Options with 46mm bhr appliance no longer available

[doclacey]

I had my right hip resurfaced by Dr. Rogerson in 2012 via BHR with 46mm appliance and it's been great.  Now my left hip needs to be done.  My challenge is I am 52 active in impact sports (dirt bikes, snowmobiles, ..) and with smith's recall  I cannot get BHR done.  I would like feedback on other options and any data on those options.  I really do not want to do a full hip replacement at this point in my life.

Thanks

Joe

[Pat Walter]

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

[doclacey]

You mention Mr McMinn, how is that possible since bhr < 46mm was banned in UK?  He would be my first choice if I went over sea's.  I am disappointed that more docs in US aren't working around bhr ban on < 46mm.  It is also sad to me that as a patient I cannot give consent to surgery with appliance of my choice, seems like it's my body after all.  I guess I am just very frustrated since my right hip feels great and now I am stuck in pain.  I am looking into Dr. Gross but if my insurance doesn't cover it I do not have a spare $30k lying around.  Not blaming him, US medical system is very broken.

[karlos.bell]

  Yo doclacey.
So is the the NZ system. Cost me about $90,000 NZ to get sorted and I had to sell assets I had built up. There was no refund from our government. I would have sold my house if that got me back on my feet and it did. Keep at it see what you can come up with..... Cheers K

[MattJersey]

You are right Mr McMinn can't do the small sizes anymore either. But ... he does have his new metal on poly resurfacing which could be of interest. (Not for me, I admit.)


In Europe I would visit de Smet who I think uses Conserve. In the US purely based on all the positive feedback on here, I'd go to Dr Gross.


Cost: in UK you would be looking at £14k or so with McMinn, in Europe something similar with De Smet.


What price Dr Pritchett in US? He would also be an option with alternative to mom, I think he offers a metal on poly and his reputation is also excellent.


Matt

[Mcopt]

Hi doclacey totally agree where you are coming from. I am booked to see Mr McMinn in November for bi-lat BHR fortunately I can have a larger size so going MOM however Mr McMinn is now offering the BHR with a cross linked poly cup that may be worth exploring he also does a mid section replacement which could possibly be a good compromise. Do have a look at his website it is very informative and his staff are very helpful and approachable as he is .
Good luck I really hope you find what you need.

[catfriend]

I'll also add my recommendation for consulting with Dr. Pritchett. He resurfaced my hip in January 2016 with the synovo preserve device mentioned in a couple of posts above. It's not MoM, but ceramicized titanium with highly cross linked polyethylene. My results are excellent. He also uses the BHR, and has experience with revision, etc etc. A consultation can't hurt. With open enrollment season for insurance coming up you might be able to choose a plan that includes a doctor that can do your resurfacing, even is said doctor is out of state.

[doclacey]

I want to thank all of your for your advice, I will definitely look into all the options that were suggested.  Right now I am primarily looking at Dr. Gross, but I will definitely look at other suggestions I picked up here before pulling the trigger.  Do any of you know if the poly liner options allow for replacement of just the liner, if so that would be interesting to me.  Not ready to give up riding dirt bikes.

Thanks

Joe

[catfriend]

If I remember correctly Dr. Pritchett did mention that just replacing the highly cross linked polyethylene component was possible in a revision. If going this route be sure to ask.

[John C]

I would offer one thought on the topic of replacing a poly liner. If it has worn out, this means that there is a fair amount of poly debris in the area which could mean osteolysis issues as has traditionally been the case.
It is an appealing thought to be able to replace just a liner as has been the case with poly liner THRs for years. However, I think that this statement needs to have the follow up thought that the poly in the old liner did not just evaporate, and the body does not do well with disposing of poly wear debris whose common side affect is osteolysis. Hopefully the new cross linked poly will not have enough wear issues to require replacing a poly liner. My understanding is that the new poly products look very good in the short run, but I have read some studies showing oxidation issues that can kick in with some products after about 15 years. I have no idea whether this would be relevant to the poly liners used by Dr Pritchett.