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DavidinGA

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33 yr old male here...

Been dealing with the pain of AVN for several months now. Bi-lateral, but asymptomatic on one side. However, I'm starting to feel the beginning of pains on that side. Maybe due to the stress of over-compensating for the other.

Long story short, the process of diagnosis and finding the best path forward have been treacherous.

I thank this forum for its work, community, and the insight it has provided.

After much deliberation, I'm pushing forward with the BMAC procedure on the 8th. Now I'm panicked and unsure if I'm making the right decision. There isn't much on here about the procedure post 2012...I kept secretly hoping that someone would report back on the effectiveness of the procedure here. User Maxpower seems to have not had a successful BMAC procedure by looking at his posts.

DANG IT. Now I can't stop thinking that I should just get a bi-lateral THR.

I'm just hoping the pain will end and that I can function normally again soon. This has been such a horrible and soul crushing journey.
 

Jaycey

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@DavidinGA Welcome to BoneSmart! Sounds like you are more than ready to get those hips fixed.
Now I can't stop thinking that I should just get a bi-lateral THR.
To be brutally honest - I would not bother with BMAC and I would go straight to BTHR. We haven't seen any dramatic results with things like BMAC on this forum. I am not saying it doesn't work. But in many cases the patient needs be at the beginning of the journey with no symptoms.

Is there a reason you are going to try BMAC? Would you need to find another surgeon for BTHR?

I'm going to tag one of our members who had BTHR not too long ago. He is now getting back to doing all the things he enjoyed before his hips failed @Irish Joe . Perhaps chatting with him will give you a bit more confidence.
 

Monika66

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Hi David,

I had a LTHR about 5 weeks ago and I was very scared and I kept rescheduling. To be honest, it was not as bad as I thought I see a light at the end of the tunnel now, I have minimum pain and am walking without aids.

I will need my right hip done too at some point, but I am happy I did one at a time, not sure for you or others considering its severity which is a major factor.

Take care, we are here for you, Monika
 

Irish Joe

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Hello David.
I'm afraid I have to profess my ignorance in relation to BMAC. What is it? I believe it has something to do with stem cells.
About 2 years I began having hip pain while training. Long story short I went from having some pain downhill to needing double hip replacement about a year ago. I am so glad I had this procedure done. The hip pain is gone and ( a few niggles aside) I'm reclaiming my life as Jaycey pointed out.

The reason I tell you this is that hip replacement is the Gold Standard treatment for hip pain (arthritis, AVN ). I wish you well whatever your decision but respectfully ask you to reconsider your procedure. Lets put it this way. Hip replacement WILL rectify your current pain problems that is a FACT but can the same be said for this BMAC thing ( I doubt it) ? It is crushing when your young and your legs are old. I ran, cycled and swam for leisure and sport and enjoyed motorcycling but all these were taken from me one by one.
Its soul destroying. After both hips were replaced I (slowly) regained that which I loved doing (with the exception of running for me ). I can cycle and swim and Just 1 month ago rode my motorbike for the first time in 2 years (elation).
The thousands of people who have had THRs for AVN are surely testament to what's the way to go.
And these new hips are lasting 30 yrs or more so age is no longer a determining factor.
I hope you give some thought to reconsidering your procedure and wish you well.
Ask me anything any time.
Joe.....
 

Josephine

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I'm afraid I have to profess my ignorance in relation to BMAC. What is it? I believe it has something to do with stem cells.
Yes it is: Bone Marrow Aspirate Concentrate (BMAC) as a treatment for AVN
After much deliberation, I'm pushing forward with the BMAC procedure on the 8th. Now I'm panicked and unsure if I'm making the right decision.
David, I agree with Jaycey - you are! Don't forget that once you've had this done, it's unlikely any surgeon will be prepared to do THR on you for at least a year. And as @Jaycey will testify, AVN hips can suddenly take quite a dramatic down-turn and get you in severe pain but with no hope of getting it remedied. It's really not worth the risk.
 

Jaycey

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And as @Jaycey will testify, AVN hips can suddenly take quite a dramatic down-turn
I can indeed testify - my left hip went from tolerable to horrid literally overnight. I had aches and pains but just kept going. The hip finally collapsed. Believe me, you do not want to experience that pain! I had to wait 6 months for my THR. Horrid pain and it did mean a longer, more complicated recovery.
 
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DavidinGA

DavidinGA

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I'm back for round 2. Thank you all for your input and support.

You were all most likely very right. Jaycey specifically nailed it on the head:

@DavidinGA
But in many cases the patient needs be at the beginning of the journey with no symptoms.
For those that are considering Stem Cell treatments for AVN, be warned, once you've developed symptoms it's most likely too late. Compounded that I was young, tried to tough it out for 4-6 weeks when I first developed symptoms, and urgency wasn't relayed well by the first or second ortho that I saw.

I'm coming up on 2 years since my BMAC procedure at NYU Langone Medical. It really helped change the pain level that I was experiencing and partially delayed the inevitable. While I can still function pretty well- I have to heavily medicate to do most normal physical/chore weekends (thank God I have an office job and a wonderful partner). Quality of life never fully reverted to how it was prior to symptoms after the procedure. I believe in the science and future benefits of Stem Cell treatments, but I just don't think folks often catch this one soon enough - especially at a young age.

Now I'm here again in this wonderful community to do my research for BTHR. I'm sooooo ready for a change in my quality of life but am terrified about the variables of this surgery even though it's so successful.

A lot of that stems from losing my father from medical/surgeon malpractice. And I know that I need to get over that.

However, particulate ware and the likelihood of revision are my main concerns. I will be doing my research on implant manufacturers and doctor association with those that I consult with. From my research, it looks like that linked poly is the way to go. Any advice or hyperlinks to other (recent) good threads would be appreciated. But, of course, I'll use the search so don't feel obligated.

I just wanted to say a very belated Thank You to this community.
 

Jaycey

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@DavidinGA So sorry you are now facing surgery. But as you say - the results will be life changing. No more planning life around pain.

Do your research. Key is finding a surgeon who does a high volume of THRs. That experienced surgeon will know exactly the implant you need based on your own medical situation and lifestyle.

Yes, there are risks to every procedure. But the success rates for THR are huge.

Stick with us here. Ask all the questions you might have and chat with our members about their experiences. You are going to love life again post BTHR.
 
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DavidinGA

DavidinGA

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@Jaycey Thank you for that.

Quick question - what would a high volume of THRs on an annual basis be?
 

Jaycey

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what would a high volume of THRs on an annual basis be
150 - 200+ per year. My RTHR surgeon's number for 2017-2018 was 227. He didn't have the best bedside manner but wow - what a result! Don't be afraid to ask a surgeon for their numbers. If they are at all awkward about answering they are not for you. You want someone who will work with you including clarifying everything before the day.
 

Barbaraj

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Hi, @DavidinGA I don't have anything to comment upon in terms of your treatment options, but if I am understanding correctly, you are thinking of stem cell injections? You are brave to consider those, in my opinion, as someone stabbing a needle in my hip creeps me out worse than the thought of surgery! Doing research and due diligence about the procedure, your choices of surgeons and hospitals, all of that is necessary to help you feel you are making a sound and reasoned decision. I know you're young (the age of my sons!) but if you were my child, I would urge you to go ahead with a surgery that truly will be life changing. Will you need a revision someday? Possibly, although implants are apparently lasting longer and longer, but before that would even happen I'd wager you'd have years and years and years of pain-free and active living. For what it's worth, I thought the surgery was not that bad, recovery fairly uneventful and steady. I loved it so much (ha!) that I'm back from round two, since both hips were arthritic. This time around, although not eager for surgery (is anyone?!!) I am nowhere near as freaked out as I was before. You can do this--you are young and you've got years of good living in front of you. Seize the opportunity! And best of luck as you ponder your choices.
 

Horseshoe

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This has been such a horrible and soul crushing journey.
Hi @DavidinGA , hang in there. The waiting period is the hard part.. you're in pain, trying to make the right decisions, hunting for a good surgeon, wondering how it's all going to pan out. It's all normal. Once you find a good OS, you hand over your worries to them. After the surgery you'll be on your way, are young, and will likely bounce back well.
 

Mojo333

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:wave:Best of luck on getting a surgeon you can trust.
Hope you get this behind you soon, so you can get your life back.:yes:
I am doing great and couldn't be happier with my new hips!:yahoo:
 

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