Regenerative Medicine Hip Injections versus Mini Hip versus Resurfacing???

[gunners]

Dear Hip issue people
I am an a crocked athlete and runner and I have visited Dr D Synder at NWH in Boston and he is recommending I select the Corin Mini Hip surgery over Hip Resurfacing for the reasons which have already been documented here. IE less muscle cutting, no metal on metal wearing risk etc. As far as I can see from extensive research on both. The one outstanding downside of the Corin Mini Hip is that it removes more bone tissue, and for that reason I cant quite commit to it just yet! I'm close but need some more digging!

I have also researched the regenerative medicine and so far I am finding that:
Yes they do inject hips and expect Cartilage to regrow
It is extremely expensive $6000 per injection, at a rough estimate!! It varies!
May have to have several injections
Is not covered by insurance
No results or reviews anywhere on line
Is not yet done in the Boston area (Lets face it, flying somewhere etc is not convenient)!!!

Does anyone know anything further about the points I have raised on regenerative medicine??? Or any further details at all?

Thanks so much I am a new member and would love to hear more. Very grateful

PS.
Please keep any responses factual and as concise as possible, and try to stay on subject! Thanks again, your blogging is terrific but the one downside to any blog as we all know is it can stray from the point.

Sincerely

Gunners

[Dannywayoflife]

Mate no matter what your doc tells you the mini hip will never be as good and allow the freedom that a bhr will.there is no metal ion issue if the device is proven and is put  in right. The regenerative is actually from what I've been told along way off. Has any of the claims of anyone who is doing it now been independently evaluated and confirmed?
If your a candidate for a resurfacing DO NOT GO FOR A MINI HIP! It's still a thr 

[hernanu]

Hi gunner, the problem with any new experimental therapy is the lack of any supporting statistics on its efficacy and reliability. Where is the regenerative therapy done?

I had both of my hips resurfaced by Dr. Snyder and am very happy with them. He was a proponent of resurfacing, did he consider it or suggest the mini hip as the only alternative?

You've done a lot of research obviously, one thing that I would do in your shoes would be to talk to a surgeon that does primarily HRs and see what they think of you as a candidate for HR.

As an athlete who is 2+ years along, the HRs have done right by me. I'm in the Boston area as well; if Dr. Snyder hadn't done HRs, I would have gone to New York to Dr. Su or another well practiced HR surgeon.

It is (obviously) your call and a mini hip is a fine device, but it does take more bone matter than an HR. My advice would be to talk to another well respected doctor and see what they say.

The claims for the Regenexx service are that it will stop further damage and alleviate pain, but won't regain ROM or add to the cartilage already lost.

http://www.regenexx.com/tag/hip-stem-cell-injection/

Good luck,

[Arrojo]

If I had a spare $5000 to blow, I'd have tried the Regenexx.  What the heck, right?  But, most people don't have that kind of cash to experiment with and the BHR is wonderful for runners.  I'm hoping to win some medals at the Connecticut Masters Games next month and couldn't be happier as a runner with my new hip.

By the way, here is an entertaining and informative thread regarding the minihip:

http://surfacehippy.info/hiptalk/hip-resurfacing-topics/resurfacing-versus-mini-hip/20/

I especially like John C's explanation on page 2 of why the minihip would not work as well for runners.  Dr. Snyder wants to do the minihip on everyone he meets, it seems.

[gunners]

Folks its Gunner again.
I just got off of the phone with the Center for regenerative medicine in Miami Florida and I had sent them a set of ex rays 2 weeks ago that Dr Synder had done on me. They told me they work on athletes but mainly for knee issues. They also said that your future athletic potential will be evaluated by them once you go visit them. The spokes person would give very little information away so I honestly did not learn a lot from the experience. He encouraged me to search more on google for information on cell therapy, and to look on their website for actual reviews done by people who have had the treatment

Gunner

[gunners]

Gunner again

Thanks to all 3 for your feedback.
Arrojo, yes Dr Synder brought out both devices to show me and he definitely lobbied for minihip, here's why:
No metal on metal risk, which takes away that 3% risk(cause is unimportant for me, what matters is risk elimination)
Faster recovery due to less cutting
His success statistics were BHR lower nineties, CMHip higher nineties

He went on to say
No cementing used it binds naturally to the bone tissue
He told me he has runners doing 10Ks on Corin MiniHip

As far as I can tell the biggest downside is that BHR takes less bone out, and that is significant for me.

Thank you again feedback like this is very informative

Gunner

[Dannywayoflife]

Gunner if the stats he's quoting you for the bhr then that's not very good. The top surgeons are close to 100% at many many times longer than the mini hip has been around. The mini hip will still have thr down sides ie stress shielding abnormal loading etc.
honestly the metal metal issue is minuscule I've not seen the 3% you've been quoted anywhere. If it were me I'd go see another surgeon mate

[gunners]

Okay Danny WL
I believe and accept that, I understand the metal on metal issue as being miniscule and will take that into consideration.
I also am concerned about the load shift as you mention, that is important.

Hernanu and DannyWL
I will think about visiting another surgeon who is a proponent of BHR and see what they say. The key concern is the load and the amount of bone tissue lost with the CMH.

DannyWL
Can you please explain your opening statement, that the CMH will not give the freedom of movement a BHR will? For what reasons?

Thank you

[Dannywayoflife]

Hi mate what I mean by that is no matter what it's a thr there will be associated issues like as I say stress shielding. Lack of proprioception etc. why would someone who is concerned about potential complications go for a total unknown. The bhr has lots and lots of data and follow up. I would seriously look at going and having a meeting with Dr Su. 

[gunners]

Thank you DannyWofLife

I will follow your recommendations and consider what you have said, I have made no decisions yet because I don't know the facts. That is why I am on here.
What I have learned is that the metal on metal issue is only a problem if the surgery is not done correctly. That is an important fact to determine.
Next I need to hear from someone who has had the Corin mini hip done, do you know anyone who has?
Doctor Su sounds like a good recommendation. thank you
Gunner

[Dannywayoflife]

We're here to help my friend. We have all made the journey that you are on I'm not sure about who's had a mini hip so can't help you there but anything else please ask away mate

[gunners]

Thanks DWL
Much appreciated, I will certainly be on here again. There are pros and cons to either, but the good thing is mostly pros with regard to the BHR from what I am hearing. When I find out more I will be back.

Gunner

[Dannywayoflife]

It's important to make your own decisions mate

[kimberly52]

Hi Gunner,

You may want to think about talking to Dr. Phillipon at The Steadman Clinic in CO.  He does a lot of cartilage  work for high profile athletes.  He will review your information via postal or email and let you know if he can help you.

I have attached links to his site and his profile.

The best of luck to you.

Kim

http://thesteadmanclinic.com/dr-marc-philippon.asp


http://www.sprivail.org/

[Marco Polo]

Gunner:  you may want to use the search function to identify past discussions about the Corin Mini Hip. I did the search and came across a number of threads that you may find useful.

Pat also operates another website called "Hips For You" that would also be a good source of information about the Corin Mini Hip.

[trgcfrg]

Gunner,

Good luck in your research. I went through the same process recently, and decided to go the HR route (just had my first of two BHRs three weeks ago with Dr. Pritchett in Seattle, second one coming in another three weeks  ).

I'm not sure what timeframe "low 90%" implant survivorship refers to, but there are many experienced surgeons with a higher success rate. Specifically, resurfacing seems to have better survivorship for younger male patients vs. THRs. Below article from Dr. McMinn, the pioneer of hip resurfacing, talks about the metal ions / metal wear issue as well as his statistics for HR vs. THR in male patients under 55. That graph, and the fact that this data seems to be reinforced by other registries, was one of my key deciding factors.

http://www.mcminncentre.co.uk/metal-ions-questions-answers.html

[Pat Walter]

Hi gunner

It is always a difficult decision trying to decide on a course of action for a bad hip.

From my reading, cartilage growth does not work well in hips of humans.  It does work in horses and dogs.  If you want to get back to a pain free active life, hip replacement is really the only option.  Especially if you want to do it fairly quickly and not pay out huge amounts for treatments.  It is very experimental and not main stream.  If it worked, I think almost all of use 3800 members of the hip talk discussion group would have done it.  Why would we go thru surgery when we could grow cartilage again? The over 140,000 BHR patients world wide would have done it too.

Hip resurfacing is a great option.  The mini-hip is a THR.  Maybe a little less bone is cut off, but never the less, the femur is cut.  The device that cuts the less bone is the best for a natural gait and loading of the femur.  The long stem of a THR changes the way the bone grows and reacts.  You can listen to  Dr. Brooks videos for an excellent explanation

http://www.surfacehippy.info/doctorinterviews/brooksinterview.php

I would like to also comment that the top hip resurfacing surgeons outcomes are in the high 90% range, many 98%.  That means the top surgeons that have done a thousand/s really know how to place components properly so there is no edge wear and high metal ions.  Many of the less experienced surgeons have stopped doing hip resurfacing because it is a very difficult surgery and they did not have good outcomes.  So it is not hip resurfacing that is not a good option, it is the surgeons skill that was lacking to generator poor outcomes.  Acetabular cup placement is very, very important and must be done correctly.  If not, the two bearing components don't match properly and there is edge wear of the device which results in high metal ions.

So the most important decision is:

1. take the slow, slow approach and try to grow cartilage which does not work well in humans yet

2. get a thr in the form of a mini-hip

3. get a hip resurfacing from one of the top, experienced surgeons with outcomes in the high 95% range and be active, out of pain and back to sports in 6 months to a year.  You will have a more natural gait, no dislocation problems and no pain or restrictions.

To me it is/was an easy decision.  I looked at all the options in 2005 and decided to get out of pain and keep my femur bone in place for a more natural gait and feel.  People with THRs sometimes have problems with the stems.  Again, Dr. Brooks explains that in the above videos.

If you take time to read these articles, you will have a much better understanding of hip resurfacing from the top surgeons besides the great info you received here from hip resurfacing patients.

http://www.surfacehippy.info/positive-results-hip-resurfacing-2012.php

Good Luck.

Pat

[podgornymd]

Hi Gunners,

Just had my BHR on left hip. I tried all the non-invasive treatments which included steroids , Syn visc., and then stem cells and PRP. I did all the research on stem cells and found that there werent alot of peer review articles on hips . I was able to get it wihtout much cost so that was one reason i did it. It worked for a few weeks then hip  got worse. Pat is totally correct. Most of the studies have been in animals. i would tell you not to waste your time or money.

[Jon]

Gunners:

I cannot contribute much to the stem cell or alternative procedure discussion, but when it comes to surgeon selection, I strongly encourage you to do sufficient research.  I'm in New England and chose to go to Birmingham to have my hip done.  By the time I had my surgery, I had met with a dozen orthopedists and had met with numerous pre- and post-op hippies. I had seven years between diagnosis and surgery to collect data.  PM if you like and I can share more.

BTW, about 16 months post-op and spent the weekend surfing and swimming.  This stuff works...

Jon

   

[John C]

I can contribute my experience with stem cell therapy. Five years ago, just prior to when I had my resurfacing, I tried autologous (meaning your own cells) stem cell injections, and it went very badly. Prior to the injections, I could walk, windsurf, and ski, though with pain and a limp. After the stem cell injections, I could not walk without crutches, could not even swim, and had regular bouts of severe pain. This continued to get worse for two months, which is when I had my resurfacing which was very successful.
With my second hip, I have had some minor success with a viscosupplement injection (Durolane), so I putting surgery off for another year.