What's the plan when HR Prosthetic fails?

[suncag]

Hi Everyone,


     I have been putting off getting my left hip resurfaced for 4 years now.  I'm an active tennis player, 52 now and was 48 when the hip osteoarthritis set in.  I agree HR is far superior to THR and have met with Dr. Gross to discuss getting mine done.  I've tried everything to put off surgery (Hyaluronic Acid injections were the most successful out of everything I tried but after 3 rounds of them, they have lost their efficacy).  I recently tried stem cells and that did nothing at all. 


So my question is this:  Am I the only one who's asking "What's the plan after the HR prosthetic fails?"  I'm told that the most I can hope to get out of an HR is about 15 years if I don't play tennis (which is the whole reason I'm getting it in the first place) or less than 10 if I do play tennis.  So what happens when I'm 62, still want to be active and the HR prosthetic fails?  All I get for an answer to his is a shoulder shrug.  Isn't anyone else worried about the long term plan?  Is it just to get a THR?


Anyone who is willing to share their thoughts on why they went ahead with HR knowing that they would outlive the prosthetic, I would be grateful to understand your thinking.  Maybe I'm missing something? 


On another topic, has anyone looked into this "sleeve" breakthrough in Germany?

[/size][size=78%] [/size]
https://www.medica-tradefair.com/cgi-bin/md_medica/lib/pub/tt.cgi/Hip_joint_sleeve_versus_endoprosthesis.html?oid=84518&lang=2&ticket=g_u_e_s_t


 Is this what Andy Murray had done?  Or did he get a resurfacing?   


Many thanks!
Chris

[catfriend]

It's my understanding that an HR may not need revision. We're all a giant experiment. A resurfacing should last longer than 10 years, even if you play tennis (unless you have some sort of unusual infection or failure or something).

Still, I do realize I could outlive the prosthetic. So why have it instead of a THR? A) In the case of my prosthetic, only the polyethylene sleeve may need replacing. B) It may be possible to only revise to another resurfacing device. C) In the worst cast scenario of having to revise to a THR I still have my femur. I still have bone to revise to (not that I want to go that router). Problems are more likely when you are revising and don't have so much bone anymore.

[Matt Duffy]

It won't be long before some of the long term success stories post on your thread, some are nearly 20 years. And highly active, tennis included, throughout.


I think all resurfacing posters on this site would tell you they had resurfacing because it would give them a highly active life back. The idea of revision and inactivity is more associated with THR. So, if you talk to one of the experienced resurfacing surgeons I think you will get a different view from 15 years if you don't play tennis ...


That said, every case is unique, no guarantees. But the stats for resurfacing from a well experienced surgeon are compelling.


As for what happens if it does fail ... Well they remove it and you go to a THR. So the bone preserving benefit "buys you time" if nothing else.


One poster, Pappy, notes in this thread http://surfacehippy.info/hiptalk/index.php/topic,6324.msg58673/topicseen.html#msg58673 that Dr Pritchett fixed a failed resurfacing without reverting to THR.

[suncag]

Thanks very much, MattJersey.  Exactly the kind of insight I was looking for.  Ok, so my thinking is not too far off.  I will read Dr. Pritchett story as well.


Catfriend - can you tell me more about your polyehtelene sleeve?  I've just started to learn about this and did not realize this was yet a surgical option, but thought it was still in clinical trials.  Who was your surgeon, if I may ask.  And is your procedure similar to the one below:


https://www.medica-tradefair.com/cgi-bin/md_medica/lib/pub/tt.cgi/Hip_joint_sleeve_versus_endoprosthesis.html?oid=84518&lang=2&ticket=g_u_e_s_t


Many thanks!
Chris

[catfriend]

I had a standard hip resurfacing with Dr. Pritchett. He used the synovo preserve http://www.synovopreserve.com/ device on me. More info on Dr. P can be found on his website seattlejointsurgeon.com. He has published numerous papers, including on revising failed HR devices to another HR instead of THR. He has several videos on his website as well.

[suncag]

Thanks so much, Catfriend!  I will check all of that out on Dr. Pritchett's website.  Do you mind my asking how long ago your HR was done?  And if you are happily active on it again without issues?


thanks very much,
Chris

[suncag]

I finally did it!  This morning Dr. Gross resurfaced my left hip.  All going well so far.  Thanks Patricia and everyone else for all your support and help through this over the past few years!

[Pat Walter]

Congratulations on the new hip.  I hope your recovery goes well.  Would you start you new story and updates under the Hip Stories, maybe with a title like Suncag's Hip Resurfacing Story with Dr. Gross 2018    That way it is easy for new people to find stories about Dr. Gross patients and keeps your story in one place.


Meanwhile, good luck and take it easy.


Pat

[suncag]

Hi Pat,

    Absolutely I will start a new topic with this so I can share my experience.  So far very positive.  Actually in the car riding home already and surgery was just yesterday morning.  My wife driving me home. 

I will start that post from home tonight or tomorrow.

thanks
Chris

[Saddlepal3]

Suncag,
Been there, done that. I had my right hip resurfaced in 2006 by Dr. Pritchett. It was a wonderful procedure and I was completely happy. Last spring, an MRI showed that I had some fluid build up around the joint. Dr. Pritchett recommended a revision. I consulted with several surgeons and most of them agreed. One would have replaced the entire joint with a THR; two others would have replaced the femoral component with a device that looked like a THR piece. After significant consultation, I went back to Dr. Pritchett. He replaced the acetabulum cup and left the femoral component alone. That was on Sept 18, 2018. Recovery has been very smooth.
Because I have osteopenia, Dr. P recommended a 4 month course of Tymlos, which is a bone building drug normally prescribed to patients with severe osteoporosis. Since bone health is key in the longevity of any prosthesis, i decided to do that. Will see if it makes a difference. Am hoping to have my HR (and THR in other hip) for a long time. Am an active 67 year old female.