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Anyone had the newest procedure yet...HiP Resurfacing??

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hvyironfr8dog

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I have had bi-lateral hip-arthritis for 6 years. Been through all the normal meds. Celebrex, Mobic, Vioxx, Bextra...now Arthrotec. Tried all the natural approaches to fix this.....the Glucosomine/Condritine Sulfates, MSM, Boswella, all the natural so-called fixes including the rub-on lotions.

The only temporary relief I get is from products like "Blue-Stuff" or it's derivates... that have cetain botanicals and of course, "Emu Oil" in them, along with other nartural remedies. However,...all that stuff I have found, is just temporary relief!

Over the years, I even tried injections of Human Growth Hormone (HGH) directly into each joint to supposedly re-grow my cartilage. I didn't see much difference... but I couldn't afford it after 5 shots. I don't know what hurt more....the $375/shot to each hip, five times each over 2 months....which is a big shot the to wallet or the shots themselves.

I also tried Suppartz, an FDA approved injectable for arthritic knees ONLY. I don't know what the hell the difference is between arthritic knees and hips. Luckily, I found a OS who agreed to try injecting it into my hips, (what they call "off-label") to see if that would work. It didn't appear to do much.

My last effort was something called "Cold Laser Therapy", in which a pad of electronic diodes of low voltage laser lights are placed over the painful area and, thus, reduce the pain.... after many treatments. It's approved in Canada and used by many sports team over there and some professional teamstrainers in the US are using this methodology with great success for sprains and broken bones and such. Although there is ancedotal evidence from the manufacturers that arthritis can be relieved from Cold Laser Therapy... it didn't appear to help me much.

All this has brought me to today. In pain....still... even worse than the last year. But...the more research I do, the better educated if get.

I've known about MIS for several years, but the OS I had didn't approve of it. He wanted to do the traditional cut...you know.... the old 12 inch scar way. I said....."I don't think so"! So I have put off surgury with him for 2 years now. Ya know, the reason many doctors don't approve of the newer MIS procedures is simply because they don't know how to do it.....nothing more.

So my search continued this week....and lo and behold I found a OS who is very talented, does well over 300 MIS procedures per year. However, I went to him because his bio said he was doing the latest and greatest....the MIS-2 procedure (two-2 inch incisions instead of one 4 inch incision).

During my consultation I find out he no longer does the MIS-2 procedure only the MIS-1...which is about a 2 1/2 to 3 1/2 inch incision. he never explained why he doesn't do the MIS-2 anymore. Oh well....My research continues.

The latest and greatest now is HIP RESURFACING. Its been done around the world for several years, originated and popular in Europe (England, I understand) and it the most "bone-sparing" of all the procedures. Very few doctors are performing it in the US, as of today. Its only been approved by "our wonderful FDA" (LOL) since May 2006 so many doctors are not only not aware of it....they certainly have not been trained.

Research the different prostesis available for your hip procedure and you will get dizzy. There are many different companies, Smith and Nephew, Zimmer, Biomet, etc. See them on this site or others...just do a google search! Try "ReCap Total Hip Resurfacing System", or just "Hip Resurfacing", or "Biomet Hip Resurfacing"... and you'll see what I mean.

I have an appointment with a surgeon here in Ft. Lauderdale next week to see if I am a candidate for this newest "HIP Resurfacing" Procedure, a procedure in which "only the femoral head" is reshaped, if you will, and then capped with a new larger, metal ball cap. Kind of like a new hat, if you will, placed over the head...the femoral head, that is. I believe this is metal on metal BTW, which may or may not be to your individual liking, depending on your research and what OS you talk to.

No stem is inserted into your thigh bone, thus no chance of thigh pain, which is a common complaint in the traditional hip procedure. The hip socket, of course, is still repaired like the traditional procedure, in that it is reshaped and "cupped" with a metal device so that the new capped femur fits in.

The advantage, I read, is less bone cutting, as the femoral head is just re-shaped for the metal capp, thus no risk of thigh pain from the stem.....a larger ball is capped on..thus less chance of dislocation as it is more stable than the traditional prostesis which ALL use a rather small metal or ceramic head. This procedure is the latest and greatest out there and preferred now for patients who are "more active" and plan on continuing an active lifestyle.

The other great advantage that I can see from this new procedure is that....if several years down the road, it doesn't work out...you can always have a MIS done in which they totallly cut off the arthritic femoral head, and insert the full prostetic stem with another MIS incision. Remember once they cut off your femoral head, there is no way to put it back on, so you could not have the traditional cut done, have that fail, and then say you want to try the Hip Resurfacing Procedure as that would now be impossible since the last doc already sawed that off. You get my logic here?

The downside...in my research...is that there has only been 60,000 procedures done worldwide so far.... as opposed to the 300,000 per year in the US alone for the normal hip replacement procedures, MIS and traditional that is. That alone may scare some people off...but not me.

The thing that may scare me off....I don't believe this procedure is done in the MIS way, according to my MIS doctor yesterday anyway. . But I think he just wants my business.

I will report what the new OS tells me after I see him next week...that is...if this procedure can be done with the smaller MIS incision, a 2 1/2 to 3 1/2 inch incision (MIS-1) thus, with a shorter recovery period, as that is what I am ultimately interested in...to minimize my time off from a paycheck.
 
Well, I think I have heard this story before:) (as in been there done that!). You really covered the gamut however, I only researched some of the things you actually did! I had all the same results as you did however, when all is said and done and it still hurts you are left with little alternatives to surgery.

My hips were too deteriorated to consider resurfacing. But I am so happy with my bilateral THR I am fine with that. I do not think I have heard of anyone with a faster recovery than I had either. I have come to believe that a great portion of surgical success is not so much the procedure or device, but rather the skill of your surgeon as well as your individual physical and mental condition.

I have an outstanding surgeon who does 360+ hips/yr using MIS posterior approach with mostly Stryker components. I had both hips replaced the same time, home in 2 days and forgetting to use my crutches in 4 days! I can not tell you how quickly I was back to just about all my activities including work:( and athletics:) Plus, I just had my 1 yr checkup which showed excellent bone growth with a wonderful prognosis of a good 20 yrs ahead of me, even with my extremely active lifestyle. I love my new hips!

Good luck in your search, and let us know what you find out!

Andrea
(Believe in Barbaro)
 
Andrea:

I too want to return to my "old" active lifestyle. A style in which I would jog 5 to 6 miles one day....or bike 30 miles the next. I haven't done any of those things for several years now.

Oh small little trips on my fat wheeler bike with the kids is not uncommon...but for exercise purposes on the 10 speed?...no...I haven't done anything in a while.

I tried swimming for exercise..its OK..I just don't like swimming enough to consider doing that everyday...and the endless laps are boring. I've tried in the past to continue the weight lifting and eliptical trainer stuff. Again..it's OK, but I travel a lot with my job (airline pilot) and sometimes get into hotels late at night....and then out early the next day, so not always convenient. And the facilities at some hotels, or lack thereof, is something to be desired. From good to bad.

I am afraid that when I do very little exercise now...like walking or playing catch with my two small children, or even simple outside house or automobile work, like washing the car, is not only taxing my strength and stamina, but my hips hurt so much after doing simple things, that I have to lay down on my bed to take the weight off of them just to recover enough to finish the day.

I know how important execise is the body and mind. And how important it is to be in shape before going into major surjury, as this will make your PT easy to do and ultimate recovery quick. I just am not sure how much getting in shape I can do before my planned surgury this November....but I will try.

I am a bit overweight, the result of 6 years of inactivity due to this situation. With the hips hurting as much as they do...the more difficult it is to get motivated to do physical activity anymore. It's a viscious, deadly cycle that I have been aware of for some time....like watching a train wreck and not knowing how to stop it from happening. The more I try to exercise, the more pain I have in my hips....thus the less exercise I do...thus....the cycle continues, you know what I mean.

You sound like you were in great shape before the surgury. How did you handle the pain before the surgury...what exercise did you do to prepare for the big day?

My OS is willing to do both hips at once and said I am a good candidate for that. He uses the Zimmer product line of prostesis....mainly, the latest, super hard ceramic ball on the newest, space age poly cup. I told him I didn't think I wanted to do both hips at once and have reservations about ceramic breakage...but also have reservations about too much metal, as in metal on metal products. He ***ures me the latest and greatest of "ceramic on poly" is now the way to go. What do I know...he's the doctor.

I have been told by others that 'one at a time' is the way to go. I understand you need a great support group to do both at the same time. My wife works full-time and I have no one here to help me get through this post op stuff as she is a teacher and wouldn't be home until 3pm. Then it's helping the kids with homework and preping for dinner and so on....So I am concerned about trying even one hip... with little help here, let alone two. You see what I mean?

My work schedule is such that I have one week of vacation due in November and 10 to 15 days of sick time left to use this year. With my pilots schedule, I may be able to take off 4 to 5 weeks and still be on full pay. Sounds like enough time for one hip but ...I don't know about two.

How long did it take you to recover from the bilateral procedure?

I see you did you get the MIS-1 (one aprx. 4 inch incision). Did you consider the newer MIS-2 (two 2 inch incisions) or did your surgeon stop...(as did mine) doing this procedure, or is he just not trained in it?

My research on MIS-1 explains the difference betweeen the anterior (side cut) vs. posterior (back cut). It tells me the anterior incision does not cut "any muscle" while the posterial attempts only to "minimize the muscle cutting". A big difference, in my opinion, thus the recovery most likely will be longer.

My MIS surgeon, I found out the morning, does the Posterior Incision. Not happy about that...so my search continues....

I will see the Hip Resurfacing surgeon next week...but not happy about the supposed larger incision that is commonly needed in this procedure, (one 6-8 inch incision)... which is what I read on the Smith and Nephew, "Birmingham Hip" product pamphlet I got in the mail this week.

The surgeon I will see uses the Biomet "Recap" system. This is a clinical trial for him as there are not many surgeons doing this procedure in South Florida, and he is only one of a few using this product. I don't know if there are any advantages to this company's prostesis over Smith and Nephew. I have many things to ask him....like is this a trial for the product...or a trial for the procedure...and how many have you done, etc.

So many unanswered questions....yet...so little time, as I want to get at least one of these done in Nov.

Thank you for your response and insight. Hope I didn't bore you with all my questions....

chuck
 
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