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Author Topic: Upcoming Resurfacing with Dr. Su for AVN  (Read 3760 times)

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mynameisjudge

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Upcoming Resurfacing with Dr. Su for AVN
« on: July 26, 2014, 09:05:22 AM »
I am a 29 year old male who was diagnosed with Avascular Necrosis (aka Osteonecrosis, AVN) in my right hip a few weeks ago. My pain at this point is more of a persistent annoyance than it is truly debilitating. I have seen two doctors, one that recommended I wait until the pain was unbearable and then get a total hip replacement. The other doctor was Dr. Su at HSS, who said I was an excellent candidate for a resurfacing and that it was a 'no-brainer'.

I am scheduled to get the resurfacing in early September, as I don't want to delay and potentially have my condition worsen to a point where resurfacing is no longer an option.

Just wondering if anyone has a similar story that has any results to share. I had previously read something from one of the big name doctors about how AVN patients fared better when they had a bone graft with the resurfacing, instead of filling in the cysts (which I have) with cement, though I can't seem to find that now. Any and all info is welcome.

Ben
RBHR 9/6/14 Dr. Su at HSS

Vinman

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Re: Upcoming Resurfacing with Dr. Su for AVN
« Reply #1 on: July 26, 2014, 11:40:03 AM »
Hi mynameisjudge.  I am 39 years old and too had AVN and had resurfacing surgery with Dr. Su 12 weeks ago.  I was limping for 10 months and the pain was annoying as well.  Not sure I would define it a completely debilitating but limping around, not being able to exercise, dreading going up or down stairs and trying to figure out best ways to not walk as I plotted by day was just too much.  I asked Dr. Su the same question and regarding whether or not I could wait and given the items I mentioned as well as the fact that you want to use as much good bone as possible (as opposed to waiting for the AVN to further deteriorate your femoral head) we decided to proceed.   It was a great decision and while there are still some aches and struggles here and there, I am back to 90% and can walk around and do the things I mentioned above without thinking about them. It's like I am a new person  Dr. Su is an outstanding surgeon and HSS is the best.  I too had doctors (very top people in orthopedics in NYC) that recommended I wait until the pain was too much and get a total hip replacement.  Thank goodness I did not listen to them.  Keep in mind that many surgeons have not done or have not done enough hip resurfacings to be objective in my opinion.  This website is a great resource.   If you have any other questions, let me know as I had a very similar experience as you.

mynameisjudge

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Re: Upcoming Resurfacing with Dr. Su for AVN
« Reply #2 on: July 26, 2014, 12:09:01 PM »
Hey Vinman. Thanks for the info and encouragement.

I am curious to hear about your progression re: getting out of hospital, using crutches & canes, physical therapy, activity restrictions, etc. How immobile were you right after the surgery? Did you need someone home with you to help you, or were you able to manage on your own? How has the pain been?

You say you are at 90%. What is the remaining 10% you are waiting for? Have you been able to go back to work?
RBHR 9/6/14 Dr. Su at HSS

obxpelican

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Re: Upcoming Resurfacing with Dr. Su for AVN
« Reply #3 on: July 27, 2014, 09:35:57 AM »
Ben,

Dr. Su is clearly one of the tops in the HR field, if it were me I would for sure listen to whatever he says.  Read the many stories by people who have had Dr. Su perform the surgery.  Dr. Su was on my short list 6 years ago when I needed a replacement.

Dr. Su can fix you, don't get a THR, you are WAY too young for a THR.

BTW, I would ask Dr. Su your questions about bone grafting.


Chuck

I am a 29 year old male who was diagnosed with Avascular Necrosis (aka Osteonecrosis, AVN) in my right hip a few weeks ago. My pain at this point is more of a persistent annoyance than it is truly debilitating. I have seen two doctors, one that recommended I wait until the pain was unbearable and then get a total hip replacement. The other doctor was Dr. Su at HSS, who said I was an excellent candidate for a resurfacing and that it was a 'no-brainer'.

I am scheduled to get the resurfacing in early September, as I don't want to delay and potentially have my condition worsen to a point where resurfacing is no longer an option.

Just wondering if anyone has a similar story that has any results to share. I had previously read something from one of the big name doctors about how AVN patients fared better when they had a bone graft with the resurfacing, instead of filling in the cysts (which I have) with cement, though I can't seem to find that now. Any and all info is welcome.

Ben
Chuck
RH/Biomet U/C Dr. Gross/Lee Webb
8-6-08

Vinman

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Re: Upcoming Resurfacing with Dr. Su for AVN
« Reply #4 on: July 27, 2014, 11:32:08 AM »
Hi Ben.  You can look at some of my earlier posts to get some details I put up along the way.  I had surgery at 3:30 pm on Thursday and was discharged at 10 am on Saturday.  They get you up and walking right away.  I had a little bit of a delay because I was very groggy from the pain meds.  The pain was very manageable.  I was surprised at how manageable after such a make surgery.  Interestingly I was told that Dr Su now injects some sort of pain killer into the hip area as they are closing you.  They found it is just as effective as keeping the epidural in post surgery which they did not do.  Take everything they give you in hospital.  At home I was off the good stuff within 3 days.  Was on two forearm crutches (highly recommend) for 4 weeks and then one crutch for an additional two.  Could probably have been off sooner but the made me feel more comfortable.  One of the things you will notice during the rehab is that sometimes you are just scared to do something and then you do it and all is fine.  I was up and about walking a little in front of my house right after I got home.  You will need someone around the first couple of days to help you as you heal.  Getting out and into bed and in and out of shower was sometimes a challenge and useful to have someone around to help steady you if needed.  That said you should try to do as much as you can as movement is what is part of rehab.  When I mention 90% I still am on restriction for soore months before I can do anything high impact.  At my recent 4 month  checkup they said it was ok to so light tennis, etc.  I'm still a little nervous to run so won't try that until I feel more comfortable.  One thing I would ask about is a catheter.  I was not given one (I think some don't like to do as it can lead to an infection). I couldn't pee and had to have one put in the night after the surgery which was not fun.  If the can do while you are under much better.  Don't worry about it either way but I would ask.

oldsoccerplayer

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Re: Upcoming Resurfacing with Dr. Su for AVN
« Reply #5 on: July 28, 2014, 07:52:12 AM »
As an alternative to the catheter you might want to ask for some medication to get the bladder working that you can take immediately post-op. I had the same problem in a previous surgery so I had a prescription of flomax lined up. Unfortunately there was a mix-up with where they called it in so I didn't get it. I had to spend an extra night in hospital as a result.
BioMet Left Hip Resurfacing, Dr. Gross, 07/2013

mynameisjudge

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Re: Upcoming Resurfacing with Dr. Su for AVN
« Reply #6 on: July 28, 2014, 07:44:11 PM »
Thanks everyone for the advice.

There is one other thing that is on my mind right now, and I wonder if anyone else looked into this. For AVN patients, Dr. Su said his success rate was around 90-92% for the resurfacing. His hypothesis for why it is lower than for non-AVN patients is that a lot of AVN patients have AVN due to alcoholism. When they do not stop drinking after the resurfacing, the AVN continues to progress and leads to failure. For a patient like me where the AVN is caused by a one time event (in my case, likely from steroid use), there would be no progression. This, however, seemed like just a hypothesis that was not necessarily backed up by hard data.

According to Dr. Su, they 'ream' any cysts and AVN changes out of the bone and clean out whatever is left. On the other hand, Dr. Vijay Bose in India apparently has just as high success rate on AVN patients as on non-AVN patients. He has a paper about it, as well as some stats on his website. From reading various postings of his on surface hippy as well as on his own website, it appears that he may do a bone graft procedure during the hip resurfacing, and that this may be responsible for his higher success rate.

Has anyone done any research on this, or better, actually had this procedure with AVN from Dr. Bose?
RBHR 9/6/14 Dr. Su at HSS

HowieF-16

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Re: Upcoming Resurfacing with Dr. Su for AVN
« Reply #7 on: July 28, 2014, 08:54:14 PM »
Ben, although my need for an HR was different than yours (osteoarthritis), my approach was similar to Dr Su's recommendation and your approach. In my case, the pain was not unbearable, but my quality of life was not what I wanted. Rather than delay to the point that the pain was unbearable, I opted to get the HR sooner, rather than later. There are lots of benefits to that choice. First and foremost, I was able to work with my PT to design a plan that got my hip and leg as strong as possible to enable a quicker recovery. Second, the pain and discomfort had not yet seriously altered my gait, so learning how to properly walk again was easier. Third and final...if your going to have the surgery, just get it done and get healing so you can enjoy life again. I am almost 8 months out of surgery and do not feel limited at all. Like most surface hippy's I expect to be 100% within a year from surgery. Good luck and I applaud your decision. Howie F-16
« Last Edit: July 28, 2014, 08:55:58 PM by HowieF-16 »
RBHR, Dr. Raterman, 1-8-14

mynameisjudge

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Re: Upcoming Resurfacing with Dr. Su for AVN
« Reply #8 on: September 06, 2014, 05:59:21 PM »
The deed is done. I had my right hip resurfaced with Dr. Su at HSS at 7:30am this morning. Was able to walk with two crutches and go up and down stairs early this afternoon on my first attempt. Lots of soreness and it is pretty tough to move the leg in certain ways. For instance, when sitting, trying to move my thigh straight up is very difficult.

I didn't get to speak with Dr. Su yet (he has 7 surgeries booked today back to back), but he told my family it went beautifully.

Only real problem right now is I am still mostly unable to pee. Anyone have any luck with flomax for this problem?
RBHR 9/6/14 Dr. Su at HSS

mynameisjudge

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Re: Upcoming Resurfacing with Dr. Su for AVN
« Reply #9 on: September 07, 2014, 06:04:02 AM »
Small update - I took myself off of all narcotic pain meds, and my peeing is back to normal. Pain is worse without them, but not bad, especially when just sitting or lying.

I am wondering how much difficulty others had with certain motions after the procedure? As I mentioned, lifting my thigh upwards is difficult. Is this normal?
RBHR 9/6/14 Dr. Su at HSS

John C

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Re: Upcoming Resurfacing with Dr. Su for AVN
« Reply #10 on: September 09, 2014, 03:13:57 AM »
Moving your leg around much right after surgery is usually challenging, and totally normal. Many of us described the leg as being just a lump of sausage. Little tricks involve using your other ankle to get under the operated leg in order to lift it up. Also people have used loops of various kinds to lasso the foot and help in moving it around. Your hip has just been through a train wreck, and your body is trying to shut down much movement for a few days in order to let things settle down; smart body. I did a number sets of minor leg lifts under the covers that first night, and was soundly scolded by the PT the next morning for doing anything like that so early. Sounds like your body is telling you just what the PT told me.
After the first few days, you should start seeing slow but steady improvement. It is always a good idea to ask your doc or his assistant about any concerns, but it is pretty common to have lots of ups and downs over those first few weeks or months.
John/ Left uncemented Biomet/ Dr Gross/ 6-16-08
Right uncemented Biomet/Dr Gross/ 4/25/18

oldsoccerplayer

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Re: Upcoming Resurfacing with Dr. Su for AVN
« Reply #11 on: September 09, 2014, 08:08:40 AM »
Welcome to the other side! I think as much as the physical discomfort you're experiencing some post-op anxiety that is very common. For the first few days focus on resting, taking the meds, and moving only as much as is comfortable. The leg will heal, just give it time. I think around the 5 day mark is when it's likely to turn all shades of black, blue, purple and red, which is alarming but goes away after a while. Try to keep the leg elevated when you're lying down.
BioMet Left Hip Resurfacing, Dr. Gross, 07/2013

Vinman

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Re: Upcoming Resurfacing with Dr. Su for AVN
« Reply #12 on: September 26, 2014, 08:56:41 PM »
How are you feeling now?  You will go through various phases of feeling great and then not so much which is all part of the process.  The journey is not linear.  Please let us know how you are feeling.

mynameisjudge

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Re: Upcoming Resurfacing with Dr. Su for AVN
« Reply #13 on: October 12, 2014, 09:30:37 AM »
Quick update - I am doing great. At my one month follow-up, doc said I was doing better than 98% of patients at that point. Walking without any assistance (for many miles at a time), doing all of the exercises and stretches fully. Sometimes there is some pain or discomfort when walking, but not always, and when there is, it is not much.

So, so far, so good. Most of the time during the day, I can barely notice that I even had the surgery.
RBHR 9/6/14 Dr. Su at HSS

 

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