Dr. Su or Dr. Gross?

[mh]

I'm choosing between Dr. Gross and Dr. Su for a single hip resurfacing sometime in the next few months.  I have done my homework and they both appear to be extremely gifted surgeons with plenty of HR experience and many positive outcomes.  Two great options!  But still, need to choose!

I'd assume others have faced the same choice.  If you went down this same path, would you be willing to share why you chose one or the other?

My background, in case it's relevant - mid-40s, male, used to be a semi-serious distance runner, hip fell apart a little while back.  Only one operation needed now but the other hip isn't too far behind.

Cost is about the same between both surgeons / not the driving factor in any event.  I'm traveling about the same distance for each and I don't have family in either NYC or South Carolina, so again, no different in convenience between the two.

Goals are diminished pain, getting back to active (as much as possible), and keeping the new hip for as long as possible -- pretty much the same as everyone else on this board, I'd imagine.

Thank you for sharing your knowledge!

[Saf57]

You will be in great hands, and achieve your goals, with either doctor. As you already know from your research, these are two of the preeminent resurfacing surgeons in the world. The difference will be in the device. Dr. Su uses the BHR, while Dr. Gross uses a Biomet device that he helped develop, and which utilizes a cementless femoral component, as compared to the BHR's cemented component. Dr. Gross believes there is a theoretical, but as yet to be proven, advantage in using an uncemented femoral component. The developers of the BHR(McMinn, Treacy) would likely disagree. You can read about it yourself both on this site and elsewhere, and judge for yourself. And perhaps others on this site will add their opinion. The bottom line is that these are two great surgeons, and both the devices they use have a demonstrated track record, albeit the BHR is somewhat lengthier.

[Rn2md]

Hi mh,

I went through the exact same choice very recently. They are both extremely talented and it’s a win-win scenario in my mind.

I ended up picking Dr. Gross, but it was a very challenging decision. I obsessed over it for months.

There are very compelling and valid arguments you could make in choosing one vs the other.
Have you sent each of them your information and been accepted by each yet?
If so, have you spoken with either of them?

In making my decision, I went through the following factors, in order of highest to lowest priority;
1. Surgeon experience and published results
2. Type of implant and results
3. Patient experience as evidenced by accounts on this site, as well as some videos of patient accounts online
4. Surgeons Pre and post op protocols and other technical factors (independent vs supervised PT, +/- pre op blood donation, type and duration of post op anticoagulation, technical surgical procedure factors like incision size and type of anesthesia techniques used, outpatient vs inpatient, published infection rates, notable athletes who are former patients, frequency of follow up visits and metal ion check ups, cemented or uncemented)
5. Insurance coverage and costs of procedure and accommodations
6. Convenience factors (IE location, airport accessibility, commute time and ease for follow ups)

After much research, I found there were many similarities, but the most important one was the results at least to the mid term appeared similar. I couldn’t find any published results of Dr. Su, but he did present some of his mid term results at a surface hippy meeting a few years back and they seemed similar to Dr. Gross’ published ones.

So since I concluded that the results appeared to be similar, I Reasoned that the rate of complications must also be similar. On HSS website, I saw that it’s rate of infection was 0.3 %, but that was probably from all procedures and surgeons combined. I couldn’t find Dr. Su’s rate, but surely it is low. Dr. Gross rate was 0.1% according to his last paper in 2017 on young adults <50.

I also looked at experience and Dr. Gross had several years advantage there. In fact, it says on Dr. Su’s website that Dr. Gross was one of the surgeons that Dr. Su learned from.

I liked how Dr. Su used the most common implant with the most literature documenting its successful use.

I didn’t necessarily prefer to be in a hospital, but I did like how HSS had the reputation of being the best in the country.

Dr. Gross’ outpatient protocol with an uncemented implant seemed like a progressive, cost effective and logical approach to the procedure. It seemed ahead of its time, in a way.

Although the Biomet implant he uses seemed inferior to the BHR in the Australian registry data, the surgeons using it there probably weren’t as talented as Dr. Gross, since his own data is comparable to the BHR data. Additionally, the cement in the BHR implant seemed like an eventual cause for loosening somewhere down the line. So I reasoned that the uncemented implant might have an advantage in the long term. But there was no long term data to support that hypothesis though.

I also liked the smaller incision and less invasive approach that Dr. Gross uses. I saw a you tube video on Dr. su’s procedure where he needs an incision about 8 inches, which seemed large. Personally, I thought I would prefer a smaller incision, all else being equal.

Also, the Belair guest hotel next to the HSS hospital was at least $600 per night, and Dr. Su’s protocol is to have the patient stay in NYC for 9 days before being released.
In contrast, Dr Gross has you staying 1-2 nights in the Residence inn for $130/night for the outpatient option, before being released home.

Dr. Su wants his patients to do formal PT for several weeks after surgery. Yet Dr. Gross has an independent, self driven PT protocol. I liked the latter option, since I wouldn’t need to manipulate my work schedule around multiple PT appointments.

I did like how Dr. Su happens to operate on notable celebrities and athletes.

I also liked how Dr. Su’s PA was always available by phone or email to answer questions or address concerns

I didn’t particularly like the idea of donating blood preoperatively to automatically decrease my blood count, like the HSS protocol calls for.

The hypotensive spinal anesthesia technique at HSS scared me a little, particularly when I would have already donated blood preoperatively.

I honestly think one of the biggest deciding factors for me was the direct phone call to me by Dr. Gross. It gave me a chance to get the measure of him as a doctor. Additionally, his taking the time to call me personally when it wasn’t guaranteed that I would use him, really gave him an edge in my mind.

It made him more of a known quantity, for a major procedure that I was concerned about.

That’s what really made the difference for me.

Anyway, these are all personal preferences. They are both obviously great surgeons and I’ve read many great accounts both both surgeons.

I think it will be key for you to go through both surgeons in a systemic fashion with your own priorities in mind.

Then hopefully you will be able to come to a decision you’re comfortable with.

[mh]

Saf57, Rn2md -- Thank you very much for all the extremely helpful info!!  I figure the data that Gross publishes + # of procedures he's done + the potential upside to uncemented balances out the fact that he is using an unusual device.  I do put some stock in the # of pro/elite athletes that have gone to Su -- they have the incentive / resources / connections to make a well-considered choice (or perhaps they just prefer a trip to NYC to a trip to South Carolina...).

Thanks again to both of you! 

[blinky]

Either one would be a great pick and you have been given some comprehensive advice.

I would have gone crazy staying in a hotel for nine days post op. I wanted to go home asap!But different strokes for different folks. If my H had been the patient, he would have preferred staying in a hotel or hospital as long as possible. To be near the doc and be waited on.

[Rn2md]

Saf57, Rn2md -- Thank you very much for all the extremely helpful info!!  I figure the data that Gross publishes + # of procedures he's done + the potential upside to uncemented balances out the fact that he is using an unusual device.  I do put some stock in the # of pro/elite athletes that have gone to Su -- they have the incentive / resources / connections to make a well-considered choice (or perhaps they just prefer a trip to NYC to a trip to South Carolina...).

Thanks again to both of you!

You’re very welcome.
Deciding between those two great surgeons is daunting.
The uncemented vs. cemented and inpatient vs. outpatient might be helpful deciding factors, if you hold surgical skills and implant survivorship stats constant.
Experience also may be a difference that could be considered.
Both surgeons operate on all kinds of clients, including athletes.
As you suggested, location may explain at least part of the high profile client selection process. Or maybe differences in publicity, marketing, facility reputation, referral by another athlete, perceived surgeon reputation, and so on. We can’t know for sure. Yet, the significance of the facility reputation seems less clear if one were considering this as a potential outpatient procedure, with no inpatient stay.
I think many would agree that it’s the surgeon that is most directly responsible for the ultimate outcome.
That’s why at the end of the day, the surgeons outcomes and implant survival data are very objective items to fall back on as you decide.
If you meet or speak with each surgeon, you may find you’re more comfortable with one or the other, which could help a great deal.
Again, best of luck with the decision.

[Sboon]

I am just starting on this 'adventure' so weight my comment appropriately.... I considered Dr. Su as well. If you are smaller he will not use the BHR because they discontinued small sizes due to poorer outcomes. That means he will use Gross' Biomet. I decided on Gross vs Su for that reason; I would rather have the surgeon who developed the device put it in. Oh, and if you don't have insurance cost is definitely NOT the same - Gross is MUCH lower (but that shouldn't be the deciding factor). The food variety is probably better in NYC... ;-)

Good luck!
Sboon

[catfriend]

Would you like the orange or the apple?
Or the peach or the mango?
I think you're stressing about trying to make the perfect choice, as there clearly has to be one, right? No. They are both top flight surgeons. Neither is better than the other. Whichever you pick will be the right one.