Newbie - looking for some information

[Faustiano]

Hi,
So I have been living with AVN in my Right Hip for most of my life (since I was about 8 years old). I ended up wearing a leg brace for several years which seemed to help the issue for most of my young adult life and I forgot about the problem. About 10 years ago, the problem sprang back up and the femoral head started to collapse. However, I have always been active, and the Dr I saw told me that he could do a total replacement surgery, but I did not think I was in enough pain to deal with that. Over the last 10 years, I have my good days and bad days (more like months or years). While I walk with a limp, I never felt like I was in any real pain other than flair ups or additional head collapse. So the reason I am here today was that I was on an elliptical last week and then I noticed things were starting to hurt - again. But now that I am getting older, I am debating on how much longer I should put this off. I will be 50 this year, and I have a young son. I know I am getting more and more limited, but I feel if I do not get this done, I may be missing out on activities with my son in the future. Plus, I read that if I wait too long, it could cause further complications.

While I was not specifically tied to my doctor, he is no longer in the practice as he retired. So now I am looking for recommendations from some of you good people that have already gone through this. I am not sure if people can mention Surgeons (I did read many posts before posting and noticed there were comments about them, so I think it is ok).

- I am leaning towards the anterior procedure as it appears to be the way to go now adays - but I have seen some pros and cons for both. Maybe even using the latest robotics technology (Mako).
- I am located in Orange County, CA and willing to drive wherever I can find a good Surgeon (I have a PPO so I can go anywhere).
- I was going to Newport Orthopedics for my original doctor - but not tied to this facility.
- I read that Cedars Sinai is one of the best, but I am not familiar with them, and I have heard that Hoag and UCLA are good. Problem is most of this is from reading and many sound like advertisements.
- Also not really worried about bed side manners... I am more interested in a Dr. who knows what he is doing, but must be willing to answer my questions.

thank you for taking the time to read and comment - this site is great and I have been lurking around for a while now.

 

[djklaugh]

@Faustiano Welcome to BoneSmart! Up at the top of the page in the blue header is a section called Surgeon Locator. All of the surgeons listed there have been vetted by members here. That is a good place to start to find an excellent hip surgeon. You want to find one who does a lot of hip replacements - 250-300+ per year.

As for approach -- IMO the best predictor of good outcome for hip replacement surgery is the surgeon's expertise and not which approach he/she uses. The surgeon will use the approach they were trained with and with which they are most familiar. I myself had bilateral hip replacements (both done at the same time) 10+ years ago and the approach was an anterior-lateral approach - straight down the outside of my hips. For me that was excellent and I had a very problem free recovery. And 10 years on the hips are still doing great!

Best wishes to you and do keep us informed of you journey.

 

[Elf1]

@Faustiano and welcome to the forum. Here's some info that may come in handy while you're trying to figure things out.

While you may not feel like you're in that much pain the fact that you're limping is your body trying to compensate and ease the pain. And the longer you limp along with the additional damage being done to your hip and the rest of your body can also make your recovery that much tougher.

HIP PRE-OP

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

 

[Eman85]

I didn't have to deal with AVN or my hip collapsing, I had SFCE and delayed THR for 30+ years. The decision is yours and you have to base it on your situation. Get OS recommendations and choose the OS, not the approach or the 5 color brochure touting fast fun and easy. We're a long ways apart so my recommendation of an OS does you no good. There is a directory on here and start asking around your area. I was surprised at how many people I knew had been through it and I didn't know they did. I knew mine was going to have some complications so I wanted a competent OS. I didn't just sign up for the cruise right away, I even made multiple trips to my eventual OS before signing up.

 

[Faustiano]

@djklaugh thank you for the information on the link. I was hoping to get a bit of a head start with other people’s experience and the surgeons they selected. But this is a start!!! Thank you!

@Elf1 thank you for the list of articles.

@Eman85 I’m with you on that. It is a big decision and each person has to make their choice. Many of my friends had told me to get it for the last 10 years, but honestly that will never sway my decision. It’s on me. Appreciate the feedback. I am sure it will be a long process in finding the right OS!

 

[Jaycey]

@Faustiano My advice - don't wait! Recovery after a hip collapse is much longer and more complicated. Too many other areas of the body deteriorate trying to compensate for a sore hip. Been there, done that!

We do keep a list of recommendations from our members and colleagues. Here is the list for Surgeons near Los Angeles:

Ran Schwarzkopf, M.D. - hip and knee primary and revision
Dr. Steven Barnett - hip and knee primary and revision (Orange County)
Thomas P. Schmalzried, M.D. - primary and revision hip and knee surgery
Jay R. Lieberman
Keck School of Medicine
University of Southern California
Speaker at 2018 ICJR workshop on problem hips and knees

 

[Autumn01]

I had Mako mini posterior.
best decision ever. I am told by my son it was barely in the theatre and the call from the doc came so fast he initially thought there was a problem. But no! All was done, went in, under and …zoom….i was out in recovery.

Mako is nothing more than a PT scan that converts your body into an engineering diagram that is then used to pin point exactly where to cut, for how long and where to position for best results.

the skill of the surgeon is still paramount. the surgeon and his team are still the surgeons, they still do the work and still can have bad days when things just go wrong.

but Mako sure gives them the best tools and start to do all that technology can do to assist in the outcome.

if you can afford it, use it. But still question and select a surgeon you are happy with.

 

[Faustiano]

@Jaycey thank you for the list. I have already reached out to Dr Steven Barnett’s office to make an appointment to start some discussions. It’s been a while since I was went to the dr for my hip so this is a good time to see how things are going.

@Autumn01 that is great. I have been doing some research on Mako (still gathering data) so I had a better understanding of how they use the tool. I am happy to hear how well it worked for you. Also I was not aware it was used in posterior surgeries, but I should not be surprised since it is really a tool for placement, it could be used in multiple ways.