Hip Resurfacing vs THR. Anyone have experience with both?

[BruceH]

Hi,

I've been referred to surgery consults by a sports doctor. An MRI showed deep cartilage loss in the hip and femur along with labral tears, I've been having hip pain for almost a year.

The sports doctor thinks I'd be a good candidate for resurfacing. I'm consulting with a surgeon who specializes in resurfacing and I'm seeing a surgeon who only does THR.

Resurfacing looks to be the best way to go at first glance. However, the more I research it the more I find people having problems with the femoral neck fracturing or suffering from necrosis.

I've become numb from all the research. I'd like to hear from those who were or are candidates for either procedure and why you chose what you did.

Thanks,
Bruce

 

[Pumpkin]

BruceH,
Welcome to BoneSmart, glad you joined us!
Members who have had resurfacing/THR will be along to share their experiences.
Here is a link to a list of members who have had hip resurfacing.
https://bonesmart.org/forum/view/hip-replacement-recovery-area.5/?prefix_id=20

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
Score Chart: How bad is my arthritic hip?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced hip, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing hip recoveries

 

[BruceH]

Pumpkin,

Thank you for the info and the links.

 

[Uncivil]

I looked into resurfacing but was denied because of how bad my arthritis was. Think it was a blessing in disguise. So many people said they wished they just did the thr as many had to do that anyway.

 

[FailedBHR]

I had great hopes with a BHR resurfacing which lasted one year, it was great for a year as I like to ski, but I got a large psuedotumor complication and just had it revised. They where able to use the cup and then I have the traditional ceramic plastic metal spike in my femur versus a recovering as in BHR.

My hip feels natural as the BHR did and the recovery is easier, I have a non desk job so I am off work for 2 months a second time now I worry about losing my job.
I went to Mayo and Froedtert - big medical centers - and both places do not do them because of metallosis which I got from metal on metal bearing and 300 cc's of darkish fluid drained off my hip after they cleaned up all the muscle necrosis. No matter what they tell you having your hip revised from a BHR is not easy and had they not been able to save the cup the new cup needs the pelvis dished out deeper, bone grafting and a very difficult procedure it becomes. Studies say a large amount of BHR revisions have complications like 30 percent can have revisions so take this bone sparing BHR conversion "not litely".

Is it worth the chance to have your hip ripped out again if it fails, I really really like to ski, and am a risky impulsive guy? I would say no now the conventional hips of today are pretty strong.

Once you have one hip surgery you will not want another but you have no choice if you get metallosis. Brings tears to my eyes the fear, the huge soft bulge I got on the side of my leg, the extra money and time lost from work and the wages again! Thanks best of luck!

 

[Pumpkin]

@BruceH and others reading this thread, Metal on Metal implants are rarely used these days for hip replacement due to metallosis complications, but they are not banned in the US (they are banned in the UK). So it is important to be aware of the potential risks if your surgeon recommends this type of prosthesis. Here are some links for additional information:
Metal on Metal warning (old but ongoing news) (thread in hip pre-op forum)
Metallosis: what is it?

@FailedBHR
Sorry to hear of your experience with metal on metal implants, why don't you start a thread in the recovery forum and tell us more about your story.
Starting a new thread and posting

 

[BruceH]

I had great hopes with a BHR resurfacing which lasted one year, it was great for a year as I like to ski, but I got a large psuedotumor complication and just had it revised. They where able to use the cup and then I have the traditional ceramic plastic metal spike in my femur versus a recovering as in BHR.

My hip feels natural as the BHR did and the recovery is easier, I have a non desk job so I am off work for 2 months a second time now I worry about losing my job.
I went to Mayo and Froedtert - big medical centers - and both places do not do them because of metallosis which I got from metal on metal bearing and 300 cc's of darkish fluid drained off my hip after they cleaned up all the muscle necrosis. No matter what they tell you having your hip revised from a BHR is not easy and had they not been able to save the cup the new cup needs the pelvis dished out deeper, bone grafting and a very difficult procedure it becomes. Studies say a large amount of BHR revisions have complications like 30 percent can have revisions so take this bone sparing BHR conversion "not litely".

Is it worth the chance to have your hip ripped out again if it fails, I really really like to ski, and am a risky impulsive guy? I would say no now the conventional hips of today are pretty strong.

Once you have one hip surgery you will not want another but you have no choice if you get metallosis. Brings tears to my eyes the fear, the huge soft bulge I got on the side of my leg, the extra money and time lost from work and the wages again! Thanks best of luck!

Thank you for sharing your experience. MoM is one of the concerns I have with resurfacing since the Smith and Nephew is the only one approved for use in the US and it's MoM. My other concerns with it would be neck necrosis and the need for revision based on that.

There appear to be positives related to MoM. A much larger bearing surface and no plastic to break down and cause problems. There is also the neck sparing which means a revision should still leave enough for another revision down the road.

It is very important to me to be able to golf, hike, and walk more than a few miles at a time. I also realize it might not be possible but I want the best chance at being able to be active while I am middle aged. This is the time in my life that I worked so hard to get to and it's time to enjoy it as much as possible.

 

[BruceH]

I've been glued to the computer doing research and reading about people's experiences. I am now of the opinion that THR is all I will consider.

Had a diagnostic guided steroid injection yesterday, waiting for it to work. First OS appointment is in two weeks.

 

[Going4fun]

I've been glued to the computer doing research and reading about people's experiences. I am now of the opinion that THR is all I will consider.

Had a diagnostic guided steroid injection yesterday, waiting for it to work. First OS appointment is in two weeks.

Ditto here. I looked very hard at resurfacing ... but I couldn't convince myself to go metal-on-metal. It also bothered me that only a tiny group of surgeons do resurfacings in high numbers. Then I discovered that a number of hip surgeons now think total hips (with recent materials) can handle and sustain high activity.

I stayed with total hip.

 

[DaleB2020]

Great thread!,

I am 41 Active Duty military. I am facing the same concerns, I want to keep my active lifestyle. My left hip says no! I had my torn labrum repaired and hip cleaned up June 2016 and now I can hardly walk or anything for an extended period of time. I am intrigued with hip resurfacing due to the ability to stay active. I read an article about ceramic resurfacing in the UK to circumvent the whole MoM issue. Who knows, I am just glad I found a group with friends going through the same issues and choices.

 

[Going4fun]

You can stay active with a total hip.

 

[Celle]

You can stay active with a total hip.

You sure can!
Stories of amazing hip recoveries

 

[Eman85]

You can stay active with a THR and your OS might release you and tell you that you can do anything. But your results may vary as with any surgery. Much depends on just how much you're willing to risk and do you want to do this again? Many go skiing and horseback riding,running and other activities. Things do happen and you have to be willing to accept the risks the OS release is not a get out of jail free card.