Is 26 too young?

[Mark.D]

Hi guys,

Im new here, have done some reading on the resurfacing but when it says for active younger patients most people are still around 40. I am only 26 years old, suffering badly with arthritis and bone spurs in my left hip. Im pretty sure its relating to a bad accident I was in 7years ago. I work on cars for a living and cant do anything active anymore, hardly make it through a days work cant sleep at night etc. Im nervous that getting this operation done at only 26 what will happen in the future if it fails. Is a resurfaced hip the only option or is there other tactics to consider. I am doing physio, drinking a ton of water and have started glucosamine. I have been waiting a while to see the local orthopedic department on what they suggest. Any and all info would be great. Thanks,

Mark

[hernanu]

Hey Mark, welcome to the site... I'm sorry you're dealing with this, but treat it like any other illness, sometimes it strikes people who are not typical.

You've already been diagnosed with osteoarthritis?

We have several younger folks here who for any number of reasons had their hips go on them and had HRs or THRs. I'll let them chime in...

Again, welcome and ask anything, we've been where you are.

[Mark.D]

Thank you

Yes I have been diagnosed with osteoarthritis

[Dannywayoflife]

Hay Mark! Welcome!

I was a young resurfacing patient at 28 at the time of my operation. If you have the symptoms that you have now its time to take action mate. You can leave it too long and do irreversible damage and end up with a thr.

My advice to you would be to go see THE BEST SURGEON YOU CAN!! That means a surgeon who has done thousands with great results. Where in the world are you? Maybe we can point you in the direction of a top surgeon.

Danny

[Mark.D]

Well I'm in Kingston, Ontario so not a ton of surgeons. There is one in our town that does them I don't know about thousands though. I am trying to deal with this as quick as possible especially trying to run a business and with a child on the way. I have been waiting over a month just to find out when my appointment is so speedy isn't exactly an option for health care around here unfortunately.

[Dannywayoflife]

Mark any operation carries risk. But at your age you need to minimise the risk. Seeing a top surgeon who has done a large amount of these is THE BIGGEST way to minimise risk. I know you want to get repaired and get on with life but think about the bigger picture. If you see a less experienced surgeon who screws it up then long term it won't be good for you or your family and business. Look at your options even if it means going international. Vijay Bose is a top surgeon and he is pretty cheap thanks to a great exchange rate with India!

[Granton]

Backing for Danny's point about a top surgeon. They will often review X-rays sent to them as a start. Would give you an idea of whether you are a candidate.

David

[bestbob]

Hi Mark, I agree with all the prior comments. Here is a link to all the doctors Pat tracks, hope it helps.

It was updated 10/3/13.

http://www.surfacehippy.info/listofdoctors.php

http://surfacehippy.info/hiptalk/doctor-information/

Bob

[greateressex]

Hey. I'm Canadian too. I live in the Windsor area.  I waited 2 years for my surgery with dr Richard Mcalden in London Ontario. I did my research on him. He is one of the best around our region. He wrote a few books on hips.  He is only a few around that I would trust with my hip. I'm getting a hip resurface done in 10 days. So I'm nervous as he'll right now. I'm only 41.  I would recommend him for you.

[Mark.D]

I appreciate the replies and info guys. Not that I want to bring it up but just because of the age IF a hip resurface fails down the road can it be re-done? The surgeon in Kingston that does them is the chair of the orthopedic department and also the teacher at Queens University. Do you still think I should seek further? Also would Arthoscopy be an option for me, or no?

[Dannywayoflife]

Yes a resurfacing can easily be redone to a primary thr should the need arise.

As far as your surgeon goes you need to find out how many he has done how long he has been doing them with what success rate. What were the reasons for any failures and what device he uses. As I say being young it is even more important to see the best as the surgeon is the single biggest factor in success followed by device and patient selection. Get some X-rays on disc and send them to some of the top surgeons who will give you a free opinion.

Danny

[Mark.D]

Okay thanks Danny. I do see there is a surgeon in NY state which is close to me who has done over a 1000 but money may be a factor going out of country. Any idea on what the going rate is in the states?

[Gazza2]

Mark,

 There is quite a lot of info out there that indicates there is a learning curve through the first 200 operations (Revision rate is higher during the early operations). Also there are some surgeons who are only doing this operation infrequently which is also not good.  If you find out how many the surgeon in Kingston has done and how often he does HR surgery (And which device) please post here for others to find.

  I don't know whether you can be referred to a surgeon in Ottawa under OHIP, but there are two experienced surgeons in Ottawa General (Dr Paul Beaule, and Dr Paul Kim who was my surgeon)  who have done a lot of HR and are doing them every week.

[gfunk309]

Mark, have you had anyone talk to you about labral tears and femoral acetabular impingement (FAI)?  These are conditions of the hip which cause pain in younger folks, and perhaps your dr is just saying osteoarthritis as a general cause of your pain.  Have you had only x-rays?  Need MRI for labral tear diagnosis.  You can get free consults over the phone from some surgeons, I know Dr. Gross will.  They can look at your x-ray and say whether or not you have FAI, which can cause labral tears.  If you do, there are other options besides resurfacing.  I had my hip scoped at age 32 and that gave me 4 years of relief before I finally needed resurfacing, some get longer.  The only reason I say all this is because FAI and labral tears have only been on the ortho radar for the past 10-15 years.  Some docs don't regard it as a real problem, though most have come around to the hypothesis.  The arthroscopic surgery is less invasive and gets you back faster.  Many professional athletes get this procedure and are back to playing their respective sport in 3 months.  I imagine at age 26, you can have OA, but I wouldn't be surprised if you actually had FAI that was causing cartliage wear and tear.  Google FAI/hip and hip labral tears. 

[Mark.D]

I may check into that, if it was FAI would I still have bone spurs due to that? When they gave me the results they told me there were minor bone growths (spurs) as well as moderate OA. I was an athlete my whole life hockey, extreme sports etc. Had a bad motocross accident where I broke numerous bones. I expected arthritis in my wrist and arm which is full of plates and screws but its all good still (knock on wood) so this was very unexpected. I have had pain in the groin and my SI joint for a while. Now its full hip sometimes right into my knee etc. Maybe I should have an MRI done to see further. That gives me a lot more hope too. Thanks

[gfunk309]

Mark, labral tears cause groin pain and the fact that you have been athletic your entire life doing high impact sports, it is highly likely you have one and that it may be caused by FAI.  Bone spurs are definitely associated with FAI as the bone on the head of the femur is constantly rubbing the rim of the acetabulum (socket).  As the bone rubs, the labrum tears and the cartilage gets worn.  Also, bone spurs result as the small pieces of bone (osteophytes) that get rubbed off start growing together and calcify.  The calcification of the osteophytes results in less joint space and thus further rubbing and eventual cartilage damage/wear (osteoarthritis).  I do think you should exhaust less invasive options as at least a stop-gap before major hip surgery (resurfacing or replacement).  Like I said, I got 4 years extra before I needed further intervention, though I had a less state-of-the-art procedure.  Some folks, according to literature, who have arthroscopic repair and microfracture procedures may get 10-15 years before further intervention is needed.  That would put you in your late 30's-40's like many of the rest of us here.   

[Mark.D]

That is some excellent information. Thank you so much gfunk309. I pray that's what it is, because this is exactly what I was hoping for something minor to get me through like your saying to me mid-late 30's before a major surgery. I have just emailed my doctors office on sending me for an mri

[gfunk309]

Good luck and let us know how it goes!

[bestbob]

Mark, to make a long story short, I to0 had hip and groin pain prior to surgery. Also, 3 months prior I started to experience knee pain. My diagnosis was minor OA, and than a MIR (with dye) showed a labral tear. The OA by itself was not enough to make me a candidate for a BHR, but add in the labral tear and I was a candidate.

I am know 4 months post op, no hip nor groin pain. I do have minor knee pain when weight bearing and am doing PT in hopes it goes away.

Hope this helps.

Bob

[Lauren Lee]

Hi Mark, In my early 20's i had a snowmobile accident. I was told I had a "groin pull" but for years (30+), I sufferred. It just got progressively worse and worse. Of course, now I know it was a labral tear with developement of osteoarthritis and spurs. I was holding on until I was "old enough" for a hip replacement but then I found out about BHR. If I had had that option sooner I would have done it a whole lot sooner. I am one day ahead of my friend bestbob in the previous post and am recovering nicely. It's no easy walk in the park but it sure beats not being able to walk in the park at all.