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wyman

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I am a 68 year old active male. Five years ago I stopped running after 40 years due to hip pain. I have limited range of motion in my right hip and X-rays show that the cartilage is mostly gone. One doctor recommended a total hip replacement and another one recommended a Birmingham hip resurfacing. I am inclined to go with the BHR. What do you think?
 
Thanks for the reference to surfacehippy. I wonder if any other readers could give me their experience with BHR?
 
Welcome to the forum, Wyman. This is a case where you need to do some research, talk with your doctors, pick one you trust and go with his (or her) recommendation. It's good to be aware of all options, but the skill and reputation of your selected surgeon are most important. Here is a link to a guide that will give you some additional information.

And here is another link within BoneSmart that will help you if you need to (broken link removed: https://bonesmart.org/clinic_lookup.phpin your area.

Good luck to you and post any time you have a question or concern. We are here to support you.
 
Great advice Jamie! There is also another site, different web address even though they look very similar, this one I found has no commercial advertising at all.

broken link removed: https://www.surfacehippyinfo.com/

HipPain
 
Thanks, I will visit that site. Any more feedback on the Birmingham Hip Resurfacing procedure? How does this compare to total hip replacement?
 
When you met with your doctors, didn't they explain each of the procedures to you?

There are not many members of our forum who have had resurfacing and it may take a while to receive comments from someone who has had that procedure. Do you have some specific questions or concerns? If not, it might be a good idea for you to Google both and do some reading about them so you can understand them better.
 
Hi Wyman,

Hip resurfacing has been unreal for me, it literally has given me back my life AND some. NOT just relieved me of my pain which of course is so important too, but I do not even feel like I have a metal part in my joint. I can run, do yoga, jump over things, carry heavy things, literally do not even think about my hip unless I am going through airport security!! (smile) If you read that site that I have read, you will see amazing real life patient stories, a ton of them that have all returned to heavy impact sports that they love. It is amazing! You might want to try another support group on yahoo devoted to this
broken link removed: https://health.groups.yahoo.com/group/surfacehippy/

and ask some questions there. At 68 there might be some limitations to whether or not you are a candidate for the procedure, but "only" a top orthopedic surgeon that does both procedures on a regular basis can tell you that for sure. But please go to one that does BOTH procedures otherwise they will give you only a biased opinion. Jamie gave you excellent advice, but I would also take a look at this article that I read about selecting a surgeon.

broken link removed: https://www.surfacehippyinfo.com/Selection/2008102629/Selection/Hip-Resurfacing-Selecting-The-Right-Surgeon-For-You/menu-id-43.html

I did not realize that NOT all THR surgeons do hip resurfacing but all resurfacing surgeons do THR'! Wow!. Only a surgeon that does both and has a lot of experience in both can give you a real and honest objective opinion. I have learned so much in my reserach and am just so thankful. I really wish you the very best Wyman, and if you found a doc that already mentioned the BHR device to you, that is fantastic, because what I have learned is there ia an extreme bias against resurfacing today, and there really shouldn't be. Patients should be allowed to research all options. Feel free to email me directly too, I can get you in touch with someone that realy helped me do my research.

HipPain
(I would call myself something else now, except now the OTHER hip is now causing pain and will be facing another surgery some time, hopefully not too soon, :-( but the reason I am on this site (smile). I wish the other hip felt as good as the resurfaced one!!!
 
Thanks, I will visit that site. Any more feedback on the Birmingham Hip Resurfacing procedure? How does this compare to total hip replacement?

I had the Birmingham Hip Resurfacing procedure done a little over 5 months ago and oculdn't be more pleased with the results. Here are a few comparative observations based upon my own experience and opinions.

The surgery is actually a little more complicated than a normal THR and can take a little longer; I don't believe they have perfected a minimally invasive way to perform the work.

There are several excellent resources on the Internet to find an experienced surgeon; and there is no substitue for experience in this procedure.

My initial recovery was farther along in some ways than other people I know who had a THR; but I have no way to know how much of that should be attributed to the resurfacing system and how much to the difference between my motivation and physical condition vs. others I saw.

Being only 52, I was very concerned about what happens 20 years down the road if the device (or my bones) fails and I need to have a revision. The concept that my second procedure will probably be about like most THR patients first one is comforting. The saving of leg bone was a big factor in my decision, as was the metal on metal large ball engineering.

I have always had strong bone structure and have little concern of failure of my femeral neck and head and won't be surprised at all if I never need a revision - but f I do, the next one won't be so tramatic.

I have heard a lot of "claims" of advanced recovery speeds and marvalous stories of physical activity shortly after a BHR process; I don't put too much stock in claims that don't pass the smell test, i.e., one accounted a guy jumping rope at two weeks, another running in a 10K race at 4 weeks, etc.

I'm pain free, have good ROM, and I am confident that the BHR minimized my loss of bone and maxamized my ability to lead a normal life. Other than that, I can't think of anything else of relevence to offer.
 
Here I go again. . .

As far as current research I can see, there is nothing to suggest that hip resurfacing is superior to a metal bearing total hip. There are volumes to suggest it is equal to total hip and in most discussion sections of these papers there are many theoretical advantages touted (bone stock, stress-shielding, etc).

To address the question of revision, I have seen several papers touting the ease of which a resurfaced hip can be converted to a total hip. Many of these cases describe the dreaded femoral neck fracture in a resurfacing having to be revised to total hip. Intuitively, this makes sense. On the other side of the argument others feel (my revision-specialist surgeon included) that the overwhelming majority of revisions of a total hip since the widespread use of the modern taper-fit, porous femoral stem involve the acetabular cup. I have seen one observational study involving a very small cohort of young people (18-30yo) who had follow-up around 12-15yrs. A few required revision during that time and none involved the femoral component. Since the acetabular cup is essentially the same for metal resurfacing and metal total hips, the argument is - "is revision really any different?"

I suspect we have years to wait to know if one is superior to another or whether there are other factors we didn't even dream of at play. In the meantime, pick an awesome surgeon and do what he/she is comfortable with! If there was a huge difference in outcomes, we probably would have discovered it by now. . .

BTW - Went to a wedding last month and sat next to a guy from London. We got to talking and I found out he had a resurfacing a day after I had a total hip! We were both two months+ out. He looked like he was hurting! I felt good enough to dance all night (dating myself with my enthusiasm for Michael Jackson's Thriller). But I bet in a year, we look pretty similar! So don't let the big incision from a re-surfacing scare you!
 
I absolutely agree with you mudpro that every recovery is completely different in any major surgery. But I looked at some of these videos on this one site ant it amazed me. When I went to that site I noticed the most looked at articles and this story happened to be one of them. I don't think it was made up?? Do you?

broken link removed: https://www.surfacehippyinfo.com/Other-Patients/20090109350/Other-Patients/Jared-Manders/menu-id-41.html

How would anyone make upi a full video and why would they?

I believe there must be quick recoveries with both THR's and resurfacings but what I am more interested in is long term. Certainily when I need my other hip done, probably sooner than I think :-( I will look into resurfacing again and not a THR because I believe I am still too young for a THR.

HipPain
 
Hi UTDave,

But as I contemplate my next hip (pain) doesn't it make sense to try to conserve the bone first if you possibly can?? That is what I have come up with for all my research and I am very happy with my first hip which was resurfaced. I wish all my joints felt as good! (smile) I would still want to keep as much of my bone as possible even if the results were the same, wouldn't you if you ever needed your other hip done?

HipPain
 
I'm new to the forum but wanted to add my experience/results with resurfacing as one of the moderators indicated there weren't that many resurfaced members. I am now 1 yr. 4 mos. out from my Biomet hip resurfacing and am totally thrilled with the results. I was diagnosed at the age of 46 with osteoarthritis and told that I would need a hip replacement. I was also told by the orthopedic surgeon to endure the pain as long as possible because at my age I would more than likely face a couple of revisions to the replacement given my life expectancy. I immediately researched other options and for me, saving my bone simply made more sense. As stated in a previous post, it is a more complicated procedure so if you choose resurfacing, it is imperative that you choose an experienced surgeon. I traveled out-of-state to see one of the experts and it was the best decision I ever made. I have absolutely no restrictions and my range of motion in the resurfaced hip is better than the non-operated hip. My recovery was smooth and uneventful, and friends and family were amazed at my progress after surgery. Should anyone want more info concerning resurfacing, I really encourage you to visit the two sites listed in this thread and if anyone would like to contact me, I'm more than happy to talk with you offline. I have some early signs of osteoarthritis in my other hip and when the time comes, I will again choose resurfacing over replacement. BTW, my incision is all of 4 inches long if that's a concern for anyone.
 
I absolutely agree with you mudpro that every recovery is completely different in any major surgery. But I looked at some of these videos on this one site ant it amazed me. When I went to that site I noticed the most looked at articles and this story happened to be one of them. I don't think it was made up?? Do you?

broken link removed: https://www.surfacehippyinfo.com/Other-Patients/20090109350/Other-Patients/Jared-Manders/menu-id-41.html

How would anyone make upi a full video and why would they?

I believe there must be quick recoveries with both THR's and resurfacings but what I am more interested in is long term. Certainily when I need my other hip done, probably sooner than I think :-( I will look into resurfacing again and not a THR because I believe I am still too young for a THR.

HipPain

My recovery was about the same as that man's for the first 10 days; but that is where the simularities end... the remainder of my recovery from week 2 until now has been much more aligned with the average THR story you will read elsewhere on this forum.

I am not in a position to judge anyone's credibility and I have no reason too. But I will say openly that I stopped participating on that other site because I just felt there was too many extrodinary claims being attributed to the work of one or two doctors who were favored by the site's administration. Maybe there are miracle workers out there that can get a hip replacment patient up and walking the Effel Tower at week two and maybe not. Maybe my doctor wasn't a miracle worker and that's why i still walked with a cane until week 5 and didn't go jogging on ice while walking my dog.

What I found on this site is an administrator who only guides the conversation with insightful commentary and reference and who has no agenda other than assisting people to help and offer support to one another while keeping the medical barometer in check.

I think that site is passionate about "promoting" hip resurfacing; and this one is passionate about helping people deal with the issues associated with healing and recovery.
 
I absolutely recommend hip resurfacing over replacement. Both my hips have been resurfaced and now both knees have TKRs.

My hips are natural feeling, I don't even know anything was done. I can do so much more without fear of dislocation, any sport. And now that I've had TKR and experienced the horrible pain of bone cut pain, I'm sure glad I didn't have to go through that with my hips. Since bone wasn't cut the pain doesn't compare to resurfacing.

It is extremely important to get an excellent surgeon. I flew cross country to one of the two best in the US in 2006, now more OS's are available closer. All the negative research I have read, when investigated, are due to surgeon error...not the top surgeons. Of course that is necessary for knees also.

I had excellent, fast recoveries from my resurfacings, meanwhile a few friends of mine had hip replacement and they are not doing as well as fast, plus dealing with more pain.

Why cut off all that bone?

Hollie
 
Thank you, Jamie, Hippain and Mudpro for your enthusiastic support for BHR and for the references. I have continued my research and will definitely go ahead with the BHR with great confidence in the probable outcome.

Wyman
 
Thanks, UTDave, dublin1062 and hollie9 for your input. I am planning to have Dr. Gilbert perform the BHR at Cal Pacific Med Ctr (CPMC). Does anyone here have any experience with Dr. Gilbert? From my research he seems to be an excellent hip surgeon.
 
Wyman, in no way was I "enthusiastically supporting" hip resurfacing.

Mudpro has the focus of BoneSmart exactly right. We do NOT champion any one procedure over another nor do we promote specific doctors. We suggest you do your research and make the best decision for yourself.

If you feel that resurfacing is the best option for you - go for it.
 
Best of luck to you Wyman. I looked at resurfacing, but ultimately I was told I was not a good candidate, I think, because of leg length discrepancy and severe arthritis. I am very happy with my BTHR. But we are all different and from everything I've read, BHR looks like a great alternative. I would echo what others have said. Get a very good surgeon.
Tom
 
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