Bi-lateral OA looking at RS

[Tin Soldier]

I'm a newb looking for more info on RS.  Pat - this website is excellent and I thank you and the others here so much for all the great info. 

In March 2010 I found out that I simply had bi-lateral OA from a not-so-helpful Dr. that said nothing about impingement, femoracetabular impingement (FAI), potential treatment options,...eventhough he was looking at my x-rays during the exam.  Sadly I walked out of there thinking that my active lifestyle was over at the ripe old age of 41.  He said, "I'm not trying to sell you a new hip" and then handed me a thin booklet on THR.  "Get on the hip train to local ortho clinic and get yourself some shiny new hips (THR)" was how I sarcastically felt about the whole thing.  So I embarked on the journey I am now on.  I had serious limited ROM in the left hip with pain during walking and other activities.  Cycling, soccer, running, stairs, decent sleep, were all becoming something of the past.  Right hip, surprisingly, had less spacing on the images, but better ROM and no pain.

I did some research and the first thing I honed in on, was FAI and arthroscopic techniques to clean up the osteophytes and acetabular rim.  Not sure why, but I really had little knowledge of RS.  I focused on some papers by Phillipon in CO and looked for a doc in the northwest.  I found Wagner in Portland, OR.  I scheduled a visit to Wagner and he did the ROM exam and took some pics and told me I was not a good candidate for arthroscopic work.  I think it had to do with limited spacing (I think less than 4 mm between ball and socket).  Wagner was great though and he recommended that I see a PT that's had a lot of experience with FAI and hips.  That was Mark Ouellette in Eugene, OR where I lived.  He gave me lots of great info and he even studied with Phillipon.  He recommended cortizone, and possibly fake synovial fluid until I was ready for a new hip or RS. 

In September I got a cortizone injection on the left hip and instantly had relief.  The gait got better, I played a little bit of light soccer, ran a little,... all the while knowing that I'd be looking at major surgery sometime in my future.  It gave me a little reprieve from the pain, which I did not realize was that bad until it was gone.  I think the pain was associated with a labral tear, but have no images to prove it.  During the reprieve, I thought I ought to get busy and start looking at the next option, RS.

I went to Harold Boyd in Salem, OR last month and had a great visit with him and his staff.  They spent as much time as needed to be sure I had my questions answered.  He said I'm good to go for both hips, but he preferred not to do both in the same surgery.  Actually separating by about 5 weeks.  He pointed out how poor my ROM had gotten and I had not realized it because I just wasn't doing those types of movements anymore.

I am considering having it done within a year.  I am looking at all the info right now to prepare for it.  That's my story, I'll try to keep posting info as it goes.  I also plan to spend some time communicating with others in order to learn more. 

Thanks again for all the work put into this website.

[Pat Walter]

Hi
Thanks for your kind words about the website.

I assume Dr. Boyd suggested hip resurfacing since you are so young.  Many men require resurfacing due to FAI. Over 70% of Dr. Gross's male patients have FAI. 

Only a few resurfacing surgeons will do both at one time.  Dr. De Smet of Belgium is one, but I assume you want to stay in the US.  You might check out several of the other really experienced surgeons to see if they will do them both at one time.  It is more diffiuclt to do both, but you only have one recovery.  Most that have it done at once, say there were glad they did.  Other people say they did not think they could get thru the recovery.  It is a personal decision and you have to find a surgeon that does both at one time if that is your decision.

Dr. Gross's video interview from 2008 has quite a bit about FAI  http://www.surfacehippy.info/doctorinterviews/grossinterview.php

There are a lot of doctors in CA which are very expeirnced. You can look at the list  http://www.surfacehippy.info/listofdoctors.php#California_

Pat

[double trouble]

I have completed bilateral BHR surgery on 9/28/10 by Dr Scott Marwin at NYU Hospital for Joint Diseases in NYC. I am 62 yrs and reasonably good physical condition
Been 7 weeks since surgery, still walking with lobster crutches, but can walk very short distances in the home unassisted.
I have been driving a car since 4 weeks after surgery, which when I started out patient PT which continues.
I plan on returning to work on 11/30 using commuter RR and NYC Subways.
The rehab is tough because both side muscle groups have been impacted and strength and balance needs to be rebuilt.
Dr Marwin informed me that the recovery/rehab would be tough but I would not have to look back, and although I was a good candidate for bilateral not every patient may be.
I have to say I am happy with my decision, both hips were bone on bone I was in constant pain could barely put on my socks or get in and out of a car. If I did only one side, my other side would be of no support in the rehab, and the thought of going back for a second surgery and rehab is not pretty.
I also know Dr E. Su at Hospital for Special Surgery in NYC also does Bilateral BHR.

[Tin Soldier]

Well I guess it's a bit like having twins without ever having a single first.  You have no idea what it's like to just have one.  In other words, if you have a bilateral surgery you would not have to go through it again, so if you had only one and it was rougher than you expected you might fuss about going through it again.  My wife and I had twins, so we had no idea what we were getting into.

When it comes to my hips, though, at 41, I suspect I am looking at more than 2 surgeries down the road.  2 RS's soon and then possibly 2 THRs at 60-70 or so.  Who knows.  Right now, my right hip could probabaly go a few years, though.

Thanks for the input. 

[hernanu]

Just had my first resurfacing done on Aug. 24th, going in on Nov. 29th to do the second (right, less damaged) one. I also put it off, until I had major issues with my hips (dislocation on the left, pain, etc.). I'm 53 and until last year, had been trying to keep doing soccer, weights, etc. and finally gave up.

I can tell you that for me, the procedure has been great, not much pain and the previous pain was just gone. I have had a great experience with the surgeon, the nursing staff, the home visiting nurses and both the home and outpatient physical therapists.

One of the goals we set at the outpatient physical therapists (Bay State Physical Therapy in Franklin, MA, USA), was to strengthen the operated leg to at least equal the unoperated right leg in both range of motion (ROM) and in strength. As of two weeks ago, we had accomplished that, and am now actually exceeding it.

So although I also am following my Doctor's advice not to do both hips at once, in my case, I am looking forward to the second and am less nervous about it since the first has gone well. Just my opinion, but I am sure you can also read other stories about folks who had both hips done who also progressed well. Mine is just a testimonial that (so far) a sequential dual hip is progressing just fine.

When you do choose to do it, I think you'll find it's the best thing you've done. Again, just IMO.

[Tin Soldier]

Thanks for the advice.  I think I will be similar in that I feel I'll recover pretty quick and have a good attitude about it.  Like I said before, you don't realize how much pain you are in until it goes away.  That will brighten anyone's mood.