BHR v. MIS?

[yoda226us]

Dear Ones:

I broke my hip 6 years ago. My right femoral head, from necrosis, is only 1/3rd remaining.
I have a less than a 50 percent chance of being viable for the Birmingham Hip Resurfacing technique.
But I would prefer it over a total hip replacement; as I live a physically active life and am only 46 years old.
And I’ve found a doctor who does it. He's the second orthopaedist that I've seen so far.

But, since then, I’ve heard about the Zimmer 2 incision minimally invasive cutting technique that lets you walk out of the
hospital the next day.

So, my first option would be resurfacing; even though there’s not a large percentage of a chance that it’s viable for me.
But I’d still like that option. But that doctor doesn’t do the minimal incisions; which I want also.

I have insurance for only one month. So I need to find a doctor, in my area, this month, that does both of these surgeries.

My original doctor does the minimal incisions; but not the resurfacing. Should I switch back to my original doctor, and give
up the BHR option; to get the quick recovery? Also, is the BHR titanium? Oh, and one more; is there a a BHR FULL hip
replacement; that is, with their head and the stem; that could be done with the minimal incisions; with my original doctor?
What's the likelihood that my new doctor does A minimal incision technique; but just isn't listed on the Zimmer web site?

I can never just call a doctor and discuss all of this. I have to drive 1.5 hours, and get a great sales pitch from two
world class people; each with 1/2 of a great idea. :-(

I live 90 miles west of San Antonio. Both the minimal incision surgeon and the BHR surgeon are in San Antonio. I've
looked through BHR's web site and Zimmer's web site. No names overlap in San Antonio or Austin. Maybe I should look
for an overlap in Houston or Dallas? But that's a 4-6 hour drive. :-(

Got any suggestions? My time and resources are VERY limited in solving this puzzle. My wife suggested that I just
get the total hip replacement (TITANIUM). But I like to run and jog. My new doctor thinks that if I get a full hip
replacement, with the Birmingham head (if there is such a thing; his talk suggested that there was), that I would
not be likely, even if I were VERY physically active, to run into the same issues that Bo Jackson did when he
played baseball. And he says that the recovery speed is the same with BHR and a total hip replacement. I had read
otherwise.

I guess that I'm leaning towards going back to my original doctor and scheduling a total hip titanium replacement
with the minimal incisions. Once again, is this (THR) animal available with a Birmingham Head.

Sincerely;


Mike Beaver CHt.
830-275-2278
http://www.profoundstates.com

[Vicky]

It is always good to preserve your bone first if at all possible.  Your chances of returning to full activities is much greater with a resurfacing.  With AVN you really need to find an experienced doc to have the best chances at getting resurfaced and having a full successful recovery.  I would be very careful with the MIS THR's. I have heard of a lot of horror stories of docs that did not have that much experience with them and ended up damaging nerves.  A quick recovery sounds great, but with this type of surgery you need to really look at the long term.  If you are active at all, with a THR you will end up with revision surgery after revision surgery like Bo Jackson. 

Take a look at the list of docs on this site for a doc in Texas.  Or if your insurance allows it, check into Dr. Gross in S.Carolina, he is one of the top resurfacing surgeons in the world.  If you can swing paying out of pocket, you can go to the TOP AVN specialist for resurfacing in India for around $12k.  That is what I did and couldn't be happier.  Dr. Bose has done over 350 AVN resurfacings, some were done 7 years ago and still going strong.  He has done a total of almost 1000 resurfacings and he operates in a world class hospital, Apollo in Chennai.  Let me know if you want more info on him.  Think of it this way, what did you pay for the car you drive maybe an hour a day.  You will have your hip with you 24/7 for the rest of your life.  $12k is not a lot of money for your future livelihood.  I took out a home equity loan, others have used credit cards.

Vicky

[Pat Walter]

Hi Mike

I would also suggest that you try to have a hip resurfacing if possible. You would have to talk to really experienced hip resurfacing doctors to find out if you are a candidate.  The newer trained BHR doctors are much more conservative than the experienced doctors.

I would not worry about a MIS surgery.  I had a hip resurfacing and walked out of the hospital on day 2 1/2   The next day after surgery they have you up and walking and learning to do stairs.  I was on one crutch at 4 days and no crutches at 4 weeks. I was 61 and not in very good physical shape.

Many of us traveled long didstances to get the great doctors in the world to do our surgeries.  I went to Belgium because Dr. De Smet has done over 2000 hip resurfacings and I could afford him. $13,500 for medical costs.  I did not have health insurance.

Dr. De Smet, Bose and Gross are a few of the doctors that will give you a free consultation.  De Smet and Bose will do so if you send them an email with your x-rays attached in a .jpg format.

A hip resurfacing is always a better option than a THR since it is bone conserving in that they don't saw off the whole top of your femur bone and there is very little chance of a dislocation.

Check out my doctors list   http://www.surfacehippy.info/listofdoctors.php

If you can't discuss all of the quesitons you asked below plus these   http://www.surfacehippy.info/questionsfordoctor.php  with your doctor - then that is not a doctor to use.  All of the experienced hip resurfacing doctors will answer all of your questions.  Dr. De Smet and Bose answer them via email.

They type of surgery you have will not guarantee a quick recovery no matter what type of hip you get THR or BHR.  It is your own body that determines how quickly you will recover and you can't determine that ahead of time.

Some athletic people were running marathons 3 months after their BHR surgeries, but most take that long to get back on their feet and starting to live a normal life.  Hip repalcement in any form is major surgery.

I hope that helps you get started on your search for a new hip.

Pat in Ohio
3/15/06 LBHR De Smet