try to find surgeon doing ceramic on ceramic

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Roza53

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After reading about different implant materials, I think I would better have implant with ceramic-on-ceramic bearings. I do not feel good about accumulating polyethylene particles around my joint over time and possibility of osteolysis. I learned that fracture of ceramic happens very rare now, and ceramic squeaking is mostly due to poor placement. So in hands of experienced (with ceramic-on-ceramic) doctor, it is not a big risk.
The problem now is to find experienced doctor in USA who does ceramic on ceramic THR. I know that THR with ceramic on ceramic is very common in Europe. But here, in USA, I couldn't find any doctor yet. Looks like the recent problem with ceramic on ceramic Stryker implants (with poor rim design) keeps doctors away from this material. Any advice?
You BoneSmarties are so kind and helpful, I learned a lot from this forum and I'm very thankful!<input id="gwProxy" type="hidden"><!--Session data--><input jscode="leoInternalChangeDone()" onclick="if(typeof(jsCall)=='function'){jsCall();}else{setTimeout('jsCall()',500);}" id="jsProxy" type="hidden">
 
Thank you, John! This is very impressive technique! Your doctor probably does mostly this method... I asked earlier another doctor about it, and he said I can't be a candidate for Superpath because my hip doesn't flex more than 40 degrees anymore. But hopefully ceramic implant can be used with different method as well...<input id="gwProxy" type="hidden"><!--Session data--><input jscode="leoInternalChangeDone()" onclick="if(typeof(jsCall)=='function'){jsCall();}else{setTimeout('jsCall()',500);}" id="jsProxy" type="hidden">
 
Hi Roz,
I live in the uk and have had a ceramic on ceramic LTHR which my OS said was good for active relatively 'young' people. He used the lateral/posterial approach. Although problems are rare it is difficult to predict the longevity as they have not been used as long as other types of hardware. If you read some of people's stories they seem to be very happy with other types of hips. I understand outcomes are very similar except that some types of metal on metal ones have caused problems.
I think whatever your decide it is more important that your OS is experienced and comfortable with what he/she uses and the approch used. I'm sorry I cannot help with any recommendations of surgeons but someone from the US may be able to. There is both a wealth of knowledge, experience on this site as well as fantastic support.
I am very happy with what has been a problem free recovery so far and with no more bone on bone pain! Two weeks ago I started mainstream palates and can comfortably walk 3 miles. My range of movement continues to improve week by week.
I do hope you do find an OS that you have confidence in.
I am sure others will express their opinions...and hopefully give you info which will help you on your journey.
Ali
 
Hi Roza - you will read many times on this site but I will say it again - please don't worry about what implant your surgeon will use. They will use the implant that best suits your pre-op situation and the one they are most experienced with. They will not use something that might jeopardize your successful recovery.

Better to spend your time finding a surgeon you trust and who will listen to your needs.
 
I'm thinking not only about short term recovery, but about long term results as well, specifically about minimizing possibility of revision surgery due to osteolysis. The 3 local doctors I've met so far have very limited implant choices to offer. Each of them offers one particular type of implant, from particular company, to all their patients (of course different sizes). It is likely they have a contract with only one particular manufacture and, consequently, have experience with only one type of implant. For example, one of this doctors works only with metal on metal implants. When I expressed my concern, he said, without enthusiasm, that he can make exclusion for me and place ceramic on poly, (again from the same manufacturer) IF I am not going to be very active for the rest of my life. His concern is that the ball is not as big as in Me on Me, and dislocation is possible. He does posterior approach.

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Well in that case I would find a new surgeon. Statistics have shown that metal on metal in female patients have problems. My OS said he no longer uses metal on metal. Sounds like he is in a bit of a time warp!

OS usually use the implant they are most comfortable with using. After all you wouldn't want them experimenting on you! I have ceramic on poly and have no restrictions or problems.

Find someone who you trust using what you are comfortable with. Approach or manufacture make no difference in the end.
 
Please don't get too wound up about this. All implant materials are pretty much as good as one another. For instance: Metal on poly was the gold standard for years, I mean like 50 odd years, during which time millions have been put in. Since then, the instances of osteolysis are so rare they still number in the hundreds. Ceramic on poly has been the same though obviously with a much shorter history. Ceramic on ceramic has a pretty good track record but no better than the others.

As for the revision stats, there are literally thousands of people still walking about with their original replacement that they had done as long ago as 1970 and a few even longer. Consider how far technology has come since then!

At a hip surgeon's conference I attended last year, the delegates were confidently talking about the 'forever hip'. Think about that!

I know there are still a lot of surgeons out there who insist in telling their patients that these things only last 10-15 years but that's not been true for a long, long time. Fact is, they are a lot sturdier and the surgical techniques a lot more dependable than they have ever been in the past.

My advice to you is to make sure you choose a really good surgeon, one who does a lot of hip replacements, and trust him to use the device that is best in his hands, because that will be the best there is. Choosing implants and etc., is a skilled job requiring a depth of medical and scientific knowledge that you don't have. That's what you will be paying him the big bucks for. So, as the saying goes, why keep a dog and do the barking yourself?

How to choose a surgeon and a prosthesis
 
I agree with Josephnine. I think the best thing is to choose a surgeon who is well regarded and one you feel very comfortable with. Let him decide the approach and hardware best for you. I am getting my THR tomorrow - lateral posterior approach. I read a lot about different approaches and different devices, and even wanted an anterior approach - but I like this guy so much it was an easy decision. He does over 300 of these a year.

Only 26 more hours until my new life begins!
 
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