Alternative for Hip Replacement

[mel]

I discovered this site about a year ago, while trying to debate a hip replacement. I am only 27 and I have bilateral hip protrusion and late September I found out there was no cartilage left in my right hip. Fortunately, I went to the right place, Mayo Clinic. They didn't want to replace my hip due to my age but they have discovered a new surgery to post-pone hip replacement. The surgery has been 90% effective in patients on young and old. What they do is, remove the cartilage and take a tendon from your hip and anchor it to the hip ball. I wasn't even put out for the surgery, they just put an IV in the right hip so that was the only leg I couldn't move. They have to break or saw the leg bone off your hip but they screw it back together. The surgery was expensive but I don't know what a replacement might cost. I was up walking the next day and could get around on my own about four days later. The leg stayed dead for a good two days after, I had no pain. Here is the downfall, the healing does take longer compared to hip replacement because you have to get all your old muscles back. You have to be on crutches for a long time but I didn't mind. I have no pain the hip and my left hip is still in good shape. I cannot tell you how happy I am to not have that pain anymore. It's hard living with hip pain for most of your life and then poof it's gone. I am truely grateful to my doctors and I can't wait to see them in September. I can actually play with my daughter and go for walks. I don't know why I waited so long to do something. I have to tell you that I wouldn't knowing what I know now.

It has been nine months since my surgery and I am still getting my muscles back. I don't think it has much to do with the surgery but the lack of what I was doing for so many years. The tendon will last just as long as a hip replacement if I am good to it. I would be happy to answer any questions that people have. I am hoping that this will help so many people since it isn't widely known. I hope I haven't left anything out.

 

[Texas]

Hey Mel I'm happy for you . No more pain that's great.....With your muscles your right you haven't used them for a long long time. They will come back. Keep working at it. Sounds like you are doing great. Keep it up....Post anytime let us know how you are doing.......

 

[Jamie]

Hi Mel. Welcome back to the forum. Your surgery is something I have not heard about before. I'll be curious to see what Josephine has to say about it. What you described is very interesting. Sorry the recovery is so long, but you'll get there. I can already tell what a wonderful difference it has made in your life.

 

[Peta]

Wow Mel! I've never heard of anything like that before! Sounds amazing! I'll await Jo's input with great interest............!

 

[Josephine]

Jo has little or nothing to say about it because she's never heard of the procedure! But I shall do my darnedest to find out! Which Mayo Clinic did you go to, Mel, and what was the name of the surgeon?

And welcome back! Good to know you got sorted in the end.

 

[mel]

Mayo Clinic in Rochester, MN and the doctors name was Trusdale. Well, the surgeons are interns so I don't know who exactly operated on me. It was very effective and I am glad I could help by offering something different for people. I also have a pic of my new hip but I don't think I can get it on here to show you. I am going searching for my paperwork and get you the full details. Please be patient while I find them. :pnc:

 

[mel]

Would you like the surgical report? I sure can write that up if you would like to know exactly what they did. The procedure was call s/p right hip offset procedure with labral reconstruction. Robert Trousdale was the doctor and from what I gathered while talking to him that he came up with it, but he has been doing it for a couple years. There were people having it done weekly so I don't understand why this isn't widely known. His success rate is remarkable. I can see it with me how much it helped and I don't have to worry about having hip replacements at such a young age.

 

[Clunker]

Hi Mel,and sounds like Mayo did you good. Trusdale, is one of the older surgeons there,and a teacher as well. I live in Rochester and have heard good things about him. Here is his web bio>
broken link removed: https://www.mayoclinic.org/bio/10487832.html

Very good luck Mel.

 

[Josephine]

Thank you, I'd love to see the surgical report! I'm most intrigued.

 

[mel]

This is the surgical report, it is very long but if it helps!!!!!

The right hip was prepped and draped in the usual fashion. Through a lateral incision, the hip was approached. the fascia was split. We did a trochanteric osteotomy from posterior to anteriorly with a little ridge of bone anteriorly for stabilization at the time of reduction. We then exposed the anterior hip capsule. We incised the capsule and dislocated the hip, trying to keep the round ligament as long as possible. We then harvested the round ligament. It was not long enough to reconstruct the labrum, so we did harvest a 6cm piece of fascia lata autograft. We exposed the acetabulum. There were some arthrictic changes in the posterior inferior compartment, measuring about 1.5cm in cricumference. The labum was intact posteriorly and inferiorly but only for about a centimeter. The rest was extremely atrophic, and most of it was ossified. We removed approximately 8mm of circumferential acetabular rim. We then did an osteochondroplasty of the head/neck junction, improving the head/neck ratio of the femoral head. We then took the fascia lata autograft and fixed it with multiple mitek sutures down to the rim, and I was very pleased with the overall stability of the reconstructed labrum with the fascia lata autograft. we reduced the hip before we placed the autograft down, and I was very pleased with the overall range of motion before impingement occurred. the patient flex well past 115 and had a very full range of motion without impingement. The wound was thoroughly irrigated. The trochanter was fixed with three 4.5mm screws anatomically. After the capsule was closed, the fascia, sink and subcutaneous tissue were closed routinely over drains.

Hope you know what all that means Josephine!!!

 

[Josephine]

I do indeed! It makes perfect sense.

What they did was take a sheet of the fascia lata, which is a fibrous covering of the large muscle in the thigh, stretch it across the acetabulum (socket) making a kind of ground sheet to lie between the femoral head and the acetabulum. In effect, they used it as a interface liner between the two.

The Mitek sutures are threads with barbed anchors on one end to fix in the bone - very cute and effective! They can be used anywhere in the body.

 

[mel]

So you have heard of it? Or do you just understand what they did? Sometimes I think it just sounds so simple that I wonder why it took them so long to think of it!!!

 

[PRGal]

So is this kind of a cartilage replacement, Jo? (And only you would call a barbed suture "cute!" :hehe:

 

[Josephine]

Not really, it's rather difficult to describe but what they've done is use a sheet of fibrous tissue as an interface between the femoral head and the acetabulum. I've never heard of it before and can't wait to mention it when I'm back in clinic! Be interesting to know how long it lasts! Also what the procedure is called. I suspect it's an old procedure rejuvenated. It sounds very 1930s!

 

[UTdave]

This sounds like an enhanced version of the old osteotomy procedure with the addition of a graft "cushion" (I hesitate to say cartilage) and labrum reconstruction via grafting, no?

A procedure to buy time. . . and time's worth a whole lot!

Good luck!