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The Hip Talk Discussion Forum was hacked a few weeks back. It has taken me a long time to fix it. The only backup I could use was way back to April 2020. All members and posts up to that date are available. Anything newer has been lost. I am sorry, but that has been the only way to get things up and running again.

Author Topic: Choosing a Hip Resurfacing Doctor  (Read 81516 times)

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Pat Walter

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Choosing a Hip Resurfacing Doctor
« on: August 17, 2008, 04:43:38 PM »
You will often hear me and some of the other Surface Hippies recommend that you use the really experienced hip resurfacing surgeons.  There have been published medical studies to indicate there is a steep learning curve for hip resurfacing surgeons.  The really experienced hip resurfacing surgeons all had a few revisions in their early surgeries.  Most of them were doing hip resurfacing before there was as much formal training like there is now.  They had to do more experimenting to learn how to get the job done properly.  There was less instrumentation to help surgeons place hip resurfacing devices than existed for THRs.

All doctors have to learn to do hip resurfacing.  It is a much more difficult surgery than a THR.  Some doctors can learn after doing 20 surgeries and other might take 200 surgeries.  Some decide that hip resurfacing is just not for them and prefer to do THRs so the patient has a good outcome.

The survivorship rate of the BHR used to be 99.8% according to some McMinn studies.  Some informal information now indicates that the survivorship rate might be 96% and I had one doctor tell me he thought the revision rate for the US was 7%. None of these numbers are from published medical studies. It does make common sense that it takes time to learn to do a complicated surgery consistently.  I have heard the better know doctors say this. Some mention this in their videos interviews on Surface Hippy. http://surfacehippy.info/category/surface-hippy-videos/doctor-interview-videos/

In an effort to help people have good outcomes from their Hip Resurfacing Surgeries, we often tend to suggest the most experienced surgeons.  There is little chance of serious post op problems.  Many people can't, however, always go to these surgeons.  Also if we only had a small handful of surgeons performing hip resurfacing, we would all wait years to get our surgeries done. Some people have to go to the doctors that are in their insurance plans which often include many of the newer surgeons. Some people just can't travel far distances or just don't want to travel to go to the more experienced surgeons.  We are all different in our feelings and opinions.

Therefore, many people successfully use the newer surgeons.  Most have successful surgeries and recoveries.  Even if the odds say 4 out of 100 will have a revision, that is still pretty good odds.  That means 96 people will have successful surgeries.  Similar odds were given to my husband going into his triple bypass surgery.  5% chance of death or very serious complications.  We felt that the odds were in his favor.

There are many discussions about doctors' surgical approaches, hip capsule preservation, best type of hip resurfacing devices and the cement/cementless issue.  Many doctors have different post op protocols where some let you be 100% weight bearing immediately, others make you partial weight bearing for six weeks. Some keep you on walkers while others allow you to use one crutch or a cane post op.  No one can say what is best for each individual person. No one can say what is the best approach for each surgeon to perform successful surgeries.  Many of us had an experience with our doctor and we feel it was the best, so we want to share that with everyone.  We want to see everyone have an easy surgery with a quick recovery.

Unfortunately, not everyone has the same experience.  That may be due to our individual bodies, problems before surgery and our doctor’s techniques.  It is difficult to separate the individual problems in such a complex situation and know why we all differ so much. 

Therefore, we each have to read, talk to the doctor and make our own decisions.  It is good to know others experiences, but each person has to feel good about their doctor.  They need to have faith that they have chosen the best doctor which in turn makes all the important surgical decisions for them.  Sometimes people choose the experienced surgeons and sometimes they choose the newer doctors.  We all have to respect each others decisions.  If no one ever used the newer surgeons, they would never become experienced.  All the doctors started in the same place - doing their first, 10th or 50th hip resurfacing surgery.  They all take the same path.  People need to decide what is most important to them and choose the doctor feel will do the best for them. 

PS.  I wanted to comment on this because we somtimes get carried away with our own experiences and don't understand how other people feel.  We should always support each other in our choice of doctors.
« Last Edit: July 05, 2016, 02:45:22 PM by Pat Walter »
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JulieB

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Re: Choosing a Hip Resurfacing Doctor
« Reply #1 on: December 01, 2010, 05:03:49 PM »
I have read of the importance of having an experienced doctor perform the hip resurfacing surgery.  This is my dilemma.  My insurance will pay to have the PA doctor who has done less than 100 hip resurfacings do my surgery, but it will not pay to have the MD doctor who has done over 2000 hip resurfacings do my surgery.  I was hoping to have surgery last year around this time so I have postponed this long hoping to be able to have the MD doctor perform my surgery.  Should I continue to wait or go ahead and have the surgery?  My activity level is significantly hindered.  I would like to have about 6 months under my belt before the summer as I work at camp in the summer.

jgenese

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Re: Choosing a Hip Resurfacing Doctor
« Reply #2 on: December 02, 2010, 12:16:10 PM »
That doesn't make sense to me. I would think it would be the other way and them wanting to pay for experienced only.
Is that something you can work out with your MD and have them talk to your insurance company?
As far as the timing of your surgery...it is time! Tomorrow will be 6 weeks post op and things are getting back to normal without that annoying pain that I felt before surgery. That's completely gone. Just getting the muscles back into shape and that's feeling pretty good. You deserve the same! Talk to your surgeon. By the way, what do you have for insurance?

23109VC

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Re: Choosing a Hip Resurfacing Doctor
« Reply #3 on: January 07, 2011, 07:05:57 AM »
i am about to get hip resurfacing and I also live in Riverside.  I was seeing Dr. Tooma at Inland Vallley... he flat out told me that he thought I needed hip resurfacing, b/c of my age (38) but he told me doesn't do it and no one in his group did...  i was eventually refered to a guy in Los Angeles named Dr. Bengs.  I met with him, very n ice guy, but when I asked him how many hip resurfacings he had done, he said 30.  I think he coudl tell that that wasn't what I wanted to hear... I never went back.. maybe he is a great surgeon..but I want someone who has more experience under their belt...

petition your insurance to see someone out of county if you can.  another option is to change insurance.  that's what I did.  my HMO sent me to the guy in LA who only had 30 surgeries.  I am paying more per month, but switched to a PPO plan and I can see whoever I want prettymuch.  Ddr. Gross, Schmalzreid, and many of the other "top" guys are all "in network" ... but that's with a PPO...

can you switch plans?  if you can't swtich, and you don't like who the HMO is giving you, you can petition them.  ultimately all the HMO caresa bout is $. if you can find out what the out of county doc wants..and it's the same as the in county doc... why shoudl they care... if the costs are the same then they probably woudl be more inclined to approve it...

good luck.
Sean
Dr. Gross- Biomet uncemented, 2/23/11

kach4

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Re: Choosing a Hip Resurfacing Doctor
« Reply #4 on: January 13, 2011, 04:24:19 PM »
I am a newbie on this site.  In October, after an ex-ray revealed severe osteoarthritis, I started to explore the options of hip replacement.  I didn't know anything about hip resurfacing and was spending a fair amount of time looking at the different surgical approaches and their pros and cons.  After meeting with a highly regarded surgeon in the Minneapolis/ST. Paul area, he suggested that I might consider resurfacing.  I then waited over two months to meet with a surgeon named Thomas Nelson.  He looked at my ex-ray, and told me I was a candidate for either resurfacing or replacement--it was up to me.  He has done 150 resurfacings, but only operates one day a week.  We set a surgery date, and he told me to let his staff know three days before surgery what I wanted the BHR or THR.  We spent a total of 15 minutes in his office.  After doing serious research this week--I am really nervous about this particular doctor.  I have tried to get into see a Dr. Palmer in Stillwater, but have to wait three months again!  I can see a colleague of his Dr. Pancek in two months. Has anyone had experiece with Dr. Thomas Nelson?  I am in a lot of pain every day and the waiting is difficult.

Mi Corazon

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Re: Choosing a Hip Resurfacing Doctor
« Reply #5 on: January 19, 2011, 04:02:13 PM »
I live near Minneapolis and St. Paul and have researched doctors in this area extensively.  I believe that Dr. Nelson is one of the better ones in the Cities, but I have no first hand info or research on him and suggest you keep digging.  I've been to Mayo and Dr. Palmer, as well as St. Croix Orthopaedics.  I have to say this:  Do not pin your hopes on Dr. Palmer.  He is 70 years old and I know a person who works in the unit where he performs surgeries.  Lots of post-operative bleeding and problems.  He is willing to operate at the drop of a hat and gets it done, but makes kind of a hash of it.  That is the inside story.  I don't know anything about Pancek.  Really, your best bet and the one I am going to use is Dr. Rogerson in Madison.  He is highly professional, has a great staff and knows what he is doing.  Plus, he has thought about all aspects of the surgery, including using a warm-water pool during rehab to increase ROM.  That's the best doctor I've found in this area.  Mayo -- don't even think about them.  I'll post the full story soon.

All the best,

kach4

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Re: Choosing a Hip Resurfacing Doctor
« Reply #6 on: January 22, 2011, 04:53:32 PM »
Mi Corazon,

Thank you for your response!  I just can't get a read on Nelson.  I did go see Dr. Panek (Dr. Palmer's associate) and was very impressed.  But everything I am reading kind of points to Rogerson.  How long did it take you to get into Dr. Rogerson? 

Kimberly

Mi Corazon

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Re: Choosing a Hip Resurfacing Doctor
« Reply #7 on: January 23, 2011, 12:27:46 AM »
Dr. Rogerson has quite a waiting list.  By the time I identified him as the number 1 doctor, it was around the middle of December.  I didn't get a firm surgery date until December 21st, and by that time the surgery slipped all the way to March 21, so three months waiting list.  Dr. Rogerson takes some time off in the winter, and who can blame him with the weather we've had.  But, he doesn't operate the week before his vacation, in case there are problems post-surgery, which, shows some good sense.  Anyway, I think his operations are down for 6 weeks this winter, which explains why surgeries are so far out.  But, with people flying in from out of state, truth is, you'd rather have the doctor in demand than the guy with a lot of holes in his schedule.

dinabm

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Re: Choosing a Hip Resurfacing Doctor
« Reply #8 on: February 13, 2011, 03:47:34 PM »
Help!!  I am baffled trying to make decisions about my surgery.  6 months ago I had unsuccessful hip scope surgery that left me in worse pain then prior to the surgery. I am clear at this point that resurfacing is the way to go for me.  I am a 46 year old woman living in the Albany NY area.  Dr. Su is one option for me and I've scheduled a consultation with him for the end of April (soonest I can get to see him).
  I've seen the only 2 docs in my area that I am aware of who do resurfacing.  One does BHR the other CHR.  I am leaning toward BHR just because I've been able to read more about it but not sure if that's a good reason to choose.  The other reason is I really did not like the doc who does CHR and he is in the same practice as the doc who did my unsuccessful surgery. (also not necessarily the right reasons). 
The doc I do like up here says he's done about 400 or more in the past 4 years but is not listed on this web site and does not have any statistics for resurfacing on his own website (Dr. Fletcher, Northeast Ortho,  any input). 
Part of my concern is that because there is an "experienced" doctor in my area my insurance company is less likely to approve Dr. Su in NYC, so I'm not sure what the out of pocket expense might be (even if they do approve I'll be in position of paying the difference between what they are willing to pay and what the actual cost is. I have not been able to get any clear information about what that will be yet.). 

I'm leaning toward the doctor up here because of cost and timing.  He can do the surgery before I can even get into see Dr. Su.  One of my concerns about Dr. Fletcher has been that he appears to underestimate the surgery so its hard to know what his success has been.  He said things like I could be back to work in 2 - 3 weeks, which seems contradictory to everything I've read and didn't seem to have a lot to say about any negative experiences he's had during surgery - that always worries me because I wonder what he's not telling me.  I always prefer people to be upfront and direct about both good and bad. 

My previous bad experience with hip scope is making me extremely cautious and I would appreciate any and all feedback that will help me sort this out.

thanks for all of your help.

Lopsided

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Re: Choosing a Hip Resurfacing Doctor
« Reply #9 on: February 13, 2011, 04:00:05 PM »
What is CHR?


Proud To Be Dr. De Smet's First Uncemented Conserve Plus, Left, August 2010

Dayton96

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Re: Choosing a Hip Resurfacing Doctor
« Reply #10 on: February 13, 2011, 04:01:05 PM »
Several quick thoughts here.  When looking at medical expenses, don't forget that while your insurance may not cover the doctor's fee completely, it may completely cover the hospital, etc.  So a little research is in order.  

A second thought concerning your comment about being uncomfortable with some of the responses, or lack of responses, from Dr. Fletcher.  I experienced some of the same problems when doing my own research.  I strongly suggest you find a doc you are comfortable with.  Have you take a look at Dr. Clarke in Syracuse?  He has done over 1000 HR and uses the BHR.  Would he be covered by your insurance?  

I chose Dr. Gross for mine, even though I have to wait three months to get it done.  I think I preferred to wait for the most experience surgeon who was busy, as opposed to a local surgeon who had done quite a few less and who was readily available.

A last thought.  Why call you insurance company and explain your concerns and see what they say your options are?

Good luck,

Mac
Dr. Gross, Uncemented Biomet, Left, March 2011

dinabm

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Re: Choosing a Hip Resurfacing Doctor
« Reply #11 on: February 13, 2011, 04:02:09 PM »
Cormet Hip Resurfacing - still resurfacing but different product?  different technique (I think)

Lopsided

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Re: Choosing a Hip Resurfacing Doctor
« Reply #12 on: February 13, 2011, 04:04:49 PM »
Help!!  I am baffled trying to make decisions about my surgery... and I would appreciate any and all feedback that will help me sort this out.

As I mentioned earlier in this thread, find a surgeon who accepts you as a human being.

D.



Proud To Be Dr. De Smet's First Uncemented Conserve Plus, Left, August 2010

dinabm

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Re: Choosing a Hip Resurfacing Doctor
« Reply #13 on: February 13, 2011, 04:15:11 PM »
thanks - Syracuse is just as far (and out of my insurance as NYC)  - the hospital coverage part is a good thought though I didn't ask about that part, which is probably the biggest expense I would think.  I did talk to my insurance company but didn't get any great information.  It was late Friday though so I'm hoping I might get a bit more when I call again on Monday.  My Primary care md has been great and she is trying to help me navigate through the insurance nightmare.  I'd hate for the decision to be financial but I'm guessing the cost could be in the tens of thousands.  

Does anyone have any info or experience with Dr Fletcher?

Pat Walter

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Re: Choosing a Hip Resurfacing Doctor
« Reply #14 on: February 13, 2011, 07:34:58 PM »
CHR - Cormet hip resurfacing
Webmaster/Owner of Surface Hippy
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Magnus

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Re: Choosing a Hip Resurfacing Doctor
« Reply #15 on: March 22, 2011, 03:26:25 PM »
Two words....Dr Gross...excellent.  I wish I would have gone to him the first time.

Denver_wrench

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Re: Choosing a Hip Resurfacing Doctor in Austin
« Reply #16 on: June 20, 2011, 12:30:41 AM »
I have just had a left BHR last week and am happy so far. My brother, who lives in Austin, TX will have to have a replacement soon and I wanted to be helpful. Can anyone recommend a Dr. who does resurfacing there?
LBHR June 9, 2011, St. Joseph's, Denver, CO

Jimdg

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Re: Choosing a Hip Resurfacing Doctor in Austin
« Reply #17 on: June 28, 2011, 12:23:09 PM »
I have just had a left BHR last week and am happy so far. My brother, who lives in Austin, TX will have to have a replacement soon and I wanted to be helpful. Can anyone recommend a Dr. who does resurfacing there?

The superstar here is Dr Shelby Carter.  All the doctors go to Carter.  Prepare for a long wait for surgery though.  It took me over six months once I got in to see him also a month wait for my first appointment.  Just had mine done on May 31.  I hardly know it's there now and have range of motion increases every day.  Totally pain free the first time in nearly 3 years.  Tell him to accept no on else. 

Denver_wrench

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Re: Choosing a Hip Resurfacing Doctor
« Reply #18 on: July 03, 2011, 05:18:56 AM »
Thanks, Jimdg...I'll pass this along.
LBHR June 9, 2011, St. Joseph's, Denver, CO

twday63

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Re: Choosing a Hip Resurfacing Doctor
« Reply #19 on: September 17, 2011, 07:32:46 PM »
I am in the Twin Cities of Minnesota. Before tripping over this website, I'd booked an appointment with Dr. Patrick Morgan. Does anyone have experience with him?

Also, I looked over the list of questions for surgeons on the Surface Hippy website but I'm not sure what sort of answers I should be looking for. Any advice would be greatly appreciated. I haven't been in a hospital since I had my tonsils out 55 years ago.

 

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