Contemplating

[rico]

Hello,
In Feb. 2011, I (42) went to a Or-tho in Tampa, because of groin pain and ROM . He said that I had OA on both hips and was bone on bone towards the bottom on both hips. Since then, the pain is getting more intolerable (it's amazing how fast it effects you). I did cortisone injection in April and it worked fine. I was able to to workout and many other things with no problem. That lasted for about 4 months and recently got more injections about 3 weeks ago. The shot worked well on my right hip but my left one hurts especially walking stairs. I fell like I have to constantly have to stretch my hip flexors to have some relieve.

Anyways, when I went to the Dr. and he said that femoral heads of both were  what they call shaped like a Dillinger pistol. The Dr. said that he could do BHR but I would also have to consent to THR if he couldn't do the BHR. The Dr. did say he would mostly like be able to do it. This has me a little nervous.

One question I did have, is if you are bone on bone what long term effects does that have on you?

I don't know when I will do it but I could see myself definitely doing something within the year if not sooner.

Does anybody know what future treatments for OA in the hips? I was just curious.

This forum is very helpful and extremely informative. Thanks to all

Be safe

[Tin Soldier]

Most of the really experienced surgeons don't expect to have to go to THR midstream.  I suspect there could be a special case, but my doc didn't even mention it to me and I think he said he's only had to do it a few times in 2800 surgeries.  If you get a really experienced surgeon I suspect they will know by looking at the x-rays whether you're good for HR or not. 

I don't think bone on bone means you're too far gone for HR.  Actually I think that's a pretty common stage for folks to be getting HR.  I was a hair from it, maybe a millimeter of spacing.  I think I moved just right, I could get a decent shot of bone pain.

I'm 42, had one shot of cortizone about one year prior to surgery, worked for a bit. 

Future - stem cells?  Don't know.  In the immediate (a few years) the future may provide some healthy debates on different component materials, but I don't know if HR will drastically change much for quite some time.

Stick around, lots of info here, you'll learn a lot.

[Hitman]

Rico, if you wait to long, you will start putting undo stress on your lower back.  I forget the actual terminology that my doctor used, but the jist of it was that since your hip joints are unable to handle or distribute your weight properly, your lower back will suffer.  My back is in as much pain now as my right hip is now.  I'm going for the BHR in December.  I'm 45.  Good luck.

[Lopsided]

I did cortisone injection in April and it worked fine ... and recently got more injections about 3 weeks ago. The shot worked well on my right hip but...

No, no, Rico. It might have got rid of the pain for a while, but it did not work. It might even have made it worse.

Does anybody know what future treatments for OA in the hips?

Yes, resurfacing will be around for a long time.

Stem cell treatment might or might not work for growing bits of cartilage, but it will not round off misshapen femurs, fill in cycts, file off bone spurs, and definitely will not help when you are bone on bone.

D.

[FlbrkMike]

My surgeon, who has done many hundreds of HRs, mentioned the possibility that he could have to change to a THR during the surgery.  He also mentioned that he had never actually had to do it.

[obxpelican]

Most experienced surgeons will tell you that there is a VERY slight possibility that you MAY wake up with a THR, but it's VERY rare with a good surgeon.

Inexperienced surgeons will tell you something like "I will have to make my decision which you will get once the surgery begins", that's a bad omen.  Ask your surgeon how many times it's happened to him.  If he says a dozen, run if you can, if not walk fast out of the office.

A good surgeon can look at your bone density reports and your x-rays and be able to tell you what you will get.  Dr. Gross told me for sure I would wake up with an hip resurfacing and I asked him if he knew for sure and he replied YES.


Chuck
 

[Luanna]

Rico,
Like Tin my doc never mentioned the possibility of having to go with a THR. Because of your situation, maybe your surgeon felt that you might need to be prepared for both options.

I asked my surgeon, Dr. Pritchett, if there was any possibility of having to change to a THR midstream and he seemed a bit taken aback - not insulted mind you - but annoyed. He said that he would not change in mid-stream and he would know before hand exactly what he was going to do by studying the x-rays, etc. He may have been commenting only on my hip and my surgery but it seemed like his philosophy in general. Don't know.

I also had dysplasia and my bones are shaped a little bit oddly. Born that way.

Luanna

[jjmclain]

Rico,

My surgeon (like most experienced surgeons) informed me of the possibility of a THR (and I had to sign consent forms for both). When I asked how many times that has happened to him, he said zero. That made me confident that when he said he could do a BHR on me, that is what I would end up with.

When you are bone on bone, cysts start forming. If the cysts get too large, it could hinder your chances of a successful BHR or the possibility of a BHR. I had a very large cyst, but my surgeon was able to handle it. If I had waited any longer, who knows what would have happened.

Surgery can seem scary...but would it be any worse than the pain you are living with right now? Or the inability to be as active as you want? When I was contemplating it, I was told by someone that I would wish I had done it sooner. I wish I had! The only reason I didn't is because I didn't know about it! Once I found out about BHR, did some research, asked questions, and got a referral to an experienced surgeon in my area, I was on the fast track to surgery.

I will have my one year anniversary on November 11th and I feel like I have been given my life back! If you have any further questions, you can send me a private email or ask anyone on this forum. They are all fantastic!

June

[hernanu]

Hey Rico, welcome to the site... Dillinger's pistol was a Derringer (at least the one I know about), don't know if he's talking about its flat look?

Anyways, if he's unsure about whether he can do a BHR or a THR, it may be good to look at other surgeons. If you're in Florida, I think we had some posters who are from Florida who had a good experience with a BHR from a surgeon there.

It's always good to get other opinions (I had three), have you thought of getting your X-Rays and submitting them to Dr. Gross, or some of the other surgeons who are listed here? They will give you an opinion for free and have a great deal of experience with both BHR and THR surgeries, so they can give you a much better idea of where you stand and how quickly you need to act.

Many people have also travelled to get their procedure done by a more experienced surgeon if the local surgeons are not a good fit. So going to say, Dr. Gross if other things line up (insurance, etc.) is an option to consider.

Good luck and welcome.

[ScubaDuck]

Like Luanna, I asked Dr. Pritchett if he had ever had to switch to a THR.  He also seemed a bit annoyed and then amused.  It seems he gets that question alot because it is a standard question.  He said he has never had to switch in the middle of surgery and he has done almost 3,000 HRs.

I agree with the others on this site.  If the doctor isn't comfortable knowing ahead of time I would seek a second and third opinion.

Best wishes.

Dan