Concerns about Hip Surgery

[DMiller]

I am a 53 yr. old male and I am starting to plan for hip replacement surgery. I am experiencing similar symptoms that everyone else has with this problem. I have heard of various ways of having the procedure done and I am confused about what direction to take. I understand that each surgeon has his own way and will usually steer you in that direction. I have heard of hip resurfacing, minimally invasive surgery, or the conventional hip replacement procedure. And then once the surgery procedure is decided then what materials are the best for a relatively young and active patient.....metal on polyethelene, metal on metal, or ceramic on ceramic ? Furthermore, I find it hard to decide on the right surgeon for the job. I live in St.Paul- minneapolis, Minnesota area. I would appreciate any comments or suggestions. Thank you , David

 

[Kelli M]

David,
I just want to wish you good luck with your hip replacement surgery. Hopefully you're a candidate for the minimally invasive surgery. I am scheduled to have my 3rd total hip replacement on December 6th. You'll be surprised at how fast you'll be up and on your feet!!

Take care,
Kelli

 

[Kraft]

Dave, if I were your age I would at least inquire about ceramic implant.

You are close to Mayo clinic in Rochester. That should be a good source of surgical talent.

Minimally invasive surgery is fine if the surgeon does a lot of them. Personally I care more that the surgeon can see what he's doing! My incisions were 11" long (I have two THRs). I note that the surgeon who did mine 4 years ago is now doing a type of MIS with about a 4-5" incision. Then there's another type of MIS that uses two very small keyhole incisions. The jury is still out on that one and there may be no particular advantage (and some additional risks such as femur fractures) to that technique. The orthopedic medical journals have recently published studies showing that there aren't any particular advantages to MIS surgery except patient preference and cosmetic concerns. Even the cosmetic concerns aren't really valid. My old 11" scars are barely visible now, although at age 59, my thighs are almost always covered anyway!

Resurfacing, you may have already discovered, is a very controversial procedure in some ortho camps. You probably already know the claims - that if you are young and active, you may have full range of motion like the hip you were born with, plus the head of the femur is preserved so you can have a THR later. Not very many surgeons in the US do resurfacing. Beyond that I will not comment further.

 

[DMiller]

David,
I just want to wish you good luck with your hip replacement surgery. Hopefully you're a candidate for the minimally invasive surgery. I am scheduled to have my 3rd total hip replacement on December 6th. You'll be surprised at how fast you'll be up and on your feet!!

Take care,
Kelli

Thanks Kelli, I'm still trying to decide on a surgeon and whether I should do it as a minimally invasive pocedure or the conventional way. It's nice to hear that most people recover quite nicely. Why did you have to have one side redone? David

 

[DMiller]

Dave, if I were your age I would at least inquire about ceramic implant.

You are close to Mayo clinic in Rochester. That should be a good source of surgical talent.

Minimally invasive surgery is fine if the surgeon does a lot of them. Personally I care more that the surgeon can see what he's doing! My incisions were 11" long (I have two THRs). I note that the surgeon who did mine 4 years ago is now doing a type of MIS with about a 4-5" incision. Then there's another type of MIS that uses two very small keyhole incisions. The jury is still out on that one and there may be no particular advantage (and some additional risks such as femur fractures) to that technique. The orthopedic medical journals have recently published studies showing that there aren't any particular advantages to MIS surgery except patient preference and cosmetic concerns. Even the cosmetic concerns aren't really valid. My old 11" scars are barely visible now, although at age 59, my thighs are almost always covered anyway!

Resurfacing, you may have already discovered, is a very controversial procedure in some ortho camps. You probably already know the claims - that if you are young and active, you may have full range of motion like the hip you were born with, plus the head of the femur is preserved so you can have a THR later. Not very many surgeons in the US do resurfacing. Beyond that I will not comment further.

Reply:......
Thankyou for your info it was very helpful. Do you understand that minimally invasive procedures have a shorter recovery because of less muscle cutting of do you think that it's insignificant. David

 

[Kraft]

David:
You may be interested in these:

From: "The Journal of Bone and Joint Surgery (American)"[a scholarly medical journal]. 2005;87:2432-2438.
Early Complications of Primary Total Hip Replacement Performed with a Two-Incision Minimally Invasive Technique
B. Sonny Bal, MD, MBA, Doug Haltom, MD, Thomas Aleto, MD and Matthew Barrett, MD
broken link removed: https://www.ejbjs.org/cgi/content/abstract/87/11/2432

From Medscape: "Minimal Incision Procedures in Total Hip Arthroplasty Not Without Risks" AAOS[a trade ***ociation] 72nd Annual Meeting: Abstract 143. Presented Feb. 24, 2005.
https://www.medscape.com/viewarticle/500444

From Medscape: "Outpatient Surgery in Hip and Knee Arthroplasty Requires Comprehensive Approach" AAOS [a trade ***ociation] 72nd Annual Meeting: Symposium: Less and Minimally Invasive Total Joint Replacement: Pro and Con. Presented Feb. 27, 2005.
https://www.medscape.com/viewarticle/500209

From Amer. ***oc. of Hip & Knee Surgeons[a trade ***ociation], a position statement: "Minimally Invasive and Small Incision Joint Replacement Surgery:
What Patients Should Consider" broken link removed: https://www.aahks.org/pdf/MIS_position_statement.pdf

From Sweden's Dr. Valle Surin's Totaljoints website[a non-commercial site], on hip resurfacing:
https://www.totaljoints.info/surface_hip_replace.htm

From Joint Replacement Institute[a hospital/business]: "History of Hip Resurfacing" by Harlan C. Amstutz, M.D.
https://www.jri-oh.com/hipsurgery/Surface.asp
AND,
"Viability of Femoral Heads Treated with Resurfacing Arthroplasty", by P. Campbell PhD, J. Mirra MD, and Harlan C. Amstutz, M.D.
https://www.jri-oh.com/hipsurgery/Viability.asp

It will be interesting as the years go by and more retrospective looks are taken to see what the long-term results of these new techniques turn out to be.

 

[jsalai]

I am a 53 yr. old male and I am starting to plan for hip replacement surgery. I am experiencing similar symptoms that everyone else has with this problem. I have heard of various ways of having the procedure done and I am confused about what direction to take. I understand that each surgeon has his own way and will usually steer you in that direction. I have heard of hip resurfacing, minimally invasive surgery, or the conventional hip replacement procedure. And then once the surgery procedure is decided then what materials are the best for a relatively young and active patient.....metal on polyethelene, metal on metal, or ceramic on ceramic ? Furthermore, I find it hard to decide on the right surgeon for the job. I live in St.Paul- minneapolis, Minnesota area. I would appreciate any comments or suggestions. Thank you , David

David, I had hip resurfacing 8 years ago and have been very happy with the results. I was in a study group of 25 so I think my recovery time was a little longer than it is today. My other hip is giving me problems and I'm starting to research which direction I'm going to go this time. I've been very interested in the MIS but not sure if I would be a good canidate. I had a friend who had this surgery and had some problems following the surgery because I don't think he was a canidate. I'm looking into the Hospital for Special Surgery in New York to see if I would be a canditate. I worked in orthopedics for 12 years so I do know getting a surgeon who has performed many of these is IMPORTANT. I wouldbe happy to share my reseach with you if you want...Jim

 

[JEANETTE]

My Mother Need To Have A Hip Replacement, She Is 63 Yrs Old And I"am Concern About The Surgery Is
It Safe

 

[sbrown]

It is my understanding the hip replacement is one of the most successful and safest surgeries you can have. Of course, you need to find a competent doctor, one who has done enough of these surgeries often enough to be totally familiar with the technique.

 

[DMiller]

David:
You may be interested in these:Thank you for the info and articles. I will be reading all of them. Thanks again David

From: "The Journal of Bone and Joint Surgery (American)"[a scholarly medical journal]. 2005;87:2432-2438.
Early Complications of Primary Total Hip Replacement Performed with a Two-Incision Minimally Invasive Technique
B. Sonny Bal, MD, MBA, Doug Haltom, MD, Thomas Aleto, MD and Matthew Barrett, MD
broken link removed: https://www.ejbjs.org/cgi/content/abstract/87/11/2432

From Medscape: "Minimal Incision Procedures in Total Hip Arthroplasty Not Without Risks" AAOS[a trade ***ociation] 72nd Annual Meeting: Abstract 143. Presented Feb. 24, 2005.
https://www.medscape.com/viewarticle/500444

From Medscape: "Outpatient Surgery in Hip and Knee Arthroplasty Requires Comprehensive Approach" AAOS [a trade ***ociation] 72nd Annual Meeting: Symposium: Less and Minimally Invasive Total Joint Replacement: Pro and Con. Presented Feb. 27, 2005.
https://www.medscape.com/viewarticle/500209

From Amer. ***oc. of Hip & Knee Surgeons[a trade ***ociation], a position statement: "Minimally Invasive and Small Incision Joint Replacement Surgery:
What Patients Should Consider" broken link removed: https://www.aahks.org/pdf/MIS_position_statement.pdf

From Sweden's Dr. Valle Surin's Totaljoints website[a non-commercial site], on hip resurfacing:
https://www.totaljoints.info/surface_hip_replace.htm

From Joint Replacement Institute[a hospital/business]: "History of Hip Resurfacing" by Harlan C. Amstutz, M.D.
https://www.jri-oh.com/hipsurgery/Surface.asp
AND,
"Viability of Femoral Heads Treated with Resurfacing Arthroplasty", by P. Campbell PhD, J. Mirra MD, and Harlan C. Amstutz, M.D.
https://www.jri-oh.com/hipsurgery/Viability.asp

It will be interesting as the years go by and more retrospective looks are taken to see what the long-term results of these new techniques turn out to be.

Thank you for the info and articles. I need all the help I can get. It seems to be a big decision for me. David

 

[DMiller]

David, I had hip resurfacing 8 years ago and have been very happy with the results. I was in a study group of 25 so I think my recovery time was a little longer than it is today. My other hip is giving me problems and I'm starting to research which direction I'm going to go this time. I've been very interested in the MIS but not sure if I would be a good canidate. I had a friend who had this surgery and had some problems following the surgery because I don't think he was a canidate. I'm looking into the Hospital for Special Surgery in New York to see if I would be a canditate. I worked in orthopedics for 12 years so I do know getting a surgeon who has performed many of these is IMPORTANT. I wouldbe happy to share my reseach with you if you want...Jim

Jim, Thanks for your input. I would love to hear about your research. !! I talked to a guy today who wants to go out to CA. to have hip resurfacing done. He's convinced that it's the place to go. I also had friend who had hip resurfacing done and he fractured it after about 1.5 years after the surgery. Is it true that sometimes the Circumflex? arteries that supply the femoral head can be damaged and then the head becomes necrotic and fractures? Or is it hard to line up these components and then they eventually fracture because of undo sress? Your eight years is a good testimony for hip resurfacing. Why would you not do it the same way? Have you heard of Oxilium oxidizing zirconium prosthesis? David

 

[Annemarie]

My Mother Need To Have A Hip Replacement, She Is 63 Yrs Old And I"am Concern About The Surgery Is
It Safe

I am a 65 year old mother also and hip surgery, although somewhat feared, was the best thing I have done for my aching hip. It is far less painful then I thought. Although I was hooked-up to the I.V. for three days ofter the surgery (antibiotics, pain medication etc.) I was expected to get out of bed the day after the surgery and with the use of a walker go to the bathroom. Mind you, anything is better then sitting on those bed-pans. Physio begins 3 to 4 days after surgery. After one week you go home and use whatever help you need to walk about the house. I find crutches better then a walker. The operation takes about 1/1-2 hour and once you have been given the initial IV you are out for about 5 hours before beeing wheeled into your room. The movement of the "wheeling" made me feel sick, turning my stomach, all else is uphill from there. Good luck, go for it.

 

[Mr.Valery Korobeynyk]

Dear David,
As I can see, Your case it seems is the most interestig: after November 2005 You have 427 Views and 11 Threads.
How are You now? Did You find and decided to make Hip replacement? I'll be glad to hear from You and it'll be great if You can tell me some more detaily about Your illness (how long are You suffering, diagnose, what medicaments did Yiu use before, etc).
Like You I am 53 y.o. and intend to make my left Hip replacement. But as You maybe can see from my messages, I have unfortunately additionally and some other problems.
With best wishes to You from so far and maybe unknown for You Ukraine.
Your "collegue" with our Hip-prpblems,
Valery Korobeynyk

 

[marshall perkins]

I am at the stage of deciding the type of prosthetic. I am 48 years old(active but in pain) and will be having surgery in July. Joel Matta is my surgeon in Los Angeles. I am looking for info on the Ceramic ball and metal cup combination in a large size for sports realated activities. Cycling is my primary activity.

Any suggested links for this combination?

Marshall

 

[Annemarie]

Greetings Marshall P. I am 65 and had a total hip replacement on Apr 11. The surgeon said it was a ceramic implant. If it was all ceramic or not I have no way of knowing. I am 5'6, slim and in good health, I figure the implant must have been of average size. I have heard of others at my age going back to cycling after about 16 weeks of recouperation which would indicate that you could do likewise once you are healed. Good luck, keep us informed about your progress.

 

[marshall perkins]

My physician is asking me to make the choice of a specific combination. I am sure it is a liability issue he wants to avoid. He says high activity in a Ceramic on Ceramic may be an issue(cup splintering) which is why he mentioned the Ceramic/Metal by Depuy but the website seems light on actual data and features. Any sites that offer a shoot out of features by manufacture(like cars) would be helpful.

Thanks in advance,
Marshall

 

[diclidophora]

I am 72 year old male and have avn of the left hip, lasting about 3 years. I certainly need surgery because that leg is about 2 inches shorter than the right. My chief difficulty is that I have a dreaded fear of surgery. Also, though the pain was excruciating when the avn started, it became less with time. Now it is sore, but does not keep awake at night etc.
Of course I am pretty well informed about the risks, but have not so far overcome my dread. I also have questions about the type of prosthesis. There seems to be some advantage in having one with a larger head in order to reduce wear and the possibility of dislocation, tho this has to be weighed agains a history of success and longevity with other implants.
There is also the possibility of MIS. I would not go for two incision MIS because I think it is a technique which is still under development. On the other hand, short single incision surgery seems to have the advantage of being based on existing successful techniques (tho inflicting less trauma) with possibility of extending the incision should that become necessary at the time of the operation.

DC

 

[Annemarie]

After enduring a decade of severe left hip pain, I too, although adverse to hip surgery at 65, underwent total hip replacement 7 weeks ago and I am pleased to report that all went fine. It was worth it. The entire 90 min. procedure removed the hip pain entirely. Certainly there was some discomfort from the incision and the tighness of the staples, but that faded with every p***ing day and much faster once the staples had been removed two weeks after surgery. You do have to watch how you sit or move. I still use crutches indoors because my other hip is also in need of repair and I do not wish to overload my implanted hip. We have to be grateful that this is not 1950 when such operations sliced up your entire seat area, my poor mother, then only 31had it done three times in total. Good luck.

 

[diclidophora]

Dear Annemarie.

This is just to thank you for your reply here. I am gearing up to see yet another orthpod in the hope that he will inspire confidence.

Best wishes

DC

 

[Annemarie]

Greetings fellow hip replacement seekers. I have had my 8 week post-op,
X-ray and check-up. All is fine, the (rather long) implant, an uncemented ceramic one, looks as straight as an arrow on the computer screen. I also found out that a small bone graft had been done on a rather shallow bowl, the bowl containing the hip ball-joint, the femoral head. Although my right hip is in need of replacement also, I am still hoping that those new European MBT "wonder shoes" could prevent that, if not at least delay it.