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Author Topic: It's Time to Get This Done...What's a Hana Table?  (Read 4711 times)

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MikeinNeb

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It's Time to Get This Done...What's a Hana Table?
« on: April 22, 2011, 03:52:17 AM »
Well, I've dealt with this gimpy hip for years and it's deteriorated to the point where this week I had my Doctor give me an anti-inflammatory prescription. Prior to this Monday, I'd take Ibuprofen maybe once every few weeks. But I've reached the point where I can't run and I walk with a limp. I'm an 18 year old in a 46 year old body with an 86 year old hip.

Well enough. My hip now haunts me. I can't be me. I like to bike, play softball, go for long walks....Yet my hip will flare up and all I want to do is go to bed. I take ibuprofen, feel better, go for a jog, then feel absolutely miserable when it wears off.

I've decided to have a resurfacing done within the next 18 months. I just have to get ready. REALLY Lose weight, REALLY get in shape, REALLY get my sick leave built up, and pick a Doctor and procedure.  My family doctor told me I've just worn down my cartilage, with a too round femur head helping the process.

Questions; What procedure to pick?, which Doctor?, etc. I'm all for reduced recovery times and minimal cutting. I have seen the following from my internet searches, but these Doctors don't seem to be listed on this site, nor is the procedure. Is anyone familiar with this?   

Thanks, MikeinNeb

Orthopedic surgeons Dr. Bruce Janke and Dr. Steven Naide are performing the procedure using the hana® table housed at North Broward Medical Center. The hana® table is a specially designed surgical table that allows for hyperextension, adduction and external rotation of the hip to an extent not possible with conventional tables. While utilizing the table, surgeons are able to reach the hip socket without detachment of the muscles or tendons from the hip or thigh bones. North Broward Medical Center is the only hospital in Florida to own two of these unique tables designed specifically to aide orthopedic surgeons in the anterior approach to hip surgery.

“The anterior approach has been extremely successful with total hip replacements,” says Dr. Bruce Janke, Medical Director of the Joint Replacement Center at North Broward Medical Center. “It just makes sense to transfer the concept to other types of hip surgery.”

With the anterior approach, a small four inch incision is made just below and to the outside of the groin. Two muscles are then pushed aside, giving the surgeons access to the hip socket to perform the resurfacing. No muscles at any time during the procedure are split or detached. For the patient, this results in a faster recovery, less pain, smaller incision, less blood loss and less scarring.

“We’re especially excited about what this means for our younger patients,” says Dr. Steven Naide, Medical Director of Orthopedic Trauma at North Broward Medical Center. “Patients in their 20’s, 30’s and 40’s won’t have to go through the recovery process and live with the precautions associated with traditional hip resurfacing through the posterior approach.”

Patients receiving anterior hip resurfacing experience none of the precautions related to resurfacing utilizing the posterior approach, including no post-op dislocation precautions, no restriction of post-op activity, immediate use of normal toilet height, no post-op abduction pillow (between the knees) required, cross legs as desired, no shoe lift requirements and no post-op sexual activity limitations.

habs

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Re: It's Time to Get This Done...What's a Hana Table?
« Reply #1 on: April 22, 2011, 04:09:49 PM »
Hey Mike...

In my honest opinion, 18 months is much to long to wait for hip resurfacing surgery.   I won't comment on the best approach for the surgery, for me it was the posterior approach and I'm 6 weeks out today.

I waited a full 12 months to get this surgery ( I live in Canada, free medical care but longer wait times ).  In that wait period, I lost considerable  muscle in my left leg, developed a horrible limp due to an impingment and walked incorrectly for that time. From my original diagnosis, I went from anti inflamatories infrequently to being unable to walk any distance in a short time.  My wife was away working for about six weeks and when she returned she couldn't believe how much I deteriorated in that time.

For me, I had gained 25 extra pounds over a two year span and I wanted mosy of that gone before surgery.  I lost 23 pounds in about 8 weeks using a high protein, super low carb diet supplemented with light weights and the rowing machine 3 times per week.  Trust me, the key was the diet as the weight melted off in a short time.  Since the new hip, I have lost 6lbs more as now I walk outside and cycle daily at the gym.  Google Protein Power and you will find the basics of this diet that worked really well for me.

Today, I can walk unassisted for 25 to 30 minutes well but have a long way to go to regain my prior health.  In saying that, the positive changes happen so fast!! I wish I could have had the surgery befor the limp took control of my life.

Glenn
Doctor John Antonoiu Montreal, Canada
Adept 11/03/11





Glenn - LHR 11/03/11 - Adept - Doctor John Antoniou, Montreal, Canada

moe

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Re: It's Time to Get This Done...What's a Hana Table?
« Reply #2 on: April 22, 2011, 05:03:50 PM »
Mike, here is my 2 cents. I have never heard of the hana table or those surgeons  mentioned on here, maybe others have. I would concentrate my search more for the most experienced resurfacing surgeon who you also feel comfortable with. Let him decide what approach or table to use. Min invasive is great but what really matters in the long run is proper placement of the implant. I'll take a longer recovery with good long term results over short term issues any day. Even though there may be less cutting of tissue involved the bone repair and ingrowth still has to occur.

You mentioned your family doctor, have you seen a experienced resurf surgeon yet and gotten an evaluation or opinion? From your description of symptons it sounds like you are ready. Are you in Nebraska? I know some here have mentioned good surgeons in the Denver or Colorado area.

Hope this helps, moe
Bi-lateral, BHR, Dr Marchand. 7-13-09

einreb

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Re: It's Time to Get This Done...What's a Hana Table?
« Reply #3 on: April 22, 2011, 05:46:06 PM »
My personal opinion is that the risk of 'foot drop' due to potential nerve damage for the anterior lateral approach outweighs the potentially higher dislocation risk of the posterior approach.

I also suspect that the anterior approach is more marketable towards the small ball THR's since they are at a much higher risk of dislocation than the large ball metal on metal.

None of the "precautions related to resurfacing utilizing the posterior approach" have been an issue for me at all.

In the end...  whatever your surgeon is most comfortable with is the right move, but that then depends on the surgeon you choose

40yo at the time of my 2/16/2011 left hip uncemented Biomet resurface with Tri Spike Acetabular cup by Gross

MikeinNeb

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Re: It's Time to Get This Done...What's a Hana Table?
« Reply #4 on: April 22, 2011, 05:52:08 PM »
Well, I've got to wait a period of time both because i don't have enough sick leave and because i'm getting ready to start a major project at work that will run about a year. My family Doctor had no idea what resurfacing is.

So I'm starting from zero on getting smart on this. One thing i need to do is just understand what Aetna would pay for. They need the diagnosis and treatment codes. I can get the diagnosis code from my Dr., but does anyone know how to find the treatment code? I'm looking into the overseas surgeons too. What if Aetna says "just take medicine for now"?

I'm concerned with the cutting because I'm pretty stocky and I'm worried about muscle damage. I'm 6'4" and right now 269 lb. I could use to lose some weight, but i'm not fat. I had back surgery in high school (Herniated disk) and I know my back has been weaker from that. Nothing awful, but i know there was a change. That and I would think the less cutting, the less pain and a quicker recovery. If i had to take 6 weeks off, I'd definitely have to wait a year and a half just to save up the time!!
This Broward Hospital press release almost makes it sound like some orthoscopic event where you are back on your feet immediately. I know that can't be the case, but Dr. Kreuser in Houston uses something that sounds similar.

But I absolutely agree that i want this done right for the long term. I think about how people, prior to today, just had to live with this pain with no respite. Just having this as a possible option is a blessing.

FlbrkMike

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Re: It's Time to Get This Done...What's a Hana Table?
« Reply #5 on: April 22, 2011, 05:56:32 PM »
Here's some more on the Hana table.

http://www.orlive.com/broward-health/videos/anterior-hip-replacement-using-the-hanaandreg-table


Quote
Patients receiving anterior hip resurfacing experience none of the precautions related to resurfacing utilizing the posterior approach, including no post-op dislocation precautions, no restriction of post-op activity, immediate use of normal toilet height, no post-op abduction pillow (between the knees) required, cross legs as desired, no shoe lift requirements and no post-op sexual activity limitations.


I have to agree with Bernie, many of the "precautions related to the posterior approach" are not as great with the larger ball used in resurfacing.  Many BHR surgeons (mine for one) do not impose the 90 degree flexion limit.  I was allowed 120 degrees immediately.  I can't really get close to 120 degrees very easily anyway because my hamstrings are so tight.  Also, I was using a normal toilet the day after surgery, and I don't mind sleeping with a pillow between my knees - something I've been doing for several years anyway.  I'm not sure what they mean by "shoe lift" requirements but I haven't heard of any posterior resurfacing patients with significant leg length problems.
Dr. Ball
56 years old
LBHR 2/11/11
RBHR 3/11/11

FlbrkMike

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Re: It's Time to Get This Done...What's a Hana Table?
« Reply #6 on: April 22, 2011, 06:20:59 PM »
Well, I've got to wait a period of time both because i don't have enough sick leave and because i'm getting ready to start a major project at work that will run about a year. My family Doctor had no idea what resurfacing is.

So I'm starting from zero on getting smart on this. One thing i need to do is just understand what Aetna would pay for. They need the diagnosis and treatment codes. I can get the diagnosis code from my Dr., but does anyone know how to find the treatment code? I'm looking into the overseas surgeons too. What if Aetna says "just take medicine for now"?

I'm concerned with the cutting because I'm pretty stocky and I'm worried about muscle damage. I'm 6'4" and right now 269 lb. I could use to lose some weight, but i'm not fat. I had back surgery in high school (Herniated disk) and I know my back has been weaker from that. Nothing awful, but i know there was a change. That and I would think the less cutting, the less pain and a quicker recovery. If i had to take 6 weeks off, I'd definitely have to wait a year and a half just to save up the time!!
This Broward Hospital press release almost makes it sound like some orthoscopic event where you are back on your feet immediately. I know that can't be the case, but Dr. Kreuser in Houston uses something that sounds similar.

But I absolutely agree that i want this done right for the long term. I think about how people, prior to today, just had to live with this pain with no respite. Just having this as a possible option is a blessing.


Mike,

When I started looking into this I had many of the same concerns and issues that you are having, but I knew that I wanted (needed) to get it done.  No matter which approach is used, it’s major surgery (much more than an arthroscopic event) and there will be significant recovery time.  Everybody’s recovery is different, some are longer and some are shorter.  But almost all posterior patients are “back on their feet” the day of the surgery, though obviously not at full strength.

As a point of reference for you, I’m fairly stocky too – about 5’ 11” and 235, 55 years old.  I was also having some back problems (though no surgery) and am now convinced that a lot of my back pain was coming from improper alignment caused by the OA in my hips. 

I also couldn’t afford to take 6 weeks off.  In fact, I was promoted to Engineering Manager two weeks before my first surgery, so I had two weeks to learn a new job and then rely on others to cover for me while I was out.  I had two BHRs, four weeks apart, and used a total of 10 days sick leave / vacation.  I was out for one week each time, worked from home for a couple of days and was back in the office before the end of the second week.  It helps that I have what is mostly a desk job and can work effectively from home.

Don’t get me wrong, six weeks after my second BHR I’m not “fully” recovered and don’t expect to be for several months.  But I’m walking unassisted a couple of miles a day, driving, and going to physical therapy two days a week.  In a lot of ways I’m already a lot better off than I was before my surgery.  The OA hip pain is gone and I can tie my shoes in the middle.  There are people on this site who were skiing, running, surfing, etc. within six to eight weeks.
Dr. Ball
56 years old
LBHR 2/11/11
RBHR 3/11/11

hernanu

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Re: It's Time to Get This Done...What's a Hana Table?
« Reply #7 on: April 22, 2011, 09:32:40 PM »
Well, I've got to wait a period of time both because i don't have enough sick leave and because i'm getting ready to start a major project at work that will run about a year. My family Doctor had no idea what resurfacing is.

So I'm starting from zero on getting smart on this. One thing i need to do is just understand what Aetna would pay for. They need the diagnosis and treatment codes. I can get the diagnosis code from my Dr., but does anyone know how to find the treatment code? I'm looking into the overseas surgeons too. What if Aetna says "just take medicine for now"?

I'm concerned with the cutting because I'm pretty stocky and I'm worried about muscle damage. I'm 6'4" and right now 269 lb. I could use to lose some weight, but i'm not fat. I had back surgery in high school (Herniated disk) and I know my back has been weaker from that. Nothing awful, but i know there was a change. That and I would think the less cutting, the less pain and a quicker recovery. If i had to take 6 weeks off, I'd definitely have to wait a year and a half just to save up the time!!
This Broward Hospital press release almost makes it sound like some orthoscopic event where you are back on your feet immediately. I know that can't be the case, but Dr. Kreuser in Houston uses something that sounds similar.

But I absolutely agree that i want this done right for the long term. I think about how people, prior to today, just had to live with this pain with no respite. Just having this as a possible option is a blessing.


Mike, I'd agree with people here, go for the most experienced surgeon and don't mind the length of the incision. I've found that to be the least of my worries. If I ever need to wear a bikini, I'll just decorate the incisions, make them look like tattoos  ;D.

As far as the time off. I'm an engineer and involved in "must be there" projects. I had to ask myself whether I was willing to let my health be first for one time in my life or not. Having helped to start three companies, I know the stresses involved, but the truth is that they can do without you for the time required.

One thing that I assumed was that I would have to use vacation time only for my recuperation. So I hoarded my time, and waited a while. I did this without checking with my human resource people. Not smart on my end, because when I did check with them, I found that this was the reason that short-term disability was created.

The Human Resources people laughed when I told them of my plans to do it with vacation time. The policy in my company is to have the employee use one week of vacation time, then you get short term disability for the balance of the time determined by your doctor at full pay for up to six months. That's per injury, so in this case, I could have taken six months per hip. I actually took five weeks each, so that cost me two weeks in vacation time.

I guess what I'm saying is that I was totally unaware of my rights to short-term disability, and since this is a medical issue, all that you need to do to have this kick in is that it is medically necessary. It doesn't have to be work related, just something that a doctor will back that you need.

As to the "I need to be there" part, you'll have to confront that yourself, and admit, like I did, that my health and happiness is worth the absence. I left the project in  reasonably good hands, returned to another project and that is going well now.
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

Tin Soldier

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Re: It's Time to Get This Done...What's a Hana Table?
« Reply #8 on: April 23, 2011, 05:06:48 AM »
I agree with everyone else on finding a good surgeon with lots of experience.  Does your x-ray show OA?  18 us pretty damn young.  You sure it's not a labral tear or some other soft-tissue damage?  A cortizone shot might get rid of it.  However, if the x-ray and ROM tests show impingement and other OA issues then, yes, I get it resurfaced.  You should also check the other hip because it could be more genetic, unless you had an injury you can blame this on.  Good luck.   
LBHR 2/22/11, RBHR 8/23/11 - Pritchett.

phillwad

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Re: It's Time to Get This Done...What's a Hana Table?
« Reply #9 on: April 23, 2011, 06:57:41 AM »
Mike

Location, location, location – it is the old story – make sure you go to the location where the surgeon has a bunch of experience – why deal with someone you YOU have to educate when there are great surgeon who have done enough to have “grown” with changes in the procedure and are up to date.

I agree with other posts here - we all need to keep our jobs so there is a serious feeling of wanting to keep the employer happy.  I was lucky that I got permission to work from home for a while; my doctor restricts driving for 6 weeks.  I am working at having my boss visit me as i can work - just can't drive

Cheers - Phill

MikeinNeb

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Re: It's Time to Get This Done...What's a Hana Table?
« Reply #10 on: April 23, 2011, 02:48:12 PM »
The 18 year old is strictly brain only........I'm 46, with a hip that started to not feel right maybe 8 years ago, It really worsening over the past few years. Loss of mobility, pain, a limp, a burning ache that doesn't fade, etc.

Hbing1967

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Re: It's Time to Get This Done...What's a Hana Table?
« Reply #11 on: May 16, 2011, 01:50:43 PM »
Hi Mike--not sure if you're still checking this post, but I just had a hip replacement using the anterior approach (which I believe is different from the anterior lateral approach someone else mentioned). A week ago today I was laying on a stretcher getting ready to go into surgery, and today I'm shocked at how well I am doing. I am easily walking on one crutch, and have been since day 3 or 4, standing supporting my full weight, as tolerated, I have no movement restrictions, a nice, little scar, and am getting around rather well. As soon as I can get around to buying a cane, I'm going to start using that instead of the crutch. My biggest issue is that I'm really tired, but I think that is normal with any surgery.

I agree with what others say about going with a really good doctor that you trust...though I have to say I'm really happy I happened to find one who was doing this specific procedure, and who had a lot of experience and a solid track record at it. I also agree that if you can find a way to do it sooner, you might as well. Good to get past this painful time in your life and move on.

I should mention that I had something called the Corin mini-hip, rather than resurfacing. For various reasons, my doctor felt this was a better fit for me than resurfacing, but it still conserves bone and allows for easy revision somewhere down the line if it fails. I believe it gives slightly better range of motion than HR and THR too, as well as having a few other advantages that appealed to me. There are only maybe 4 doctors doing this one right now in the US, so I doubt that will be an option for you, I just thought I'd mention exactly what I did to clarify that I didn't have an anterior HR exactly.

I'll be getting my second hip done 5 weeks from today, and I'm really looking forward to my new, more physically active life.

Lopsided

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Re: It's Time to Get This Done...What's a Hana Table?
« Reply #12 on: May 16, 2011, 01:58:06 PM »
I had something called the Corin mini-hip ... I believe it gives slightly better range of motion than HR and THR too, as well as having a few other advantages

    ? ?



Proud To Be Dr. De Smet's First Uncemented Conserve Plus, Left, August 2010

Anniee

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Re: It's Time to Get This Done...What's a Hana Table?
« Reply #13 on: May 16, 2011, 02:14:15 PM »
Mike,

I also had many of the same concerns in regards to work.  I was involved in a project that should have been completed in March, so I scheduled surgery for mid-April.  However, things changed and the project was not completed by the time I went out for surgery.  I thought I had set things up so that the rest of the team could implement, but discovered last week that nothing much has happened, and probably will not until I get back to work next week.  And guess what, the world has not come to an end!!  Your health is more important than projects at work!  I really wished afterwards that I had not delayed, because the pain in my hip got worse every week.

I had resurfacing with the posterior approach, was off two crutches after the first week, and ditched my cane this week.  Just walked 3/4 mile this morning with no support.  The restrictions have been a bit of a pain, but as others have said, it is the long term results that really matter.  Do your research, listed to the experiences of people on this site, make an informed decision, and put your health first!
Annie/ Right Uncemented Biomet 4-20-11/Left Uncemented Biomet 10-12-11/Dr. Gross

 

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