Six years later - is resurfacing still the way to go?

[tricky]

I had a very successful resurfacing six years ago and have returned to high activity singles tennis with no problems.  Unfortunately, the past weeks I have felt the unmistakable symptoms of impending failure of my other hip.  I'm sold on resurfacing and would not think twice about going the same way again, except a friend I referred to my doctor reported that he was no longer doing resurfacing because the technology had improved to such a point with a THR that the risks associated with resurfacing were no longer warranted.  I intend to make an appointment with the doctor and discuss this in person, but I'm wondering what everybody else's take is on this opinion.  Thanks.  I'm been off the website for several years but found it extremely helpful during my first procedure.

[blinky]

I'd go hear this doctor out and ask why he stopped resurfacing, but I'd still have one.


My hips are almost two years old. I talked to both resurf and THR docs. One THR doc did make a persuasive case for the procedure, telling me about newer, longer lasting devices and better surgical techniques. Best of all, he told me I could run post op. THR is a better option than it was six years ago.


However, it still suffers from a  few basic defects. First, you lose more bone and when it's gone, it's gone. Second, as a result, your hip won't feel as natural. (There is a study out there comparing the gaits of resurf and THR patients, and resurf patients move more naturally and feel better about their hips).Also as a result, the stresses of movement will go into your femur differently, causing you to LOSE bone with a THR and GAIN bone with a resurf. Pat just posted a clip about this, a McMinn presentation at ISTA. I am no expert, not an engineer nor a doctor, but I wonder if this would cause a greater likelihood of aseptic loosening, of the device coming loose from the bone. Even if your device can last fifty years, if it comes loose from your bone, you will need a revision.


On the side of having the THR, I'd argue that if you have problems someday, finding a THR revision specialist will likely be easier. Plenty of docs do THRs and those devices are abundant. Resurfs? The number of docs doing the procedure has decreased so it will likely be tougher to find a doctor who could revise you if needed.


I'd be curious when this doctor stopped resurfacing and how long he did it. There are some recent studies that show extremely good results of resurfacing FWIW. (The clip referenced earlier. Also Dr Gross has a recent study of dysplastic women, the hardest group to get right, with great results.)


Good luck. I am sure you will pick the best option for you.

[Joe_CA]

Hi Tricky,

My experience with physicians that I encountered during my ordeal (with the exception of the surgeon who ultimately performed my hip resurfacing surgery) leads me to be skeptical to any and all opinions and recommendations that are critical of, or lead you away from,  hip resurfacing.

A couple of your statements lead to more questions. First of all, you're already a successful and satisfied resurfacing patient, so you know of all the benefits. Secondly, I'm not specifically aware of new total hip replacement "advancements" that can compete with hip resurfacing for patients who want to return to high impact sports. I am aware of "big ball" THR devices, which can offer more stability and less risk of dislocation. However, as far as I'm concerned, they still can't compare to the stability and longevity of hip resurfacing devices.

My Spidey-Sense tells me there may be another reason your physician no longer performs resurfacings (beyond the THR advancements assertion). I won't make an opinion on the skills of your surgeon, but there's a chance he's had problems with prior resurfacing patients. I will also speculate that others here will provide similar concerns.

What I would do is reach out to other highly skilled surgeons (who perform many HRA procedures) and see what they have to say about any new advancements in THR surgeries/devices. I'm assuming you want to continue to pursue relatively high impact sports. I would be surprised if an experienced resurfacing surgeon would recommend a THR.

Let us know how it goes.

Joe

[Pat Walter]

Hi Tricky

Here is a post I just made to another person:

There are still surgeons doing hip resurfacing for women and small men.  Here is a group of articles which discuss that

http://surfacehippy.info/category/hip-resurfacing-for-women-and-small-men/

In the US, Dr. Gross, Dr. Pritichett and Dr. Su are still doing women and small men with other devices.  Then you also have the option of going overseas to surgeons like Dr. De Smet of Belgium, Mr. McMinn of UK and others.

Do a little searching and you should be able to find a surgeon.  Most people do have to travel to get a hip resurfacing.  Most the surgeons above will do an free email consultation if you send them a copy of your x-rays in a digital format.

I hope that helps.

Pat

[tricky]

Thanks everyone for your thoughtful inputs. I remember how useful this site was when I was doing my initial research, and nothing has changed. I regret not periodically monitoring the site during my "good times" to offer input of my own, but I will improve this time! I will talk to my former Dr. And see what he says but I am also fortunate to live about 90 miles from Dr.Gross.  The other factor I didn't mention was I am 73 but just competed in the national clay courts tennis championship so would like to believe I still have tennis in my future.