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Author Topic: When should I do it?  (Read 3415 times)

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Jbennett

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When should I do it?
« on: October 27, 2011, 06:26:04 PM »
I'm a 43 old male and struggling with the decision to do resurfacing or wait. I am pretty much uncomfortable every day but I'm not disabled or anything. I do find myself being grumpy >:( because of it sometimes or not  participating in a sport activity like (tennis) because I don't want to deal with the pain consequences. I went and saw an orthopedic guy a few years ago who told me I'd eventually have to do something.It's definitely putting a damper on my fun but I keep wondering if I should hold off another year or two. I have a friend who is a hand surgeon and he recommended 4 memphis doctors at two different practices who he thought were great surgeons. I chose one of them and went to see him. He said he would resurface whenever I made the decision. He is younger than me and has only done 22 resurfacings. Would the low number bother you? He has installed both BHR and Conserv+ devices. He said he has done more BHR's but prefers the Conserv+ because it is an easier surgery. I guess he thinks it is technically easier to perform correctly. Any thoughts? There is another guy who I think is supposed to be THE local hip guy but I could not even get the appointment secretary on the phone. Got put on hold forever. This guy is young but I like him and my hand surgeon friend named him as one of four surgeons in Memphis he would let operate on his mother.
Right Biomet Uncemented Dr. Gross 3/14/12

Dannywayoflife

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Re: When should I do it?
« Reply #1 on: October 27, 2011, 06:34:41 PM »
Hi mate,
           this is obviously effecting your life now and you can leave it too long and make yourself illegable for HR.
I am 28 and am having my left hip done in 2 weeks time. At your age if a good device is placed perfectly i wouldnt be too worried about a revision.
I would be very very wairy about a surgeon with so little experience as its a very complex surgeory!
Just my 2 cents Danny
Train hard fight easy
LBHR 10/11/2011 Mr Ronan Treacy Birmingham England
60mm cup 54mm head
Rbhr 54mm head 60mm cup 12/02/15 Ronan Treacy ROH Birmingham England
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curt

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Re: When should I do it?
« Reply #2 on: October 27, 2011, 06:36:09 PM »
More is better in my humble, non-medical opinion!!  While I'm not a doctor, as a patient, undergoing a pretty dramatic surgery, with lots at stake mobility-wise, I chose the guy with a LOT of experience.  Its a pretty artsy surgery, and while the techniques are getting better to limit the oopsy factors, a surgeon who has done hundreds or thousands has learned a lot at others' expense.  I think it would be smart to do some more research on very experienced surgeons rather than training a less experienced one.  Just food for thought. Curt
51 yr, RHBiomet, Dr. Gross, 9/30/11
happy, hopeful, hip-full

Boomer

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Re: When should I do it?
« Reply #3 on: October 27, 2011, 07:59:28 PM »
jbennett,

I read a quote from Dr. De Smet, one of the resurfacing heavvyweights, and one of the most experienced surgeons. He's done 5,000 + I believe.

He said, "I've done thousands of successful resurfacings, and I still find it to be a difficult procedure. There's no room for complacency."

Curt and Danny are right. Find someone who has done 500 or more of these surgeries. Find someone who has lots of happy Hippys posting on this website.

Boomer
RBHR with Dr. Rector on 11/30/2011
LBHR with Dr. Rector on 6/11/2012

maxx6789

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Re: When should I do it?
« Reply #4 on: October 27, 2011, 08:10:39 PM »
like you, i was uncomfortable everyday and started to eliminate all the activities i loved the most. for me ... it was a lifestyle decision (not a pain or disable decision); i wanted to "get my life back" and be able to do all the things that i used to do. so far (after 6 weeks) i am able to do more with no pain then pre-surgery. you will know when it's time.

everyone is going to have an opinion on "how many" operations it takes. on a web site (i think it was on vicky's) they asked this question to surgeons ... how many operations does it take to become an expert at resurfacing? several doctors answered and each doctor had a different number (it was just their opinion). for me, i selected a doctor with 300 resurfacing (with a great reputation as a surgeon) which most would say is on the low side when compared to doctors like gross, bose, su, etc. of course, 22 is lower than that. you have one body, you need to make the best for yourself.

good luck to you and your hip!!
Left BHR Della Valle, Sept 14, 2011
Right BHR Della Valle, April 4, 2012

imgetinold

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Re: When should I do it?
« Reply #5 on: October 27, 2011, 08:23:20 PM »
I am scheduled for surgery in early January.  If you read some of my posts (I'm a 44 year old male), you'll see that our stories are very similar.

I saw an ortho about 4-5 years ago, and he pointed out I "wasn't quite bone-on-bone yet".  I am now.  I am not in debilitating pain every day.  If I am more or less sedentary, I can be pain free.  But Tennis on any regular basis is out.  Running is occasional.  If I push at all, then I hobble for about 4-5 days.

I'll trade surgery now and back to my lifestyle for the extra year later.  My ortho in Atlanta does resurfacing, but he pointed out that he does both, and that THR was a viable option.  That just tells me he is not very experienced at HR.  I am going to Dr. Gross in South Carolina, and have YET to find anyone with anything negative to say about him and his staff.  If you read the recommendations on this site, it is to go to the most experienced surgeon you can find.  I feel bad for those surgeons who are new to HR, but I would personally NOT go to a surgeon who hadn't performed 500 of them to date.

Good luck.  It's not an easy decision when you still have good days......
Andy
- Right Biomet uncemented HR with Dr. Gross on 1/11/2012
- Left Biomet uncemented HR with Dr. Gross on 10/28/2020

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Anniee

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Re: When should I do it?
« Reply #6 on: October 27, 2011, 08:37:23 PM »
Only you can decide when you're ready for surgery.  However, if you are uncomfortable every day, do not wait too long!  I think you will find that most of us, myself included, who already had resurfacing wish we had had it much sooner than we did.

As far as the experience level of the surgeon, as others have said, the more the better.  That does not mean someone who has only done 22 resurfacing could not do a good job with a successful outcome.  However, this surgery is quite complex and difficult, and the learning curve is long.  That is the reason so relatively few surgeons perform it.  I would at least consider some of the more experienced resurfacing surgeons before going with the one in Memphis.  You only have two hips...
Annie/ Right Uncemented Biomet 4-20-11/Left Uncemented Biomet 10-12-11/Dr. Gross

B.I.L.L.

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Re: When should I do it?
« Reply #7 on: October 27, 2011, 08:49:08 PM »
Don't be this guy,


just my $.02  8)

 


Tin Soldier

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Re: When should I do it?
« Reply #8 on: October 27, 2011, 09:03:46 PM »
Nice one B.I.L.L. 

I passed up a surgeon with over 600 HRs to go to a surgeon that had over 2600 HRs.  Eventhough I really liked the other surgeon and I felt he was perfectly competent, I just got hung up on the numbers.  I feel kinda bad for the young surgeons, where are they going to get their experience?  On the other hand, who wants to be a cute little furry rodent?

BTW - being grumpy sucks!
LBHR 2/22/11, RBHR 8/23/11 - Pritchett.

Jbennett

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Re: When should I do it?
« Reply #9 on: October 27, 2011, 09:10:17 PM »
Traveling to an out of network provider and hospital in another state would make it crazy expensive. Im already anticipating a cost of 8-10k as it is. I might investigate this other local doctor who is older and more established since he is also in network for me. I honestly feel uncomfortable at that big sterile practice though. They are the biggest in town and one of the most respected ortho clinics in the country I think but getting an appointment is like pulling teeth. The first Ortho I saw was at that practice (he's really old and doesn't do surgery anymore) and it was extremely nice clinic and all but I really felt like I was just another patient. I know this younger guy hasn't done many but I really like him. He spent a lot of time with me answering questions. The recommendation from my surgeon friend makes me a little more comfortable about it too. He was very blunt with me about the local options. I feel like he was giving me kind of an inside look from the perspective of another surgeon saying "hey I've watched this guy operate and he's a very skilled surgeon". I think I'm leaning towards the Conserv+ device as well. Hopefully that one will have a greater margin for success.
Right Biomet Uncemented Dr. Gross 3/14/12

B.I.L.L.

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Re: When should I do it?
« Reply #10 on: October 27, 2011, 09:32:49 PM »
one of the most respected ortho clinics in the country I think but getting an appointment is like pulling teeth.
Start pulling


Hahaha sorry couldn't resist ;D


 I guess a guy has to get experience somehow, and he would probably get it in fine, especially if he is a craftsman perfectionist type of guy, but I went to a close guy for my right hip 3 years ago and am now looking at a probable revision, it's not confirmed yet, but what is confirmed is my close to 60 degree cup angle, high ion levels, abnormal synovial fluid, clicking, knocking and discomfort. I am willing to travel further this time... hindsight is 20/20. Good luck whatever you decide 8)
« Last Edit: October 27, 2011, 09:34:17 PM by B.I.L.L. »

obxpelican

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Re: When should I do it?
« Reply #11 on: October 27, 2011, 10:02:51 PM »
Here is what I did.

Back in November of 2007 I was hunting with a friend, at that time I was in major pain, I could walk maybe 50-100 yards and I would have to stop.  By the end of the first day of buck season I was really hurting, I kind of thought I needed a new hip for a while.  That night I took a hot soak in the tub, when I shifted in the bathtub I hear a clicking in my hip, I knew for sure at that point I needed a new hip.

When I returned from hunting I googled hip replacement and the word "alternatives"  one of the sites I found was this one, from this site I found the surfacehippy group over at yahoo.  I lurked for a number of weeks till I finally joined yahoo and asked questions.  I had a number of people speak well of Dr. Gross and Dr. Su.  I love the Carolinas so I contacted Dr. Gross's office, although I am sure Dr. Su would have done a great job.The rest is history for me. 

Dr. Gross was booked pretty solid so I had to wait a while for my surgery.

In the end, don't rely on someone telling you that a surgeon is "the best in the US".  I did visit a doctor here in Pittsburgh, at the time he had around 100, he told me that the 100 included him assisting and cadavers.  I still to this day wonder how the cadavers are doing.

I say, let the others be the guinea pigs.  I wish I had a $100 for every patient that wrote me or posted that they wish they would have traveled and used the most experienced surgeon, I would be retired.  I've probably read posts or been messaged probably 100s of people who regreted not going for experience.

This surgery is NOT like a THR, the only thing it has in common is the acetabular cup.  The placement of hardware is super important.  When you hear of people with high ion reading most of them are from misplaced hardware.  You pretty much only get one shot to get this surgery right, yes sometimes they can re-set a cup but for the most part you get one shot at this.  Why risk having to get a revision?

Pick the most experienced surgeon.

Ask questions, lots of questions, like, how many failures does he have?  What is the infection rate at the hospital he uses?  How many times have you had to change midstream from an HR to a THR? 

Be the best possible patient advocate for yourself, if you can afford to go out of network (I did) spend the money and travel.


Chuck



I'm a 43 old male and struggling with the decision to do resurfacing or wait. I am pretty much uncomfortable every day but I'm not disabled or anything. I do find myself being grumpy >:( because of it sometimes or not  participating in a sport activity like (tennis) because I don't want to deal with the pain consequences. I went and saw an orthopedic guy a few years ago who told me I'd eventually have to do something.It's definitely putting a damper on my fun but I keep wondering if I should hold off another year or two. I have a friend who is a hand surgeon and he recommended 4 memphis doctors at two different practices who he thought were great surgeons. I chose one of them and went to see him. He said he would resurface whenever I made the decision. He is younger than me and has only done 22 resurfacings. Would the low number bother you? He has installed both BHR and Conserv+ devices. He said he has done more BHR's but prefers the Conserv+ because it is an easier surgery. I guess he thinks it is technically easier to perform correctly. Any thoughts? There is another guy who I think is supposed to be THE local hip guy but I could not even get the appointment secretary on the phone. Got put on hold forever. This guy is young but I like him and my hand surgeon friend named him as one of four surgeons in Memphis he would let operate on his mother.
Chuck
RH/Biomet U/C Dr. Gross/Lee Webb
8-6-08

Pat Walter

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Re: When should I do it?
« Reply #12 on: October 27, 2011, 11:03:37 PM »
JBennette

Experience is the most important aspect of choosing a hip resurfacing surgeon.  The current retention rate for hip resurfacing world wide is 96%.  That means that 4 people out of 100 will have problems.  If you don't want to be a statistic, then it is best to choose a resurfacing surgeon that has done many resurfacings.  The surgeons that have done a thousand or more have more consistent outcomes than the new surgeons in the learning curve. The typical learning curve according to the medical studies and according to the experienced hip resurfacing surgeons that teach at the hip resurfacing courses I attend indicate the typical learning curve is 100 resurfacings.  Then it takes hundreds to become consistent.  You want a surgeon that does them often, not a surgeon that does a few now and then.

Using a surgeon that has only done 22 doesn't mean you will have probelms, but the odds are higher that you could have problems.  You only have 2 hips.  You can read the many sad stories here and on the internet of folks that wished they had choosen the more experienced hip resurfacing surgeons because they were the statistics that had problems.  The less experienced surgeons have more probelms placing the femur component centered on the femur neck and the acetabular cup placed at the proper angle.  If the components are not placed properly, they cause edge wear which causes high metal ions, pain, problems and a revision.

I know money is tight, but I was 61 when I had my resurfacing.  I had no insurance and did not want a THR.  I put my surgery on my credit cards.  I wanted a resurfacing and wanted it done right.  I spent $18,000 to go to Dr. De Smet in Belgium.  You can say WOW, that's a lot of money - but your hip will last you a lifetime.  It is not a car that will get rusty and old.  It is the best money I ever spent - on my own health.  I wanted a resurfacing and I wanted it done right.

Take some time to think about what is most important in your life.  Is it a new car, home, boat or your hips?  If you hips are not done properly, then you will not be able to be active, have pain and be miserable and possibly face revisions.  Look into some other surgeons before making your decision.  Dr. Gross is close to your area.  He will give you a free email consultation and call you if you send him an email and a copy of your x-rays in a digital format as a .jpg.  There are a lot of Gross patients here.

Listen to the folks here.  They have been there and done it.  There are also a few that wished they had found this site and heard the advice to use the most experienced surgeons when having hip resurfacing.  Good LUck.

Pat
« Last Edit: October 27, 2011, 11:04:19 PM by Pat Walter »
Webmaster/Owner of Surface Hippy
3/15/06 LBHR De Smet

newdog

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Re: When should I do it?
« Reply #13 on: October 28, 2011, 02:11:51 AM »
I live in central Pennsylvania where the most total hip replacements are performed in the state. That is the statistic that I was told last year (2010). There are quite a few orthopedists who practice here because this is a good place for their business. This is where Penn State University is located. I of course will not say names, but one has the reputation for being the best in the area in total hip replacement. He also performs hip resurfacing. When I was checking around for HR he had 66 resurfacings performed at that time. I could have had my surgeries done 15 miles from my home. Instead I chose to travel 600 miles to a much more experienced surgeon. I know they all have to learn and get experience but there is no way I felt good about him being a newbie and doing my hips. Like everyone here says, it is a very technical surgery.
Steve, Dr. Gross bilateral, uncemented Biomet, January 10 & 12, 2011, Columbia S.C.

Tin Soldier

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Re: When should I do it?
« Reply #14 on: October 28, 2011, 03:18:44 AM »
My surgeon was out of state for me, but surprisingly in-network for my insurance (Providence).  I don't know how far insurance companies tend to consider in-network or how geographis they are, but maybe you'll find an experienced surgeon that is in network for you, if you dig around.  Also, I like the idea of medical tourism, I might have saved up for a trip to Belgium or India.   
LBHR 2/22/11, RBHR 8/23/11 - Pritchett.

Dannywayoflife

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Re: When should I do it?
« Reply #15 on: October 28, 2011, 10:12:03 AM »
Nice one B.I.L.L. 

I passed up a surgeon with over 600 HRs to go to a surgeon that had over 2600 HRs.  Eventhough I really liked the other surgeon and I felt he was perfectly competent, I just got hung up on the numbers.  I feel kinda bad for the young surgeons, where are they going to get their experience?  On the other hand, who wants to be a cute little furry rodent?

BTW - being grumpy sucks!
Isnt that what the prison population is for? ;D
Train hard fight easy
LBHR 10/11/2011 Mr Ronan Treacy Birmingham England
60mm cup 54mm head
Rbhr 54mm head 60mm cup 12/02/15 Ronan Treacy ROH Birmingham England
;)

hernanu

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Re: When should I do it?
« Reply #16 on: October 28, 2011, 01:51:17 PM »
Traveling to an out of network provider and hospital in another state would make it crazy expensive. Im already anticipating a cost of 8-10k as it is. I might investigate this other local doctor who is older and more established since he is also in network for me. I honestly feel uncomfortable at that big sterile practice though. They are the biggest in town and one of the most respected ortho clinics in the country I think but getting an appointment is like pulling teeth. The first Ortho I saw was at that practice (he's really old and doesn't do surgery anymore) and it was extremely nice clinic and all but I really felt like I was just another patient. I know this younger guy hasn't done many but I really like him. He spent a lot of time with me answering questions. The recommendation from my surgeon friend makes me a little more comfortable about it too. He was very blunt with me about the local options. I feel like he was giving me kind of an inside look from the perspective of another surgeon saying "hey I've watched this guy operate and he's a very skilled surgeon". I think I'm leaning towards the Conserv+ device as well. Hopefully that one will have a greater margin for success.

I'd check around a bit. Find out what the expense of someone like Dr. Gross would be for you, with the travel, insurance, etc; this gives you the hard information to know you're making a good choice. It doesn't need to be him, there are others in Cleveland, several places that might be in network for you.

I know some hippys have traveled from fairly far to get to Dr. Gross, you could PM them for their experiences, both financial and medical. Also could send your info (XRays, etc.) to check with him. I'm not promoting him, since I've never dealt with him and went with someone in my area, but mine had over 800 when I went to him and did them continuously as part of his practice.

You could do the same with other surgeons who have plenty of experience, I think you might be able to find someone who fits you. Not denigrating your surgeon, I'd just get as much info as possible.

It's really your decision and respected as such, but I went to three surgeons to make sure I was giving myself the best shot at a good result.
« Last Edit: October 28, 2011, 01:53:49 PM by hernanu »
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

curt

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Re: When should I do it?
« Reply #17 on: October 28, 2011, 02:23:07 PM »
You might try having a surgeon who's office has billing experience go to bat with your insurance.  They know the correct diagnosis and treatment codes, which if incorrect could derail an approval.  Dr. Gross, or any other with lots of experience with HRs would also have lots of experience with insurance companies.  My plan was based in TX but covered the operation in SC with Dr. Gross...worth trying anyway.  Good Luck, Curt
51 yr, RHBiomet, Dr. Gross, 9/30/11
happy, hopeful, hip-full

Anniee

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Re: When should I do it?
« Reply #18 on: October 28, 2011, 08:23:10 PM »
I agree with Curt that you should at least check with one or more of the more experienced surgeons before settling for one of your local ones.  I think Dr. Gross may be the closest one to you.  If your insurance will not cover their services, I know at least Dr. Gross will work with you on the price, and if he does, probably others do also.
Annie/ Right Uncemented Biomet 4-20-11/Left Uncemented Biomet 10-12-11/Dr. Gross

Jbennett

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Re: When should I do it?
« Reply #19 on: October 29, 2011, 02:09:33 AM »
I talked to a lady at Dr. Gross's office today. She said my BC/BS of TN would cover them and their hospital in network. I guess I need to confirm that but thats great if I decide to go that route.
Right Biomet Uncemented Dr. Gross 3/14/12

 

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