What would you do?

[hipnhop]

My Kaiser Doc has recently been trained on HR.  I will be her first HR patient although she has offered me  THR of which she has been doing for more than 17 years. I have been on crutches for the past 9 weeks due to Spectic Necrosis caused by a Cortisone shot and I want to get rid of pain and return to my life. Should I let her do the HR and hope for the best or go with her experience in THR?

What would you do?

[Dayton96]

I would beg, borrow, or steal $12,000 and go see Dr. Bose.

Mac

[resurface]

Why can't you see another Kaiser surgeon?  And put a check in the No F'n way I would have it done by a first timer!

[Lopsided]

I will be her first HR patient...

What would you do?

Run (or hobble) away!

And if you have to pay or borrow to get a good surgeon and get it done properly, you won't be the first.

[littleb]

With all you have been through I think you know the answer. Find someone with a proven track record and who will understand your health issues now with what special needs you might have.

[Luann]

Hi "Ed",
 It is kind of a sad paradox that in order to to be experienced, a Dr has to have a "first" (and second, and hundreth, for that matter) but no one wants to be that person!
 On the other hand, if you read all of Pat's posts on how important experience is (she is very studied on the subject!), you would never even consider this proposition!!
 I had HR almost 7 months ago, and even as well as I am doing and feeling, I sometimes wonder how mine will turn out in the long run, with my Dr having only done about 450 HR's total. 
 PLEASE, no matter what it takes, do not consider a Dr that is not at least within the 100's. Please! From what I understand it is ALL about technique and placement (which ='s EXPERIENCE)  Good luck, Lu

[swilliams]

It's true, someone has to be the first or how will a surgeon ever get experience! My problem is that such a sensible, logical reply is followed immediately by "yes, but why does it have to be me?"

In short I spent ages on the net finding out who was considered the best in the business because, if I was going to have spare parts, they were going to be installed by an expert or I was going to hobble on crunching painkillers!

All my research roads led me to Derek McMinn. Now, 18 months after my op (he found he couldn't do a hip resurfacing for me so went ahead and did a THR) I haven't had one moment of regret. So my advice? Beg, borrow or steal (well maybe not the latter  ) and go see the best!

[Pat Walter]

swilliams

Thanks for your post.  I agree that if you consult or use the very top surgeons and then receive a THR rather than a resurfacing - you have the peace of mind that you really were not a good candidate.  When a surgeon that has only done a few hundred gives you a THR - you always have the question left - what if I had used one of the top surgeons.   I also felt using Dr. De Smet allowed me to be able to accept a THR or even a revision in the future because I knew I used the best.  I would never have to second guess my self saying - this would not have happened if only I used the top surgeons.

The top surgeons have the type of experince that can only be earned by doing thousands of resurfacings.  They have more in reserve to do tough jobs than the less expeirnced.  I will say that for normal resurfacings, many people do well with the less expeirnced surgeons and it is not a given that they will not do a good job.  The statistics however, say that 4% of the people will have problems with resurfacing - so why take a chance.

Good Luck.  I know you will live an active life out of pain with your MOM THR.  Not a bad solution when you can't have a resurfacing.  Keep us posted on your life with your THR from Mr. McMinn.

Pat

[Cutter3]

Ed - I know you're on the East Coast, but Dr Klug is an outstanding resource within the Kaiser community.   You may want to give his office a call and see if you could at least talk to him about your situation.   He's now done over 500 resurfacings (including mine), and he has always been open and honest about things when I've had questions.     

And a ticket to California is waaaay cheaper than a ticket to Europe.   (if you really want to feel like you're in Europe, talk to his office admin - she's from the Eukraine...     )

http://www.permanente.net/homepage/doctor/raphaelklug/

[Cutter3]

also, with the necrosis on your femoral head - do you/they know how deep it goes?   It was an issue during my surgery, but luckily for me, it didn't go too deep, and there was still enough healthy bone underneath for the resurfacing to be successful.

[shipnc]

Ed...let me throw out some other thoughts on your question since I was faced with a very similar decision a year ago as I prepared for a procedure.  Let me say first off that I am very happy that I was able to find an experienced surgeon who was able to do a resurfacing here in my hometown, and I believe that resurfacing is a better alternative than THR, particularly if you are anxious to return to an active lifestyle, as I was.   I would also insist on a surgeon that had considerable experience in this challenging surgery.  However, I also believe that THR is a perfectly fine option, and many people have successfully undergone this more traditional procedure with very good results.  In fact, the tennis pro at my club had both his hips replaced over 10 years ago, and he was able to return to the courts successfully. The technology continues to improve with larger head components and different material options that tend to reduce the limitations and dislocation tendencies that have been negatives in the past.  As I recalled in my hip story, posted elsewhere on this site, I had reached a point where I had just about decided to go with a THR because I could not find a surgeon here in Charlotte who was sufficiently experienced in resurfacing, and I felt that the disadvantages of paying big bucks out of my pocket and having surgery away from home outweighed the advantages of resurfacing over THR.  Fortunately, I was able to find an experienced and highly regarded surgeon that practices locally, so I didn't have to make the compromise.  As I said before I am a believer in resurfacing but I could have lived with a THR as well.  It's all about finding a skilled surgeon and realizing that tradeoffs may have to me made..

[hernanu]

I would pass. It is definitely a catch 22, since surgeons need to start one someone, but given the dependency on skill (IMO), I chose a surgeon (Dr. Snyder) with over 800 operations (at the time).