2.5 weeks out, any last minute advice?

[toby]

Hi Gazza, I share the sentiments and concerns you express in your post. When I was doing my research some 6/7 years ago there were many questions aimed at the HR surgeons and much research re- learning curve for HR and most conclusions indicated around 100. I feel that I conducted my extensive research diligently and had the good fortune of being helped by a close friend who is a world renowned ENT surgeon operating in top London hospitals, who was able to gain some additional information from staff working in the operating theatres. Living in the UK I had the opportunity of going with McMinn or Treacy but opted for a highly respected surgeon who had performed around 250 HRs, who had written extensively, was a huge advocate of HR and in his post of Head of Orthopaedics at Imperial College Hospital (leading/cutting edge UK teaching Hospital) trained surgeons in Hip Resurfacing. Also, he was working on 3D Scanning and using robotic technology to achieve placement precision, which appealed to me as I was a pretty complex case having had a major femoral fracture in my early twenties. So I guess in answer to your question, yes I feel that although they don't get the coverage there are many talented lower profile surgeons performing and developing Hip Resurfacing. Gazza, I also feel that we have a responsibility to those new to the site to encourage them to do their research wisely and opt for a surgeon who has appropriate HR training/up to date knowledge/experience/patient reviews/supporting data etc but of course it doesn't mean that they have to completed thousands to be sufficiently talented. Indeed, if several hundred/thousands were needed then everyone would have come over to the UK/Belgium for Mcminn, Treacy and DeSmet and HR would have missed out on the talents of Gross, Su, Bose, Brooks, Antonio, Kim, Pritchett, Rogerson et al Plus, these top surgeons were able to achieve incredible results inside the learning curve well before we had the current understanding of deal prosthetic placement and advanced operative technique which newer surgeons now have.
So yes Gazza if we really want HR to remain an option we also have a responsibility  to support and encourage those up and coming talented surgeons who like us advocate and know the advantages of HR to pick up the baton and develop Hip Resurfacing into the future.
Regards
Toby

[toby]

oops line should have read and HR would have missed out on the talents of Gross, Su, Bose, Brooks, Antonio, Kim, Pritchett, Rogerson, and even further afield..Shiminn, Blackley, MacMahon et al cos there are numerous others

[DeviceGuy]

You really have nothing to worry about with Dr. Gross and company steering your ship.  They leave nothing to chance as I'm sure you've discovered.  They tell you and/or put everything on paper that you need to know for your prep and recovery.  With no worries on the administrative and prep front you can just focus on your comfort and getting well.  Take it slow, if in doubt - don't do it, and don't be a hero.  You want this to last your lifetime so let things heal and in due time you're back to as normal as you could hope.  This is coming from a guy who is 13 weeks out and loving every day for being pain free and my decision to finally do something about it.  You did all your homework, now let it be!!!
Stay ahead of pain with meds, ice is your friend, let family and friends help you, and GOOD LUCK.

[hernanu]

Hello all my name is Elliot and a police officer for the royal Canadian mounted police. I am 43 years old and ten weeks bhr right hip. Well what a ride it has been so far doc had complication due to muscle size 14 inch incision hard time getting cup on no femoral neck. Had bad recovery had bad medication Withdrawels what ever has been talked about had happened.  Going for check up in calgary used Dr Jim Mckenzie. All I can say Matt is it all is worth it still limping a little but way better then before. Have hard time deciding what I can do what I cant. Doc said have at er just stay away from impact stuff for ah wile. The hardest part for me is the emotional part. We are trained to help the public give our lives without hesitation and now we are the helpless ones. Not a good feeling. Got help for depression and right now I am starting to believe fellow hipsters.  It does get better. Matt all I can tell you is it is better anytime you want to talk feel free good people out there.  One thing I will say is don't listen to much to the people that are running twenty miles 4 weeks post op. Not encouraging at all!!!  Lol fellow police officers remember we act and are trained to think we are impenetrable but remember we are human. Glad to finally be on the site.

Congrats and welcome ... I had depression fro a few weeks both times, the second even while knowing it would come. It just seems to be the case for some hippies. It was truly gone, and then you enjoy the improvements.

Everyone is different in their recovery; you want to be well healed before you try to put stress on it, which is why my surgeon had me wait six months to bear more than 50 lbs of weight, and a full year before I returned to heavy duty martial arts.

It seems awfully long, and some folks can do more earlier, but for me that seemed best.

[Tim Bratten]

Here's my take: if it doesn't cause pain (I'm not talking about short term muscular soreness that goes away) and you enjoy doing it, then hiking up and down four miles with poles at ten weeks is good for what ails you. Be careful not to take a spill and go for it. If it causes pain, then step back, take it easier and try for less. But keep walking. 

From what I can tell, most of the top resurfacing surgeons seem to think that walking is the best rehabilitation you can do. For someone who is in reasonably good shape and not having difficulties with their recovery, four miles up and down with poles at ten weeks does not sound at all excessive to me.   
Cheers
Tim

[Comfortably Numb]

First let me say that I have absolute confidence in Dr. Gross and his selection of hip resurfacing devices.  If this question involved anything more than semantics, I would direct it to him or Lee.  That being said, as I read this website with particular attention directed towards those of you who have used Dr. Gross, I get very confused concerning system terminology. 

For example, my surgical order specifies Biomet, and the FAQs indicate that I will have a Biomet uncemented metal on metal hip.  When I look at what some of you say you have, I generally see one of the following:  Biomet; Biomet Uncemented; and Uncemented Biomet Recap/Magnum. 

In looking at one of Dr. Gross' more recent abstracts, I see this terminology used:
"Hip resurfacing with the Biomet Hybrid ReCap-Magnum system: 7-year results."
http://www.ncbi.nlm.nih.gov/pubmed/22595183
And then when I look on the internet, I see all types of legal issues with the Biomet M2a Magnum.
http://www.drugwatch.com/hip-replacement/biomet/

Can anyone shed some light on what this thing(s) I'm getting is called? I know that it's Biomet and I know it will be uncemented (I assume this refers to the FDA approved femoral component).  I also know that the acetabular component will be uncemented, but I don't know what it is called.  And where does the "Recap Magnum" come into play?

It could be that my confusion arises from his "off-label" use of the acetabular component (if I'm correct about that), and maybe that's why he uses the term "hybrid."  Any clarification would be appreciated.

[Dannywayoflife]

Not a Gross hippy or anything but it's my understanding that Dr Gross has to use both components off label. I think this is because both are FDA approved however it's not approved as a system to work together. That may be where the "hybrid" part comes from? Your best bet would be to email him. He was very responsive when I have my first HR done and I was seriously considering Flying to the states to use him at one point.

[karlos.bell]

Hi Gazza.
Hopefully yes.  I will ask De Smet when I see him in end of April and get back to you.
See what he says. Cheers

[Simpatico]

Thank you all!!

Great responses! This has given me some level of comfort and a few thing to consider.

I did have that feeling that Dr. Shimmin was giving me the worst case scenario and will build from there.

Much appreciated.

[NYRFan19]

Hey thanks everyone for taking the time to read my long post, and to reply back with well wishes and advice. 

Well- tomorrow is it...D-Day...scheduled to be at the hospital for 7:30AM with a scheduled surgery time of 10:30AM.  Hope everything goes according to plan and schedule, and hopefully this time tomorrow I will have good news to report.  Still extremely nervous for the surgery and have all kinds of crazy thoughts running through my mind like will it work, will I end up with a THR, will I regret surgery, but I imagine that this is all common. 

[DeviceGuy]

The Biomet Recap femoral component, was approved by the FDA for use as a Hemi resurfacing where only the femoral head is resurfaced and capped but the acetabulum is left intact.  Problem was and is that there is much accelerated wear on the acetabular cartilage and there are poor outcomes in general.  It is not used in that application much if at all anymore.  The FDA approved Magnum metal acetabular cup was used with a total hip replacement system that was discontinued by Biomet because of the MoM controversy and our litigious society.  Dr. Gross has "married" the two approved components to create a complete resurfacing system, Recap/Magnum.  This system is not FDA approved as a unit and so must be used "off label" or for use other than it's approved status.  It is completely legal for the physician to do this.  It is kind of like not having a UL listing for a product but it is nonetheless reliable.  Dr. Gross's registry speaks volumes as to the worthiness of the Biomet System of which he had a hand in designing.  If you are a believer in HRA, MoM, and uncemented components,  Dr. Gross is your man.  I hope this helps and please chime in fellow hippies if I've overlooked something.

[Comfortably Numb]

The Biomet Recap femoral component, was approved by the FDA for use as a Hemi resurfacing where only the femoral head is resurfaced and capped but the acetabulum is left intact.  Problem was and is that there is much accelerated wear on the acetabular cartilage and there are poor outcomes in general.  It is not used in that application much if at all anymore.  The FDA approved Magnum metal acetabular cup was used with a total hip replacement system that was discontinued by Biomet because of the MoM controversy and our litigious society.  Dr. Gross has "married" the two approved components to create a complete resurfacing system, Recap/Magnum.  This system is not FDA approved as a unit and so must be used "off label" or for use other than it's approved status.  It is completely legal for the physician to do this.  It is kind of like not having a UL listing for a product but it is nonetheless reliable.  Dr. Gross's registry speaks volumes as to the worthiness of the Biomet System of which he had a hand in designing.  If you are a believer in HRA, MoM, and uncemented components,  Dr. Gross is your man.  I hope this helps and please chime in fellow hippies if I've overlooked something.

This helps more than you'll ever know.  I've had bits and pieces of this explained to me before but I've never really been concerned about any of it because of my confidence in Dr. Gross and the fact that I could care less about the FDA (I'm paying Dr. Gross/Lee out of pocket because I'm on Medicare).  I think the term "Magnum" has peaked my curiosity lately because of the M2a Magnum controversy.  Are you saying that the Magnum cup that was discontinued by Biomet because of MOM issues (maybe it's the M2a??) is not the same as the Magnum cup that is part of Dr. Gross' marriage?  Must not be, otherwise there would not be two approved components.  Thanks

[ecchastang]

Good luck with surgery and keep us updated. 

[DeviceGuy]

If I'm not mistaken the Magnum 2a is synonymous with Magnum.  The 2a was a THA system of femoral and acetabular components.  Dr. Gross may have had modifications made to the cup in some fashion but I don't know that for a fact.  The Magnum 2a was not recalled but removed as a sellable product system.  Now the Recap/Magnum are sold individually and used as a system off label.

[Comfortably Numb]

If I'm not mistaken the Magnum 2a is synonymous with Magnum.  The 2a was a THA system of femoral and acetabular components.  Dr. Gross may have had modifications made to the cup in some fashion but I don't know that for a fact.  The Magnum 2a was not recalled but removed as a sellable product system.  Now the Recap/Magnum are sold individually and used as a system off label.

Thanks again for your help with this.  I think you are exactly right.  This is a fairly recent bio of Dr. Gross, and it also clarifies the issue:
http://www.grossortho.com/doctor.htm

[JHippy]

Yes he combines two different components (I never asked why). Looking at my operative report it says I got the Biomet Magnum acetabular component and the recap HA femoral component.

[JHippy]

Keep your thoughts positive and good luck!

[DirkV]

I just celebrated my 7 yr anniversary with resurfaced hips. I was a "staged" bilateral, with the 2 sides done 5 weeks apart, the 2nd one on March 31, 7 yrs ago. I long ago reached the point where I don't think about my hips when considering any physical undertaking.

With the negative press about resurfacing in general and ASR in specific, I want to give the good report on my 7 yr anniversary. I just reread my hip story from 7 yrs ago that Pat has hosted to remind myself of the early days (http://surfacehippy.info/hipresurfacing/stories/dr-ball/212-dirk-van-dyke-bilateral-hr-dr-ball-2008)
The summary for me is that the surgery has been very successful. It's almost a cliche to say "it gave me back my lifestyle," but that is the case.

Before surgery: Daily movement was painful. I recall getting irritated doing house chores such as mowing the lawn, just because of the pain.
Now: On the eve of my 7 yr anniversary (for my 1st resurf), I took a 4-day weekend to participate in building a home in MX - kind of a Habit for Humanity lite. I was sore in lots of places, but no problems in hips. Had a great time. In fact, I've done this every yr since the resurfacing.

Before surgery: Quit hockey. Hung up the skates approx a yr before surgery, due to pain and diminished level of play.
Now: Playing hockey again. I didn't start again until a good yr after surgery. I get up to 2-3x per week, until my body starts telling me that's too much for somebody over 50, and then cut back to once or twice per week. (If you are a goalie, and show up, you can play as frequently as you want.)

Before surgery: I recall going on a hike with family friends, a month or so before surgery, knowing that I'd turn around after 1/4 mile and go back to the trailhead and read a book.
Now: I've hiked the Grand Canyon a couple times post surgery. In a couple weeks, I'm taking a short 4-day vacation to hike remote canyons in Utah. It's great to get this back.

The only thing that's a bit of a cloud is the ASR. I geeked out on research, and I feel that J&J put profits ahead of patients in withholding or minimizing known problems. If those concerns had come to light, I would have requested a different device. It seems that the ASR design is intolerant of sub-optimal placement. So perhaps my research on selecting a surgeon trumped the device selection. Or maybe I'm just lucky. Knowing what I know from following the legal proceedings, even though my resurfacing is fine so far, my gratitude is mixed with ill feelings towards J&J. It's kind of like they played ~85% odds russian roulette with me, twice.

But I'm going to enjoy my blessings and get out from under that cloud. Thanks to Pat for hosting the site, and Vicki (wow, time flies, the community certainly misses her) for all she did for resurfacing, and Chuck for his concern and advocacy.

On this forum, I'm kind of in that camp of people who have had a successful surgery and gradually fade away, as hip functionality and lack of pain becomes normal.
It's been a great 7 yrs with fake hips (well the first couple months were a bit of struggle, but mostly forgotten now).

[Dannywayoflife]

Congrats Dirk. I hope you have many years ahead of you with your shiny fake hips

[JHippy]

Congrats, Dirk! 7 years! We don't hear too often from the long-timers, loved reading your story. Glad you didn't have problems with the ASR.