons.

If you are young and want to stay active, you need to talk to the top surgeons and find out if you are a candidate.  Don't talk to local orthopedics - they simply are not educated in resurfacing, even if they have done a few.  Look at my list and contact the top surgeons.  Dr. Su, Dr. Gross, the overseas surgeons and a few others depending on where you live.  Dr. Gross will give you a free consultation and call you on the phone. Dr. Bose and De Smet will give you free evaluations. 

Don't get an old fashioned small ball plastic/metal THR - you won't even be able to cross your legs.  Be care what surgeon you choose and what device you get.  You can't get any better than those that have done over a thousand on my list http://www.surfacehippy.info/listofdoctors.php  There are top resurfacing devices like the BHR, Wright C+ and the Biomet.  Stick with the devices that are used the most.

Do some more research. Send out some emails to the top surgeons and find out if you are a candidate.  The local doctors won't know.  Don't let a surgeon/s without experinced and great knowledge about resurfacing influence you until you talk to the best.

Pat

[ginnie]

I am part of an ION study and just was told my ion levels are very low. there are no statistics to support any known side effects.

[KayakDeb]

Shannon - my resurfed hip has been a Godsend for 8 years.  I have some issues that are cropping up now that I'm in the process of addressing.... but they would have also arisen with a THR and the past 8 years wouldn't have been the same.

But through the years, as I've met other folks with THRs - they are continually amazed at what I am able to do!  No restrictions on movement or weight-lifting has always been a HUGE plus for me, since I love to sail and scrambling around on small boats puts me in some real pretzel shapes...LOL!

Yeah - the metal ion thing long-term IS a big question mark - but ALL devices create "debris".  If you're lucky and your body ignores that debris - you could go a LONG time with no problems at all.  If you want to live your life free of "debris worry" - then you need to buy a wheelchair and stock up on pain meds.  That's really what the choices are right now.  No, it's not fair - but if life were fair, then I'd have been born a Princess ;-)

Best wishes!