Too Big??

[erikatwork]

I'm 6'4" tall and 285 lbs. I was told by the specialist I was referred to that I was to big for hip resurfacing and that I would have to "tough it out" for awhile before having hip replacement surgery. I'm 47 and in fairly good shape and I'd like to know if it possible that there is a size limitation to getting a hip resurfaced instead of waiting around for replacement surgery?

[Anniee]

Your question is interesting, because women get told they are too small!  I don't know if there is such a thing as too big, but these size issues seem to depend on which surgeon you are talking to.  Have you contacted any of the hip resurfacing surgeons listed on this site for an opinion?

[Lopsided]

I was told by the specialist ...

Quite obviously, he is not a specialist in resurfacing.

"Tough it out." That is not compassionate and totally wrong.

[ScubaDuck]

I don't understand that response.  If you are too big for hip resurfacing then wouldn't you be too big for hip replacement?  After all the THR is far more invasive and damaging to the bone.  If your bone density is good why would you be considered too big.

I would definitely send your x-rays and background to an experienced hip resurfacing surgeon for a second opinion.

[KirkM]

I'm 6'4",  200 lb and DeSmet, McMinn, Bose and Su never even mentioned anything about my size in relation to getting a BHR.  They all looked at the x-rays and said no problem.  I am going to get a LBHR with Dr. Su in 2 days.  Go with a resurfacing specialist.  Any doc that says just wait it out and get a THR is NOT a doctor you want to use.  Just my .02.

[FlbrkMike]

The only problem that I could see with size might be if your existing hip joint (ball and socket) is larger than the available implants.  I believe that they try to match the diamater of the prosthesis to the diameter of the existing hip.  

I'm not sure what the ramifications might be of trying to install a BHR that's significantly smaller than the existing hip - having to remove too much bone from the femoral side to fit the ball, or maybe problems with implanting the acetabular cup?

[bdoughty]

I'm 6-4, 220 (although that's at least 10 more than I want - working on it) and the topic never even came up in my discussions.

Bill
LBHR 3/2/2011
Dr. James Rector
Boulder, CO

[FlbrkMike]

The "you're too big" argument may just be a slightly more subtle version of the answer I got from my original ortho when I asked about resurfacing:

"We don't do them and generally don't recommend it."

[Pat Walter]

Hi

Please remember that a MOM  metal on metal THR uses the same acetabular cup and basically femur ball component except it is on a long stem than a short stem.  So if you can't find a hip resurfacing device large enough for you - then you can't find a modern, large ball THR.

I would be very careful who I used since you are younger and are large.  I would only get opinons from  several of the top, most expeirnced hip resurfacing surgeons.  See my list to see who is closest to you.  Most people do need to travel to get their hip resurfacing and often their MOM THRs if the local ortho doesn't use them.

You need to have a lot of questions answered and best by the top surgoens.  A few surgeons like Dr. Gross and Dr. Rogerson will give you a free email consultation if you send them an email with a copy of your x-rays in a digital format.  They will tell you if you are a good candidate.  http://www.surfacehippy.info/listofdoctors.php

Most local orthopedics are not specialists in hip resplacment - they do a little of this and a little of that.  So use only surgoens that do a large amount of hip resurfacings or THRs.  All the top hip resurfacing surgeons also do many THRs.  So they can give you great information on either solution.

Pat

[Tin Soldier]

I think Kirk and Patty nailed it, with regards to experienced surgeons.  I'm a smaller guy, so I don't have much experience with being large.  Does the surgeon think they don't make a ball and cup large enough?  That seems unlikely.  Shop around. 

[AlanN]

I am 6'4" and 235lbs.
Also very fit.

My first two surgeons were not at all interested in resurfacing and gave me the "too big" line.

The surgeon who finally performed my (brilliantly successful) operation also commented that on someone of my size, the operation presented some challenges, mainly the manipulation required apparently.

If you get the opinion of a surgeon *very* experienced in resurfacing you will hear different things!

Good luck!

[AlanN]

The "you're too big" argument may just be a slightly more subtle version of the answer I got from my original ortho when I asked about resurfacing:

"We don't do them and generally don't recommend it."

Yep, I got that twice 

[othepain4]

I had mine done 3 years ago when i was 6' 1" and 285lbs. and have not had any problems