Advances in Hip Resurfacing

[sdcycling]

I consulted with a hip resurfacing specialist.   He encouraged me to wait five years if possible because he felt that the technique would significantly improve over that time period.     At present, my hip pain is manageable, but five years is a long time.   I did not get clarification with respect to the types of improvements that he was expecting.    What is going to happen over the next five years that could possibly warrant waiting that long?   Thank you.

[Dannywayoflife]

Hmm well your guess is as good as mine, but i think theres several things that could be.
Theres a big debate at the moment with reguard to cementless femoral components. I have seen several companys are producing laminated ceramic components. They could also be looking at new alloys etc,
Although the more data the surgeons and engineers have the better.
Danny

[obxpelican]

Within 5-10 years stem cell therapy will be here I bet, they already do it on dogs, a local vet has it pretty well perfected.

That's just my guess.

Of course with genetic defects and accidents etc hip resurfacing and total hips will still be needed.

Chuck

I consulted with a hip resurfacing specialist.   He encouraged me to wait five years if possible because he felt that the technique would significantly improve over that time period.     At present, my hip pain is manageable, but five years is a long time.   I did not get clarification with respect to the types of improvements that he was expecting.    What is going to happen over the next five years that could possibly warrant waiting that long?   Thank you.

[moe]

I don't understand why he mentioned "improvements" without details. If you are having pain and ROM issues now I would get another opinion. Five years is a long time to wait when there are tested and proven products and techniques now. Anything that comes along in the next five years will have a very limited track record. The BHR has 13 years of data. Many people who get resurfacing say they wish they didn't wait so long.

Good luck, moe

[Lopsided]

Five years is just too specific. If your hip is degenerating, it is totally unknown how long until you are bone on bone. When my left hip started to go, I asked my local orthopaedist many times how long it would last and he told me there is no way to know, until one day I hobbled in and he said, "It is about time you got done." I have asked both him and Dr. De Smet how long till my right hip goes and they both say again there is no way of knowing.

So 'wait five years' sounds like 'find another surgeo'n.

I do not think stem cell cartilage growth will be an alternative to resurfacing for many people. It does not address the reason behind the initial degeneration of the cartilage, dysplasia or FAI, and would not help at all with bone spurs or cysts. I do not believe cartilage will be created with the same engineering standard as alloy. Stem cell technology in general seems a bit hit and miss. (Sorry Chuck)

[resurface1]

I made the decision not to wait for a simple reason... I wanted to live my life! 

Waiting placed too much on hold. As far as stem cells, it will be many years, the clinical trial necessary to prove efficacy and safety will be daunting.  Not that the market would not be there should it show positive results but this is a major, multi-center undertaking IMHO. 

[phillwad]

sdcycling

What did the x-rays show?  I went to my doctor my hip hurt and I had range of motion issues.  We decided on a bunch of stretching exercises.  After a year - my next regular physical - we talked again and I expressed the lack of progress.  During this year I had done a number of 100K mountain bike races, cross country ski a bunch and a full cyclocross season - very active.

He took x-rays and found major bone on bone contact both sides - decided as I already had a flat spot on the right hip & that although I was not in much pain - the bone on bone wear is really bad - i should not wait.   Now I could not imagine continuing with what I was doing and waiting another 5 years

I am now 4 weeks post op and will soon have the left hip done - I already see huge improvement

Cheers - Phill

[einreb]

He encouraged me to wait five years if possible because he felt that the technique would significantly improve over that time period. 

Was he talking about devices or surgery technique?  I can't imagine that the surgery technique will get too much better than that demonstrated by top docs.

As for the devices... this stinker of that waiting game is that there may be new devices, but you'll be comparing them to devices with very long track records.

[23109VC]

Waiting may work if your not too bad off and you can handle postponing surgery.  Waiting is not an option for some.

Eventually, the pain gets to a point were it makes your life so limited that waiting is counterproductive.

I knew I had to have surgery eventually in 2007, but o decided to wait.  I was in pain but not and enough that I felt I had to do it.  Eventually, I didn't want to wait and wanted it fixed.

I am sure that as time goes by, the devices, tech Oakes, etc will always continue to improve....so you can always rationalize waiting by saying that if you wait, the devices will get better.  But eventually you have to do it.  It's the same with tvs and computers...whatever you buy will eventually ne outdated!  But eventually your tv will break and you either have to buy what is available....or go without tv....

They may have a "better" hip in 10 years, or 5 years.... But I have on enow that works! 

[John C]

Hi Chuck,
Just some input on stem cell therapy for hips, based on my experience. Before I had my resurfacing, I ran across the same information that you mentioned on the stem cell work being done with dogs. I called and researched around the world, and found a Dr in Colorado that was doing basically the same thing with human knees, and claimed some success. He had not done a lot of hips, but had done a few, and felt that it might help in my case. For me the stem cell treatment was a disaster, and I went from skiing and walking with some pain, to instantly being unable to walk at all without crutches. It got progressively worse over the next two months, and lead to me getting the resurfacing. My understanding is that the process has since been regulated by the FDA, so that it is arguably less effective than it was when I had it done.
There were some reports of people having good success with this treatment in knees; but for me, the good news was that it forced me to stop  procrastinating any longer to get my hip resurfaced since I could no longer walk, swim, or do anything else.
I, like you, continue to hold hope for this in the future, but my recent experience would indicate that it is a way.

[phillwad]

John C

Great to hear from someone who has experience with the Stem Cell research, sorry it did not work out for you.  From your photo it looks like you are back skiing.

Cheers - Phill

[hipnhop]

Unless ALiens are going to share some new technology, I'd say HR is going to be the standard for young active patients for the next 10-15 years.  Every year in pain is a loss of a year without pain.  I am looking forward to resuming 90% of my normal activities in the next five months.  I couldn't wait 5 years.

[cwmoto]

I just got my right hip resurfaced , but could have put it off and endured longer. Taking pills and being a couch potato after work isn't something I want to keep doing. Also, health insurance these days isn't the most secure thing anymore.

[Lori Cee]

The prosthesis that I have 'installed' the BMHR is the next step from resurfacing for patients where bone quality doesn't support a resurfacing.   It pretty much looks the same with a thicker stem and there is more inside where the femoral head goes.  

Now the reason that I bring this up is that the BMHR has been used in the UK since 2006 and since then approved for use in Australia and only some surgeons are using it.  It is not yet FDA approved and thus is not being used in the US.  In five years who knows whether it will be approved for use in the US.  It will have an extra 5 years of data under it's belt relating to revisions etc (which currently look very similar to the BHR for Mr McMinn, so I'm hoping to see similar results to my surgeon's long term BHR's).  

If I had of gone for surgery when it was first offered to me, I would have only had the option for total hip replacements.  Now the benefits to me for the BMHR are similar to the BHR in that it is bone conserving and at 33 I will need a revision down the track that will be easier that a total hip revision.  

Having said that, surgery was not the right option for me when it was previously offered and luckily, I ended up with a better option.  It's the right time for me now, and I have the BMHR.  Popular consensus between my rheumatologist and the surgeon was that I could probably stick it out for another two or three years before I was screaming for them to fix it and I had to make a choice in relation to my quality of life now.  I decided that it was time and took the option available to me now.  I don't know what will be available in 2 or 3 years but it will be 2 or 3 years that I will hopefully live without the old pain.  

At the end of the day it comes down to what is right for your life now and don't be afraid to keep seeing surgeons until someone gives you a solution that works for YOU!

[Tin Soldier]

I'm a couple days late here, sorry, but I have to add something.  The FDA, at least in the US, will drive how quickly new technology comes around.  If the FDA won't approve it, your insurance won't either.  Insurance is getting tighter and tighter every year.  If stem cell or other technology comes out, it will be some time before it's approved by a government body and thus approved and paid for by insurance.  My surgeon, whose been researching HR since the late 80s, told me rather frankly, that MOM HR will be surpassed by some other technology, but not in my lifetime.  That's pretty sad since I'm only 41, but he was simply suggesting that FDA approvals take a long time (8 to 10 years or more) and he was being a little dramatic to make the point.

In short, I would have gotten a THR if HR was not available.  I wouldn't wait 5 years hoping for something that may or may not be there.       

[Pat Walter]

Thanks for the heads up.  Wise Guru is history.  If a person is against resurfacing and wants to post - they need to identify themselves as a doctor, patient, reporter, medical writer, etc.  Negative opinons from unknown posters will not be left on the discussion group.

I removed several other posts that had the original info quoted with the responses.

Pat

[lori.36]

Pat, Confused why you would not let people post negative items about hip resurfacing on this talk group?  This is your website, but as a follower, I am intrested in all angels of thought with hip resurfacing.  Just my 2 cents.

[sroberts]

Lori,

Constructive debate is a good thing. Anonymous trolling with BS info is not.


best,

spencer

[moe]

I agree with Spencer, it was a bunch of bs that has no place here.

[newdog]

Lori,
You had to read the post. It was total B.S. from start to end. I too will listen to and consider anyone else' opinion and many times I have benefited from it. This wasn't just opinion or point of view, it was total misrepresentation of the latest facts on hip resurfacing.

Sorry, All, I didn't know that "Wise Guru" was trolling when I posted a reply yesterday.

Steve