HR joint feel compared to normal joint

[Ljpviper]

I have a question for those who have one HR hip and the other a natural one in decent shape. When I met with Dr. Gross he was concerned I would not like the new hip since I had so much joint space left. I have the one bad spot on the anterior superior actablum which is causing all my issues on both hips. I am still confused as I have chronic pain, would it not be better to have no pain and a resurfaced hip? Doing another arthroscopy is risky as it may or may not hold up again, i would need to really baby my hip. I am not keen on going that route again.

Can you actually feel the difference with the HR compared to a normal joint?

Thanks,

Larry

[shabbis]

I am only 2 weeks post-op, so lots of muslce soreness still, but when it comes to the joint itself, I cannot feel any difference between my BHR hip and my natural hip. My BHR hip had a lot of arthritis and bone spurs, so in fact in actually feels smoother now than before surgey.

[Arrojo]

Over two years out, after a marathon, a few half marathons, two rounds of P90X, and qualifying for the National Masters Track & Field Championships in the 100 meters, 200 meters and long jump, I can categorically say "NO".  There is no difference.

If it weren't for the metal detectors in the airport, I'd forget that it was even there.

[Tim Bratten]

I'm only 10 months out, but my hip certainly feels stronger, more flexible and less irritated than it has in years. I should say that I never had real pain before the surgery, only irritation and discomfort during and after activity. However, I felt my hip was limiting me, and even though I didn't have much pain before surgery, at this point I'm real happy I had the surgery done.

[Dannywayoflife]

Personally I'm going to say as good as a bhr is it's not quite as good as a fully functioning natural hip. But you do have to do some fairly extreme stuff to find that out

[luann again]

This is a great question. I can feel a difference, but like Dannywayoflife, only if I really push it (like running fast, stepping up with that leg first and carrying something heavy, etc). Every now and then, a little tiny stiff or sore after sleeping (or a really strenuous hike). Overall, I am super happy with it and so glad I did it! I, too, had a lot of cartilage left but lots of osteophytes! Very painful and limited mobility. I can reall do anything I want now!
If you are in a lot of pain, consider it (carefully with an awesome HR Dr!).

[Ljpviper]

Thanks for all the responses I appreciate it.

I don’t think I can justify another two arthroscopic surgeries if the first two failed. I never went back to impact sports, I followed the protocol. I the micro fracture just did not hold up(fake cartilage). I understand Dr. Gross point of replacing a joint that has only a 20% bad spot.

Unfortunately  for me the 20% area is a spot that has continuous contact when sitting and any type of squat movement. So I am in constant pain 24/7.

I may seek another hip resurfacing doctors opinion on the entire matter. As stated in another post Dr.Gross will do the surgery if I ask.

Thanks,

Larry

[Dannywayoflife]

It does sound like it's adversely effecting you buddy!

[chuckm]

Ljpviper, I'm wondering whether Dr.Gross misspoke or perhaps you heard him wrong. That question about liking it or not sounds a bit off to me. I could understand him saying that "he" doesn't like to perform resurfacing on someone with so much joint space.
On the other hand, I'm not sure it is possible for someone in any pain to not like the results of a resurfaced hip. The pain is gone and you can go back to any activity you want.

But, I did wonder what it would feel like after resurfacing, like maybe it would feel different.
It doesn't. It's like you have been fixed. 

Chuckm

[oldsoccerplayer]

Agree with Chuckm. I think you should talk to Dr. Gross or one of his staff and emphasize how much pain you're in. If they are confident that the HR will relieve the pain I think you should go for it.

[Ljpviper]

Here is what he wrote, let me know what you all think

Mr. Platas does have some residual symptoms in his hip despite hip arthroscopy. This is due to the fact that he does have
small areas of chondral loss in the anterior superior corner of the acetabulum. I do not feel that repeat arthroscopy would be
beneficial. He has tried injections and anti-inflammatory medications and these have not worked. His only option at this point is
to move on to arthroplasty. However with his mild degree of arthritis, I am not at all sure that arthroplasty will satisfy him. I
would estimate with his degree of arthritis that there is a 70% chance that he will be improved with hip arthroplasty and it will
take at least a year to know for sure. If he does choose to undergo hip arthroplasty and he does not like the outcome. There is
no going back to his current hips. I think hip resurfacing offers a higher functional result than total hip arthroplasty, but even hip
resurfacing does not provide a normal joint. If we strongly desire to proceed, I would perform a hip resurfacing form on one side
and wait a year to be sure that he was happy with the result. If we so, we could then do the other side. However, I think there is
high enough chance that he will not be completely satisfied that I would encourage him to live with his condition longer and not
request resurfacing. Unfortunately, there are no other treatments. The only thing I would recommend that would be helpful. I do
not believe that platelet concentrate or stem cell injections have any value. I will recommend continuing a regular aerobic
exercise program such as elliptical and exercise bike because he can tolerate this well. Higher fitness level will allow him to
tolerate the symptoms better. I would not recommend chronic narcotics and he is not requesting these. Since sitting bothers him
the most. He should look into alternative seating option such as high chairs or kneeling type chairs, which will avoid the high
flexion hip positions that bother him. I would be happy to reevaluate him at any time and if he does desire hip resurfacing, I
would perform this for him with the understanding of the limitations I have discussed with him in the detail above.

[toby]

Hi Larry, I'm sorry to hear of your hip problems but in answer to your question -no I feel no difference between my resurfaced and normal hips. Also, having been involved in the resurfacing community for around six years, although in London UK I have tremendous respect for Dr Gross and have become aware of his work, contribution to the development of resurfacing, care for his patients and numerous positive testimonials. So I feel his current reluctance relates to your 20per cent issue and that you are not classed as end stage arthritis. Maybe he feels that it's worth trying out the other suggested approaches before surgery which is always a last resort. However, I certainly sympathise with the fact that you've most cartilage remaining but unluckily have such discomfort-as others have suggested, have another appointment and reinforce your pain levels.
Good luck
Toby
LHR adept Prof Cobb 30-1-10

[JHippy]

Gotta say reading that definitely gives me even more confidence in Dr. Gross.

"When" to have the operation is a real personal decision. One one hand we just want to be fixed and go on with our lives like it never happened. But surgery is always a risk. You can pick the best surgeon, the best everything, but there is always a real risk.

I would weight the risk vs benefit right now and not feel rushed (unless it's flat out something you can't live with). You're a candidate for the surgery now, and you'll still be a candidate next month, next year and on down the line.

[curtieman1]

Larry, speaking from how my Dr explained my decision to go ahead with both of my Resurfacings especially my second. He told me that the X-rays don't look that bad and to go ahead with surgery would give you a whole different kind of pain, & until it healed completely it could put into a depressed state. We talked about it & I assured him that since it was my second hip I was ready to face the consequences. If you have already been through some failed surgeries you are ready to move on to a pain free life. We are our best advocates. Best of luck to you. Curt

[chuckm]

Here is my take on that Larry. First of all sorry for your situation. The comments from Dr. Gross lead me to believe he is really troubled by your symptoms. It appears to me he is implying that your x-rays do not pinpoint for sure the reason for your constant pain levels. Not that you are not experiencing pain but he questions if resurfacing is going to resolve the reasons for the pain you have - like the pain one gets from bone on bone cartilage loss. Since it takes a year or so to really recover from resurfacing, it would be disappointing for you to get there and realize that resurfacing didn't fix it. The way he writes about being disappointed with the outcome does not apply to someone with severe arthritis, I think it is a special instance for your case since he notes that you have good joint spacing.
I guess he needs to be absolutely sure that all of the pain symptoms you have can be resolved with resurfacing. Good luck and keep at it.

Chuckm

[Ljpviper]

I went to my OS today to inject the right side at least for now. I am also going to get a left hip MRI as well.

I like Dr.Gross is so upfront and honest. He is looking out for the patient not just to have another surgery under his belt, he is way pass that.

My problem is I am out of options, either go through another two arthroscopic surgeries to try another microfracture. My OS states there is no data to suggest that it will work a second time.

He will do it but no guarantees, i just dont think its wise to try again knowing that is can fail so easily.

At least with HR i know the damaged cartiledge will be removed. Lets see what my left hip MRI shows.

thanks all for the support...

[HippyDogwood]

Your surgeon is pretty dismissive of stem cell treatment!

The technique is being continually refined and there are a few surgeons here in the UK that have a lot of faith in the procedure. It's not just about harvesting the stem cells but then introducing them with a suitable medical scaffold to bond the outcome.

We all have different opinions on stuff on this site and that's life - there are lots of surgeons who are strongly against resurfacing as well and they can't all be right!

 All I will say is that my condition is way worse than yours and I have deemed it worth trying stem cell treatment in the hope it buys me time for new materials to become proven in resurfacing rather than metal on metal as I personally feel ceramic will end up being the optimum solution. Now I may end up no better off, but I had one side done 7 weeks ago and am back in on Tuesday so I'm putting my faith in the fact that one of the Worlds leading hip surgeons thinks stem cell treatment does produce tangible results and are working towards publishing results from their 18 month study in 2015.

It is very early days in that procedure, but don't let one guy put you off, seek further opinions and then go with your gut as microfracture is not the same as microfracture with stem cells, so it is something you have not tried yet

[Ljpviper]

Did you just have stem cells injected into your joint?

[HippyDogwood]

Did you just have stem cells injected into your joint?

No it was wrapped into a bigger surgery for removal of FAI, labral tear stitched and anchored and coupled with a microfracture - over 2 hours worth!

The important thing seems to be to use microfracture to provide a "key" for the new growth and the mix they use to produce a medical "scaffold" to firmly bond everything so that it has some longevity. Really not convinced that a mere injection would do a lot for a hip

I'm under no illusions about the pioneering nature of this surgery and may end up no better off, but just wanted to flag to you that I wouldn't take one surgeons outlook on this as gospel in that another eminent surgeon will tell you that resurfacing is fundamentally flawed (I had one guy explain it to me as how any engineer will tell you that metal on metal is a bad thing and in an engine you have oil to lubricate and a magnet in the sump to collect metal filings!). My view is that there are significant merits in both, it's just tricky to tell when you have crossed the line from one being viable to needing the other.

If I get an OK outcome with at least one of them then I'll take that as worthwhile and then get back to looking at resurfacing on the other!

[Ljpviper]

Who did the surgery Dr. Villar? Not many surgeons are using stem cells. Good luck with that, I would stay away from impact sports, ie running and jogging. I believe that's what made mine fail as I was ok for a couple of years after the surgeries.

Thanks,

Larry