INCISIONS

[shelle]

I am 41, have hip displaysia, and am ready for a hip resurfacing. (Feb!) I have seen two doctors that I am happy with in the Houston area (Dr. Kruetzer and Dr. Stock (if you have any opinions, I'm open)).  One doctor does the incision in the back and through the muscles and the other does a front incision without going through muscles. 

Any opinions on this?? 

[Pat Walter]

Hi Shelle

Welcome to Hip Talk.

There is a lot of pros and cons about posterior and anterior surgery.  Here is information from a handful of doctors explaining why they use the approach that they do  http://www.surfacehippy.info/faqsurgicalapproach.php

Personally, I am a conservative older person at 63 and had my hip resurfacing almost 2 years ago with Dr. De Smet of Belgium.  The really experienced surgeons with thousands of hip resurfacings still prefer the posterior approach.  After reading for about 3 years, I tend to agree with them.  I am not medically trained, just well read since I do this website and several others.

De Smet, Bose, Amstutz, Gross, McMinn all use the posterior approach. You can read about it and why.  It is muscle sparing. The anterior apporach leaves a lot more opportunity for nerve damage.

The approach doesn't really have that much affect on your recovery in my opinion.  I was walking on one crutch at 4 days and no crutch at 4 weeks. Had absolutley no swelling or brusing, no drains and no staples, only stitches.  I did not take any pain meds except Advil after leaving the hospital for muscle sorness.  I was with 8 other hippies that had the same experience. We were together for about 9 days.

I guess it is always a personal decision to decide on what approach you want.  Personally, I would look for a really, really experienced doctor and let them decide on the surgical approach and the type of hip device to use.  If you use the really experienced doctors - they will use the posterior approach.

You are very young and I hope you find a doctor you really like and get out of pain.

Keep in touch.

Pat

[hb pain]

Hi there,  I am 41 with displaysia as well, if you are still around this post how did your procedure turn out?

[dgm]

Hi there,
I had RBHR on 2/14/08 with Dr. Rogerson in Madison, WI.  He uses the posterior approach.  A few of my friends had THR with the anterior and had very quick recoveries so I was a little concerned.  But I needn't have been, I have had a very smooth recovery (thankfully!)  The incision is 8ish inches and I think will fade nicely over time.  By the time I had surgery I was in so much pain they could have done a 2 foot, zigzag Harry Potter scar and I wouldn't have cared as long as I stopped hurting!

Good luck!
Denise

[xocy]

Assuming an experienced surgeon performs an MIS resurfacing, are more muscles, tendons, ligaments, etc. cut with the resurfacing when compared to an MIS THR? I was told by one surgeon that the surgery was more difficult than THR.

mraycox@aol.com

[Pat Walter]

Hi

Most definitely a hip resurfacing surgery is more difficult than a THR for a surgeon.  That is why there are not very many doctors performing hip resurfacing yet.  Some don't want to take the time to learn and others don't have the level of skills to perform the surgery.

Most surgeons don't perform MIS resurfacing.  Some do smaller incisions than others.  For instance Dr. Gross does a 4 " incision while Dr. De Smet does a 8 - 10"    The size of the incision has no bearing on the quickness of your recovery.

There are not more ligaments and tendons cut in resurfacing than in a THR.  They are quite different surgerys.  There is DEFINITELY more bone cut off in a THR than a resurfacing   Check out the BHR is Bone conserving video here  http://www.surfacehippy.info/shvideos/videos.php

If you want to learn much more about hip resurfacing - listen to the new doctor videos. They are all great - but Dr. Gross does a really good explanation of the size of incision needed to do a hip resurfacing  http://www.surfacehippy.info/shvideos/videosdoctor.php

Pat