Is it the Doc or the Device? Wright, Cormet, and BHR

[kriyamon]

 


I thought I was all approved by my insurance for resurfacing by Dr. Smalzried in March.  Iwasn't ready then but now I am.  They had to re-submit for approval.  The approval came through, but only for the two FDA approved devices, the BHR and Cormet. Dr. S. and it seems the best I read about use the Wright C+.  Dr. S will use the BHR, but does not prefer it...and has actually only performed one BHR operation.  He prefers the Cormet to the BHR but I'm told they are unavailable now because they are being "stamped" or something.  So        

So I've got to rethink everything again.  I have Blue Cross Blue Shield PPO which is pretty good, but they are saying all the other devices are experimental.  I don't know what exactly happened in March.

Are there stats on success of devices and doctors?  JRI says the procedures are basically the same but some "instrumentation" used to perform them is different.  I sure would feel more comfortable with a doc that uses the same device all the time.

Any advice.  I'm in South Central California and really can't afford to travel far or pay much.

[Pat Walter]

Hello

First and foremost - choose the best doctor you can.  That would be Dr. Schmalzried.  He is one of the most experienced in the US.  If you prefer to travel because your insurance won't cover your surgery, you can use Dr. De Smet ( he has done over 2400 hip resurfacings) or Dr. Bose ( he has done over 800 resurfacings)   They are about the 2 most affordable.  De Smet at about $17,000 total cost and Bose at about $10,000 to $12,000.

It is always the doctor's skill that is most important.  Hip resurfacing is much more difficult than a THR surgery.  The most used hip device in the world is the BHR. That is what is most often used in other countries.  That is why I think the FDA approved it first even thought there were no ongoing test using it in the US.  Over 60,000 people have had hip resurfacing world wide.

Dr. De Smet will use the BHR for as many hip resurfacings as possible. Most of his 2400+ were usually BHR unless the size was not correct. Then he would use the Wright c+ because it comes in more sizes.  The reason you might need a different size is because of your height.  If the doctor uses the wrong size, you will have a leg that is too short or too long.  Most people are more upset when they don't get a BHR.  I was with 8 others in Belgium when I had my hip resurfacing last year and most of us got the BHR.  One lady got a Wright C+ and was upset about it.  The hip devices are very much the same, but the instrumentation to put them in place is different. 

Here is a quote from my page about the Wright C+ http://www.surfacehippy.info/wrightcplus.php

The Wright Conserve Plus right offers 11 femoral head options compared to 6 by Smith & Nephew (BHR) and 5 by Corin (CORMET). The CONSERVEŽ PLUS femoral heads are also available in 2mm increments as compared to others than use 4mm increments. This greater range of sizes allows for better patient matching and more bone conservation.

In my opinion, which is not medically based but based on all the reading and studying I have done, that the doctor is the most important part of the surgery.  Dr. S is VERY skilled and I am sure would have no problem using a different hip device than he is normally use to using. If he were one of the surgeons just learning the hip resurfacing surgery, I would be very leary of using him.  But he is one of the best known in the US.

My friend here in Marietta, OH used Dr. S for his hip resurfacing 2 years ago.  He is doing absolutely great and would not have used any other doctor.

I think Dr S has given you an honest opinion of the situation.  He has not used the device much and the instrumentation is different - but he knows hip resrufacing inside out.

In the end however, you have to make the decision.  If you are not comfortable with the doctor of situation, you need to find a doctor you are comfortable with. 

All of the Doctors on my California list are expienced.  Many of the people from the Yahoo Surface Hippy Group of over 6000+ people have used them.  Maybe you should check some of them out.  None of them, however, will have more experience than Dr. S.   Here is the list:

Harlan Amstutz , MD
Joint Replacement Institute at St. Vincent Medical Center
2200 West Third Street, Suite 120
Los Angeles, CA 90057
213-484-7600 phone
213-484-7566 fax
jri@laoh.ucla.edu
http://www.jri-oh.com/

Scott Ball, MD -Trained with Amstutz 2006
UCSD Department of Orthopaedic Surgery
200 West Arbor Drive
San Diego, CA 92103
(858) 657-8200
Hillcrest
(619) 534-6312
UCSD Dr. Ball Website

Peter W. Callander M.D. - BHR Trained McMinn 2006
California Pacific Orthopaedics & Sports Medicine
3838 California Street Suite # 715
San Francisco, CA 94118
Phone (415) 668-8010
Fax (415) 752-2560
Email  pcallander@cposm.com

Dr. Robert J. Gilbert, M.D. - BHR Trained 2006
California Pacific Orthopaedics & Sports Medicine
3838 California St., Suite 715
San Francisco, Cal. 94118
http://www.cposm.com

Dr. Raphael Klug
The Permanente Medical Group
1600 Eureka Road
Roseville, CA 95661
(916) 784-5051
Website for Dr. Klug

Thomas Schmalzried, MD
Joint Replacement Institute at St. Vincent Medical Center
2200 West Third Street, Suite 120
Los Angeles, CA 90057
213-484-7600 phone
213-484-7566 fax
jri@laoh.ucla.edu
http://www.jri-oh.com/

Dr Keith Ure
Doctors Park
635 Lassen Lane Suite 100
Mt Shasta, CA 96067
530-926-521
Doctors Park Website

Dr. Thomas Parker Vail
UCSF Department of Orthopaedic Surgery
500 Parnassus Ave.
MUW 320 San Francisco, CA 94143
Phone: (415) 476.1166
Fax: (415) 476.1340
E-mail: calcagno@orthosurg.ucsf.edu
UCSF Website


Pat

[Sapita]

I live in Ohio.  I have found two doctors.  Dr. Victor Goldberg with University Hospitals.  He uses the Wright Medical T.  Has performed close (??) to 90. Trained with Dr. Amstedt.
The other doctor is Peter Brooks with the CLeveland Clinic.  Has performed 75 since last September and uses the Birmingham.

Have you heard anything about these doctors?  I am not sure who to choose.

Another Dr. in Cincinnati is Michael Swank. Don't know much about him
Thank you
In pain

[Pat Walter]

Hi

I live in Marietta OH.  I know of both doctors. I was going to have a consultation with Dr. Goldberg, but I did not have insurance.  I was also a 61 year old female with some loss of bone density.  So I decided to choose a really experienced doctor that I could sorta afford.  My choice was between Dr. De Smet in Belgium having done 2400 hip resrufacings and Dr. Bose in India having done over 800 hip resurfacings. They are 2 of the best in the world.

If I were you and could afford it, I would personally visit and talk with each doctor. You will get a gut feeling who is right for you.  Dr. Goldberg has been doing hip resrurfacing longer than Dr. Brooks. The type of device they use really isn't very important since it is the doctors skill that is important.  The Wright C+ is used a lot in other countries as is the BHR. A lot of doctors will normally use the BHR and if they need a different size, they use the Wright C+.

I was a little concerned 2 years ago when I read about Dr. Goldberg because I read a personal hip story by Joseph Waltenbaugh http://www.bananarepublican.info/Hip_Surface_Replacement.htm about his hip resurfacing. He had a problem and required a revision in the first year. 

I do know that every doctor will have a few more problems during their learning stage than after they are experienced.  So I was a little leary of using him.  But many have used him and are very happy.

It is a personal choice of how you feel.  You won't know until you talk with them and ask all the questions you can think of. Here is a list you can print to add to your own  http://www.surfacehippy.info/questionsfordoctor.php  The doctors should be happy to answer all your questions.  If they aren't, I would not feel at ease using them.  But again, that is only my personal opinion.

Keep us informed about how things are working out for you.  It will be nice for other people from Ohio to hear about your experience.

Here is one story someone sent to me that used Dr. Brooks  http://www.surfacehippy.info/lorijarosz07.php

Good Luck. A bad hip and pain keeps you from living your life.  You are on the right track to get a hip resurfacing if you are a candidate - get rid of your pain and start living again.
Pat