How Long Will BHR last?

[LDG]

I had a BRH on my left hip 2 years ago and recently had the right hip done.  At age 51 I'm wondering how many revisions I will have or if I will need THR in the future.

My surgeon told me that he expects my BHR to last 20-30 years but I think that's overly optimistic.

What type of longevity did your surgeon project?

[hernanu]

Well, since this is a relatively new procedure, it's hard to speculate into the three or four decades.

The results from the country registries, especially Australia point to good success, about 94% or more retention at the 10 year mark. That's for all patients, all doctors, all situations.

So the chances are good, especially when you look at other procedures and their success rates.

We have some solid results for that time frame, and although you can extrapolate from those with some statistical confidence, until we've actually spanned the decades, we won't know the actual results and get some hard evidence going forward.

The tendencies seem to be that if you get doctors who are experienced and active, with good results from current patients, you increase your chances of success.

I would take ten years as a good possibility, since we have hard facts on that. Anything beyond that is speculation, but as far as trends go, if you've been successful for that long, the chances are good for further success.

Muddy waters, but that is the problem with being in the first wave of any procedure, I think.

[LDG]

Thank you for the response. 

I'm purposely babying my hips post surgery hoping to get more longevity.  I'm doing mostly low impact activities like walking, biking and the elliptical machine.  I'm even trying to reduce my weight.
Hopefully that will lessen the wear and tear.

I'd hate to think that I will need to have hip surgeries when I'm in my 70's or 80's so the motivation is there for me to take it easy.

[hernanu]

I guess I'm kind of doing more impact. The mechanics of bone growth are that a certain amount of pressure will promote heavier and thicker growth, so long as you're not catastrophically stressing them.

So I lift weights, kick the bejeebers out of a punching bag and so on.  There is a possibility (I believe) that we will have a revision, but like people at risk of osteoporosis, lifting weights helps to grow stronger bones.

 I think I (and my bones / device interface) can benefit from the challenge.

Just my opinion, given that I'm not a medical type, and definitely not something to be done early (I started heavily at one year), but I think it makes sense to me.

[obxpelican]

Bear in mind most of the failures in the registries are NOT the device wearing out but rather other reasons.

The actual device would probably last a lifetime in someone 45 years or older assuming nothing happens such as a high impact injury etc.

IMHO, if you get 10 years you will probably die with your implant, many people already have.


Chuck

[LDG]

Living my life out with this device would be a dream.  Having lived a lifetime with painful hips has hopefully earned me a pass.

[hernanu]

Living my life out with this device would be a dream.  Having lived a lifetime with painful hips has hopefully earned me a pass.

I'm wishing you some great experiences; it seems like you're doing good things. Here's to celebrating our thirtieth HR anniversary.

[Dannywayoflife]

It's not humanly possible to "wear out" a bhr. It will all depend on how well the bone can stay attached to the device. Having spoken to my surgeon about this ( and he's done a few!! And has been doing them as long as the bhr has been out! ) and he said at nearly 20 years his stats are something like 98% retention, and he said there not just going to all fall out at 25 years! The thr's that used the same metallurgy as the bhr many of them lasted over 20 years and some are still in place over 40 years after being installed. The answer to your question is an unknown but I would wager that someone in their 50's if they have a bhr installed properly by a top surgeon then they'll never need a revision. I suspect that I will need 1 in my life time but then I was 28 at time of installation and I'm hardly easy on it!

[DavidJ]

Great topic.  Way to many variables to get an answer.

I think its exciting for someone like me, 40 yrs old who needs a BHR soon,  that their is a good chance I will be better off after surgery and it could last the rest of my life. 

[Dannywayoflife]

Like you say David way too many variables to give a definitive answer however the data from the top surgeons who have been doing this since the 90's is very very encoraging and does seem to hint at a very long lasting device in the bhr.

[Jason0411]

Yes it is about attachement not wearing it out. My Brother is still doing Karate 14.5 years after BHR. He has solid bones thanks to activity, if you baby it too much you risk having weaker bone structure holding it in place. I am not saying push it but just live a normal life and try not to think about it.

[Dannywayoflife]

Your right mate you've got to live your life. I try and balance doing my stuff with the fact that I've got a bhr. Therefore when doing high impact stuff like running I use the ultra high shock absorbsion shoes like hoka's.

[Canadian-Ice]

From what I gather from several top surgeons, various kinds of running don't affect the BHR. However, I did hear there are those who feel running caused an early failure, but the details I do not know.

One thing I wounder about is how long it takes to return to running safely after surgery?

[Dannywayoflife]

I've read Mr McMinn has had a failure because the patient returned to running early and this caused the bone not to properly adhere to the cup. Rather than being hard solid bone it was fibreous.

The when is it safe to do high impact is a matter for debate. Mr Treacy told me initially a year but the at my 6 month review was so astounded by how fast my bone had healed and at how solid it was he said I could start then if I wanted. I figured I was in no rush and left it. Mr mcminn states 12 months as it does take that long for the femoral bone to completly heal and return to normal bone density. However many surgeons say 6 months.

I personally think that we need some high impact to ensure longevity of these devices and if we do pound them a bit the bone respondes and will grow into the components even more. But I do try and balance that with the fact I am bionic. So I've switched more activities to non impact. I rarely kick the pads or bags now instead I just box and use elbows and knees. I've tried to just modify my fittness so I'm still active but I figure I wore out my natural hip smashing it running and Thai boxing etc why wouldn't a bionic one be any different! So I still do them but I cross train more.

[Canadian-Ice]

6-12 months? Sounds good.

Yeah, cross training is maybe better anyway! Adding in other sports and activities is good for fitness even if not bionic.

The beauty of martial arts is that you can build your personal game around any ground and stand-up combo you want!

[Dannywayoflife]

That's what I do! the annoying thing is people who don't understand that there's not only the book way of doing something try and change the way I do things! Even usually after I've just handed them their ass!! Lol

[Some Dude]

They will wear out if they're put in wrong. My resurface doc said 20-30 years, it was out in 5. Not trying to be Chief Dark Cloud here, just pointing out that they need to be installed correctly or all bets are off. (My cup angle was 65+ degrees) I don't know if you've ever held a bhr in your hand and played with it, I bet it'd be pretty difficult to wear one out without edge loading, they seem very tough, they're heavy and smooth as glass.

[hernanu]

Agree fully SD, your story and other's points out how important it is to use an experienced, skilled surgeon.

[Some Dude]

Agree fully SD, your story and other's points out how important it is to use an experienced, skilled surgeon.

Yep. Think Craftsman not Carpenter 

[Dannywayoflife]

SD it is very true that they have to be implanted right!! But if done so the actual bearing couple will not wear out. The wear of the as cast vitalium alloy when put in at the right angles is incredibly low. Retrieval of old devices has shown after 20-40 years just a few microns of wear I seem to remember something like 26 microns total wear for a 40 year old thr made from the same alloy. The question of how long a bhr/hr will last is all about the fixation in the bone. And I believe that the bhr and other devices will last a long long time now! Thr's are now incredible also!! If I ever need a revision I truly believe ill only need 1!