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THR Hip replacement question after failed femoral neck fracture repair with screws

@Fit4Family
Hi Sarah
You mentioned not-for-profits are better staffed. Are you referring to Georgetown, GW and other teaching hospitals?
I agree that posterior gives better visibility. I also read that femur neck fracture patients have a higher dislocation rate vs OA patients having hip replacement. Will ask the surgeon about this today
 
I don't know what the rules are about OS referrals on here. My OS is in Knoxville,TN. I never had any problems getting in to see my OS and never saw anyone but him. Generally scheduling is 4-5 weeks from appointment, this last time all I did was call when I was ready and they set a date for me. Everyone wants something different in a surgeon and beyond competance you wnt to have chemistry and communication.
 
@Eman85
Thank you for responding! Tenn is a little distant for me but will keep him in mind. I just saw a big anterior surgeon this morning and I think I will not go with that approach. He has only treated 30 cases like mine and the posterior approach sounds safer.
 
Laskyd said:
@Fit4Family
Hi Sarah,
I have seen a lot of surgeons in the DC area and we can compare experiences. Sounds like you are looking too.
This morning I have an appt with Dr Hamilton, an associate with Dr Fricka at Anderson Clinic. I had to wait three months to see him. He is the big anterior guy but now I worry that anterior approach is not ideal for me because of limited visibility in removing the screws.
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I have already scheduled with a surgeon at OrthoVirgina. He does all of their revisions and has since his residency. I am not in shape to travel about. My stem is loose so it is already scheduled, no experience yet with current surgeon so can’t recommend.
I also have not been to Georgetown. They are known to be excellent. I personally found large difference in staffing between my previous two hospitals, which given dislocation risk seemed important.

Are you in pain? I hope you find someone you are comfortable with. Best of luck.
 
@Fit4Family
I am sending you a PM. I am new on this website and hope you get it. Please let me know if you didn’t. Good for you that your surgery is scheduled!!
 
Laskyd said:
I have a question about the Surgeon locator. If the surgeon is not listed at all in the locator, is that a red flag for how good the surgeon is? Andy Engh MD in Virginia is VP of the Hip Society but I cannot find him at all.
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If a surgeon is not listed in our BoneSmart Joint Surgeon Locator, it definitely is NOT a red flag. It just means that particular surgeon was not in our initial database upload where we populated our locator. There are some 27,000 orthopedic surgeons in the US and we'll be working on getting them all included for a while. If you know of a good surgeon, please provide us with at least the name, clinic name, address, phone number and we'll get them entered. After that, you can let them know they can go in and claim their profile to add all the additional details that will help identify their specialties and get the right patients to them. We always appreciate our members letting surgeons know about BoneSmart and our Surgeon Locator.

Laskyd said:
All the surgeons I do pull up in the Locator for Washington DC, Maryland and Virginia are listed but not rated. Do you have any recommended MDs for my condition and i will go to NY or anywhere else on east coast if needed for a top
Surgeon
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We obviously depend on our members to give us ratings. So if you see surgeons with no ratings, it only means that none of our members have used that surgeon or (more likely) any who did have not gone in to rate them.

I do have surgeons in the DC area:

Arlington
Dr. William Petersen
Ortho Virginia
1635 N. George Mason Drive Suite 310
Arlington, Virginia 22205
Phone: 703-810-5215

Washington DC and Chevy Chase

Dr. Stuart Melvin III
2021 K St. NW, Suite 516
Washington, DC 20006
Phone: 202-833-1147
 
Laskyd said:
Have you heard of Dr Brian Evans, chief of Orthopedic Surgery at Georgetown University Hospital in Washington DC? I have THR scheduled for Jan 29 but not sure if I like him.
I scheduled it back in Oct after seeing him once, but now I have important questions to ask him about my surgery and recovery. Unfortunately I cannot get an appt to see him before the surgery. The surgical coordinator said a nurse or PA would get back to me but it has been over a week and no one has. I left a follow up voicemail but nothing yet.
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No, I don't know of Dr. Evans. If you cannot get an appointment to ask your questions before surgery, how about calling and leaving a message with the questions for him? Or maybe they would provide an email address for you. You deserve to have any questions answered before the surgery day.

Laskyd said:
I just saw a big anterior surgeon this morning and I think I will not go with that approach. He has only treated 30 cases like mine and the posterior approach sounds safer.
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The issue with the anterior approach is that it doesn't give the surgeon as good visibility as the posterior approach. So, in my opinion, you are right to have some reservations about using that approach in your situation. Anterior surgery can be a bit tricky anyway because of the close proximity to the Lateral Femopral Cutaneous Nerve shown in the diagram below. The surgeon makes his incision where the blue shaded area is. I think you're wise to seek a number of opinions.


incisions for anterior approaches.jpg
 
@Jamie
Yes!! I wasted several months chasing down anterior surgeons and, you are right, they probably aren’t the best for my case.
I will definitely make a trip to Georgetown this week with my list of questions. Thank you for the advice and physician names!

Also who at Hospital for Special Surgery would you recommend for my specific case? I Am seriously considering going there because they are the best
 
There are a number of good surgeons there, as you can imagine. Many of our members have had good luck with Dr. Padgett and I personally know Dr. Della Valle. Here is the information I have:


New York City
Hospital for Special Surgery (HSS)

Stavros Niarchos Foundation Complex Joint Reconstruction Center is a special program created with a $10M grant that deals with diagnosing and treating the most challenging knee and hip replacement problems. As part of the diagnosis, a committee of surgeons meets to discuss your case. There is a $500 fee for your case review. This center is headed up by Dr.Thomas Sculco.

Dr. Padgett
Shugaplum's surgeon. Also successfully did toohip's surgery.
Does both primary and revision hip surgery.

Dr. Della Valle (I have heard several recommendations on this surgeon and have corresponded with him on a couple of cases)

Hospital for Special Surgery
535 East 70th Street
New York, NY 10021
212-606-1000
https://www.hss.edu/physicians_su-edwin.asp

Revision surgeons at Hospital for Special Surgery, New York City (in order of their work with revisions both hip and knee):

Dr. Goeffrey Westrich
Dr. Russell Windsor
Dr. Seth Jerabek
Dr. Michael Cross
Dr. Michael Parks
Dr. Bostrom
Speaker at 2018 ICJR workshop on problem hips and knees
 
@Jamie
Thank you for your recommended list from HSS. After waiting 3 months to see the top anterior surgeon in the DC area, finally seeing him yesterday and having him tell me that he has only surgically treated about 30-35 cases like mine his entire career, I have decided to seriously consider HSS.
Two weeks ago I met with Dr Della Valle because at the time I was still chasing anterior surgeons. He told me then that he would only do posterior on me because of the screws. I told him that an anterior guy back home said he would do a lateral cut to remove screws and then do anterior surgery, but Dr Della Valle said that two incision approach would be too complicated and increase my healing time and infection risk. He strongly advocated posterior, which he says he does about 50% of the time. I also saw Thomas Sculco MD that day I and he said the same thing. Both surgeons were very informative and helpful. I went to see this last anterior surgeon yesterday because I had waited so long, but now I am convinced that an approach other than anterior is what I need.
My question is about Dr Della Valle. He was very nice and was willing to do the surgery but I see he isn’t on your list for revision surgery at HSS. He asked me twice why I came to him and I just told him that I heard he was good. Maybe I should see someone else on your revision list?
My goal is to get this surgery done in Feb, early March at the latest.
Thank you!!
 
I would simply ask, did you like Dr. Della Valle? Did you trust his thinking?

You can call his office and ask how many revision surgeries he's done if that's what worries you.

Another member, @prairienut ... had great success with Dr. Brad Waddell of HSS. Some of the older surgeons at HSS are sending patients to Dr. Waddell for revision.

Sounds to me, though like Dr. Della Valle outlined a clear plan that makes sense--and makes sense after all that you've learned in talking to anterior surgeons.
 
Since Going4Fun brought him up, I had also researched Dr. Brad Waddell, when I was considering HSS.
From what I remember, he loves doing revision surgeries, his father is also a hip surgeon, and you can find a video or two to hear him speaking. He seems rather brilliant. He is one of the “new comers“ to HSS and formed a group specifically of the “younger” hip surgeons at HSS to collaborate, if my memory is correct.
 
@Laskyd ... I pulled doctors Padgett and Della Valle up to the top from my list of revision surgeons because I have some personal knowledge of the two of them. Both are very excellent revision surgeons and worth your consideration if you're going to HSS. The others listed below are surgeons I would recommend for a consultation, but I don't have any direct information about them other than research.

I just heard from our CEO, Mark, today and he gave me the name of a surgeon close to you that he personally knows who he believes you should talk with before making a long trek across the country. His name is Dr. Sri Durbakhula at OrthoBethesda. If you agree to see him, Mark will run front for you to get you in quickly. Please let me know as soon as possible if you'd like to pursue this option. I highly recommend that you do. Mark has been working with surgeons across the country for decades and you can take his recommendation to the bank.

Do be sure and let any of the surgeons you see based on our recommendation that you learned of them through BoneSmart. This is an important bit of feedback for both the doctors and for us as well.
 
@Jamie
Yes! I would definitely like to meet with Dr Durbakhula. I did meet early on with his partner, Dr Cannova, who is a big anterior guy. He saw my xrays and said that he would take out the screws through the same lateral incision where they were inserted and then he would make a separate Incision to do the anterior approach. I thought it was a novel idea but when I asked for their opinion on that idea to both Sculco and Della Valle they both didn’t like it. They said it would make surgery too long and complicated and increase infection risk. Since seeing them I am starting to shy away from anterior approach.
I do not know anything about Durbakhula and would appreciate Mark’s help in getting me into seeing him if he does revision hip surgery. Thank you so very much and I will make sure Bone Smart gets credit for the referral.
Also, I do appreciate your letting me know that Padgett and Della Valle are good for revisions. Della Valle is on my short list for sure.
 
Dr. Della Valle would be my choice as well but it's primarily because I know him better than the other surgeons.

I'll let Mark know you're willing to see Dr. Durbakhula and we'll see how fast you can get in. Please send me your name and phone number in a PM so I can give that to Mark to pass on to him.
 
In case anyone is considering contacting Dr. Bradford Waddell at HSS, he just announced last month that he is moving his practice to Atlanta, Georgia, as of the first of the year. The move was to be closer to his wife's extended family and his own. So anyone in the Atlanta area needing a revision can look him up there.
 
prairienut said:
In case anyone is considering contacting Dr. Bradford Waddell at HSS, he just announced last month that he is moving his practice to Atlanta, Georgia, as of the first of the year. The move was to be closer to his wife's extended family and his own. So anyone in the Atlanta area needing a revision can look him up there.
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@Jamie - for information.
 
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