Finding a right surgeon not easy

[mindjoy]

I am considering a total hip replacement surgery due to the congenital dysplasia in my right hip. After doing a lot of research, mostly on the Internet (including this great Forum, thank you!), I came to conclusion that, since I am 48, the best implant for me would be the one based on metal on metal with large femoral head. I am concerned about needing a revision surgery down the road. I also prefer MIS (minimally invasive surgery). However, it is quite difficult to find a doctor who utilizes this type of implants with MIS, great majority works with plastic and metal with the traditional approach. Also it is almost impossible to ask the questions about the procedure, implant models, etc. before coming to an appointment, but I cannot go to 10 appointments before surgery. I even encountered a doctor who, according to his nurse/secretary, changed his mind after I visited him and told me that he wouldn't help me with the surgery?!

I guess, just wanted to hear from you people what process you have been using to find the right surgeon and procedure for your specific situation. Thanks,
John

 

[ruthz]

Hi John:

Considering your young age, have you investigated hip resurfacing? It has many advantages, the most important of which is that it preserves the femoral head and neck (as opposed to amuptating it in as in a traditional thr)so that if a revision is needed int he future, it is like having a primary (first time) total hip replacement, not a revision. Hip resurfacing surgery is done in cases of hip displasia, by the more experienced surgeons. I'm not sure where you are located. There are very competant surgeons in all parts of the United States, some of whom will review your x-rays with no charge to you(you just send them via the internet) and will let you know if they feel you are a candidate for this surgery. If you'd like further information about this alternative, you can find it on the internet. A good site is https://www.surfacehippy.info

Take good care,
Ruth Z

 

[JudyS]

John,

There is a thread by Josephine on how to find a surgeon. I imagine that will be very valuable to you.
I was already being seen by a spine surgeon in an orthopedic office , so went to see the hip surgeon. I was just very lucky as he is awesome. The nurses at the hospital all told me they love him (I was there for spinal injections). Pt's like him and said he is young, but a great surgeon. The home pt that came after surgery, who is well respected, said if she ever needed hip or knee care, she would definately have him treat her.
As far as procedure, I went with what he was the most comfortable with, which waS th posterior approach.
He told me earlier what type he would use on me. I did my research and agreed . I am 51 and have a ceramic ball/highlyx-linked poly liner.

Good luck with your search
Judy in socal

 

[Bob A.]

John
Welcome. I have to chime in with Judy about getting some recommendations from PT's in your area. I'm lucky, I'm married to one. They see all the work of the local surgeons so they have definite feelings on who and who not to go to. In my case I started with a doctor that she recommended very highly, but who also did not do any minimal invasive surgery. Since I was pretty adamant about getting both done at once, she suggested another doctor that she worked with about a year ago. She was impressed with the results of his patient who had both done with Mini-hips. She felt that I would not be a happy camper having both done with a traditional surgery. After consulting with this doctor, she came away impressed as I did and we made the decision to go ahead with the surgery in October.

I was also pretty well set on a metal on metal replacement. This surgeon wants to use a ceramic head with triple-linked polyethylene liner. At this stage of the game, I am not going to argue with him. If he feels its the best to use, then its fine with me. Ultimately I want it to work as well as possible and last as long. Go with your gut, if the surgeon and the people working at his practice give you confidence, then that's probably the one for you. Hope this helps. Good Luck.

Bob

 

[Josephine]

Mindjoy! I see you managed to finally get in! Welcome to the forum.

I cannot emphasise enough that your first concern should be in getting a skilled, active hip surgeon and let him decide which prosthesis is suitable for you. See, he will know the shortcomings of various prostheses which you will never learn from trawling the internet. Most of the sites you access for information are likely to be the manufacturer's own sites (or sites sponsored by them) and they are obviously not going to say ought but good about their own products.

It's the same with alternative procedures like resurfacing (which is usually only considered for very young patients <40 anyway). The real deals are known about by the surgeons long before they get into the public domain.

So my recommendation is in my post How to choose a surgeon and a prosthesis

 

[vickymm]

John,

I have to agree with Ruth here. You are WAY too young to get a THR. I was 48 also had hip dysplasia and was told by three "reputable" orthopedic surgeons (one at Stanford) that I did not qualify for hip resurfacing surgery, why? Because they did not do the procedure. Where are you located? I can recommend an experienced resurfacing surgeon for you if I know where you live. There are several top resurfacing surgeons that will also do free email consults.



Good luck and first see if you qualify for hip resurfacing. It is always better to preserve your bone first if at all possible and ONLY a qualified and experienced surgeon that DOES hip resurfacing can tell you for sure. All the resurfacing surgeons also do THR's but that is not the case the other way around.

Vicky

 

[mikey]

I just turned 60 and had bilateral resurfacing done by Dr. Gross in Columbia, SC. Both were done in the same week. The left on 6/23/08 and the right on 6/25/08. I was discharged from the hospital on 6/28/08. I had very good bone density. I have been for my six week checkup and from my perspective the surgeries were a complete sucess.

I was off crutches and cane by week 3. I still have some stiffness and surgical pain, but I am getting better daily. I have been walking 1.5 to 2 miles daily without a limp. I hit my first bucket of golf balls last week. I have not been able to do this for 18 months. I was advised to go slow and hit irons, but I also hit my 3 wood and was happy with the results.

I live in Atlanta and went to two other OS's locally before making the decision to travel 3 hours to Columbia. You should talk to several doctors, so your research, and them choose what is best for your situation.

[email protected]

 

[mindjoy]

Thank you everybody! Yes, I will consider resurfacing seriously, found there is one doctor locally. It's exactly what I've been looking for (large femoral head).

Is there any reason for not being able to have resurfacing? Do they check your bone density as a prerequisite?

(P.S. My location is in the upper right corner. You can update it in your CP.)

 

[ruthz]

Hello Mindjoy:

I'm so glad you are considering resurfacing! I am a ballet dancer and teacher, who is happily doing both again after bilateral resurfacing surgery in April of 2006.

Yes, good bone density is preferred, however, I know of several people who had less than ideal bone density and still got a resurf and are doing quite well. You can go to to read of a person who was successfully resurfed with diagnosed osteoporosis - her surgeon is very experienced (he's mine as well!) and he felt she could have a good outcome. He was right! In the United States, people in their 50's and 60's are routinely getting resurfacing instead of total hip replacements - it is NOT just for the younger set. I see that there have been several posts on this site recently from people who have had resurfacing surgery. Go to the resurfacing discussion thread, and also the alternatives to total hip replacement thread to read their posts.

The most important thing you can do is go to a surgeon who has had a lot of experience with resurfacing surgery. On the website I cited above is a comprehensive list of excellent surgeons in all parts of the United States.

Good luck - If I can help further, please do not hesitate to contact me.

Happy dancing,
Ruth Z

 

[rejoyce318]

Hi, mindjoy - welcome, & thanks for sharing!

I had a THR on my left hip exactly 1 month ago today. I, too, was born with hip dysplasia, & have had problems with that left hip for years. I agree with Josephine about finding a surgeon, & discussing what implants that surgeon uses.

My prosthesis isn't the newest form on the market, but it is the one the OS practice where I went (Rothman Institute) has found most reliable in the long run. I will probably have to have a revision down the road a few decades from now. I also had an anterior incision - do a search on this site if you want to know more about it.

I was not a candidate for anything but a THR - bone-on-bone between ball & socket, plus a leg length discrepancy.

I'm 47, btw, & there are members on this forum who are in their 20s & 30s who have had, or will have THRs. And to think I had stayed away from this surgery for years b/c I thought I'd be one of the youngest ones - NOT! ;) [Note: the OS who corrected my CDH had the dreariest waiting room with no children's magazines, only Modern Maturity! It scared me off of OSs for years!]

The recovery from THR takes a while, no matter what kind of incision you have, but it is SOOOOOOO worth it!

Joyce

 

[ruthz]

Hello All:

I'd like to state that people who have bone on bone deterioration ARE candidates for resurfacing surgery. I was bone on bone in each hip and I had no problems or complications.

The most important thing a person considering resurfacing surgery can do is get an evaluation by a surgeon who is enthusaistic about and well experienced in resurfacing surgery.

Some of the surgeons who are newer to the procedure don't feel they want to attempt this challenging surgery on any but a very select few patients. For a comprehensive list of very well qualified surgeons world wide, go to https://www.surfacehippy.info


Take good care,
Ruth Z

 

[mindjoy]

Resurfacing could be the best option

I found Surface Hippy very informative and helpful. I think, right now, resurfacing is my best option, just need to double check with a surgeon to see if it can be done on my right hip.

According to my little research, now more and more implant manufacturers offer hip resurfacing technologies, see hip resurfacing options on ActiveJoints.com. There is a lot of good information on the manufacturers' Web sites as well. I think everybody who consider THR, should first look into resurfacing possibility.

Here are the main advantages of hip resurfacing vs. total hip replacement:

• 
  The femur bone is well preserved. If a revision would be necessary later, you have a complete femur bone left for a revision.

• 
  Offers the opportunity to return to normal active life without the fear of dislocation and other THR restrictions.

• 
  Successful track record so far.

Hopefully there will be more and more surgeons doing it in the future.

Thanks again to everybody who suggested I look into resurfacing!

John

 

[vickymm]

Hi John,

Not sure why my other post was deleted, but I sent you an email, hopefully you will get that. It looks like you are on the right track. Resurfacing should always be a first option to look into if at all possible. Maybe Josephine can send me an email and let me know why my post was deleted so I know what the rules are here?

Vicky

 

[Josephine]

You got it already ...

 

[Eeyore346]

I am 46.

One thing I went by was word of mouth from Physical Therapists. I think they see the recovery of many patients. I was told Dr. Sarkision had a huge sucess rate for fast and successful recoveries. They said they would rather do therapy on his patients then any others. He is from Percision Orthopedics in Chardon, OH.

I then found out what a great bed side manner he had. It was amazing as I went along how many people said that he had operated on them and how happy they were with the results.

He did my right hip 6 weeks ago and I am going back tomorrow for the left.

Good luck!

Sandy

 

[rejoyce318]

"I'd like to state that people who have bone on bone deterioration ARE candidates for resurfacing surgery. I was bone on bone in each hip and I had no problems or complications."

I'm only sharing my own experience here. I did hours of online research (definitely including surfacehippy - very informative!) before checking out surgeons. Based on my research, & discussion with the surgeons, resurfacing would not have been able to correct my limb length discrepancy, which has been a life-long issue - complete with its own magazine rack! ;) for me.

I don't have the typical THR can't-do-this-can't-do-that restrictions. OK, so putting my legs in extreme positions (e.g., behind my head) is not a good idea, but I was never able to do that in the first place - my hips just don't GO that far! ;)

We each have individual needs & abilities; I'm grateful there are so many options today.

Sandy, again, my prayers are with you.

Joyce

 

[ruthz]

Hi Rejoice318:

I'll second that sentiment! I'm glad you're doing well. Any type of hip replacement gives us back our lives and I am so grateful for ALL the options available today!

Take good care and happy dancing,
Ruth Z

 

[legallyblondiedancer]

Hi...i had my hip resurfaced at the ripe old age of 62 and i have
been dancing and doing pilates and yoga and playing a lot of billards with my husband. I had severe osteoporosis -3'5 in the femur so needless to say i was a surgeon's nightmare for a hip resurface. But i did the rehab and he did the surgery and everything worked out beautifully. I think the more experienced surgeons will take on more and more older people who lead an active life style and want a bone conserving procedure done! karen