THR and BHR together

[hipchoice]

I am new to the forum and very appreciative that it is available. I was finally diagnosed with avascular necrosis after years of pain. I needed bilateral hip replacement, and had one THR done in 2005 that was covered by my insurance. That surgery was done in the U.S, and my surgeon did not perform resurfacing and related due to bone death, I could not have had a resurfacing. Unfortunately my right hip is not covered by my insurer, so I was forced to look for other options. After searching and no longer being able to delay the other surgery, I chose Medjourneys and am headed to India for surgery on 02/01/08. I read some of the other posts about Dr. DeSmet and Dr. Bose. I know Belgium, and had originally wished to go to there, but with the status of the dollar and requiring two companions to alternate their trips, I had to select India. I am heading to Delhi and will have Dr. Marya perform the surgery at Max Hospital. I feel very confident as he has performd 3000+ hip surgeries; my only concern is the long flight. I have been on flights of that length before, but not right after major surgery. Even being in good health makes those long flights extremely taxing... I spoke with Dr. Marya about having resurfacing for this hip, and he related that having a THR on one side does not work well with a resurfacing on the other side due to balance and prothesis. He related that the THR is the best choice in my situation. I have minor problems with the THR, mild pain and stiffness still, even with a quad cane for support, but I have been told that is because that leg (the "good leg") has to carry the weight for both legs and should end when both are replaced. After this long post, my question is "if anyone has had a THR on one side with BHR (resurfacing) on the other and what was the outcome?" I would appreciate any information about BHR or from anyone that may have been in Max Hospital or saw Dr. Marya. Thank you....

[Pat Walter]

Hi

Welcome to Hip Talk.  I don't understand why you need 2 people to go to Dr. De Smet in Belgium with you.  Many, many people have gone to Dr. De Smet by themselves.  I know 3 bi-lats that went by themselves.  They just booked their surgery and housing with De Smet.  They did not use a third party service - it is not needed.

About having a THR and a hip resurfacing.  There are a handful of people posting on the Yahoo Surface Hippy Group that do have both.  Some because they did not know about hip resurfacing and ended up with a THR. Then when they found out about hip resurfacing - they opted for a hip resurfacing for their second hip. 

One person I know had to have a revision of one of his bi-lat BHRs, and now has a THR and a BHR.  It is not uncommon.

You do want to make sure when you are going to hip resurfacing doctors that they tell you what your chances are of getting a Hip Resurfacing.  Most of the doctors like Dr. Bose of India and Dr. De Smet of Belgium are very honest and tell you right up front.  They don't opt for a thr if the going get tough.

I would be hesitant to use a doctor that says you cant have a THR and BHR since I know it is done.  You might want to look further and talk with Dr. Bose of India or De Smet of Belgium.  If you send them an email with x-rays attached digitally in a .jpg format = they will give you an honest assesment of your situation.

It sounds as if your doctor is experienced, but I am sorry that I don't know about him.  There are so many doctors in the world of hip resurfacing that it is difficult to know them all. 

It is a very long flight to India from the US.  That is the reason I chose Belgium.  I understand that the dollar is falling and things are getting more and more expensive.

Are you going to India because you don't have insurance now?

I also have to make sure that people reading this understand AVN is one of the main reasons for having hip resurfacing.  Read Dr. Bose of India explanation http://www.surfacehippy.info/avn.php

Pat

[Vicky]

I would definitely contact Dr. Bose directly.  You do NOT need a third party company to handle your arrangements and it is not true that once you have a THR on one side there is no reason to get a resurfacing on the other side unless you are 80 years old.  How old are you?  Can you not use the third party organization?  If you have to see if they can switch you to Dr. Bose and email your x-rays to him for his opinion.  You have nothing to lose except a lot more bone if you end up with another THR.  The moderator of the yahoo surface hippy website has one of each, he needed one resurfacing revised to a MoM THR and I know of and have met several hippies that have one of each.  Some can not tell the difference but the majority of them say that the resurface side feels more like a natural hip.  The flight home is the worst part, I went two years ago, but think of it as 24 hours of investment in your future, but get a resurfacing if you can.  At least get Dr. Bose opinion before doing anything.

Vicky

[hipchoice]

Thank you for the replies, even on a holiday. I will try to answer some of the questions. I am contacting MedJourneys tomorrow to inquire. The doctor that I am scheduled with is head of the orthopedic department at Max Hospital in Delhi, and has years of experience in India, US, Europe. I had originally chosen Dr. Bose, but changed location from Chennai to Delhi.

I also contacted Dr. DeSmet directly and he promptly replied; and yes, I am aware that I do not need a third party to organize the procedure. The reason I have two companions (they are my daughters and will have a holiday) is due to their professional schedules, neither can stay the entire time, they are alternating, and are only there for surgery week and departure week. I had orignally wished to go to Belgium, and could have gone alone. I have no problem with that, as I have lived in that part of Europe and have no qualms about the medical care.

To Pat's questions: I have insurance, but it will not cover any procedure on this hip. Yes, I did read the information on AVN  by Dr. Bose, and had seen it before on internet when researching. The total package for my surgery and going alone in Belgium at time of quote (November '07) was more than entire package with two companions, and with the dollar's peformance....!

To Vickys questions: I am 55, and as we all do, want to do hip surgery as few times as possible!!??

Thanks again for each of your replies.

[Pat Walter]

I just wanted to say Good Luck and please let us know if we can provide any other information. 

We are usually available to try and give you sources of information.

Stay in touch.

Pat

[hipchoice]

Just a quick check-in to message board...thanks for the "good luck" wishes, Pat. I will let you know how it goes.

Vicky, I should have mentioned that my surgeon from left THR 2005 related that right hip that I am having done in India was the worst of the two back at that time. Sadly, my insurance did not cover the right hip, so I went ahead and at least had the left one done. He also mentioned at  follow-up last year that the hip I am having done in India was "too far gone from AVN to have it resurfaced and nearly to point of collapse" (he knew I was not able to have him do THR and was just stating his opinion).

I am still contacting Dr. Marya at Max tomorrow to have him review and consider resurfacing. Vicky, in reply, Dr. DeSmet did not see my xrays, as I opted not to go there due to price was $7,000+ more than India. I am crossing my fingers about the outcome. I can't wait any longer to have something done. Thanks again to you both.

[Vicky]

I was just wondering if you got Dr. DeSmet's opinion on whether or not he thought you were a candidate for resurfacing.  He gives free email consults and so does Dr. Bose.  Dr. Bose is the world expert on AVN and it would not hurt to email your x-rays to him for a free opinion?  There is also the slightest chance that Dr. Bose could give you a BMHR if there is availability of that device at the time of surgery.  It is between what a BHR and a THR look like perfect for really advanced AVN cases.

Vicky