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Author Topic: Biomet VS BHR  (Read 11166 times)

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claudia

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Biomet VS BHR
« on: March 26, 2013, 01:58:35 AM »
Can someone direct me to any posts regarding the differences between the BHR and the Biomet device?  I can't seem to find any specific comparisons between the two. 
Thank you
Dr Gross, Right hip, 3/21/18

Marco Polo

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Re: Biomet VS BHR
« Reply #1 on: March 26, 2013, 11:36:57 PM »
Claudia:

Here is the link to the page on Pat's website that provides descriptions from the various manufacturers of their devices: 
http://www.surfacehippy.info/hipresurfacingdevices.php

It is sometimes hard to get past the hype, but from what I have read the BHR and Biomet are similar in terms of metalurgy (as cast cobalt chrome), clearance and coverage angle. According to Dr. Su, who installs both devices, any remaining differences are minor.

Assuming you are considering having Dr. Gross perform your surgery, the biggest difference is that he uses two Biomet devices in combination, the Recap/Magnum. This allows him to use an uncemented femoral component, rather than achieving fixation with bone cement, as is done with the BHR. 

Again on Pat's website there are articles and posts debating the pros and cons of cementless resurfacing (with either device the acetabuar component is uncemented).   The wisdom of this Board, which I followed in making my decision, is to choose an experienced hip resurfacing surgeon, and trust them to choose the device that they are comfortable with.

I hope this helps.
Marco, RBHR, Della Valle, 3/29/13

claudia

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Re: Biomet VS BHR
« Reply #2 on: March 27, 2013, 12:10:01 AM »
Thank you for the info!  Unfortunately now, I have an even bigger question that I think I will have to ask - Dr. Gross uses the Biomet device and this is not FDA approved yet.  I can only assume that all these resurfacings he is doing are part of a "trial" and my REAL concern is that he is doing resurfacing on just about anyone to get the needed stats for the trial.
Yet another question...
thank you again!
Dr Gross, Right hip, 3/21/18

Marco Polo

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Re: Biomet VS BHR
« Reply #3 on: March 27, 2013, 12:35:38 AM »
Claudia:  Dr. Gross' use of the Biomet device is not part of a trial.  While the two individual components are FDA approved, their use for hip resurfacing is considered "off label."  Dr. Gross' website explains this in further detail, but in short the physician has the discretion to use these devices for resurfacing, and the procedure is covered by most insurance companies (Dr. Gross' office will confirm this with your insurance company), but the devices cannot be marketed in the U.S. by the manufacturer for resurfacing because they are not FDA approved when used together for this purpose.

There are many Dr. Gross patients on this Board so they can chime in if I missed any thing.
Marco, RBHR, Della Valle, 3/29/13

Ross

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Re: Biomet VS BHR
« Reply #4 on: March 27, 2013, 02:26:54 AM »
Hi Claudia.  All of us were nervous and had millions of questions before surgery.  Try to read as much as you can about your surgeon and devices used.  You have some questions that you have to answer that only you can answer.  For me, I needed one of the best surgeons in the world.  Having the best surgeon in your county or state is not good enough.  Also, cement versus cement less is another factor to consider as well as long term data to support your decision.  No doubt the BHR has the most scientific data to back it up.  I believe Dr. Su retention rate is 98% at 10 years and McMinns is 96% at 16 years.  I believe that the Biomet cement less device will have very similar results possibly even better.   Dr. Gross is very scientific, factually based, and has done tons of research regarding resurfacing.  He would not touch you if he did not think that he could help you.   People from all over the world come to see Dr. Gross and there is a reason why.  He is one of the very best.

mari

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Re: Biomet VS BHR
« Reply #5 on: March 27, 2013, 09:29:39 PM »
Close to 5 years ago after much research on hip resurfacing I  came to the conclusion that Dr. Gross would be my first choice.  After he called me back and we talked it confirmed my feelings of confidence in him.  So 4 years ago we drove down from MN and had my right hip resurfaced by him and I have never been sorry.  I would do it all over again in a heartbeat.
Right Hip Resurfacing with Dr. Gross February 2009

claudia

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Re: Biomet VS BHR
« Reply #6 on: March 27, 2013, 10:28:06 PM »
Thank you for the feedback.  Now the only thing I have great trepidation about is the metalosis issues.  I have read and researched outside of this site and i must say there are some pretty frightening issues with cobalt metalosis and immune system issues.  It concerns me that one doctor highly recommends and considers it (cobalt metalosis) in the determination of whether you are a good candidate for HR and another Doc doesn't consider it at all.  One "expert" tests for allergies, another does not. One expert may say yes you are a good candidate and another says no you are not!  One says you are a female and results are disappointing and another says, it doesn't matter.  The disparity is among top surgeons in the world.  The inconsistency among experts is what bothers me.  The more I research, the more I am just willing to put up with the pain.  I don't want to go in as a healthy 55 year old women and 3 years down the road have to deal with metalosis issues.  I was hoping that the more I researched, the better I would feel but this is not the case for me.  I may wait until further data is available on the COM, BHR.  It is too bad that no one in the states is doing that. 
thank you again and sorry for the rant ;D
Dr Gross, Right hip, 3/21/18

hernanu

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Re: Biomet VS BHR
« Reply #7 on: March 27, 2013, 11:52:38 PM »
It's good to rant, this is the place to do it. I think if you look back at all of our posts, you'll find rants by everyone here.

I think you are doing the right thing by doing as much research as possible. This is major surgery and you want to do the right thing for you. All of us have put off treatment for as long as it took to reach a solid decision.

I know I tried everything possible and did research until it was clear that I could not go on without resolution. So this process is good, and we will back your research and decision in whatever way possible.

Like with any other treatment of disease, nothing is guaranteed. There were, are and will continue to be those of us whose treatment does not work out, and need revision of some sort. You'll also find their stories here.

Thankfully, if it does not work out, even with those of us who get metallosis, there is a good alternative in a revision to a THR. It is yet another surgery, but all of us have to contemplate the possibility. I'm glad that there is that if I need it, since it offers a continued way to be painless and functional. I'd rather not, but unlike with other diseases, it is a very good option.

The landscape of advice out there is confusing. I went to three separate doctors, all talking against HR, telling me to have two total hip replacements because of the different issues that were and are being talked about.

I looked at the results and the possibilities. To me, the most reliable results come from long study and many patients monitored over years. Unluckily, that does not exist in the US, because we have not kept a patient registry with statistics of successful outcome versus having to be redone.

Thankfully, there are other countries that have amassed those statistics, with (to me) Australia being the leader in these kinds of statistics. They did a massive study over ten years for both total hip replacements (THR) and hip resurfacing (HR) to see how successful they were, with the measure of success being not having to be redone surgically.

The success rate for hip resurfacing was 91.5 percent over 11 years. This is for all devices (including the recalled ones) and all surgeons (including the less experienced ones). That includes all patients, those who are more and less suited. The most successful device, the BHR had a 93 percent success rate over 11 years.

The charts over time show that the failures go down as time goes on, so the hope is, based on this data that the devices remain in good shape.

Total hip replacement had similar results. To me, that is a great success rate and bodes well for the type of treatment.

That still leaves 9.5 percent of us who do not succeed over that time, needing a revision to a THR at some point. It sucks. It is very sad when some need to go through it again, but the hope and the expectation is that the revised hip will give them long and good function for that much longer.

In the Australian results, the largest percentage of those who did not succeed wasn't because of metallosis. More than half failed because the cup on the hip side or the femur device came loose.
Of the 9.5 percent, only 16.6 percent failed because of metallosis.

So overall, according to the statistics there (and it may be slightly off, since I'm doing this from memory), 16.6 percent of the 9.5 percent failures were caused by metallosis. So if I've got the math right, one and a half percent of all hip resurfacings end in metallosis. I believe this is the same with THRs.

That is for all surgeons and all devices. There are two resurfacing devices that were recalled, because their failure rates were much higher than others. Their failure rates were about 10 - 18 percent. This was high enough to cause action, but to me it still meant a high success rate. Just not as high as the others.

I think it's a good, strong thing to do as much research as is possible, and I value hard evidence being an engineer and at one time a biochemist. Take a look at the Australian registry results, and use that to give some structure to all of the opinions that you're hearing. It helps to have their solidity, I know it did me.

Here is the summary of the latest Australian registry results, as put together by Pat:

http://www.surfacehippy.info/2012-aoanjr-hip-resurfacing-information.php

Here is the entire report, so you can see the raw data. I think it's important to read this, as helpful as the summary is, so you can feel confident that you've seen the actual results. It also breaks things down by age, gender, body size, devices and many other things. It is worthwhile, and will support your questions.

http://www.surfacehippy.info/pdf/australian-nat-reg-2011.pdf

If I were you (and I was) I also would want to be as knowledgeable and sure in what I'm doing. The one thing I can tell you, having traveled this path: if you have osteoarthritis, living with it is a temporary option only. It will not improve and it does get worse. Sometimes slowly and sometimes more quickly.

You will need treatment and the options are HR or THR. HR is an option but waiting too long can take you past the time when it can be applied.

So there is no guarantee. But the odds are good. Again it is major surgery and you shouldn't rush into this. I just wanted to make sure you have good information to help with it.

Good luck.
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

claudia

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Re: Biomet VS BHR
« Reply #8 on: March 28, 2013, 12:30:05 AM »
Thank you so much.  I appreciate the information and I will definitely look it over.
I've had two arthroscopies on my hip  - one that went very bad by a surgeon who was highly credentialed and made all sorts of promises - only to find out I was part of his early learning curve.
As a result in 2008, I ended up going to Dr Byrd, in Nashville for a second surgery (arthroscopy), who was an amazing surgeon, very experienced and a pioneer in the field of hip arthroscopy.  My hip was pretty flexible and pain free until a fall in 2011.  Another arthroscopic procedure can't be done as the hip is too far gone.  So - like most people here, I've been putting up with the gradually worsening pain for a few years.  Now I am not able to use the treadmill which is very depressing to me.   Ironically, Dr. Byrd is not a proponent of hip resurfacing.  Surprising really since all of his research is about hip preservation.  I was hoping and waiting for results of stem cell implantation or cartilage replacement which he is doing research on but- I don't think I can wait that long!
thank you again!
Dr Gross, Right hip, 3/21/18

hernanu

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Re: Biomet VS BHR
« Reply #9 on: March 28, 2013, 01:43:23 PM »
You're welcome, Claudia - I think you're in the right in emphasizing experience of the surgeon. I think I would also add committment to the procedure. My surgeon had done 800 by the time I got to him. He also did three to four per day.

You wouldn't go to a guy who fixes lawnmowers to repair your car, or one who did one once in a great while. You want someone who loves what they do, believes in it and does it often.

A surgical grease monkey.

I'd also grill your surgeon to be. Make sure they explain their recovery protocols, etc. There's a good list of questions to ask that Pat keeps on the site to help us turn that spotlight on and make them squirm a bit.

Here:  http://www.surfacehippy.info/questionsfordoctor.php

They should be able to enthusiastically answer these. Mine did.
« Last Edit: March 28, 2013, 01:45:15 PM by hernanu »
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

 

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