Why I Chose Hip Replacement Over Resurfacing

[emichel]

First, I hope everyone will respect my decision.  I know this is a resurfacing website, but thought it might be helpful to other people trying to make this decision to read about my experience.  I have read and researched incessantly on the topic of resurfacing vs. replacement, and feel it is possibly the most important decision of my life.  I met with Dr. James Pritchett in Seattle in July '10, and again for a follow up a month or two later, to discuss the subject.  Trying to keep this short, in a nutshell, I thought he was great.  I was convinced that he was totally on top of the latest data and research, pretty much on a week to week basis.  I had originally sought him out because of his stature and experience re: hip resurfacing, but here is what stuck with me.  (First, I guess it should be said, that I am a rather small female, age 59, but very active and athletic and in great shape).  He said that they "have the best results" with resurfacing with a component size of 48 and above, and he estimated me at being a 40-44.  He did not dissuade me from resurfacing, or say he wouldn't do it, but presented the pros and cons of resurfacing vs. a large ball total hip replacement. He said he had done upwards of 2,000 resurfacings, and that the decision was up to me.  I thrashed around for several days before I came to my decision.

To give you an idea of what went into my thinking... even though I am a 59 year old female, and small in stature,  I also happen to be a total karate fanatic.  I trained in my current school when I was young (late 20's/early 30's), and at that time attained the level of 1st degree black belt.  Somehow I ended up (I won't go into it now) back into the school 5 years ago, and have attained the level of 1st brown belt (I had to start over).   I need to train, and attain my black belt, hopefully a year from March.   What I got from Pritchett was that w/resurfacing, any problems would most likely show up after some months to 2 years later.  It would just do me in to go through 2 surgeries (I need both sides done) and think everything was OK, then have to go back and revise it.  I feel that for me, the large ball MOM standard hip replacement would give me the best chance of getting on with my life and continueing my training without any further complications.  But... I realize it's all a crap shoot.  Still, I trust Dr. Pritchett and there's no one else I'd rather go with.  More later... 

[emichel]

Oh yes, I forgot to mention.  I have scheduled the first surgery for mid-January of 2011.  Dr. Pritchett requires that the 2nd surgery be scheduled at least 6 weeks later, though will do it sooner if I am "well recovered".  I wanted both sides done at once, but he refused.  Even so, why would I seek someone out for their expertise, then tell them how to do things?  I guess I have to just go with the flow.

[Pat Walter]

Hi
Thanks for sharing your thoughts.  You are an older, small women and are in that range of possible problems.  I can understand your thoughts about resurfacing vs THR.  Large ball MOM THRs are still excellent solutions to deteriorated hips.  It is ultimately your choice and you have to be comfortable with it.  I was 61 when I had my resurfacing and realize I may be facing a revision if I ever have problems.  I was willing to take that chance. Not everyone wants to face a possible second surgery.

I hope you will continue to update us as you move forward and write a story for me to post on the http://www.hipsforyou.com  website.  

Good Luck.

Pat

[stevel]

Hi Eileen,

I bumped into a female skier about my age (57) and was petite (4 ft 11 in + or -) and was told by Dr. Schmazried that she wasn't a candidate for hip resurfacing.
I suggested she contact Dr. Bose for an evaluation, since he does a lot of small Asian women and does a lot of extreme athletes.
You might consider sending your x-rays to Dr. Bose, since the advantages of a hip resurfacing vs THR for high impact activities such as downhill skiing and martial arts are obvious.

[emichel]

Hi Steve -- Thanks for responding to my post.  What I was trying to make clear is that I trust Dr. Pritchett, and do not feel the need to send my x-rays elsewhere.  He was not at all discouraging about the idea of resurfacing, or his ability to do it.  It seemed like it was more a matter of being sure it was informed consent.  I don't want to say anything controversial on here, and realize that the point of this website is to provide support and information, not to argue.  (Deep kudos to Pat, UR amazing for what you have done here.)  However... I feel that I have to say that I think that sometimes there is a tendency to idolize the "best surgeons in the world".  Of course we want the best we can get, but how that is defined is not always clear.  Part of what made me trust Pritchett, aside from the fact that he has been on the forefront of hip resurfacing process and research, is that he actually said something to the effect that sometimes it seems that everything is placed properly, yet there are problems, and we don't know why.  This is not a direct quote, I am paraphrasing, but oddly, it made me trust him more.  I think that everyone needs to understand that while we all hope that everyone will have a quick and relatively pain free recovery, with no further complications, this cannot be guaranteed, even with the best and most experienced surgeons.  It is a complicated and highly technical procedure, and even if someone can boast a 98% success rate, once they have done 2000 surgeries, there are 40 people with bad results.  On some level it is all a numbers game, yet how I look at it is, if I have a successful surgery it is 100% successful, and if I don't, it is 0% successful.  Just my 2 cents worth.  -- Eileen