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Hip Resurfacing Versus Hip Replacement

Discussion in 'Hip Replacement Pre-Op Area' started by danmire, Nov 8, 2018.

  1. danmire

    danmire new member
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    Hi everyone, I'm wondering if you can give me some advice.

    My wife is scheduled for a right THR December 21. I had bilateral THR June 4 of this year and it has been amazing. She is scheduled with the same surgeon. She went to a pain management doctors appointment today and the doctor who saw her has recently had a hip resurfacing procedure and recommended she look at doing that.

    I've been trying to find UNBIASED information on which procedure is better. All the information seems to be from surgeons who do one or the other. So the information is Pro that specific technique.

    The hip resurfacing procedure is appealing to her as the femoral head is not cut off so appears not to be as invasive a procedure as the hip replacement surgery. But I thought I'd ask the community as this forum has been super helpful during by recovery phase.

    Thanks for your input.
    Dan
    BTHR June 4, 2018
     
  2. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @danmire Glad you have seen good results with your BTHR.

    I asked about resurfacing when I saw my first surgeon pre-op LTHR. Although I wasn't a candidate for resurfacing (hip was too damaged) my surgeon indicated that resurfacing for female patients was no longer advised. Here's an article from our Library that points to the same issues Resurfacing for hips: March 2012 report on HR in women advises against .
    Not really the case. This is still invasive surgery and the recovery is very similar to THR.

    I think your wife will be very satisfied with the results of her RTHR. If she has concerns please have her post here or raise the issues with your surgeon's office.
     
  3. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    The misnomer that because the femoral head is not cut off so appears not to be as invasive a procedure as the hip replacement surgery is incorrect. Generally the incisions are always posterior and very large so recovery is mostly much more protracted then with a standard THR. That surgeon sounds like he's an 'enthusiast' for HR which is not a good reason for choosing it.

    Please tell her from me that she will be much better off with a standard THR.
     
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  4. Going4fun

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    Hi @danmire, I carefully considered resurfacing before I decided to go with the total hip replacement.

    First of all, your wife most likely would not qualify for the Birmingham Hip Resurfacing, which is the most popular resurfacing device. Smith & Nephew stopped making those devices in sizes that fit most women. So she'd have to find a surgeon who used the Biomet device or perhaps a polyethylene and ceramic device. (Not many surgeons use those devices ... like a handful).

    I don't think mainstream total hip surgeons are "biased" against resurfacing. Rather, given the breakthrough in new materials in the past decade or so--namely ceramic and cross-linked polyethylene--mainstream joint surgeons simply don't think there is any need for resurfacing. Resurfacing has its own long learning curve and is a difficult surgery ... and resurfacing is metal on metal ... which has led to allergies among some women ... and increased levels of metals in the blood system that surgeons are still studying.

    I went the standard hip route because I didn't want to spend one minute thinking about metals (the metal ball rubbing against the metal cup on resurfacing device produces these particles when they touch each other) ...

    But there was another reason I chose total hip. Many of the top hip surgeons are now fine with full athletic activity after total hip surgery.

    My surgeon has no limits on my activity ... and he's at one of the top practices in the country ... and the practice based on research, agreed that there was not a need for restrictions ... Yes, I am approved for running, tennis singles, dancing--literally no restrictions.

    So given that hip surgeons had steadily improved the operation over the years ... and the new really good materials are showing every sign of lasting decades even with aggressive activity--there is less of a "need" for the resurfacing option. Resurfacing fixes a problem (limits on activity--devices wearing out in response to high activity) that no longer exists--I think that's the view of mainstream joint surgeons. That perspective isn't bias. The surgeons I consulted and the surgeon I ultimately chose didn't criticize resurfacing ... They simply don't think it's got any advantage at this point and the metal on metal risk cancels out any possible advantage.

    This is just me ... my personal view here ... but if there is a "bias," it seems to me that the resurfacing surgeons are still touting their devices as being superior to total hips based on the way total hips were 15 years ago. The resurfacing specialists (and there are NOT many--like there are two dozen resurfacing folks I think I'd trust at the most) ... don't seem to be aware of how good total hips are these days.

    For example, dislocation used to be a problem with total hips and aggressive activity ... Well surgeons over time basically resolved that issue ... And yet I was at the website of a top resurfacing surgeon about a year ago, and he was still talking about dislocation risks for total hips as part of touting resurfacing. His info is out of date, it seems to me.

    And yes resurfacing cuts less bone but also more tissue and yes recoveries tend to be longer and more brutal than for total hips.
     
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  5. danmire

    danmire new member
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    Thanks all for your responses. It really provides good perspective and is extremely helpful.
     
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  6. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    :wave:Over 5 months with those new hips.
    If you are like me...you are so grateful for a new lease on life.:egypdance:
    Hope your wife had good results also.
    I did feel at first like I would be losing something...but I honestly gained everything!
    Onward!:ok:
     

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