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Author Topic: Questions from a Newbie  (Read 2159 times)

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JeanM

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Questions from a Newbie
« on: March 16, 2008, 09:05:41 PM »
Hello,
This is my first post on this site.  So, I guess I'll bore you all with the full story.  I was first diagnosed with osteoarthritis 12 years ago.  I was 28 years old at the time and had played hockey for the previous 7 years about 2-4 times per week until the pain and stiffness in my left hip became too much to ignore.  At that time, I finally made the connection between my hip pain and my parent's talking about when I was in a series of casts as an infant because I was born with a 'dislocated hip'.  So, the true origin of my osteoarthritis is developmental hip dysplasia that went unnoticed until I was about 6 months old.  All of the doctors freaked out over my x-rays when I was 28.  They made it very clear to me that I needed to get as many years as possible out of my natural hip because a THR was imminent and I was far too young.  One 'sports medicine' doctor even told me that I needed to eliminate all athletic activity for the rest of my life.  I thought that was absolutely ridiculous.  So, I made adjustments and I learned to manage it.  I stopped playing hockey and I started cycling (both road and especially mountain biking) instead.  I was still able to continue to snowboard, which is my other favorite sport.    So, I've continue to lead an active life outdoors, just one with a lot of respect for my hip situation. 

My hip has been quite manageable until recently.  During the last two months, my hip has taken a significant turn for the worst.  For the first time in 12 years, I can't seem to get it back under control.  Something has changed.  I've lost range of motion and because of that I feel that I've lost some muscle mass.  It feels weaker and creakier.  At times the pain is at an all new level.  I can't throw the frisbee for my dogs without limping out of the dog park like an old lady.

Last week, I went to see a doctor who does hip resurfacing.  Since I'm a huge cycling fan, I've been aware of BHR as a new option because of Floyd Landis.  The doctor took x-rays and did a dexascan and has said that I'm a good candidate for hip resurfacing and that he could do the surgey in April.  Since seeing him last week, I've done lots of research (l LOVE this website) and I've come to the conclusion that he's not experienced enough.  He's only done 'a few' and he has only trained on the Cormet2000.  There's no way that I'm letting this guy practice on my hip.

By the way, I live in Utah and I'm only 41 years old.  This week, I have an appointment with Dr Hickman in Bountiful, Utah.  From this website, I understand that he has done at least 130 resurfacings and uses the Birmingham device.  It's a pretty good number.  But, I'm still not sure that's enough experience for me.

Finally, here are my questions:

1)  I'm a very small woman.  I'm 5'1" and I weigh about 108 pounds.  I know from experience, that things that come in average sizes are always too big for me.  This may sound like a stupid question, but is it going to be a problem for me to get a proper fitting device?  Is the doctor going to have to remove more bone in order to accomodate a device that is really too big for me.  I ask this question because these devices don't seem to come in very many sizes.  I think the BHR comes in 6 sizes.  Also, from what I've read, it seems that problems can occur if the device doesn't fit properly, particularly the acetabular cup.  Should I go with one of the super docs (like De Smet) because I'm smaller than your average person?  Could my size make my sugery more complex?

2)  Again, since I'm a small woman with small bones, am I at any greater risk for a femoral neck fracture than an average size person?  Again, could this be a reason to go to one of the super docs?

3)  Besides dealing with the pain, is there any other downside to waiting?  Or, should I hold out for as long as possible?  Will waiting risk damage to a point that Iím no longer a candidate for resurfacing?  I didn't think I'd be facing this for another 10 years.  I'm having a hard time coming to terms with if it's really time for this.  How do you know? 

Unfortunately, my colleague goes on maternity leave in July and may be out in June.  She's going to be out for 6 months.  If I'm going to have this operation, it would be ideal if I could get it done and be working productively before she goes out on leave.  Otherwise, I'm looking at waiting until next year.  So, that's also effecting my decision making.

Thanks,
Jean


Uncemented/Biomet/Gross/8-27-08

Vicky

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Re: Questions from a Newbie
« Reply #1 on: March 16, 2008, 09:18:14 PM »
Hi Jean,

I am also very small boned.  I am 5'3" a little taller than you but my wrists are really tiny.  My shoe size is a 6.  I got a BHR in India and I am sure they make the size I got, here in the U.S.  It wouldn't hurt to email your x-rays for the opinions of both Dr. Bose and Dr. DeSmet. 

You do NOT want to wait too long.  Once you get to bone on bone, you can start to from cysts which are like craters filled with fluid.  If those become too large, you no longer are a candidate for resurfacing and then need to get a THR which you are way too young for.  Some of the more experienced surgeons in the U.S. that use the BHR are Dr. Rogerson in Madison, WI, and Dr. Su and Dr. Clarke in NY as well as Dr. Raterman in Florida.

Please keep us posted.

Vicky

Pat Walter

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Re: Questions from a Newbie
« Reply #2 on: March 16, 2008, 09:27:19 PM »
Hi Jean

Welcome to Hip Talk.

You are very young and I certainly would not think about a THR if you can have a hip resurfacing.  You might be surprised after your hip resurfacing that you will eventually be able to return to all the sports you love.

Since your are very young, have a difficult hip problem and are very small - I would definitely recommend on of the very experienced surgeons.  Many people don't feel this is necessary, but over the last 3 years I have read hundreds and hundreds of personal stories.  I have read many medical studies and personally know Dr. De Smet since he did my hip.  He suggests that a person try to always use a doctor that has done at leat 100 hip resurfacings.  In reality, you need a doctor that has done many hundreds.  Did you see Dr. De Smets little video http://www.surfacehippyvideos.com/play.php?vid=96  Her personally explains the steep learning curve.

One other lady was very small that had hip resurfacing and she found several of the US doctors did not want to do her.  They told her they did not have the right size hip for her.  She went to Dr De Smet.

We have a few very experienced surgeons in the US with Dr. Gross in SC and Dr. Amstutz in CA being several with the most experience.  Many people like Dr. Gross. He does not use the BHR, but the Biomet.  His patients normally have their insurance company pay for his surgeries.

Many people have also had their insurance companies pay for Dr. De Smet.

Since you have a complicated problem, I would send an email with your x-rays attached digitally in a .jpg format to Dr. De Smet, Dr. Bose of India if you want to consider him and Dr. Gross.  All will give you a free consultation which I think in your case would be very valuable.  You can get input from some of the best in the world.

The doctors will tell you what your x-rays look like. Dr. De SMet never needs a bone density test - he reads it from your x-ray.  He is an absolute master of hip resurfacing. He has done over 3000 hip resurfacings and over 3000 thrs.  

I choose him because I was older with a loss of bone density and want a really experineced surgeon doing my hip.  Also many US surgeons won't do ladies in their 60's.

Please let me know what else I can help you with. You are on the right tract to learn absolutely as much as possible.  That should include input from the real pros in hip resurfacing.

Good LUck.

Pat

Webmaster/Owner of Surface Hippy
3/15/06 LBHR De Smet

abc

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Re: Questions from a Newbie
« Reply #3 on: April 10, 2008, 07:55:12 PM »
Jean:

In regard to sizes of implant (if there is a small enough one manufactured for you), the surgeon who performed my operation uses both the BHR (Smith & Nephew) and the Conserve (Wright Medical Technologies).  I believe Dr. Pritchett had said that there may be a little more range in the Conserve than the BHR.  He said that mechanically they were equivalent.

This link I believe shows the range of the conserve plus:
http://www.wmt.com/Downloads/conserveplusss.pdf

I looked on the Smith & Nephew WEB page for an equivalent to be able to compare the number of sizes each offered but was unable to find document relating this information.

Good luck.

Al

DirkV

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Re: Questions from a Newbie
« Reply #4 on: April 11, 2008, 03:26:23 AM »
Hi Jean,
I'm 47 and just had bilateral resurfacing. Although my onset was later than yours, there are a few similarities. We both had to quit hockey (I was playing 2-3 / wk until age 44). We both continued to ride bike. For me, the  final straw was telling my son I couldn't go out and shoot hoops with him (I'd invariably end up jumping and waddle-running as best I could and end up sore for the rest of the day).
You'll be glad to know that cycling should come back very quickly. With my Dr's approval, I was on my road bike (on training stand) 7 days after surgery - no resistance, just easy spinning to give the hip the nice cyclical movement. By 3 weeks, I was able to get some light workouts.
Good luck, and maybe we'll even lace up the skates again  :)
-Dirk
ASR right-side 02/25/08, left 03/31/08, Dr. Ball
Bilateral 02/08, 03/08, Dr. Ball

Jace_Dees

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Re: Questions from a Newbie
« Reply #5 on: May 06, 2008, 07:59:00 PM »
Dr. Pritchett did my joint three weeks ago.... He is one of the best in the US... If you can afford to fly to Seattle to have it done, I would suggest to go to one of the most experienced doc's for hips.  He has done several thousand hips and 1500+ BHR resurfacing proceedures.  Thus far, I am walking and have only muscle pain due to exercise. 

dgm

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Re: Questions from a Newbie
« Reply #6 on: May 07, 2008, 02:38:39 AM »
Hi there,

I had RBHR with Dr. Rogerson on 2/14/08 - at that time he'd already performed over 250 so he is probably well over 300 by now.  He deals with a lot of out of town patients (I flew to Madison from Montana) and it went very smoothly.  You go straight from the hospital to the rehab facility for land and water based PT 2 days post surgery.  He did surgery on a famous triathelete - it is on this website I think under Dr. Rogerson stories. 

I was a runner -half and marathons for 22 years.  In about 3 months, I will be cleared to get back to it.  I was able to get back to workouts fairly quickly and it has been a wonderful recovery.

I will also echo the statement above of don't wait.  I was bone on bone and had 2 cysts which could have caused me to get a THR because I was too hard headed (as my husband says) to go to the doctor.  All I can say is the second my left gives me trouble, I'm outta here.

I was worried about the travel aspect but it was the best decision I ever made regarding my health.  I'd go again in a heartbeat.

You can FedEx your xrays to Dr. Rogerson, there is a link to all the info you need to send him on this site. 

Don't wait too long, you are too young and need to get back to your life!

Good luck and keep us posted.

Best,
Denise

RBHR 2/14/08 Dr. Rogerson
RBHR 2/14/08 Dr. Rogerson

papadop

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Re: Questions from a Newbie
« Reply #7 on: May 07, 2008, 05:20:19 AM »
Size restrictions for prosthesis.

  In my discussion with dr, Boyd as to the choice between BHR and other commercial devices, he said that BHR comes in too few sizes.

That's all the factual comment I can make - Boyd  - in Salem Oregon has  by now done  more than 600 resurfacings  -- did his mentoring with Anstutz in LA, and I'm coming out of my surgery with full vigor.

Michael

drmike-s

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Re: Questions from a Newbie
« Reply #8 on: May 29, 2008, 09:20:48 PM »
Choose a surgeon who has performed at least 500 resurfacings, preferably more.  The best surgeons are in England (Drs. McMinn & Treacy) and Belgium (Dr. de Smet).  Where do you live?  Are you willing to travel to Europe?  About 4 years ago I had a Rt. BHR by Dr. de Smet and he was wonderful!  By this time there must be a number of experienced hip surgeons in the U.S., but the only one I'm acquainted with is Tom Schmalzreid in Los Angeles.

Good luck!

punakaiki

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Re: Questions from a Newbie
« Reply #9 on: May 31, 2008, 12:13:49 AM »
Hello, I am new too to this website, which is proving great for me to read and get information. I too have a very small frame and have had the smallest THR prosethis in my left hip and hope that a BHR prothesis will work for me. I will keep an eye on your posting. Good luck with your operation. I live in NZ and will have to travel for an operation, but will be worth the peace of mind.

Pat Walter

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Re: Questions from a Newbie
« Reply #10 on: May 31, 2008, 12:40:56 AM »
Hi  Punakaiki

Good Luck with getting a BHR.  I know some of the Doctors in the US don't like to do small people, especially women.  So I always tell smaller people that they need to find a really experienced surgeon since they will do more difficult cases.

I just wanted to wish you good luck and send the message to smaller people that if they don't like what their doctor is telling them, find a really experienced surgeon that will give them a hip resurfacing.

Good Luck.

Pat
Webmaster/Owner of Surface Hippy
3/15/06 LBHR De Smet

 

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