How long should I wait before getting hip resurfacing ?

[GillSmith]

I am 38 years old and last year had an MRI scan which confirmed I had advanced oesteoarthritis of the hip. I have nightly pain, often waking me up, and limp after short periods of walking. At times I can't reach my toes to put on socks etc, yet if I don't exercise to outsiders I seem fine.

So is it better to wait or is there any advantage in geting surgery sooner rather then later?

[Pat Walter]

Hi Gill

Welcome to Hip Talk.

I fought with bad hip pain for 10 years because I did not know about hip resurfacing.  I finally got to the point that all I could do was sit.  I could hardly even walk from the parking lot of Wal-Mart into the store.  I could not sleep at night even with the heavy pain meds like Vicodin.  I gave up everything I loved to do from sports to playing my sax in the big band because I could not sit for 3 hours at a time, even with a break.

As soon as I learned about hip resurfacing, I decided to have my hip done. I was 61 and much older than you. I could not even imagine living the life I did at 61 when I was 38.  I was very active at your age. Probably that's what wore my hip out. I use to play tennis several times a week, ice skate 3 to 4 times a week and work. Rode my bike and played softball on a mixed team inbetween.

A lot really depends on your own mindset.  If you are use to be very active then by all means get your hip done.  That's what hip resurfacing is for.  To let you get back into life without pain and do whatever you want.  It doesn't make any difference what other people think.  You have to live with your hip, your body and your pain.

If you are able to live with the pain and don't mind not doing anything, then you could choose to wait. 

I can't see why you would wait if you have pain and are restricted in your activities. But that is your decision.  You can also wait too long and end up missing the window of opportunity to get a hip resurfacing.  It is possible to have so much damage that you can't have a hip resurfacing.  The same is true for AVN. There is a stage where it is time to get your hip done. If you wait too long, too much damage has occured.

Your hip resurfacing surgeon would be the right person to explain to you whether you should have your hip done or not. They have the experience.  I had my left hip done in 2006 due to OA.  My right hip has always hurt some, but nothing like the left.  I asked Dr. De Smet if I should get my right done and he told me it was not time.  I am still having problems with it and 17 months after my first BHR, Dr. De Smet is still telling me it is not time to have my right hip done.  I am not on heavy pain meds for it and can sleep at night. But there are days that I limp.  I am on Celebrex again.

So it is a decision that is made between you and your doctor.  You really need to find yourself a good hip resurfacing surgeon and get their input.  You can get free email consultations from Dr. Bose in India and Dr. De Smet in Belgium if you don't have insurance or just want to use several of the best in the world.  Many people travel to them - including me to Dr. De Smet.  My surgery and travel expenses cost my hubby and I $16,000.  I did not have health insurance.  Worth every penny. I put it on my credit cards.

You can check out my doctors list  http://www.surfacehippy.info/listofdoctors.php  to find a doctor near you.

Keep in touch and good luck.

Pat in Ohio
3/15/06  LBHR De Smet

[YoungD]

Hi Gill,

My situation sounds somewhat similar to yours - I am now 53 and my hip issues started about
6 years ago when people commented that I was limping when I walked.  I didnt really have any
pain then but over the ensuing years the pain has increased substantially- I finally had the diagnosis done about 3 years ago and then started taking an anti-inflammatory called Voltaren.  I take 10 to 20 mgs of this a day and it has been very helpful in controlling the pain.  I was told I have
fairly advanced arthritis in my hip and a hip replacment/resurfacing will eventually be needed.  Since then, my pain and limping vary with
how active (tennis/golf) I am.  I just posted to this web site a question on the long term effects
of consistently taking an anti-inflammatory like Voltaren because I could avoid the HR still for
some time but not if I wasnt taking this prescription.

If you havent used a prescribed anti-inflammatory for your condition this may be a way to postpone
your hip surgery.  At the age of 36 you should also definitely consider (as you probably already know) the hip resurfacing alternative since if you need down the road a further replacement Im told it will be easier if you did a hip resurfacing the first time.

Hope this helps.

Youngd

[GillSmith]

Thank you Pat & Young D for your replies !

Sorry I haven't responded prior to this ! I went to see Mr McMinn in the UK, and had a test for metal allergies. Unfortunately I am allergic to the type of metal used in a hip recurfacing procedure.
Typical ! Mr McMinn told me he was in the process of developing ceramic on ceramic resurfacing, and also ceramic on metal (which doesn't produce as many metal ions & therefore is less likely to cause an allergic reaction) So I could be his guinea pig or wait until a few others try first ! A few procedures have now been done & I am getting xrays done to see if I am suitable.

Has anyone had this done? How did it go ?

Many thanks!

[siamac]

Gill

The technology has advanced to the stage that the advice of 'waiting' is now outdated. Your metal alergy notwithstanding, if you do have an option of resurfacing, I would go ahead and get it done without delay. You will enjoy your life a lot more. Also, when you wait too long, your body tries to adjust to the pain, normally by developing a limp, etc., which is unnecessary, and tends to be harder to get rid of once you do have the surgery.
Find a good resurfacing doctor and jump right into it; I did, and have not looked back!

Regards

[Pat Walter]

Hi Gill

I have one story about a patient with ceramic resurfacing here  http://www.surfacehippy.info/hipstories08/lindaceramicresurfacing08.php  Awhile back, I thought McMinn had placed about 40 of these devices.

You could also go with a ceramic on ceramic THR.  Dr. De Smet usually uses that when there are metal allergies.  The ceramic on ceramic THRs used overseas have a larger ball size than those used in the US. Many people use that option.  Supposedly there are no restrictions for the large ball THRs.  People are just as active as with resurfacing.  Of course, they only down side is that they have to cut off a portion of your femur bone to place the device.

I wish I had more stories for you, but not many patients have had them. You could as McMinn to give the names of several patients with the ceramic resurfacing that you could contact.  That would be a way of learning more.

Good Luck and stay in touch.

Pat

[GillSmith]

Thank you Pat & Siamacfor your replies !

I had heard about ceramic THR but I didn't realise that mobility would be similar to resurfacing? Is Ski-ing, horseriding & running Ok with THR ??
I know sooner rather that later is better but I'm scared that under the knife the surgeons would  realise they couldn't perform resurfacing & would have to do a total hip replacement.

Thanks

Gillian

[Pat Walter]

Hi Gillian

Yes, people with the large ball ceramic on ceramic THRs or MOM THRs do the same activities as people with hip resurfacing.  There are no restrictions on them and almost no problems for dislocation as with a resurfacing.  It is the size of the ball of the device that makes the hip stable.  There are studies which show your gait is more natural with a resurfacing and I have heard people that have had both or one of each say the resurfacing feels more normal - but it is a good solution for active people.  It is the small ball old fashioned THRs that cause so many problems.

It would be good to talk to your surgeon about what you can and can't do with both types of devices.  Dr. De Smet lets his patients with ceramic on ceramic and MOM THRs do whatever they want.  They do everything from marathons, Karate, etc 

Pat

[GillSmith]

Thank you Pat ! This is all very reassuring !

Gillian