Considering BHR with Dr. Brooks

[petow23]

Hi,

I am 35 and was diagnosed with OA and impingements in both of my hips about a year ago. Been dealing with the pain for years, but just always thought it was tight hip flexors, groin, and lower back pain. I stay active by playing hockey, volleyball, and riding my dirt bike. I can still do all of them right now but my hips have been making it more difficult and they are usually really sore after any of my activities. My left hip is worse than my right and it is hard to put on shoes and socks. I am trying to figure out if I should just go ahead and get it done, or should I just keep dealing with it until the pain is too much.

I am not bone on bone yet. I just had an appointment with Dr. Brooks PA that said my OA would be considered moderate. Would it be best to get it done soon before my hips completely wear out and start causing other problems? I know that I am the one who has to decide when enough is enough, but just looking for opinions from anyone that might have been in a similar situation.

Also, I am already halfway to my maximum out of pocket expenses due to other medical issues this year. So that leaves me with about $3,100 max I would have to pay, as long as everything is covered and I get it done before the end of January. Not exactly sure what the total cost after insurance would be.

Thanks for any input.

[autoazure]

Dear petow23, I am really sorry to hear that you have moderate OA at the very young age of 35! Any hip replacement procedure is major surgery, look at some of the videos on Youtube of hip resurfacing for example. Also, if you are female then I would have even greater reservations regarding any procedure. In my humble, layman's opinion is that as you have diagnosed 'moderate' OA, I would consider rest and a period of non-weight-bearing activities. Take several months' or even up to a year of this. Return gradually to your sports and gauge how you feel. Also, scientific progress will eventually lead to the 'perfect' hip replacement procedure/bearing surfaces. I have had to go for a resurfacing at the age of nearly 63 however I managed to prolong my severe OA hip for 3 years by running less and by reducing my pace! I am now bone on bone and still run half marathons and do 55 miles at least every week! To finish, I would, if I were in your position, try a year of less intensity with plenty of rest and stopping as soon as pain is felt. A delay would also mean you could save up money for any future procedure. In Scotland, thankfully, we have our wonderful NHS and I go in for my resurfacing op on Wednesday 9th October in Glasgow! All the best for the future, Jim!

[catfriend]

I am going to completely disagree with autoazure.

First off, only you know how much pain you are in, and only you can make the correct decision for yourself.

If you are in constant pain, and the arthritis is affecting your daily activities (you say that you're having difficulty putting on shoes and socks), and your quality of life is affected, then have the resurfacing. There is no reason to suffer all the way to bone on bone. It's not going to make you a "tougher" or better person. It's just going to keep you feeling miserable until you have the surgery.

I was at bone on bone on my right hip. It was 24 hour a day misery. I had an orthopedist tell me to suffer for a few more years and then have a THR. I sought a second opinion, had it resurfaced, and have never looked back. My left hip is failing. I know it needs resurfacing, but it is not nearly as bad as my right hip got. I don't need to wait for it to be bone on bone. If I had insurance I would have already had it done.

That said, yes, this is major surgery. It is not to be taken lightly. All surgical procedures have risks. There is a significant recovery period. Not everybody has a fabulous outcome. Most contributors to the board are happy, but there are those contributors for whom resurfacing hasn't worked out. Everybody is different.

What your doctor describes as moderate may be severe to you. Your doctor can't feel how you feel. Only you can.

Good luck with the decision.

[autoazure]

Yes, I agree, we are all different however, petow23 has medically diagnosed moderate OA with impingements. What's causing the pain and how bad it is only petow23 knows. The decision has to be made by petow and the consultant. Resurfacing is not a quick fix for hip pain, it is a major surgical procedure used in my opinion as a last resort after other possibilities have been explored by a hip consultant (or indeed more than one). I just hope that petow23 is given the best medical advice appropriate to a person so young! I hope others on the website would be as kind as to give their opinion on this matter!
Regards Jim

[stevel]

Dear petow23,  have you had an mri?  This will more accurately diagnose cartilage loss and extent.  I had pain of about 3-4 on a scale of 10 after or during strenuous activities then finally during normal activities.  I had more a loss of function than pain with muscle atrophy, limping and tilted pelvis.  This was for my left side which I had resurfaced 11 years ago at age 55.  Now I've scheduled right side resurfacing on Nov 1 at age 66.  In the last year, arthritis progressed from mild to severe with bone on bone contact at the top outer edge of the hip ball.  Again the pain is tolerable  but I'm proceeding with surgery earlier than the left side since I know more and it's needless to keep wearing away the bones.  Dr Bose believes the blood supply changes from outside the bone to inside the bone for severe arthritis and thereby nourishes the femoral head for a resurfacing and ensures longevity beyond 6 years.  So an MRI will more accurately determine the extent of the arthritis.

[ahausheer]

An MRI might be beneficial. An impingement can tear the labrum and cause all of your symptoms including lower back pain. An MRI can usually see if the labrum is torn.  If it is, I would think endoscopic surgery to correct the impingement and tear would be your first choice assuming rest and physical therapy have failed. Resurfacing should be considered after less invasive therapy or surgery has been performed assuming it's even an option. Since you have two potential sources for pain (impingement/labral tear, and arthritis) I would rule the less invasive one out first. 

And don't let people on this site get competitive with you.  If you are having trouble putting on socks and shoes that is very significant and is not to be minimized. There is no place for someone who is capable of running 1000 miles a week, bone on bone, to tell you how bad your condition is or what you should put up with.  Some can function well with bone on bone apparently and some will have perfectly preserved cartilage spacing and still be highly debilitated due to hip pain.   

Continue to seek advice and as others have said this is major surgery of which there is no going back and it has its risks.  A perfect pain free outcome is not guaranteed, but it is more likely than not. There are many threads on here about lingering or new groin pain which is difficult or impossible to resolve.

Having said that, as a bi lateral resurfacing patient with significant post surgical onset groin pain, I am still happy I did the procedures. I had both hips done at 36 - feel free to PM me.

[Pat Walter]

Hi  I would suggest you also send your x-rays to several of the other top hip resurfacing surgeons and get their opinions. Ask how soon you should have it done and explain how much pain you are in.  That way you have several opinions from several of the surgeons.  Dr. Brooks is certainly on of the best surgeons, but it is always nice to have several opinions. That will give you a little more information for you to make a decision.  It is not unusual to get a few opinions.

https://surfacehippy.info/doctors-with-1000-hip-resurfacings/
I wish you the best and also agree that only you know how much pain you are in.

Pat

[petow23]

Thanks for all of the replies. I have not had an MRI, but that seems like it might be a good idea. I will send the x-rays to some other doctors as well. I am definitely leaning towards getting done though. Day to day walking around isn't too bad, with a small limp, but it gets worse the more I walk though.

The biggest thing for me is that I am starting to lose the pleasure in the activities I enjoy. It is making it harder to perform optimally and the pain I deal with afterwards makes me question doing them again, and makes it very hard to sleep. I see so many people on here that quit doing the things they loved and waited to have the procedure done. When they finally do, they are made they didn't do it sooner.

I have tried so many stretching and physical therapy exercises with no real results. Every time I think I might have made an improvement, I am right back to square 1, or worse in the morning.

I can only play hockey, volleyball, ride motocross, or go snowboarding for so many years, and I would like to enjoy them as much as possible while I can.