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pilot1

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Does anyone know of any good surgeons in Oklahoma city area.
I am constrained by my insurance company on who I can use. I am getting a THR soon and have since being on this site decided to do more research into a different type of hip, metal on metal that my currrent doc does not advise of using..
A little old school but a highly respected doctor non the less..
I appreciate all the help I have received on the forum.. hope I can return the favors some day.
One observation:
Seems metal on metal is favored on the forum right? I was going with a standard hip size 38 which my DR considers large head??
Is metal going to give me very much more movement?
If my standard hip wears out in 20 years cant I just go ahead and go with the best offered at that time... I am 50 so assume I will need revision sooner or later and technology will be better in 15 years..
Next question is, why not use a standard hip that can last for a long time anyway...
Take care and thanks..
 
I think i remember you posting before.........glad you decided on the hip.....Im a knee but im sure others will be along to help.......Im sure you will do just fine.,Good luck to you....keep us posted........)
 
Hi Pilot1, I would strongly advise anyone in your age group to research "Hip Resurfacing". Anantomically sized metal on metal THR is an excellent choice for a young active person. It greatly reduces dislocation rates and usually eliminates any movement restrictions that your surgeon may impose (though with newer techniques, dislocation rates are much less than they were with even smaller heads). They should last a very long time. With good placement there is hardly any wear. Ceramic on ceramic is an excellent choice for someone who is worried about metal ions or may be metal allergic. No one will reccomend high impact with ceramics though as a fracture is a mess to clean up. Some allow high impact with the metal on metal articulation HOWEVER periprosthetic fracture of the femur can be a disaster, the "Governator" was real lucky! Unfortunately there is no free ride and all devices have benifits, drawbacks and different ideal patient populations. Anyway, the overwhelming majority of hip resurfacing/replacement patients one year down the road feel very blessed. The problem with revisions are if the stem is well fixed and needs removal. Most THR systems are modular these days to avoid this. alan
 
Pilot,
I will be getting a DePuy uncemented, large head metal on metal hip in December. My OS actually said that it is quite likely that this hip will last me the rest of my life. I'll be optimistic that it does. I think it's usually the cement that goes bad and not the joint itself so I'm thinking that's why he's saying this. I don't know if this is the best way to go for everyone but there does seem to be a lot of people on the forum lately reporting this type of hip. I'm going with what my OS says since I figure he knows a lot more then me and he hasn't led me down the wrong road yet.

I think resurfacing is a good way to go too, though I wasn't qualified for one. I suggest you get out there and meet with two or three surgeons that do these other types of replacements and then you'll go into this feeling much more comfortable in the end.
 
One observation:
Seems metal on metal is favored on the forum right? I was going with a standard hip size 38 which my DR considers large head??
Is metal going to give me very much more movement?

So far as I know, nothing is favoured or rejected on this forum. All hip prostheses are pretty much the same and have the same 'life-span' as each other. The key is to find a surgeon who is expert at using whatever he uses. This generally means that
a) he only does hip replacements
b) he does no less than 500 a year - the more the better.

Read this thread How to choose a surgeon and a prosthesis

If my standard hip wears out in 20 years cant I just go ahead and go with the best offered at that time... I am 50 so assume I will need revision sooner or later and technology will be better in 15 years..
20 years isn't a bad projection but there are plenty of people out there who've had theirs even longer! Now just think - if theirs have lasted 30-40 years it means there were put in in 1970 or 1980. Things have come along a lot since then. So you will be having a 21st century hip put in. I see no reason why it shouldn't last a lot longer even than that! Not saying it will but that it could.

Next question is, why not use a standard hip that can last for a long time anyway...
Not sure what you are asking here. Except that it's a fair statement. Why not indeed.

But - the majority of them do anyway. In this business, with litigation at a peak, do you seriously think any surgeon would use an implant with a proven longevity of only 10-15 years when the rest last a lot longer? I can promise you that such a firm would very quickly be out of business!
 
Josephine,
Thanks for your responses.. looks like I have started a double post here.
I have checked out my Dr. and he has never been sued. I wanted metal on metal or ceramic... and he told me that he does revisions from other DR.'s all the time that used the brand new marketed stuff. His recomends the metal -poly liner with 38 head ..my concern is movement with that size.
He is also the head of a major hospital orthopedic facility with a great reputation.. so I think the surgery should be as good as it gets.
I tend to fall for the latest and greatest of anything I buy.. like a camcorder.. i just bought the newest version even though it cost more.
As with a hip surgery, I have seen the new proceedures advertised where you are up and about in a day or so and recovered in a week or so..and no muscle is cut..
I suppose I could shop till I drop for other opinions and get even more confussed..
If he can do a proper surgery with the poly metal hip I guess I will go with that.. I am going to ask again about the 38 head and push metal on metal with him when I see the doc three weeks before surgery...
Take care and appreciate your continued advise and help
 
Metal on plastic has been the standard for years and has a really sound history, so don't fret. 38mm isn't that bad - Charnley hips were 25mm! I'd say you were on a pretty good option there.
 
I have metal on poly and it was recommended to me as a young athletic dancer. My doctor has high expectations for the life span of the hip.
 
Very good.. I am feeling good and excited about the no pain aspect of this surgery..
I can not wait to get the knee done after that and have a normal life again..
I think I am getting used to the pain meds too.. I take a couple of hydro's a day now and that does help.
Thank you for the reply...
On a little worry note. I was surprised the doc said other hip is showing wear too.
 
Oh dear - but yes, that happens. The hips and knees are four corners of a square and therefore interdependent. Thus they often wear out at the same time. So many people have all four replaced! My sister has had three done so far and the fourth getting ready to implode on her!
 
My PT's advice is to go with what your body says not what the xray says. If it don't hurt don't fix it! Or worry about it!

I have dysplasia in my left hip (unoperated side) as well but it has never bothered me. The right one gave me problems for 10 years. I will need the left one replaced eventually but I'm not even going to give it a second thought until it decides that it wants to bother me.
 
So true,
When they did the exray on my injured hip and said I had advanced bone wear I was amazed.. I was shocked when the doc said we can give it time but may not get better and he was right.
I was double shocked when he said I had wear in the right hip also and it also has never hurt..
I am hoping right hip and left knee make it forever...
We will see..
 
OTOH, sometimes, when you've struggled into the clinic with canes or crutches and tell them you're taking pain pills every 4 hrs on the dot, they look at the xrays and still say "there's no visible evidence of any changes or damage so nothing needs doing"!
 
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